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External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. Dec. 5, 2024

DSD liaisons: Stacie Enders and Ari Dionisopoulos

Type: Whole committee

Location: Room 2222, Elmer L. Andersen Building, 540 Cedar St., St. Paul, MN 55101

Meeting link: Webex

Access code: 2486 040 8341

Accommodations: If you need an accommodation for this meeting, you must notify a DSD liaison three days before the meeting. Email PositiveSupports@state.mn.us or call (651) 431-4300.

Common acronyms used by the committee

We ask committee members to avoid the use of acronyms. Here are common acronyms:

· BIRF: DHS form 5148: Behavioral Intervention Report Form

· CABC: Context, antecedent, behavior, consequence

· CFSS: Community First Services and Supports

· DEED: Minnesota Department of Employment and Economic Development

· DHS: Minnesota Department of Human Services

· DLI: Minnesota Department of Labor and Industry

· DSD: Disability Services Division

· DSP: Direct support professional

· EUMR: Emergency use of manual restraint

· FBA: Functional behavior assessment

· HCBS: Home and community-based services

· IRP: Interim Review Panel (Predecessor to the EPRC)

· MDH: Minnesota Department of Health

· PCA: Personal care assistant

· PSR: Positive Supports Rule: Minnesota Rule 9544

· PSTP: DHS form 6810: Positive Support Transition Plan

General reminders for committee members

Before speaking, please state your name. Committee members are expected to:

· Be on time.

· Read the minutes, agenda and supporting documents before each meeting.

· Participate in ideas and conversations, as well as pause to allow others to share input.

· Commit to spending the whole meeting time present and not engage in other activities during the meeting.

Technology

The first few minutes of every meeting will be dedicated to addressing any connectivity issues, to ensure everyone can hear other meeting participants.

Agenda items

Public comments

The committee encourages public participants to share their thoughts and ask questions about committee activities at the beginning of each meeting. The committee will continue on to the next agenda item when either 1) 30 minutes have passed or 2) when there are no additional comments or questions, whichever comes first.

Vote

The committee will discuss and vote on the minutes from November 2024.

2025 meeting calendar

At this meeting committee members will work on their in-person meeting schedule for 2025.

Updates to share

New EPRC coordinator

DHS has hired a replacement for Stacie Enders – Jessica Little will be the new EPRC coordinator and positive supports policy lead.

Stacie Enders will remain a backup for that work and may be contacted when Jessica is out of the office.

Regional positive support capacity building meetings

Committee members are invited to give any updates they may have on this topic. More information can be found at: Regional Capacity Building – Positive Supports.

Direct care workforce shortage

· Stacie Enders was recently invited to collaborate with the ARC Minnesota Regional Quality Council Staffing Shortage Workgroup. An update from their first meeting will be provided at the EPRC meeting.

· Earlier this month, the President’s Committee for People with Intellectual and Developmental Disabilities (PCPID) delivered its report to President Biden. The full report and an easy-read fact sheet can be found on the PCPID webpage, along with prior PCPID reports and materials from the committee’s meetings.

· The report took a broad look at all of the factors that need to be addressed to improve access to home and community-based services (HCBS), including workforce, community living and employment, housing, technology and communication access, among other issues. In the workforce pieces of the report, the need for higher wages, training and professionalization of direct support professionals were named as top priorities.

· DHS is working to create a new webpage to share information about wages that helps explain to workers factors that influence wages and supporting projects and legislation. Committee members are invited to weigh in on what information they think would be important for the new webpage.

Subcommittee updates

Requests for approval subcommittee

This subcommittee continues to provide feedback to teams on their PSTPs, quarterly reviews and related data.

Emergency use of manual restraint subcommittee

This subcommittee continues to review BIRF data and give feedback to teams. They are also continuing work on several PSTP examples for service providers.

Discussion

Annual goals

The committee will review their 2024 goals, which are listed in no particular order:

· Provide resources and guidance for improving communication skills.

The committee will work to share existing or create new resources or materials for teams on how to support people with developing additional communication skills. The target audiences for this goal are service providers, lead agencies, direct care professionals and families because all members of the team have a role in supporting effective communication. Additional communication skills can be helpful in giving people greater control over their services and improving health outcomes. Many people who fall within the EPRC’s purview, due to use of restraint by license holders, need support with developing additional communication skills.

· Simplify and organize online DHS materials and training resources related to positive supports or intervention services.

There are many materials related to positive supports online, but the materials are scattered and numerous, and it can be unclear to service providers where to find information. There are also some gaps in the information. The committee recommends:

· Reviewing all DHS-owned positive support materials and related topics and organizing the materials by topic and grouping related materials in fewer locations to reduce search times.

· Identifying the most helpful materials and removing less helpful materials to reduce clutter.

· Identifying gaps in resources and developing new materials as needed to fill those gaps.

The goal of this project is to provide clear and easily accessible guidance to providers so they have the tools and knowledge they need to support people with living their best lives.

· Explore ways to improve access to positive support services.

Waitlists for positive support services continue to be long, often taking several months to start services. This can be a safety concern for people and their teams when the person is engaging in serious aggressive or self-injurious behaviors. The committee recommends DHS continue working towards increasing positive support service capacity.

· Support efforts to improve the direct care workforce shortage.

While many people have quality positive support plans, it can take months or even years to find positive support specialists or other direct caregivers to implement the plans or to provide general care. Additionally, turnover in these positions is common. This can be a safety concern for people and their teams. The committee recommends DHS continuing to support efforts to address the direct care workforce shortage, particularly efforts to improve wages and benefits for professionals who provide day-to-day care that reflects the complexity and skill needed to do the job well.

Closing

Committee members are welcome to ask questions or bring up other topics for discussion.

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