External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. on Jan. 2, 2025

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: 2482 703 7275

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 December 2024.

2025 meeting calendar

The committee may want to discuss when they will work on the following tasks:

· Reviewing the committee manuals for updates.

· Reviewing the committee core responsibilities outlines for updates.

· Drafting the committee’s annual report, which must be published online by June 30, 2025.

· Identifying the committee’s 2025 goals.

Updates to share

Committee achievements

Below are a few of the achievements to note that this committee, in partnerships with other areas of DHS, has accomplished:

· 50% reduction in BIRFs since the committee began

· Developed positive relationships with many providers and worked together to reduce restraint use

· Developed the Psychotropic Medication Manual

· Developed tools:

For helping people develop additional communication skills

For assessing quality of life

For assessing the quality of a functional behavior assessment (checklist)

· Updated PSTP documents:

Modified the Quality of Life section that is no longer being routinely skipped by providers

Developed a twin section to the targeted behaviors for development of desired alternate behaviors

Added many examples and more instructions to the documents

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 (qualitycouncilmn.org).

Direct care workforce shortage

ARRM recently shared the following:

· Their 2024 industry report, which gives their members data on staff and supervisor wages, turnover and vacancy rates, program closures, impact of service recipient absences, ability to comply with cost reporting, and profits/loses history and projections.

· Their 2025 Legislative Priorities, which focus on workforce, service rates, changes to support for people who cannot live with others and technology.

Subcommittee updates

Requests for approval subcommittee

This subcommittee wanted to share that a person has added music therapy with other support strategies.

Emergency use of manual restraint subcommittee

This subcommittee has been conducting business as usual.

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 toward increasing positive support service capacity.

Support efforts to improve the direct care workforce shortage.

While many people have high-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.