External Program Review Committee (EPRC) agenda

Date: 2-4 p.m. on Feb. 6, 2025

DSD liaisons: Stacie Enders, Jessica Little 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 January 2025.

Updates to share

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

2025 Legislative session

Some bills that might affect the workforce shortage include:

· This bill proposes a substantial rate increase to several waiver services by increasing the competitive workforce factor from 6.7 to 16.76 percent. There is no enforcement mechanism to require those rate increases to be passed on to care professionals, so this will only benefit them if employers choose to give those additional funds to employees. It also changes how we calculate supervisor wages: SF 402 as introduced - 94th Legislature (2025 - 2026).

· This bill increases service rates for home health services, home care nursing and homemaker assistance, which may or may not benefit the care professionals. It also creates an awareness building and recruitment grant program, but only for a few direct care professions: SF 476 as introduced - 94th Legislature (2025 - 2026)

Upcoming survey on provider costs and wages

DHS plans to conduct a survey about provider costs and wages for some of the waiver programs. For details, review: AASD and DSD eList: Upcoming survey about provider costs and wages for rate methodology evaluation.

Cost reporting is being extended to CFSS

Effective June 1, 2025, DHS will begin to collect DWRS and CFSS cost-reporting data. For more information, review: AASD and DSD eList: DHS to continue DWRS cost reporting and begin CFSS cost reporting

Blueprint for Age Friendly Minnesota

If anyone would like to be involved in the Blueprint for Age Friendly Minnesota workforce shortage workgroup, you can sign up through this online form.

Reducing injuries to staff

The data this group reviewed last year on work-related injuries for direct care professionals has been published: Behavior intervention reporting forms that report employee injury. In 2025, DHS staff will be looking into ways to make the workplace safer for workers.

The Minnesota Social Services Association is also concerned about workplace safety and will be proposing the following to the Minnesota Legislature:

· The proposal will authorize the Department of Human Services to award grants to HHS organizations to invest in workplace safety measures. Grants would be used, at an agency's discretion, to pay for:

Safety equipment

Systems to track, monitor and prevent violence

Training

Support and follow-up services.

For additional information, contact Michelle SanCartier at 651-789-4358 or msancartier@mnssa.org.

Behavior analyst licensure

The language defining the practice of applied behavior analysis within the new behavior analyst licensure legislation has been reviewed and it has been determined it might affect providers’ ability to create PSTPs and FBAs and carry out positive support strategies.

Training opportunity

Join DHS and Minnesota Networking in Education and Assistive Technology (MN-NEAT) for a webinar leveraging technology to support people at risk of elopement and wandering. Link: AASD and DSD eList: Webinar about technology for elopement and wandering.

Subcommittee updates

Requests for approval subcommittee

Business as usual.

Emergency use of manual restraint subcommittee

Providers want to do well and when they are given the right supports, they and the people they support can be successful.

Discussion

Annual goals

The committee will review their 2024 goals, which are listed in no particular order, and discuss what will be their goals for 2025:

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.

Committee member are also asked to send Jessica any accomplishments or other things they would like to highlight for the committee’s 2024 annual report.