External Program Review Committee (EPRC) Minutes
Date: Feb. 6, 2025
DSD liaisons: Stacie Enders, Jessica Little and Ari Dionisopoulos
Type: Whole committee
Attendees: Jodie Greenstein, Dan Baker, Kim Frost, Antonina Puente, Melanie Eidsmoe
Not present: Lindsay Nash, Susie Haben, Laura Daire, Danielle Bishop
Vote
The committee voted on the minutes from January 2025:
Updates to share
Regional positive support capacity building meetings
Committee members were invited to give any updates they may have on this topic. More information can be found at: Regional Capacity Building – Positive Supports (qualitycouncilmn.org).
Discussion: Melanie attended last meeting – Discussed rural barriers, school system barriers and transitioning out of school age (waitlist issues and training availability), vocational services – lack of opportunities, especially in rural areas. Could invite DEED or mention them as a resource. It was shared that members of the Community Capacity and Positive Supports team will begin to attend
Direct care workforce shortage
2025 Legislative session
Some bills that may 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 MN
If anyone would like to be involved in the Blueprint for Age Friendly MN workforce shortage workgroup, you can sign up through this link.
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 Legislature:
“Our proposal will authorize the Minnesota 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:
“For additional information, contact Michelle SanCartier at 651-789-4358 or msancartier@mnssa.org.”
Discussion: Committee discussed the changes to safety standards. Here’s the DLI update mentioned that will change OSHA standards for some providers: Minnesota State Register Volume 49 Number 32.
Behavior analyst licensure
The language defining the practice of applied behavior analysis within the new behavior analyst licensure legislation has been recently reviewed and it has been determined it may affect providers’ ability to create PSTPs and FBAs and carry out positive support strategies.
Discussion: Stacie and Jessica talked to ARRM about bringing a proposal that would exempt every 245D provider and 245A provider that are subject to 9544 and implementing positive support strategies. Concerns were voiced regarding vast instances throughout service settings of positive supports being used, as defined in the new legislation, and those using the strategies without licensure being subject to consequences such as a misdemeanor. Goal is to have providers who are currently implementing 9544 to be able still to implement 9544. Here is the BA licensure language: Chapter 127 - MN Laws.
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
Provide resources and guidance for improving communication skills.
Status: Committee has completed the resource which is going through the DHS communications process to be finalized. No new updates on progress.
Simplify and organize online DHS materials and training resources related to positive supports or intervention services.
Status: DHS is working on taking an inventory of what is available to providers. Alan is making a list that might have categories such as intended audience, content, etc.
Positive support manual – getting ready to send separate pages to DHS communications to begin to build this resource. Manual will include resources and input from separate departments. Manual will continue to build over the next few years.
NOTE: To search different topics in the psych med manual, use the glossary section. It was recently updated for easier navigation.
Explore ways to improve access to positive support services.
Status: The committee receives updates, as they are available, from the Intervention Services Redesign project.
Working on writing a draft and moving toward a proposal that will be reviewable this summer.
Support efforts to improve the direct care workforce shortage.
Status: The committee receives regular updates from the Workforce Shortage Group.
Working through a list of ideas on how to fix the shortage. Have asked groups to submit a pitch as to why an idea should be pursued based on criteria such as:
Once pitches are provided, they will be reviewed. The committee will vote on which ideas might be the best to bring to leadership. Once leadership feedback is provided, they will begin working on a proposal that will include a longer explanation and will expand upon how the idea might be implemented.
The committee discussed continuing/discontinuing goals and what the goals would be going into 2025:
Provide resources and guidance for improving communication skills.
Committee chose to sunset this goal as it is complete, and the material is in the queue to be evaluated by DHS communications.
Simplify and organize online DHS materials and training resources related to positive supports or intervention services.
Committee chose to sunset this goal but would like to continue receiving updates on the progress of this inventory project.
Explore ways to improve access to positive support services.
Committee chose to sunset this goal but would like to continue receiving updates from the Intervention Redesign Project members. It remains important to the committee that DHS continue working toward increasing positive support service capacity.
Support efforts to improve the direct care workforce shortage.
Committee chose to sunset this goal but would like to continue receiving updates from the workforce shortage group. It remains important to the committee that DHS stays committed to addressing the workforce shortage in meaningful ways.
New 2025 goal: Create and maintain training materials as needs are discovered and as project opportunities emerge.
Some projects might include: PSTP examples, reinforcement (token) programs, implementing 9544 for 245D providers, trainings for specific behaviors or disorders (PICA, fecal smearing, self-harm ingestion) and relating that to state regulations.
This goal is meant to reflect the committee’s commitment to providers by giving them resources that align with the goal of reducing the use of prohibited procedures and increasing the use of positive supports. Spending time working with providers gives them a great perspective on topics that need further explanation.
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