What Are Positive Supports?

Positive supports

After Jan. 1, 2014, organizations that provide services and support to people with disabilities and people over the age of 65 no longer can use certain procedures. Minnesota law, chapter 245 now requires all providers to use positive supports. It also prohibits the use of punitive practices and procedures, such as seclusion and restraint. Legislation allowed an 11-month transition period, if needed, to end prohibited practices. The transition period ends Dec. 31, 2014.

What are positive supports?

Positive supports include strategies that teach people productive ways to deal with stress. These supports are essential to:

1.Eliminate the use of prohibited procedures
2.Avoid emergency use of manual restraints
3.Prevent physical harm to the individual and others.

Why do providers need to know about this?

Relying solely on positive supports can be a challenging transition, but funding and other resources are available to support this change. DHS wants to help connect providers and lead agencies to the right resources, training and answers throughout this transition.

The outcome of any positive support plan should be to improve a person’s quality of life and recognize their dignity. For more information on the history of positive supports, see theDHS Jensen Settlement page.

What providers does this legislation apply to?

This applies to licensed 245D providers whodeliver services and supports to people with:

·  Brain injury

·  Dementia

·  Development disabilities

·  Mental illness

·  Other acquired conditions that were not previously subject to Rule 40

·  Physical disabilities.

What do providers have to do?

Providers are required to:

1.Base service planning and delivery for people on positive support strategies. Their goal should be to meet and achieve the person’s needs, interests, preferences and desired outcomes.

2.Support the person’s preferences, goals, service outcomes, daily needs and activities. To accomplish that, providers should use the principles of:

·  Person-centered service planning and delivery

·  Integrated settings and inclusive service delivery

·  Self-determination

3.Develop aPositive Support Transition Plan, DHS-6810 (PDF)for people who require intervention to maintain safety when their known behavior poses an immediate risk of physical harm to self or others.

For statutory information about positive support strategies, seeMinn. Stat §245D.07, subd. 1a. For information about requirements for positive support transition plans, seeMinn. Stat §245D.06. subd. 8.

What are allowed procedures?

Minnesota supports the use of positivesupports for complex behaviors. Examples ofallowedstrategies include, but are not limited to the following:

·  Modifying the environment to the individual’s behavior and routine

·  Positive reinforcement

·  Providing alternatives to undesired behaviors

·  Teaching the individual new skills.

What are prohibited procedures?

Minnesota law prohibits the following procedures:

·  Chemical restraint

·  Mechanical restraint

·  Programmatic use of manual restraint

·  Seclusion

·  Time out

·  Any other aversive or deprivation procedure

Examples include, but are not limited to the following:

·  Contain, restrict, isolate, seclude or otherwise remove people from normal activities without monitoring them.

·  Deprivepeopleor restrict their access to normal goods and services

·  Requirepeople to earn normal goods and services

·  Use any action or procedure as punishment

·  Use physical intimidation or a show of force.

What resources are available to providers?

DHS has developed resources listed below to help providers navigate these changes.

Capacity

These providersresponded to a November 2014request askingproviders to self-identify if they had immediate capacity to provide:

·  Services to people with complex behavioral and/or medical needs (PDF)

·  Consultation on person-centered planning and/or positive supports to other providers serving peoplewith complex behavioral and/or medical needs (PDF).

Presence on this list is not a DHS endorsement of the provider’s qualification to provide a service. More information is included in each PDF.

Funding
Funding is available to meet the needs of waiver recipients. Use theDisability Waiver Rate Systemexception processto help you meet the needs of people with extraordinary needs.

Technical assistance
ThePositive Support Community of Practiceis a group dedicated to the promotion of positive supports and the transition from punitive and aversive practices. Contributors to the community include experts in positive practices, people receiving services, providers, case managers, advocates and family members of people with disabilities.

TheDeveloping Positive Support Transition Plans: A provider guide for 245D-licensed HCBS services in Minnesota, DHS-6810C (PDF)helps providers understand and complete required plans:

·  Positive Support Transition Plan, DHS-6810

·  Positive Support Transition Plan Review , DHS-6810A

·  Positive Support Transition Plan Instructions, DHS-6810B

Training

•College of Direct Support
•Person-centered training
•TrainLink
•Webinars and training events

*Updated on 08/18/2015