Training Requirements for The Positive Supports Rule (PSR): Frequently Asked Questions

Minnesota Department of Human Services
DHS Licensing

January 13, 2016


TRAINING REQUIREMENTS OF THE POSITIVE SUPPORTS RULE

On August 31, 2015, a new rule governing Positive Supports Strategies and Restrictive Interventions went into effect. This rule is frequently referred to as the Positive Supports Rule (PSR). The rule establishes training requirements, which vary depending on a staff member’s position.  This guidance illustrates who in your organization needs training, and which training, to meet the requirements of the rule. This guidance document is the second in a series of FAQs that DHS’ Licensing Division is developing on the Positive Supports Rule for license holders. See, “Overview and Frequently Asked Questions for DHS License Holders about the New Positive Supports Rule,” for general questions and answers. 



Does this training requirement apply to me?

If you provide services under a DHS license and provide services for an adult or child with a “developmental disability or related condition,” then the PSR training requirements apply to you and the services you provide.

If you provide services under a 245D Home and Community Based Service (HCBS) license, then the PSR training requirements apply to you. This is because every individual who receives your services is automatically covered by all the requirements of the rule, regardless of their diagnosis.

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Why is training necessary?

The Positive Supports Rule represents a significant change in policy and, for some license holders, a significant shift in practice.  Training is essential to ensuring that all individuals who are involved in providing services have adequate skills and knowledge to provide safe and effective services.

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What are the training requirements of the PSR?

The training requirements of the PSR will depend, based on the person’s level of responsibility and qualifications. If someone has multiple roles in the organization as described below, then the person may have to take more than one training.

In brief:

(a)  Staff who provide direct services to a person/child with a developmental disability or related condition and have responsibility for developing, implementing, monitoring, supervising or evaluating:  1) positive support strategies; 2) a positive support transition plan, or 3) the emergency use of manual restraint must complete 8 hours of “core training” before assuming their responsibilities, and 4 hours of refresher training applicable to their responsibilities;

(b)  Staff who develop positive support strategies for a person/child with a developmental disability or related condition must complete 4 hours of “function specific training” in addition to the core training before assuming their responsibilities and four hours refresher training applicable to their responsibilities. License holders, executives, managers and owners may also need to complete the 4 hours of function-specific training if their duties involve the substance of the function specific training; and

(c)  License holders, executives, managers, and owners in nonclinical roles must complete 2 hours of management training before assuming their responsibilities. At a minimum, all controlling individuals listed on your license with DHS must complete this management training. A license holder, executive, manager or owner in a nonclinical role may need to complete “core training” and “function specific training” if s/he provides direct services, or develops positive support strategies, to a person/child with a developmental disability or related condition. 

The training requirements should be completed as soon as possible.

 

Core Training (8 hours) covers:

A.  de-escalation techniques and their value;

B.  principles of person-centered service planning and delivery, and how they apply to direct support services provided by staff;

C.  principles of positive support strategies, such as positive behavior supports, the relationship between staff interactions with the person and the person's behavior, and the relationship between the person's environment and the person's behavior;

D.  what constitutes the use of restraint, including chemical restraint, time out, and seclusion;

E.  the safe and correct use of manual restraint on an emergency basis;

F.  staff responsibilities related to prohibited procedures; why the procedures are not effective for reducing or eliminating symptoms or interfering behavior; and why the procedures are not safe;

G.  staff responsibilities related to restricted and permitted actions and procedures;

H.  the situations in which staff must contact 911 services in response to an imminent risk of harm to the person or others;

I.  the procedures and forms staff must use to monitor and report use of restrictive interventions that are part of a positive support transition plan;

J.  the procedures and requirements for notifying members of the person's expanded support team after the use of a restrictive intervention with the person;

K.  understanding of the person as a unique individual and how to implement treatment plans and responsibilities assigned to the license holder;

L.  cultural competence; and

M.  personal staff accountability and staff self-care after emergencies.

 

Function-Specific Training (4 hours) covers:

A.  functional behavior assessments;

B.  how to apply person-centered planning

C.  how to design and use data systems to measure effectiveness of care; and 

D.  supervision, including how to train, coach, and evaluate staff and encourage effective communication with the person and the person's support team.

 

Management Training (2 hours) covers:

A.  how to include staff in organizational decisions;

B.  management of the organization based upon person-centered thinking and practices, and how to address person-centered thinking and practices in the organization; and

C.  evaluation of organizational training as it applies to the measurement of behavior change and improved outcomes for persons receiving services.

 

Annual Refresher Training (4 hours)

Staff providing services to a person/child with a developmental disability or related condition, which includes all staff working for a program licensed under 245D, are required to complete four (4) hours of refresher training on an annual basis. The Refresher Training covers topics from the Core Training and Function-Specific Training. The rule requires staff to complete trainings that are applicable to their responsibilities. 

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Can the license holder count equivalent trainings that staff and others have already completed and that are on the topics of the PSR (e.g., de-escalation techniques)?

Yes. The goal of the required training is to ensure competency of staff in the knowledge and skills outlined in the PSR. However, you will want to carefully document those equivalent hours of training and why you think they meet the requirements of the new rule. For both the Function-Specific Training and the Management Training, the rule allows for counting “equivalent training approved by the commissioner” only if the equivalent training was completed within the previous 12 months. 

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What is meant by “demonstrated competency” in the PSR?

The PSR requires that the license holder ensure that staff demonstrate their competency, through testing or observation, to perform positive support strategies that are "relevant to the primary disability, diagnosis or interfering behavior of the person."

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Do I need to document that personnel have completed the trainings? What needs to be documented?

The license holder is responsible for ensuring documentation of the completion of the Core Training, additional trainings, and competency testing or assessments.  The following information should be documented for each staff in the personnel record: (1) subject area(s); (2) date(s) of training; (3) the number of training hours per subject area; and (4) the name and qualifications of the trainer or instructor.  A sample training documentation form is being sent to the Authorized Agent.

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How are license holders and their staff to get the training required by the rule?

Each license holder is responsible for getting the training themselves. DHS is working with the College of Direct Support at the University of Minnesota to ensure appropriate and accessible training content is available to license holders.

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The training section of the PSR talks about a “qualified individual” delivering the required trainings on the PSR. What is the definition of a “qualified individual?”

“Qualified individual” (referenced in the training section of the PSR) is not defined in the rule, so the license holder must determine who is a “qualified individual” for training purposes. 

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If we don’t have an individual with a developmental disability or related condition now in our care, but might someday, do we have to complete the training?

If you are currently serving someone with a “developmental disability or related condition,” then the PSR applies to your service to that person/child and you must comply with the PSR in its entirety and as soon as is practically feasible.

If you are not currently serving someone with a “developmental disability or related condition,” you must come into compliance with the PSR prior to providing services to them.

Remember, if you are providing services under a 245D HCBS license, then each person you provide services to is covered by the PSR and you must comply with the PSR in its entirety and as soon as is practically feasible.

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Will DHS Licensing cite us for not having received the training?

The Department recognizes that license holders will need time to learn about the PSR and to develop a plan for complying with the PSR as soon as possible, including completing the required training.

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Where can I find more information?

More information can be found at these web sites:

DHS Partners and Providers: Positive Support Web page

Positive Supports Rule Web Page

To access DHS forms and instructions, visit DHS eDocs and enter the document number, below, in the search box: 

  • 6810 - DHS Positive Supports Transition Plan - form
  • 6810A - DHS Positive Supports Transition Plan Review - form
  • 6810B - DHS Positive Supports Transition Plan - Instructions
  • 6810C - Developing Positive Supports Transition Plans: A Provider Guide for 245D-Licensed Home and Community-Based Services in Minnesota (A good resource for ALL DHS License Holders, not just 245D License Holders)
  • 6810D - DHS Request for the Authorization of the Emergency Use of Procedures - form
  • 6810E - Positive Supports Rule Staff Training Record

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