A Statewide Model of A Statewide Model of Regional Brain Injury Regional Brain Injury Resource CentersResource Centers

Anne McDonnell, OTR/LAnne McDonnell, OTR/L

Special Projects DirectorSpecial Projects Director

Brain Injury Association of Brain Injury Association of VirginiaVirginia

CNI Project #02-226

Executive SummaryExecutive Summary

The Brain Injury Association of Virginia, the Department of The Brain Injury Association of Virginia, the Department of Rehabilitative Services and the Medical College of Virginia Rehabilitative Services and the Medical College of Virginia collaborated to conduct the most comprehensive outreach collaborated to conduct the most comprehensive outreach effort ever done in Virginia to the brain injury communityeffort ever done in Virginia to the brain injury community

The state-wide needs assessment for people with brain injury The state-wide needs assessment for people with brain injury and their families occurred from 1999-2000; it included and their families occurred from 1999-2000; it included nineteen town meetings (attracting over 650 people) and a nineteen town meetings (attracting over 650 people) and a written survey (distributed to over 10,000 survivors and written survey (distributed to over 10,000 survivors and caregivers) caregivers)

Education, awareness, outreach and advocacy were identified Education, awareness, outreach and advocacy were identified as priorities in Virginia’s Statewide Needs Assessment and as priorities in Virginia’s Statewide Needs Assessment and subsequent TBI Action Plan subsequent TBI Action Plan

This project was conceived to fulfill the need to provide This project was conceived to fulfill the need to provide resources and assistance in underserved areas of the state resources and assistance in underserved areas of the state (Roanoke/Danville/Martinsville and Hampton Roads area)(Roanoke/Danville/Martinsville and Hampton Roads area)

Used to leverage federal TBI Act grant application; enabled us Used to leverage federal TBI Act grant application; enabled us to establish additional regional resources centers in unserved to establish additional regional resources centers in unserved areas of the state (far Southwestern Virginia, the Shenandoah areas of the state (far Southwestern Virginia, the Shenandoah Valley and the Fredericksburg/Middle Peninsula/Northern Neck Valley and the Fredericksburg/Middle Peninsula/Northern Neck area) area)

Significant Significant AccomplishmentsAccomplishments Over the last three year, approximately 50,000 individuals Over the last three year, approximately 50,000 individuals

received information about brain injury through the activities received information about brain injury through the activities of the central office staff and regional resource coordinatorsof the central office staff and regional resource coordinators

At least 5000 people have attended over 75 presentations At least 5000 people have attended over 75 presentations done by the Regional Resource Coordinators (RRC) and the done by the Regional Resource Coordinators (RRC) and the Project Director Project Director

Development and nationwide distribution of high quality Development and nationwide distribution of high quality projects:projects:– Pediatric Brain Injury and the Schools: Best Practices for Pediatric Brain Injury and the Schools: Best Practices for

Primary and Secondary EducationPrimary and Secondary Education – Advocacy AcademyAdvocacy Academy– Domestic Violence Tip cardsDomestic Violence Tip cards– Policymakers Manual Policymakers Manual

Numerous (~20) television and newspaper stories in both Numerous (~20) television and newspaper stories in both RRC areas and RichmondRRC areas and Richmond

Appointments to the local Disability Service Boards, Human Appointments to the local Disability Service Boards, Human Rights Councils, Human Services Commissions, Special Rights Councils, Human Services Commissions, Special Education Advisory committee, and Virginia Brain Injury Education Advisory committee, and Virginia Brain Injury CouncilCouncil

Project Goals: Project Goals:

Increase public awareness and Increase public awareness and understanding of brain injuryunderstanding of brain injury– Utilized BIAV newsletter, articles in newspapers Utilized BIAV newsletter, articles in newspapers

and other newsletters, presentations, in-services, and other newsletters, presentations, in-services, conferences, workshops, website, support groups, conferences, workshops, website, support groups, service on committees and coalition groups, service on committees and coalition groups, television interviews and radio PSA’s in all television interviews and radio PSA’s in all locations, golf tournaments, health fairs, posterslocations, golf tournaments, health fairs, posters

– Collaborated with other stakeholders and the Collaborated with other stakeholders and the Roanoke Express Hockey Team to distribute over Roanoke Express Hockey Team to distribute over 3000 brain injury tip cards at a home games series3000 brain injury tip cards at a home games series

– ““Transcending Brain Injury” conference in Transcending Brain Injury” conference in Roanoke and “Opening Doors” in RichmondRoanoke and “Opening Doors” in Richmond

Project Goals: Project Goals:

Increase knowledge among people with brain Increase knowledge among people with brain injury and their families about the disability; injury and their families about the disability; maximize their use of existing support programs maximize their use of existing support programs and services; empower them to be better and services; empower them to be better advocates for their needsadvocates for their needs– Served on VA Department of Medical Assistance Served on VA Department of Medical Assistance

Services work group for a Medicaid Real System Change Services work group for a Medicaid Real System Change Infrastructure grant that developed a statewide “road Infrastructure grant that developed a statewide “road map” of services and supports for persons with map” of services and supports for persons with disabilitiesdisabilities

– Developed and conducted training program for Developed and conducted training program for survivors, caregivers and advocates on self and systems survivors, caregivers and advocates on self and systems advocacy advocacy

– Grant staff have taken on leadership roles and/or Grant staff have taken on leadership roles and/or enhanced support groups in Danville, Virginia Beach, enhanced support groups in Danville, Virginia Beach, Richmond, and the Roanoke and New River Valleys Richmond, and the Roanoke and New River Valleys

– Continued increases in I&R calls to BIAVContinued increases in I&R calls to BIAV

Project Goals: Project Goals:

Increase knowledge among professionals Increase knowledge among professionals and service providers about the needs of and service providers about the needs of people with brain injury and their familiespeople with brain injury and their families– Domestic violence counselorsDomestic violence counselors– Community Services BoardsCommunity Services Boards– Occupational Therapy students at the Medical College of Virginia, medical Occupational Therapy students at the Medical College of Virginia, medical

students at Eastern Virginia Medical School and the University of Virginia, nursing students at Eastern Virginia Medical School and the University of Virginia, nursing students at Old Dominion University, counseling and social work students at students at Old Dominion University, counseling and social work students at Radford University, education and social work students at Virginia Commonwealth Radford University, education and social work students at Virginia Commonwealth UniversityUniversity

– School nurses at annual statewide conferenceSchool nurses at annual statewide conference– Hospital therapy staff in areas served by the RRC’s and Project DirectorHospital therapy staff in areas served by the RRC’s and Project Director– Special Education Directors, teachers, coaches, therapists, psychologists, nurses, Special Education Directors, teachers, coaches, therapists, psychologists, nurses,

social workers and instructional assistants in public schools across the statesocial workers and instructional assistants in public schools across the state– Community College staffCommunity College staff– Mental health agency staff Mental health agency staff – Homeless sheltersHomeless shelters– Civic organizationsCivic organizations– YWCAYWCA– Virginia Chapter of Case Management Society of AmericaVirginia Chapter of Case Management Society of America– Virginia Association of Rehabilitation ProfessionalsVirginia Association of Rehabilitation Professionals– Adult day care providersAdult day care providers– Adult and Pediatric Brain Injury Case ManagersAdult and Pediatric Brain Injury Case Managers

Project Goals: Project Goals:

Increase the number of professionals and Increase the number of professionals and service providers serving people with brain service providers serving people with brain injury injury – Brain injury day program MartinsvilleBrain injury day program Martinsville– In collaboration with Neuropsychology Department at MCV, In collaboration with Neuropsychology Department at MCV,

developed regional trainings for professionals; designed to developed regional trainings for professionals; designed to increase comfort with and willingness to treat persons with increase comfort with and willingness to treat persons with BIBI

Requires infrastructure, resources, and time Requires infrastructure, resources, and time Difficult to know if existing providers of services to Difficult to know if existing providers of services to

other disability populations have increased the other disability populations have increased the numbers of persons with BI that they servenumbers of persons with BI that they serve

Also difficult to increase number of providers when Also difficult to increase number of providers when no funding stream for services existsno funding stream for services exists

Project Goals: Project Goals:

Maximize the probability of survivors living Maximize the probability of survivors living happily and productively in their communityhappily and productively in their community– Educated policymakers about needs of BI community Educated policymakers about needs of BI community

during last year's General Assembly and helped facilitate during last year's General Assembly and helped facilitate turnout and testimony at local budget hearings turnout and testimony at local budget hearings

– Are actively working the Disability Commission, Are actively working the Disability Commission, legislators and policymakers, VA Departments of legislators and policymakers, VA Departments of Rehabilitative Services and Medical Assistance Services Rehabilitative Services and Medical Assistance Services to develop and obtain funding for a BI waiverto develop and obtain funding for a BI waiver

– Involved with numerous state and local initiatives: VA Involved with numerous state and local initiatives: VA Department of Health taskforce for the Health Promotion Department of Health taskforce for the Health Promotion for Persons with Disabilities, Olmstead workgroup, Real for Persons with Disabilities, Olmstead workgroup, Real Systems Change grant, Virginia Brain Injury Council, Systems Change grant, Virginia Brain Injury Council, Virginia Alliance of Service Providers, DD waiver Virginia Alliance of Service Providers, DD waiver workgroupworkgroup

– Have identified persons with brain injury and family Have identified persons with brain injury and family members from across the state for nomination to members from across the state for nomination to boards, councils, workgroups and taskforcesboards, councils, workgroups and taskforces

Project Goals: Project Goals:

Develop sources of support to sustain Develop sources of support to sustain the services provided through the the services provided through the grant grant – Created Policymakers manual; delivered to Created Policymakers manual; delivered to

legislator's in their home offices by BIAV staff, legislator's in their home offices by BIAV staff, survivors, caregivers and advocatessurvivors, caregivers and advocates

– Regent University created a documentary on Camp Regent University created a documentary on Camp Bruce McCoy; the video has tremendous potential to Bruce McCoy; the video has tremendous potential to call attention to brain injury and the need for funds call attention to brain injury and the need for funds to help the organization fulfill its responsibilitiesto help the organization fulfill its responsibilities

– Continuing to pursue other fund development Continuing to pursue other fund development opportunitiesopportunities

– Expanding database for fundraising effortsExpanding database for fundraising efforts– Legislative advocacy resulted in new money being Legislative advocacy resulted in new money being

appropriated in state budget for brain injury servicesappropriated in state budget for brain injury services

Lessons LearnedLessons Learned

Information Technology costs and needs changed Information Technology costs and needs changed significantly:significantly:– Regular maintenance and trouble shooting Regular maintenance and trouble shooting – Database developmentDatabase development– Providing staff with the appropriate equipment and Providing staff with the appropriate equipment and

trainingtraining– Linking the regional staff into the network Linking the regional staff into the network – Obtaining software licensingObtaining software licensing– Replacing the serverReplacing the server

The amount of time other BIAV staff would spend The amount of time other BIAV staff would spend on grant activities was underestimatedon grant activities was underestimated

Communication systems had to be enhancedCommunication systems had to be enhanced RRC positions are well received and appreciated, RRC positions are well received and appreciated,

but many consumers expect case management but many consumers expect case management servicesservices

Challenges FacedChallenges Faced

Human Resources Management: Human Resources Management: – Became far more time consuming and complicated Became far more time consuming and complicated

than it had previously been because of the increased than it had previously been because of the increased number of employees, the geographic distribution of number of employees, the geographic distribution of offices, health insurance issues, and worker’s comp offices, health insurance issues, and worker’s comp claims claims

– Extended absence of one employee was problematic; Extended absence of one employee was problematic; difficult to hire temporary employee for positions. Sub-difficult to hire temporary employee for positions. Sub-contracted a part-time employee from co-location contracted a part-time employee from co-location partner to attend to the essential position functionspartner to attend to the essential position functions

Finance: Finance: – The fiscal reports became much more time consuming The fiscal reports became much more time consuming

and complicated and complicated – Tracking revenue and expenses also became far more Tracking revenue and expenses also became far more

complicated due simply to the increased volumecomplicated due simply to the increased volume– Financial management systems required a near Financial management systems required a near

complete overhaulcomplete overhaul

An Unqualified SuccessAn Unqualified Success

Raise public awarenessRaise public awareness Work directly with local chapters and support groups Work directly with local chapters and support groups

to expand and improve their effortsto expand and improve their efforts Foster development and expansion of programs and Foster development and expansion of programs and

servicesservices Help educate staff at existing programsHelp educate staff at existing programs Provide one-on-one assistance to survivors and Provide one-on-one assistance to survivors and

caregiverscaregivers Assist survivors and their families in becoming Assist survivors and their families in becoming

successful self- and systems advocatessuccessful self- and systems advocates Educate policymakers about the needs of survivors Educate policymakers about the needs of survivors

and family members, and advocate for increased and family members, and advocate for increased funding for servicesfunding for services

With a presence in the Roanoke & With a presence in the Roanoke & Hampton Roads areas, BIAV has Hampton Roads areas, BIAV has been able to :been able to :