A Statewide Model of Regional Brain Injury Resource Centers Anne McDonnell, OTR/L Special Projects Director Brain Injury Association of Virginia CNI Project #02-226

Executive Summary The Brain Injury Association of Virginia, the Department of Rehabilitative Services and the Medical College of Virginia collaborated to conduct the most comprehensive outreach effort ever done in Virginia to the brain injury community The Brain Injury Association of Virginia, the Department of Rehabilitative Services and the Medical College of Virginia collaborated to conduct the most comprehensive outreach effort ever done in Virginia to the brain injury community The state-wide needs assessment for people with brain injury and their families occurred from ; it included nineteen town meetings (attracting over 650 people) and a written survey (distributed to over 10,000 survivors and caregivers) The state-wide needs assessment for people with brain injury and their families occurred from ; it included nineteen town meetings (attracting over 650 people) and a written survey (distributed to over 10,000 survivors and caregivers) Education, awareness, outreach and advocacy were identified as priorities in Virginia’s Statewide Needs Assessment and subsequent TBI Action Plan Education, awareness, outreach and advocacy were identified as priorities in Virginia’s Statewide Needs Assessment and subsequent TBI Action Plan This project was conceived to fulfill the need to provide resources and assistance in underserved areas of the state (Roanoke/Danville/Martinsville and Hampton Roads area) This project was conceived to fulfill the need to provide resources and assistance in underserved areas of the state (Roanoke/Danville/Martinsville and Hampton Roads area) Used to leverage federal TBI Act grant application; enabled us to establish additional regional resources centers in unserved areas of the state (far Southwestern Virginia, the Shenandoah Valley and the Fredericksburg/Middle Peninsula/Northern Neck area) Used to leverage federal TBI Act grant application; enabled us to establish additional regional resources centers in unserved areas of the state (far Southwestern Virginia, the Shenandoah Valley and the Fredericksburg/Middle Peninsula/Northern Neck area)

Significant Accomplishments Over the last three year, approximately 50,000 individuals received information about brain injury through the activities of the central office staff and regional resource coordinators Over the last three year, approximately 50,000 individuals received information about brain injury through the activities of the central office staff and regional resource coordinators At least 5000 people have attended over 75 presentations done by the Regional Resource Coordinators (RRC) and the Project Director At least 5000 people have attended over 75 presentations done by the Regional Resource Coordinators (RRC) and the Project Director Development and nationwide distribution of high quality projects: Development and nationwide distribution of high quality projects: –Pediatric Brain Injury and the Schools: Best Practices for Primary and Secondary Education –Advocacy Academy –Domestic Violence Tip cards –Policymakers Manual Numerous (~20) television and newspaper stories in both RRC areas and Richmond Numerous (~20) television and newspaper stories in both RRC areas and Richmond Appointments to the local Disability Service Boards, Human Rights Councils, Human Services Commissions, Special Education Advisory committee, and Virginia Brain Injury Council Appointments to the local Disability Service Boards, Human Rights Councils, Human Services Commissions, Special Education Advisory committee, and Virginia Brain Injury Council

Project Goals: Increase public awareness and understanding of brain injury Increase public awareness and understanding of brain injury –Utilized BIAV newsletter, articles in newspapers and other newsletters, presentations, in-services, conferences, workshops, website, support groups, service on committees and coalition groups, television interviews and radio PSA’s in all locations, golf tournaments, health fairs, posters –Collaborated with other stakeholders and the Roanoke Express Hockey Team to distribute over 3000 brain injury tip cards at a home games series –“Transcending Brain Injury” conference in Roanoke and “Opening Doors” in Richmond

Project Goals: Increase knowledge among people with brain injury and their families about the disability; maximize their use of existing support programs and services; empower them to be better advocates for their needs Increase knowledge among people with brain injury and their families about the disability; maximize their use of existing support programs and services; empower them to be better advocates for their needs –Served on VA Department of Medical Assistance Services work group for a Medicaid Real System Change Infrastructure grant that developed a statewide “road map” of services and supports for persons with disabilities –Developed and conducted training program for survivors, caregivers and advocates on self and systems advocacy –Grant staff have taken on leadership roles and/or enhanced support groups in Danville, Virginia Beach, Richmond, and the Roanoke and New River Valleys –Continued increases in I&R calls to BIAV

Project Goals: Increase knowledge among professionals and service providers about the needs of people with brain injury and their families Increase knowledge among professionals and service providers about the needs of people with brain injury and their families –Domestic violence counselors –Community Services Boards –Occupational Therapy students at the Medical College of Virginia, medical students at Eastern Virginia Medical School and the University of Virginia, nursing students at Old Dominion University, counseling and social work students at Radford University, education and social work students at Virginia Commonwealth University –School nurses at annual statewide conference –Hospital therapy staff in areas served by the RRC’s and Project Director –Special Education Directors, teachers, coaches, therapists, psychologists, nurses, social workers and instructional assistants in public schools across the state –Community College staff –Mental health agency staff –Homeless shelters –Civic organizations –YWCA –Virginia Chapter of Case Management Society of America –Virginia Association of Rehabilitation Professionals –Adult day care providers –Adult and Pediatric Brain Injury Case Managers

Project Goals: Increase the number of professionals and service providers serving people with brain injury Increase the number of professionals and service providers serving people with brain injury –Brain injury day program Martinsville –In collaboration with Neuropsychology Department at MCV, developed regional trainings for professionals; designed to increase comfort with and willingness to treat persons with BI Requires infrastructure, resources, and time Requires infrastructure, resources, and time Difficult to know if existing providers of services to other disability populations have increased the numbers of persons with BI that they serve Difficult to know if existing providers of services to other disability populations have increased the numbers of persons with BI that they serve Also difficult to increase number of providers when no funding stream for services exists Also difficult to increase number of providers when no funding stream for services exists

Project Goals: Maximize the probability of survivors living happily and productively in their community Maximize the probability of survivors living happily and productively in their community –Educated policymakers about needs of BI community during last year's General Assembly and helped facilitate turnout and testimony at local budget hearings –Are actively working the Disability Commission, legislators and policymakers, VA Departments of Rehabilitative Services and Medical Assistance Services to develop and obtain funding for a BI waiver –Involved with numerous state and local initiatives: VA Department of Health taskforce for the Health Promotion for Persons with Disabilities, Olmstead workgroup, Real Systems Change grant, Virginia Brain Injury Council, Virginia Alliance of Service Providers, DD waiver workgroup –Have identified persons with brain injury and family members from across the state for nomination to boards, councils, workgroups and taskforces

Project Goals: Develop sources of support to sustain the services provided through the grant Develop sources of support to sustain the services provided through the grant –Created Policymakers manual; delivered to legislator's in their home offices by BIAV staff, survivors, caregivers and advocates –Regent University created a documentary on Camp Bruce McCoy; the video has tremendous potential to call attention to brain injury and the need for funds to help the organization fulfill its responsibilities –Continuing to pursue other fund development opportunities –Expanding database for fundraising efforts –Legislative advocacy resulted in new money being appropriated in state budget for brain injury services

Lessons Learned Information Technology costs and needs changed significantly: Information Technology costs and needs changed significantly: –Regular maintenance and trouble shooting –Database development –Providing staff with the appropriate equipment and training –Linking the regional staff into the network –Obtaining software licensing –Replacing the server The amount of time other BIAV staff would spend on grant activities was underestimated The amount of time other BIAV staff would spend on grant activities was underestimated Communication systems had to be enhanced Communication systems had to be enhanced RRC positions are well received and appreciated, but many consumers expect case management services RRC positions are well received and appreciated, but many consumers expect case management services

Challenges Faced Human Resources Management: Human Resources Management: –Became far more time consuming and complicated than it had previously been because of the increased number of employees, the geographic distribution of offices, health insurance issues, and worker’s comp claims –Extended absence of one employee was problematic; difficult to hire temporary employee for positions. Sub-contracted a part- time employee from co-location partner to attend to the essential position functions Finance: Finance: –The fiscal reports became much more time consuming and complicated –Tracking revenue and expenses also became far more complicated due simply to the increased volume –Financial management systems required a near complete overhaul

An Unqualified Success Raise public awareness Raise public awareness Work directly with local chapters and support groups to expand and improve their efforts Work directly with local chapters and support groups to expand and improve their efforts Foster development and expansion of programs and services Foster development and expansion of programs and services Help educate staff at existing programs Help educate staff at existing programs Provide one-on-one assistance to survivors and caregivers Provide one-on-one assistance to survivors and caregivers Assist survivors and their families in becoming successful self- and systems advocates Assist survivors and their families in becoming successful self- and systems advocates Educate policymakers about the needs of survivors and family members, and advocate for increased funding for services Educate policymakers about the needs of survivors and family members, and advocate for increased funding for services With a presence in the Roanoke & Hampton Roads areas, BIAV has been able to :