2013 Report: Brain Injury in Virginia Anne McDonnell Executive Director

A Few Statistics The Centers for Disease Control and Prevention (CDC) estimate that 1.7 million people in the U.S. sustain traumatic brain injuries (TBIs) annually and at least 5.3 million children and adults live with a permanent disability as a result of a TBI Nearly 200,000 Virginians are disabled as a result of brain injury, which is roughly the same number as those with intellectual and developmental disabilities The waiting list for services at some of Virginia’s state funded community based brain injury services exceeds 3 years State funding for brain injury supports and services is less than $4 million annually; yet, in the last 2 years more than $40 million was appropriated to fund the federally required expansion of community based services and supports for persons with intellectual and developmental disabilities

A Few Thoughts Falls are the number one cause of brain injury, but we are more likely to buy and use helmets for our smart phones than for our heads Each year over 1 million Americans sustain a brain injury…that’s more than hear a diagnosis of cancer, and yet more money is devoted to treating and curing cancer than treating and curing brain injury No other organ system that is injured or diseased is subject to the same limits as treatment for brain injury… When someone has a mild heart attack, we don’t tell them we’re not going to worry about it until they have “the big one” or that their eligibility for post-acute treatment depends on the likelihood of reasonable improvement 24 therapy visits is like saying to someone, “Take your blood pressure medication every other day ”

2013 Legislative Initiatives - National Access To Care Medicaid Expansion Eliminate the Medicare 2 year waiting period Preserve and Expand TBI Rehabilitation Research Capacity Increase funding for current TBI Model Systems research Expand number of funded centers Re-Authorize the TBI Act H.R was introduced in March by Reps. Pascrell and Rooney, co-chairs of the Congressional Brain Injury Task Force Will reauthorize and improve current programs, reemphasize the impact of TBI across the age span and make things better for those with brain injury

2014 Legislative Initiatives- Virginia Working with Del Kirk Cox on $4.4 million budget amendment to fund existing core safety net services (Case Management, Day Programs and Clubhouses, and Resource Coordination) to address waiting lists, provide a rate adjustment, and expand core services into unserved and underserved areas Possibilities: Access to mental health and neurobehavioral care Expansion of menu of core services to include Community Supports and Residential Services Medicaid expansion Hit counts/concussion reporting Other opportunities will be identified as bills get filed and partners start sharing their agendas

Opportunity’s Knocking… Department of Justice Settlement Requires Virginia to improve the rate at which individuals are discharged from state training centers and transitioned into the community. The Department of Behavioral Health and Developmental Services, the state agency in charge of implementing the settlement, has contracted a study on integrating the ID and DD waivers into a “needs based” or “universal” or “functional” waiver. Neurobehavioral Program A small subset of people with brain injury have significant behavioral issues that put their safety and the safety of others at risk, but the system of care in Virginia is inadequate Several have been placed in out of state facilities, and the inability to get the right help at the right time has culminated in deaths, placed others at great risk, and frustrated those who have been injured, their families, clinical staff and state agency personnel.

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