1. Resource Facilitation in Brain Injury Institute of Medicine TBI Workshop July 2005

2. Frontal Lobe Parietal Lobe Occipital Lobe Temporal Lobe Cerebellum Brain Stem Parietal Lobe Sense of touch Differentiation: size, shape, color Spatial perception Visual perception Occipital Lobe Vision Cerebellum Balance Coordination Skilled motor activity Temporal Lobe Memory Hearing Understanding language (receptive language) Organization and sequencing Frontal Lobe Initiation Problem solving Judgment Inhibition of behavior Planning/anticipation Self-monitoring Motor planning Personality/emotions Awareness of abilities/limitations Organization Attention/concentration Mental flexibility Speaking (expressive language) Brain Stem Breathing Heart rate Arousal/consciousness Sleep/wake functions Attention/concentration Simplified Brain Behavior Relationships

3. Changes After Brain Injury  Motor coordination  Hearing and visual changes  Spasticity and tremors  Fatigue and/or weakness  Taste and smell  Balance  Mobility  Speech  Seizures Physical Changes Cognitive ChangesBehavior Changes  Memory  Decision making  Planning  Sequencing  Judgment  Processing speed  Organization  Self-perception  Problem solving  Thinking  Depression  Mood swings  Disinhibition  Lack of response to social cues  Problems with emotional control  Difficulty relating to others  Reduced self-esteem  Stress, anxiety, and frustration

4. What Do People Need? Assessment/Evaluation Behavioral Services Community/Family Education Companion Services Durable Medical Equipment Emotional Support Financial Assistance Housing Individual/Family Counseling Legal Advice Life Skills Training Long-term Residential Personal Care Recreation/ Socialization Respite Special Education Supported Employment Substance Abuse Treatment Rehabilitative Therapies Transportation Vocational Services

5. Where Do People Get It? VRHousing MR/DD & Disability Services State BIA Transportation P&A HospitalHospital Medical Assistance Special Ed Advisory Council SSA OfficeVA Center SNF Acute Rehab Health/MH Systems to Navigate Youth & Family Services Aging Svcs Public Safety Corrections ILC

6. Transportation Example DC Dept of Transportation VA Dept of Transportation MD Dept of Transportation WMATAWMATA Metro Rail Metro Bus Metro Access Washington Flyer County School BusCounty Ride On Bus ?

7. How Do People Pay For It? Private Insurance (HMO, PPO, etc) Legal Judgment/Settlement Workers Compensation State & Federal Public Funding: –Medicare –Medicaid (State Plan & Waivers) –Federal Block Grant –VA Benefits –Trust Fund –State General Revenue –State Special Revenue (eg Tobacco Settlement Fund, No Fault, PIP) Self Pay

8. What is Resource Facilitation? Resource facilitation is a partnership that helps people and communities choose, get and keep information, services and supports to make informed choices and meet their goals. Info & ResourcesCase ManagementResource Facilitation A word about… Coordination Service vs. System

9. How Does RF Work? Assessment Planning Identification Negotiation Monitoring Reassessment Outreach Education & Training RF ActivitiesRF Costs About $101/mo plus cost of services as compared to $4000/mo for nursing home care in FY 1999 Persons Served 6250 people served 16 Public/Private Programs

10. Who’s Doing RF?

11. What Guides Facilitators? Facilitation is individualized Facilitation is accessible Facilitation is holistic Facilitation is effective and valued Facilitation is participant directed Facilitation is creative and flexible Facilitation builds community partnerships Principles for Resource Facilitation

12. Thank You! Susan H. Connors President and CEO Brain Injury Association of America 8201 Greensboro Drive, Suite 611 McLean, VA 22102 703-761-0750 ext. 627 shconnors@biausa.org