Resource Facilitation in Brain Injury

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

2. Simplified Brain Behavior Relationships Parietal Lobe• Sense of touch• Differentiation: size, shape, color• Spatial perception• Visual perception 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) Parietal Lobe Frontal Lobe Occipital Lobe Occipital Lobe• Vision Temporal Lobe Cerebellum•Balance• Coordination• Skilled motor activity Cerebellum Brain Stem Temporal Lobe• Memory• Hearing• Understanding language (receptive language)• Organization and sequencing Brain Stem• Breathing• Heart rate• Arousal/consciousness• Sleep/wake functions• Attention/concentration

3. Changes After Brain Injury Physical Changes Cognitive Changes Behavior Changes •  Motor coordination •  Hearing and visual changes •  Spasticity and tremors • Fatigue and/or weakness • Taste and smell •  Balance •  Mobility •  Speech •  Seizures •  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? • Long-term Residential • Personal Care • Recreation/ Socialization • Respite • Special Education • Supported Employment • Substance Abuse Treatment • Rehabilitative Therapies • Transportation • Vocational Services • 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

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

6. Transportation Example Metro Rail DC Dept of Transportation WMATA Metro Bus VA Dept of Transportation Metro Access MD Dept of Transportation Washington Flyer County School Bus County 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. 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. What is Resource Facilitation? Info & Resources Resource Facilitation Case Management A word about… Coordination Service vs. System

9. How Does RF Work? RF Activities RF Costs • Assessment • Planning • Identification • Negotiation • Monitoring • Reassessment • Outreach • Education & Training 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? Principles for Resource Facilitation • 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

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