Indiana’s TBI Grant and Brain Injury Resource Facilitation

1. Indiana’s TBI Grant and Brain Injury Resource Facilitation

2. r Indiana’s TBI Planning & Implementation Partnership GrantApril 2006-March 2009 1.Complete a statewide assessment of needs and resources; 2. Develop and implement statewide information and referral initiatives; 3. Develop and implement statewide education initiatives for targeted groups – Vocational Rehabilitation, individuals with a BI/caregivers, professionals, educators; 4. Develop a Grant Advisory Council/Workgroup; 5.Develop statewide systems of supports.

3. Grant Objective 1Statewide Needs & Resources AssessmentResults Provided by Luther Consulting, LLC • 4000 surveys distributed to individuals with a brain injury and the caregiver; 378 surveys completed • Provider Surveys – 1000 sent, 59 completed • Focus Groups • BIAI Support Groups • Caregiver for under-aged youth • Long Term Care • Special Education Teachers • State Agency Personnel

4. Grant Objective 2Information and Referral • Expanded 2008-2009 Brain Injury Association of Indiana Statewide Resource Directory • Development of Indiana’s Brain Injury Resource Facilitation Pilot Project

5. Brain Injury Resource Facilitation - Background The U.S. Department of Health and Human Services sponsored a Summit hosted by BIAA - September 2000 Resource Facilitation: A Consensus of Principles and Best Practices to Guide Program Development and Operation in Brain Injury; Brain Injury Association, Inc. May 2001 Resource Facilitation a partnership between individuals and communities to secure and keep information, services and supports to make informed choices to meet goals

6. Brain Injury Resource Facilitation Resource Facilitator - person-centered advocate, not bound by systems, without conflict of interest, bridging information across systems throughout the recovery journey Services include: • Individualized, accessible, holistic support initiated as early as possible and lasting beyond hospital discharge • On-going, flexible information and resource development for the home and community; • Assistance with problem solving and advocacy, • And regular follow-up and long term support

7. Brain Injury Resource Facilitation • Outcomes: • increased rate of return to work; (Minnesota-nearly 2 times the national average); • increased likelihood students receive appropriate education supports; • increased family understanding & support; • reduced dependence on public assistance; • reduced risk of institutionalization or incarceration; • decreased utilization of mental health/addictions services

8. Brain Injury Resource Facilitation in the United States • Resource Facilitation –in the BI arena - Missouri, 1984. • 30 States offer (at varying levels) Resource Facilitation; some of these programs were initiated in the 1990’s. • The National Association of State Head Injury Administrators (NASHIA) Resource Facilitation Work Group Connecticut, Florida, Georgia, Iowa, Indiana, Kansas, Kentucky, Maryland, Massachusetts, Minnesota, Missouri, Montana, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, South Dakota, Texas, Virginia, Washington, Wyoming and 2 individuals from NASHIA’s TBI Technical Assistance Center *Data basing

9. Brain Injury Resource Facilitation in the United States • Cost Effectiveness The Honorable Jeb Bush, Governor of Florida, & Margaret Bowden, a researcher at FSU Center for Policy Studies writes of the BIA of Florida’s resource facilitation program: As a mechanism to reduce the incidence of inappropriate institutionalization (nursing home, hospital, mental illness facility, or correctional institute), it appears to be the most cost effective. A review of three years of records reveals that the total average cost per client is less than $100 per month. Compare this, for example, with an average nursing home cost of $4000 per month.

10. Brain Injury Resource Facilitation in the United States • Average caseload =20 to 40 clients per 1 FTE • Est. annual cost (1999), per participant=$1,200 • Funding Sources –State Trust Funds, Budget Line Item, contracts with state offices of Developmental Disabilities, Special Appropriations, charitable donations, Waiver Funds • Programs are administered by –State BI, Private Organizations, Department of Health and Senior Services, State Department of Health, etc.

11. Indiana’s Brain Injury Resource Facilitation Pilot Project Goals: • Determine if IN’s Resource Facilitation Project replicates outcomes found in other states • Use rigorous scientific research model with random control trials • Demonstrate the impact in terms of return-to-work and the costs/benefits Partnerships • Individual’s with a brain injury and his/her caregiver • FSSA’s Vocational Rehabilitation Services • Brain Injury Association of Indiana • 1 Central Indiana Rehabilitation Hospitals • Providers of services in Indiana

12. Indiana’sBrain Injury Resource Facilitation Project • Methodology • 30 BI individuals (and a caregiver) will be recruited from 2 central IN Hospitals from January to April 2008. 9 individuals have been recruited; 5 have been selected to receive treatment (4/9/08) • Randomization will continue. The treatment group and the standard follow-up group will each have 15 individuals • Resource Facilitation will be provided for 6 months (+/- April to September 2008) • Outcome measures, data analysis and report to be completed +/- October 2008

13. Brain Injury Resource Facilitator Roles/Responsibilities… • The Brain Injury Association of Indiana has hired two part-time Brain Injury Resource Facilitators • Brain Injury Resource Facilitators will: • Partner with the Vocational Rehabilitation Brain Injury Specialist; • Locate/advocate for resources and refer client/family to resources; • Contact the client every two weeks, at a minimum; • Provide education regarding brain injury to the client, family, employer, supported employment team, others as needed;

14. Roles and Responsibilities - continued • Brain Injury Resource Facilitators will: • Provide the client and family with information regarding positive personal advocacy; • Provide the client and family with a Statewide Brain Injury Resource Directory; • Partner with the client and family to develop a personalized Brain Injury Resource Handbook/Organizer; • Survey the client and family

15. Grant Objective 3Statewide Education • BIAI Annual Conference • October 2007- Over 50 Vocational Rehabilitation Counselors in attendance; over 200 in attendance overall • Planning BIAI annual conference – October 2008 • TBI Grant Educational Committee activities: • Developing a web-based BI training for educators • Planning a DVD for consumers • Offering training to Vocational Rehabilitation TBI Specialists • Offering Certified Brain Injury Specialist training to professionals across IN

16. Grant Objective 4Develop an active Advisory Council/Work Group Advisory Council/Work Group membership: • individuals with a brain injury & family members, • State Agency personnel, • Brain Injury Association of Indiana personnel, • Providers of services, • Individuals from funding organizations • other interested parties The Council/Work Group meets quarterly

17. Grant Objective 5Develop a statewide systems of support • A comprehensive state-wide systems of support has • identified the responsible parties for coordinating services and supports; • identified point(s) of access/entry; • shared strategic plans between state systems;

18. A comprehensive state-wide system of support has: • shared data between state systems • person-centered case coordination • identified, coordinated sources of funding • Shared evaluation methods/outcome measures • fiscal policy & procedure development

19. This power point is funded – in part – by a US Department of Health and Human Services, Health Resources and Services Administration Traumatic Brain Injury Planning and Implementation Partnership Grant. HRSA has awarded the Indiana Family and Social Services Administration a total of $300,000.00. Indiana is scheduled to receive about $100,000.00 for each year of the three-year grant. FSSA and it’s consultants and partners are contributing a total of $150,00.00 in matching and in-kind funding during the April 1, 2006 through March 31, 2009 grant cycle. Indiana’s total TBI Planning and Implementation Partnership Grant budget is $450,000.00. Federal funding comprises about 66% of the total budget and State funding comprises about 34% of the total budget.