Brain Injury Services and Supports: What’s Available and How to Get Them Paid For Wanda Portis and Drew Nagele

www.biapa.org

What We Will Cover • describe the resources that can pay for services and supports for – living in the community – returning to school – returning to work

• explain how to – get help finding these resources – how to qualify for them – applying for them

Types of Services and Supports

Brain Injury Rehabilitation Therapies – Cognitive Rehabilitation Therapy – Physical Therapy – Occupational Therapy – Speech & Language Therapy – Neuropsychological Therapy – Vocational Therapy

– Recreational Therapy

Cognitive skills that are addressed through NeuroRehab Therapies        

Memory functioning Problem solving skills Frustration tolerance Planning and organization Time management Attention to detail Initiation Concrete thinking

   

Rate of processing Cognitive endurance Ability to follow directions Ability to benefit from and use feedback  Use of strategies  Social skills  Rate of performance

Cognitive Rehabilitation Research • shows that greatest overall improvement will come from an integrated program of individualized cognitive and interpersonal learning strategies • Integrated learning strategies address the complex interaction of cognitive, functional, and social impairments • Emphasis should be on targeting and measuring functional improvement, not on changes in a measured ability scores

How do you find NeuroRehab Therapists Trained in using an integrated transdisciplinary functional approach? • Cognitive Rehabilitation Therapist • Clinical Neuropsychologist • Occupational Therapist • Physical Therapist

• Speech Therapist • Vocational Specialist • Recreation Therapist

Finding NeuroRehab Therapies Programs that are more likely to provide this approach are those that are: • Brain injury specialized, transdisciplinary, coordinated, outcomes focused • Addresses unique medical, physical, cognitive, psychosocial, behavioral, vocational, educational, and recreational needs of persons with acquired brain injury • Care that enhances the lives of the persons served within their families and support systems, communities, and life roles • Demonstrates commitment, capabilities, and resources to maintain itself as a specialized program of care for persons with acquired brain injury

Accessing NeuroFunctional Services CARF Accreditations available relevant to NeuroFunctional services include: • Comprehensive Integrated Inpatient Rehabilitation Programs • Outpatient Medical Rehabilitation Programs

• Home and Community Based Rehabilitation Programs • Residential Rehabilitation Programs • Vocational Services • Pediatric Specialty Programs

• Brain Injury Programs • Stroke Specialty Programs

What kind of help do you most need? –Community Re-Entry - look for a transdisciplinary team that can customize its approach to individual, provide blocks of treatment –School Re-Entry - look for team that includes teachers and academic coaches, has the ability to go out to schools, universities, work with IEP teams –Work Re-Entry – also called Supported Employment -look for programs that have job coaches

–Productive Daily Activity – you may consider a Clubhouse program or volunteer work

Pennsylvania Resources

Contact Information for Brain Injured Persons and Families Telephone Information Lines:

• PA Department of Health Brain Injury Helpline 1-866-412-4755 (toll free)

• BIAPA Brain Injury Resource Line 1-800-444-6443 (toll free)

Pennsylvania Head Injury Program • Created in 1988 by The Emergency Medical Services Act • Funds rehabilitation services for individuals with traumatic brain injury • Funds services such as physical, occupational, speech, cognitive and counseling therapy for a maximum of one year

Pennsylvania Head Injury Program • Eligibility requirements: • Age 21 or older • US Citizen • PA resident at time of injury and application • Other financial resources for rehab exhausted • Meet income guidelines

Pre-Enrollment Assistance • Program to assist individuals with traumatic brain injury and their families to apply for services through the PA Head Injury Program (HIP) • Pre-Enrollment Assistance Coordinator is assigned to assist individuals in their homes and communities with the application process and to provide information about resources.

For more information, contact the PA Department of Health:

717-772-2762

Medicaid Waivers • CommCare – TBI , 21yrs or over

• OBRA – Disability occurred prior to age 22, likely to be lifelong

• Independence – Severe physical disability, age 16-60

CommCare Medicaid Waiver TBI , 21 years or over • Services available may include: – – – – – – – – – – – – – – –

Accessibility Adaptations, Equipment, Technology and Medical Supplies Adult Daily Living Community Integration Community Transition Services Home Health Non-Medical Transportation Personal Assistance Services Personal Emergency Response System (PERS) Prevocational Services Residential Habilitation Respite Service Coordination Structured Day Habilitation Services Supported Employment Therapeutic and Counseling Services

OBRA Medicaid Waiver Disability occurred prior to age 22, likely to be lifelong • Services can include: – – – – – – – – – – – – – – –

Adult Daily Living Accessibility Adaptations, Equipment, Technology and Medical Supplies Community Integration Community Transition Services Home Health Non-Medical Transportation Personal Assistance Services Personal Emergency Response System (PERS) Prevocational Services Residential Habilitation Services Respite Service Coordination Structured Day Habilitation Services Supported Employment Therapeutic and Counseling Services

Independence Waiver Severe physical disability, age 16-60 • Services available may include: • • • • • •

• • • • •

Assistive technology/specialized medical equipment and supplies Community integration services Community transition services Education services Environmental adaptations Extended state plan - visiting nurse, physical therapy, speech therapy, occupational therapy, and behavior therapy Non-medical transportation services Personal assistance services Personal Emergency Response Systems (PERS) Respite services Service coordination

Independent Enrollment Broker • Program to help streamline eligibility assessment and enrollment into waiver programs • Began on December 1, 2010 • For assistance or to make an application: Toll free helpline: 1-877-550-4227 Toll free TTY line: 1-877-824-9346 • Must say, “I have a brain injury and want assistance from a brain injury – trained independent enrollment broker”

Office of Vocational Rehabilitation (OVR) http://www.portal.state.pa.us/portal/server.pt?open=514&objID=606620&mode=2

• Provides a range of services to support you getting and keeping a job: – – – – – – – –

Diagnostic Services Vocational Evaluation Counseling Training Restoration Services Placement Assistance Assistive Technology Support Services

Other PA Resources • Brain Injury Support Groups www.biapa.org/support_groups

• Disabilities Rights Network of PA (DRNPA) http://drnpa.org/

• Acquired Brain Injury Network of PA (ABIN-PA) http://www.abin-pa.org/

Links for PA Waiver Information • CommCare Waiver http://www.dpw.state.pa.us/fordisabilityservices/alternativestonursinghomes/co mmcarewaiver/index.htm

• OBRA Medicare Waiver http://www.dpw.state.pa.us/fordisabilityservices/alternativestonursinghom es/obrawaiver/index.htm

• Independence Waiver http://www.portal.state.pa.us/portal/server.pt?open=512&objID=4984&&Page ID=481703&level=2&css=L2&mode=2

Additional Useful Websites •

The Brain Injury Association of America

www.biausa.org •

The Centers for Disease Control and Prevention

http://www.cdc.gov/traumaticbraininjury/ •

Brainline

•

http://www.brainline.org USA Brain Injury Alliance of New Jersey www.bianj.org

For Further Information:

www.biapa.org Toll Free Brain Injury Resource Line

1-800-444-6443