The Virginia Department for Aging and Rehabilitative Services

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Meeting Minutes

Virginia Brain Injury Council

July 22, 2005
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Meeting Minutes
July 22, 2005

Members Present:

David Walsh, Katherine Lawson, Paul Aravich, Pat Wilkins, Helen Butler, Nadia Webb, Patti Goodall, Carole Norton, Sherry Confer, Jane McDonald, Paul Blais, Laura Taylor, Page Melton, Anne McDonnell, Tom Dashiell, Gary Chiaverotti, Dane DeMoss, Pat Tiernan (for Nathan Zasler), Robert Demichelis

Members Absent:

Nancy Bullock, Sandy Dyche, Harry Weinstock, Gwen Smith, Paul Sharpe
Guests: Jason Young, Marylin Copeland, Lorraine Justice, Joann Mancuso, Juanita Thornton, Bobbie McCarty, Leigh Wion

The meeting was called to order by Dr. Paul Aravich, Chair, at 1:07.

Public Comment:

During the public comment period, Jason Young spoke on behalf of the Virginia Alliance of Brain Injury Service Providers (VABISP) to inform Council members of the legislative agenda of VABISP during the upcoming General Assembly session: the primary legislative goal is to secure funding for a BI waiver. He also informed VBIC that several members of VABISP have elected to join VA ACCSES, a trade organization for community based service providers; the decision will provide some support for our legislative agenda.

Minutes of the previous meeting of April 22, 2005 were approved as amended.


• State: Major state focus is to seek support for the BI Medicaid Waiver. Representatives from the Brain Injury Association of Virginia (BIAV) and VABISP met with Delegate Hamilton, who chairs the House Appropriations subcommittee on Health and Human Resources. BIAV has requested a meeting with Secretary Woods to discuss inclusion of BI Waiver funding in the HHS budget. BIAV and VABISP representatives have begun working to identify House and Senate patrons for a budget amendment for the waiver, should it not be included in the Executive budget.

• Federal: TBI Act funding was approved for $9 million in the House of Representatives. The Senate subcommittee approved $9.3 million; waiting for full Senate vote. Mr. Demichelis made a plea for contacting or visiting reps while they are in their home district offices during August regarding support for the TBI Act re-authorization, Social Security privatization, and Medicare / Medicaid prescription drug program. Brain Injury Association of America (BIAA) is studying the impact of Medicare reform on persons with brain injury; they are endorsing the elimination of the 24 month waiting period for eligibility. The new Individuals with Disabilities Education Improvement Act (IDEIA) regulations are being reviewed by numerous disability advocacy organizations. BIAA is also monitoring the Workforce Investment Act and two transportation related bills. Katherine Lawson mentioned that Virginia’s Developmental Disabilities (DD) Council and the Department of Social Services (DSS) have launched an advocacy initiative to help get TANF (Temporary Aid to Needy Families) recipients off disability. Tom Dashiell requested more in-depth information on the proposed privatization of Social Security.

TBI Act Federal Grant:The Southwest Regional Resource Center has been closed. The grant has actually ended, but DRS was granted a “no cost extension” which allows some of the projects to be continued until all money is spent (BIAV estimates that to be the end of 2005). The Educator’s Manual has been completed and the Virginia Department of Education (DOE) will provide two copies to each school district, announce the availability of the manual in a Superintendent’s memo to each school, and will put a link to the manual on their website. BIAV also provided materials on brain injury for a law enforcement training held at the Virginia’s Criminal Justice College.

Town Meetings: Valerie Brooke from Virginia Commonwealth University (VCU) Rehabilitation Research & Training Center (RRTC) discussed the process and outcomes of the five (5) Town Meetings held statewide during May / June / July 2005. Ms. Brooke provided copies of a first draft report. Summary impressions are that Virginia has a good acute care system, but that there is a pervasive sense of isolation in areas of the state relative to the positioning of services. The impressions were based on qualitative research that provides a general sense of needs rather than a vote for a specific service. Patti Goodall requested that concerns or suggestions for edits about the Town Meeting Report be submitted to her.

• Patti Goodall stated that DRS is responsible for the development of the Brain Injury State Action Plan, and that she anticipates it will be completed by 7/1/06. She asked that those interested in providing input on the draft Action Plan contact her.

• Susan Rudolph asked about “hard data” regarding the prevalence of brain injury in Virginia. Anne McDonnell reported that actual numbers do not exist, but that we have an estimated prevalence by county/city based on Virginia 2003 population estimates and the national incidence rate from the Centers for Disease Control (CDC).

• Ms. Lawson congratulated us on our success with the process and content of the statewide Town Meetings.
Department of Rehabilitative Services

• Commissioner Rothrock announced that DRS has been charged with providing a report to the General Assembly House Appropriations and Senate Finance committees on how the new state funding for brain injury services is being used. DRS will report the number of persons served, types of services available, and the success of providers in attracting non-state funds to further support their programs. He also reported that DRS is currently working on a two year strategic plan for the agency. He mentioned that if additional funds are budgeted for DRS, input on program ideas would be sought. The Commissioner mentioned a school-to-work transition program at Woodrow Wilson Rehabilitation Center as an example.

• Dr. Aravich asked how the Council could expand or improve its advisory role to DRS; Commissioner Rothrock encouraged the Council to inform him of any concerns in writing. He also recommended that the VBIC Executive Committee meet periodically with him, if they desired. Jim also mentioned that he would like the Council to help define and provide guidance as to how new money (if any) would be allocated. He feels that the five-year State Brain Injury Action Plan will provide some of this guidance, but urged the Council to take an active role in the discussion.

• Helen Butler mentioned VABISP’s legislative agenda, and asked if DRS could request a mechanism to adjust for increased cost of doing business in their budget. Mr. Rothrock stated that the agency’s last budget increase was July 1, 2005, and there is no plan to request increases at this time. Upon further conversation, he stated that our concerns relative to Waiver reimbursement would need to be directed to the Department of Medical Assistance Services (DMAS) but that he is interested in discussing the issue with the VBIC Executive Committee. He cautioned that the VBIC should not write other agency heads without bringing the issue to DRS first. He advised the Council to make a motion to have Mr. Rothrock contact Mr. Finnerty, the DMAS commissioner, to discuss the issue of Waiver reimbursement rates.

The Neurobehavioral Committee consists of Paul Aravich, Kare