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Meeting Minutes

Virginia Brain Injury Council

Virginia Brain Injury Council FINAL meeting Minutes July 23, 2010
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Virginia Brain Injury Council Meeting
Meeting Minutes
July 23, 2010

Members Present:

Carole Norton, Ph.D (Chair) Mary Buckley Foundation
Jason Young (Secretary) Community Futures Foundation
Anne McDonnell (Immediate Past Chair) Brain Injury Association of Virginia

Heather Board Virginia Department of Health
Jeff Carpenter Survivor
Susan Elmore Virginia Department of Behavioral Health & Developmental Services
Lynn Forsyth Family Member
Lisa Garver Brain Injury Services, Inc.
Tori Harding NeuroRestorative
Martha Mead Virginia Wounded Warrior Program
Debbie Pfeiffer, Ed.D. Virginia Department of Education
Linda Redmond, Ph.D. Virginia Board for People with Disabilities
Jim Rothrock Commissioner, Department of Rehabilitative Services
Mark Salisbury Family member
Barbara Seymour, R.N. Virginia Department of Medical Assistance Services
Brian Shenal, Ph.D. Salem Veterans Administration Medical Center
Jeff Sherman Virginia Department of Juvenile Justice Services
Gerald Showalter, Psy.D. Woodrow Wilson Rehabilitation Center
Alan Towne, M.D., MPH Virginia Commonwealth University
Chuck Walsh Middle Peninsula Northern Neck Community Services Board
Leigh Wion High Street Clubhouse
Michelle Witt Virginia Alliance of Brain Injury Service Providers

Members Absent:
Jeffrey Barth, Ph.D., AB-PPCN University of Virginia Medical School
Nancy Bullock, R.N. Virginia Department of Health
Patricia Goodall Virginia Department of Rehabilitative Services
Terry Miles Survivor
Michelle Nichols, R.N. Defense and Veterans Brain Injury Center
Paul Sharpe, R.N. Virginia Department of Health
Jenny Toth Brain Injury Association of America
Julie Triplett Virginia Office for Protection and Advocacy
Kelli Williams Gary, Ph.D. (Vice Chair) Survivor / Professional, VCU

Other in Attendance:
Karen Brown Brain Injury Services, Inc.
Kristie Chamberlain DRS, Staff to the Council
Kristy Joplin Brain Injury Association of Virginia
Mary Margaret Cash DRS, Assistant Commissioner, Community-Based Services Division
Page Melton Family Ombudsman, DRS Federal TBI Grant
Dena Schall DRS, Federal Grant Program Specialist


Carole Norton, Ph.D., Chair, called the Virginia Brain Injury Council meeting to order at 1:03 p.m. Members and guests introduced themselves.

Meeting agenda:
Dr. Norton announced one agenda item change: Christine Grauer, a CNI Grant Project Coordinator with VCU, will not be present to provide an overview of their Commonwealth Neurotrauma Initiative (CNI) Trust Fund grant VETS in College Grant Program Overview due to an emergency. Anne McDonnell motioned to approve the amended agenda; Charles Walsh seconded the motion. The motion passed unanimously.

Approval of Minutes:
Minutes of the April 23, 2010 were distributed and reviewed. Leigh Wion made a motion to approve the minutes; Tori Harding seconded. The motion passed unanimously.

Public Comment:
No public comment was given during the Public Comment period.

New Business:

Comments from Commissioner Jim Rothrock:
Commissioner Rothrock appointed Jeffery Barth, Ph.D, ABPP-CN, to the Virginia Brain Injury Council as his “Commissioner’s Designee,” effective immediately.

Vocational Rehabilitation (VR) funds were used to offset the 5% funding cut to the Brain Injury Services Programs. This funding will be used by state funded brain injury services providers to establish better relationships with DRS Vocational Rehabilitation offices and in turn seek to enhance vocational outcomes for persons with brain injury. Additionally, $60,000 of the Brain Injury Direct Services (BIDS) Fund was reallocated to the state-funded BIS Programs contracts to give them the ability to pay for direct client services/goods for individuals served through their programs.

The Department of Rehabilitative Services is working with the Department of Aging, Aging Disability and Resource Centers, and the Centers for Independent Living (CIL) to make more effective and efficient referrals and to increase communication and cooperation among these agencies.

The Commissioner urged Council members to pay attention to the recently passed Federal health care reform legislation and how this new legislation will impact persons with brain injury.

Martha Mead from the Virginia Wounded Warrior program announced that Penny Melvin will replace Ken Rich as the Regional Coordinator for Tidewater position in the Virginia Wounded Warrior Program.

In the Fall, the leadership of all advisory groups under the Department of Rehabilitative Services will come together to establish a training that would be useful to all and to ensure that each advisory council has a more complete understanding of each other. This training will take place at DRS and information will come to the officers via staff.

Commissioner Rothrock will be talking with the Commonwealth Neurotrauma Initiative Trust Fund Advisory Board for their support in funding a research grant for a neurobehavioral pilot program based upon the findings and recommendations of the Council’s Neurobehavioral Services “white paper.” This grant would be for $150,000/year for up to three years and would be awarded under the Commissioner’s authority to fund research grants.

Michelle Witt, Chair of the Alliance, updated the Commissioner on the Alliance’s position paper on crisis intervention for persons with brain injury. The Alliance is going to be sending this position paper to Secretary Hazel, and copy the commissioners of the departments of Behavioral Health and Development Services, Rehabilitative Services, and Veterans Services. Martha Mead requested that the Alliance also copy Cathy Wilson of the Virginia Wounded Warrior Program and herself on this paper, so they could properly brief the Commissioner of Department of Veterans Services.

New Business:

Educational Presentation to the Council from Mary Margaret Cash, DRS Assistant Commissioner:
Mary-Margaret Cash, Assistant Commissioner, Community Based Services Division, Department of Rehabilitative Services, presented on the DRS Personal Assistant Services (PAS) programs. Ms. Cash talked about the three PAS programs currently managed by DRS: State-funded PAS; PAS for People with Brain Injury; and Vocational Rehabilitation (VR) PAS. Specific examples were provided on each program, the customers served, and funds available for each program.

Federal Grant Update:
Anne McDonnell, Executive Director of Brain Injury Association of Virginia, stated that the DRS Federal Grant has approximately $60,000 to be carried over from the first year of the Federal grant to the second year (due to delays in hiring personnel and other changes in their budget). Anne requested input from the Council on behalf of DRS and BIAV as the subcontractor on ideas the Council feels would be appropriate uses for the funds. The funding must be carried over to support one of the initial goals of the current grant. Some suggested ideas include: on-line education/training module for persons working at the Department of Juvenile Justice; outreach and in-services to assisted living and nursing home facilities that serve people with brain injury; public service announcements on brain injury related issues; attending conferences and training across the Commonwealth to exhibit on the Federal Grant and brain injury related issues. Council members were asked to submit additional ideas and recommendations to DRS staff.

Appointment of Nominations and Elections Committee:
Dr. Norton appointed a Nominations and Elections Committee for election of officers and at-large members. The chair and secretary positions, as well as five at-large positions, will be vacant in January / March 2011. Members of the committee are: Mark Salisbury, Tori Harding, Lisa Garver, Leigh Wion, and Jeff Carpenter. Mark Salisbury will Chair the committee and will work with Staff on setting up meeting dates.

Old Business:

Neurobehavioral “What Next” Committee:
Tori Harding, Committee Chair of the Council’s Neurobehavioral Services Committee, provided background on the Neurobehavioral White Paper authored by the previous Neurobehavioral Services Committee of the Virginia Brain Injury Council. The Council received a “Response to the Neurobehavioral White Paper” prepared by the current committee. The Council reviewed this report during the meeting. A motion was made by Martha Mead to amend the definition of Traumatic Brain Injury in the report to mirror the State Code of Virginia definition of brain injury; to include the Department of Veterans Services, Department of Education, Department of Juvenile Justice, and the Department of Corrections on the State level Interagency Task Force; remove skilled from the term “skilled nursing home’;” and to change the wording in recommended action step #4 to include how state agencies interpret their Code of Virginia mandated responsibilities. Brian Shenal seconded the motion; the motion passed unanimously.

Dr. Norton, Chair of the Virginia Brain Injury Council, commended the Neurobehavioral “What Next” Committee for going above and beyond what was requested of them initially therefore keeping Council momentum going.

Federal TBI Grant Update:
Dena Schall, DRS Federal Grant Program Specialist, provided an update to the Council on Virginia’s Federal Traumatic Brain Injury (TBI) Grant. Kristy Joplin, from the Brain Injury Association of Virginia (BIAV), gave a report on BIAV’s activities as a subcontractor during the First Quarter of Year Two of the grant (report is included an addendum to the minutes). Elizabeth Nicholls, Research Coordinator from VCU on the CNI Trust Fund Research Grant “Best Practices for Incarcerated Youth” (this grant provides required State cash match to the Federal TBI Grant) provided an update on their CNI grant activities with the Department of Juvenile Justice (report is included as an addendum to the meeting minutes).

DBHDS Workgroup Update:
Anne McDonnell of BIAV sent a letter to Commissioner Jim Stewart of DBHDS regarding the stalling of the Department of Behavioral Health and Developmental Services (DBHDS) Statewide Task Force on Crisis Intervention Issues. The workgroup seems to have stalled in recent months and, in addition to a change in administration at DBHDS (new commissioner), Frank Tetrick who was heading up the group recently underwent major surgery and has been recovering for several months. Anne felt the response from Commissioner Stewart was favorable to the work group’s future progress.

Next Meeting:
The next meeting is October 22, 2010 from 1-4 at Woodrow Wilson Rehabilitation Center in Fishersville, Virginia. Anne McDonnell made a motion to adjourn the meeting; Carole Norton, Chair, adjourned the meeting at 4:00 p.m.

“Closing the GAP” BIAV Grant Report
Year 2 – 1st Quarter

Target Group #1: Juveniles with brain injury committed to the Virginia Department of Juvenile Justice
Data Collection
• Screening tool piloted (see report from Elizabeth Nicholls, VCU)

• BIAV conferring with other states on training mechanisms

• Year 4 goal

Targeted Group #2: Persons with Low Socioeconomic Resources
Systems Change
• Neurobehavioral Committee working on response to ‘white paper’

Data Collection
• Requested Trauma Registry names for January 2010-June 2010 from VDH; awaiting response to complete the next outreach mailing.

• Provided I&R services to 186 survivors/family members

• Domestic Violence brochure completed; mailed 25 copies to each of the 41 domestic violence programs in Virginia;
• Mailed 10 copies of the pediatric TBI sheet to each domestic violence program.

Targeted Area: Infrastructure Expansion
Systems Change
• DRS primarily responsible for meeting goals.

• Conducted ACBIS training for 32 Department of Education professionals (teachers, speech therapists, psychologists, etc.);
• BIAV website numbers: 4,055 Total visits; 3,072 Unique visitors; 10,091 Page views;
• See attached document for types of info distributed through I&R program.

• Conducted TBI/Domestic Violence presentations to the Virginia League of Social Service Executives Conference and the I-CAN! Accessibility Board meeting;
• Distributed 25 domestic violence tip cards and BIAV brochures to professionals at the DSS state conference;
• Distributed 30 domestic violence tip cards and BIAV brochures to professionals at the I-CAN! Accessibility Board meeting;
• Distributed 112 pieces of literature at the TBI Conference in Williamsburg.
• Family Ombudsmen have been attending and are actively engaging in required meetings;
• Serving as the 'brain injury' representatives on the Virginia Injury Community Planning Group;
• Continued participation in the Virginia Wounded Warrior Program.
Appendix A
Information Requests for April - June, 2010

# Individuals Requesting Information 77 109 43
Type of Information Requested
BIAV Services (Regional Resource Coordinator, Membership, Conference, Camp) 3 17 6
Support Group 38 48 18
Professionals 38 39 19
Rehabilitation and Related Programs 17 42 19
DRS Voc 12 18 5
DRS Other 3 13 4
Referred to State Contracted Services 15 23 12
Attorney/Legal Resources 7 13 2
Social Security 5 9 1
DSS 2 4 0
CIL 10 10 1
DMAS/Waiver 1 4 2
Housing 0 5 2
Special Education/Education Resources 2 8 3
Legislator 0 2 0
VOPA 0 1 0
Recreation 1 5 1
Veterans' Services 3 0 1
Articles on Brain Injury 50 57 23
Discussion / Support / Resource Education 32 54 17
Other BIA 5 4 0
Other (i.e., Other Disability Organization, Specific Community Resource, …) 17 23 6

CNI Best Practices for Incarcerated
Youth with Brain Injury Project

A partnership between the Virginia Department of Juvenile Justice, the Brain Injury Association of Virginia, and VCU’s Department of Physical Medicine and Rehabilitation Primary Investigator: Jeffrey S. Kreutzer, Ph. D.
Co-Primary Investigator: Juan Carlos Arango-Lasprilla, Ph.D.

Contact: Elizabeth Nicholls, MT, Research Coordinator, or (804) 828-2617

Project Goals:
􀂙 To improve the ability of the Department of Juvenile Justice (DJJ) to identify and meet
the needs of incarcerated juveniles with brain injury within their service system.
􀂙 To develop an effective brain injury screening tool for all juveniles entering the DJJ
􀂙 To develop education and training materials to guide DJJ personnel in screening
evaluating, and providing treatment to incarcerated juveniles with brain injury.
􀂙 To provide training to DJJ staff using a “train the trainer” model.
􀂙 To disseminate information on prevalence, screening, evaluation, and intervention
protocols with incarcerated juveniles with brain injury.
􀂙 To prepare a final report with recommendations to brain injury service providers,
educators, researchers, policymakers, relevant State agencies, and other key stakeholders
for screening and working effectively with incarcerated juvenile offenders with brain

Project Accomplishments:
􀂙 Formed advisory board consisting of representatives of DJJ, VCU, BIAV, the
Department of Correctional Education, and the Department of Education
􀂙 Comprehensive literature review re. best practices for child and adolescent TBI
screening in correctional and general medical settings; comprehensive review of
practices of other State agencies re. TBI screening and evaluation
􀂙 Created structured interview format for TBI history, currently being tested for
feasibility at DJJ
􀂙 Identified and recommended neuropsychological screening protocol to include
structured interview, sensitive neuropsychological tests, and medical record review
􀂙 Developed instructional manual for administration, scoring, and interpreting results of
􀂙 Conducting ongoing training classes for DJJ psychological personnel to administer,
score, and interpret neuropsychological tests