The Virginia Department for Aging and Rehabilitative Services

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Meeting Minutes

Virginia Brain Injury Council

Virginia Brain Injury Council April, 2011 Minutes FINAL
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Details:
FINAL MINUTES
Friday, April 29, 2011• 1:00 p.m. - 4:00 p.m.

Members Present:
Jeffrey Barth, Ph.D., ABPP-CN University of Virginia School of Medicine
Gayl Brunk Valley Associates for Independent Living
Jeff Carpenter Survivor
Lynn Forsyth Family Member/Caregiver
Melissa Fox, PT, DPT University of Virginia Health System
Aaron Goldmann Survivor
Patricia Goodall, Ed.S., CBIST Virginia Department of Rehabilitative Services
Anne McDonnell, MPA, OTR/L Brain Injury Association of Virginia
Martha Mead, MBA Virginia Wounded Warrior Program
Carole Norton, Ph.D. (Past Chair) Mary Buckley Foundation
Debbie Pfeiffer, Ed.D., CED Virginia Department of Education
Cynthia O’Donoghue, Ph.D, CCC-SLP James Madison University
Cynthia Millican Family Member/Caregiver
Jodi Power, RN, JD Virginia Board of Health Professions/Family Member
Linda Redmond, Ph.D. Virginia Board for People with Disabilities
Mark Salisbury, (Chair) Family member/Caregiver
Barbara Seymour, BSW 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
Chuck Walsh, MSW, LCSW, CSAS Middle Peninsula Community Services Board
Kelli Williams Gary, Ph.D. (Vice Chair) Virginia Commonwealth University/Survivor
Leigh Wion, CTRS (Secretary) Virginia NeuroCare – High Street Clubhouse
Michelle Witt, MALS, CBIST Virginia Alliance of Brain Injury Service Providers

Members Absent:
Heather Board, MPH Virginia Department of Health
Susan Elmore Virginia Dept of Behavioral Health & Developmental Services
Michelle Nichols Defense and Veterans Brain Injury Center
Paul Sharpe, RN, NREMT-P Virginia Dept of Health, Office of Emergency Medical Services
Julie Triplett Virginia Office for Protection and Advocacy

Others in Attendance:
Karen Brown Brain Injury Services, Inc.
Mary Margaret Cash Virginia Department of Rehabilitative Services
Kristie Chamberlain Virginia Department of Rehabilitative Services
Marcia Dubois Virginia Department of Rehabilitative Services
Elizabeth Getzel VCU: Rehab, Research & Training Center – CNI Grant #10-176
Christine Grauer VCU Rehab, Research & Training Center – CNI Grant #10-177
Kristy Joplin Brain Injury Association of Virginia
Page Melton Federal TBI Grant Family Ombudsman
Dena Schall Virginia Department of Rehabilitative Services




Opening Protocol
The Virginia Brain Injury Council was called to order at 1:08 p.m. at the Virginia Department for the Aging, 1610 Forest Avenue, Suite 100, Richmond, VA by Mark Salisbury, Chair. Members and guest introduced themselves.

Approval of April 29, 2011 Meeting Agenda
Jeff Barth made a motion to approve the agenda. Chuck Walsh seconded. The motion passed unanimously.

Approval of January 28, 2011 Meeting Minutes
Kristie Chamberlain sent electronic copies of the draft minutes of the January 28, 2011 meeting via email. There was a misspelling of Page Melton’s name in the minutes (Paige to Page). Jeff Barth made a motion to approve the minutes with the correction of the misspelling of Page Melton’s name. Chuck Walsh seconded. The motion passed unanimously.

Public Comment Period
Page Melton announced that through the collaborative effort the Department of Rehabilitative Services (DRS) and the Brain Injury Association of Virginia (BIAV) that the recent Caregiver Conference held on April 9, 2011 in Richmond was a success and that the federal grant hopes to offer it annually. Page also announced she will be moving out of state and will no longer be able to fulfill her role as Ombudsman to the DRS Federal TBI grant. Page encouraged family members on the Council to let her know if they are interested in serving in the Ombudsman capacity.

New Business
Educational Presentation: Christine Grauer & Liz Getzel: CNI Trust Fund Grant #10-176

The V.E.T.S. (Veterans Education and Transition Supports) in College program is a supported education model for veterans with spinal cord injury (SCI) and traumatic brain injury (TBI) funded by a Commonwealth Neurotrauma Initiative (CNI) Trust Fund (www.vacni.org) grant. The grant is now accepting referrals after the completion of reviews by three Institutional Review Boards (Virginia Commonwealth University, McGuire Veterans and Department of Rehabilitative Services). The program has also received approval from the CNI Trust Fund governor appointed Advisory Board to accept veterans with a PTSD diagnosis due to diagnosis similarities and probable duel diagnosis of TBI and PTSD.

The program is able to help with exposure to assistive technology, study skills, and service coordination. The mobile nature of the military presents unique program logistics coupled by program participants confronting multiple issues as they transition back to civilian life. Council members asked questions and provided comments in response to the presentation.

Martha Mead added that there will be a conference on August 9, 2011 at Virginia Military Institute (VMI) funded by a CNI Trust Fund grant awarded to the Partnership for People with Disabilities at VCU who is working in conjunction with the Virginia Wounded Warrior Program (VWWP). The conference will focus on the issue of changing the attitudes facing veterans in college, and developing student veteran's organizations. VWWP is also developing content for their website “We are Virginia Veterans on Campus.”

The Action Plan in Review: Patti Goodall, DRS & Anne McDonnell, BIAV

Patti Goodall provided some pertinent details on the initial development of the State Action plan and how the document has been revised since the initial plan was developed. An Action Plan was required as part of a Federal TBI planning grant that identified 10 major categories of need. This plan was revised in 2005-2007 utilizing the services of a consultant. The plan is available in the following formats: Executive Summary document, a booklet written for laypersons, and the full plan is to be posted on the DRS website.

Jeff Barth initiated a discussion topic of the role and function of the Council. He suggested that the Council priorities are reviewed on a regular basis at each Council meeting. According to the Bylaws, the role of the Council is to provide input to Commissioner Rothrock. Patti Goodall added that this would fit in with the requirements of the Federal grant annual report.

Mark Salisbury suggested an ad hoc committee of 5 members to present at the July meeting to develop this 1 page report of prioritizing the Council funding recommendations and other brain injury priorities. The number of members of this committee was later changed to 7 based on further requests from Council members to be a part of the committee. Anne McDonnell suggested have that document wrapped up by as soon as possible for the development of legislative advocacy. The final paper will be presented for vote/approval by the Council at the July meeting. Committee Members: Chuck Walsh, Anne McDonnell (Chair), Kelli Williams Gary, Michelle Witt, Jeff Carpenter, Martha Mead, Barbara Seymour

Recommendations for Distribution of Brain Injury Services Funding -Michelle Witt, VABISP
For the benefit of the new Council members, the process of the Council’s role in funding recommendations to the Commissioner of DRS was reviewed by Michelle Witt. The Alliance of Brain Injury Service Providers presents their recommendations to the Council on new monies allocated to brain injury or to cuts to monies allocated. By Code of Virginia, the Council provides input to the Commissioner.

In last year’s state budget, brain injury funding (which currently goes to nine service providers operating thirteen programs) received a 5% ($194,931) cut. The recommendation of the Alliance to the Council was to administer an across the board cut which the Council endorsed and the Commissioner approved.

In this year’s state budget, the$194, 931 was restored to the nine service providers operating thirteen programs. Ms. Witt explained that it was the intent of the Alliance that these monies be restored in the same manner that they were cut. A motion was made by Carole Norton to approve that a recommendation be made to the Commissioner of the Department of Rehabilitative Services that the 5% budget cuts be restored to the programs as they were original cut. Jodi Power seconded the motion. The motion carried with a vote of 12 Yeas, 0 Nays, and 4 Abstentions. As state funded brain injury service providers, Anne McDonnell, Michelle Witt, and Leigh Wion, abstained from voting.

Mark Salisbury as Chair of the Council will draft a letter to Commissioner with this recommendation.

Advisory Member Additions Discussion
There was discussion on the benefits of adding additional advisory members to the Council from the Virginia Department of Aging and from the Virginia Department of Social Services since these two agencies are most likely providing services to persons with brain injury.

A motion was made by Jeff Barth to add the Virginia Department of Aging and Virginia Department of Social Services as advisory members to the Council. The motion was seconded by Carole Norton.
The motion passed unanimously.

Old Business
Bylaws Committee Update-Michelle Witt, Committee Appointed Chair

Kristi Chamberlain apologized for error in selecting the Committee chair. According to the Bylaws, the Secretary of the Council chairs the bylaws committee. The committee realized it after meeting. Leigh Wion the current Secretary was made aware of this error after the committee met and determined that the Committee work should still be put forth.

Mostly the bylaws committee “cleaned up” the bylaws to make them easier to understand and consistent. There was suggested modification in the language of the Commissioner’s special designee(s) and the voting status of the special designee(s). Clarifying language was added for how the Council proposes a slate of nominees for Council vacancies to the Commissioner and that one voting member shall be from an organization receiving state funds. A Brain Injury Association of America standing position was removed and the termination of membership was softened.

Jeff Barth made a motion to accept the bylaw amendments. Anne McDonnell seconded the motion.
The motion passed unanimously.

Report Out Day Update—Patti Goodall, DRS
The State Agency Brain Injury Report Out Day is scheduled for July 22, 2011 at the Cultural Arts Center in Glen Allen. The emphasis of the presentations will be on what state agencies are doing surrounding brain injury in Virginia as well as an emphasis on veterans to address Governor McDonnell’s Executive Order #29 (2010) “Serving Virginia’s Veterans” (http://www.governor.virginia.gov/Issues/ExecutiveOrders/2010/EO-29.cfm) and will include two presentations by CNI Trust Fund grantees whose grant activities are veterans focused. The Brain Injury Council will meet from 8:30 am – 9:30 am prior to the beginning of the Report Out Day.

Remarks from the DRS Commissioner - James Rothrock, DRS Commissioner
Mark Salisbury reported that Commissioner Rothrock was unavailable to be present today.

Closing Protocol
Review future meeting dates
July 22, 2011
Cultural Arts Center of Glen Allen, Glen Allen VA
October 28, 2011
Woodrow Wilson Rehabilitation Center
Switzer Building Classroom

Future agenda items
A presentation on Medicaid Waivers would be very helpful to gain a better understanding of these services and any impact of the new regulations of the Affordable Health Care Reform and Money Follows the Person apply.

Family Ombudsman Position
Page Melton spoke briefly to ask interested candidates to fulfill this important role to assure the caregiver voice is represented on the Virginia Federal TBI grant. If you are interested or know of someone who may be interested, please contact Patti Goodall.

Anne McDonnell made a motion the Council formally recognize and thank Page for her service to the Council. The motion was seconded by Patti Goodall and passed unanimously.

Adjournment of meeting – Mark Salisbury adjourned the meeting at 4:06 pm

DRS Federal Grant Report: “Closing the Gap”
Virginia Brain Injury Council
Friday, April 29, 2011

QUARTERLY UPDATE:

• The U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA)-Federal Traumatic Brain Injury (TBI) Program held its’ 13th Annual Federal TBI Program Leadership Meeting in Bethesda MD on Thursday, March 16-17, 2011. Lead DRS staff, two staff from subcontractor BIAV, and our Family Ombudsman attended. DRS was able to showcase resource materials such as our Full and Executive Summary of Action Plan, Full and Executive Summary of the “Neurobehavioral White Paper”, CIT-CSB in Maine-power point/handout, and BIAV educational material in English and in Spanish.

• Caregiver Forum (“We Walk Together”): DRS TBI Grant held its’ first Caregiver Forum on April 9, 2011. It provided information / education to family members / caregivers, as well as provided networking opportunities. The objective was to introduce family members / caregivers to the work of the Virginia Brain Injury Council and to develop interest in serving as member, Family Ombudsman, or on a committee. We had 30 Caregivers and Survivors register and attend.

• Department of Rehabilitative Services Information Systems staff has been granted access to the Virginia Department of Health’s Virginia Statewide Trauma Registry (VSTR) database. DRS staff can pull out information (name, address) to prepare mailing labels each month of all persons admitted to the hospital for treatment of an injury to the head or brain (per specific ICD-9 Codes). The Brain Injury Association of Virginia (BIAV) provides the literature and oversees the mailings each month.

• DRS’ Federal TBI Grant webpage, brochure, and display (table exhibit) are in process. We plan to post resource materials and other helpful websites to the TBI Website in a link called Resource Directory (deliverable of the grant). We will be able to post materials and handouts from past events such as the Caregiver Forum.

• Year Two (April 2010-March 2011) required grant activities that are in progress:
o Annual report: In discussion.
o Federal Traumatic Brain Injury Act Grant Biennial Retreat: The Executive Committee of the Virginia Brain Injury Council (Chair, Vice-Chair, Secretary, and Immediate Past Chair) held a retreat on February 15, 2011 to review and better understand the Brain Injury State Action Plan. The retreat focused on future Council goals and activities. The Virginia Brain Injury Council Annual Calendar was reviewed at this time.
o Biennial “Brain Injury Report Out Day”: The Federal Grant team is participating in Council planning for the July 2011 Brain Injury Report Out Day. Council staff (Kristie Chamberlain) found a location for the event pending approval at DRS (Glen Allen Cultural Arts Center). The focus of the Report Out Day is to share information on how various state agencies are serving Virginians with brain injury.

Possible Carryover Projects: The Department of Rehabilitative Services has revised its request to
HRSA for the use of carryover funds (approximately $65,000) from Year One to Year Two. Proposed
Projects include:

• Nursing Home Intervention Project: DRS is awaiting approval from HRSA and then will issue a Request For Proposals (RFP) to solicit a vendor to carry out the activities of this project.

• Department of Health Professions Mailing List for outreach activities.

• Virginia Commonwealth University [working with Department of Juvenile Justice (DJJ)]: National Policy Summit and “Ethics” Webinar for DJJ staff and continuing education for psychologists.


Subcontractors Brain Injury Association of Virginia and Virginia Commonwealth University will present updates on their Federal TBI Grant activities in separate reports.

BIAV: Federal Grant Report: “Closing the Gap” Year 2, First Quarter
Friday, April 29, 2011


Target Group #1: Juveniles with brain injury committed to the Virginia Department of Juvenile Justice
***Deliverables being modified for year 3***

Data Collection
• Application submitted to VCU Institutional Review Board because of changes in data collection and analysis procedures.

Education
• Utilization of the existing DJJ training system proved to be an inaccessible option for educating DJJ professionals on brain injury; working to develop and provide materials through different mechanisms.

Outreach
• Began modifying outreach plan and target populations secondary to changes at DJJ and anticipated deliverables.

Targeted Group #2: Persons with Low Socioeconomic Resources
Systems Change
• Participating in separate workgroups with DMAS and VDH to identify possible solutions to lack of access to neurobehavioral supports and services.

Data Collection
• Provided I&R services to 317 survivors/family members and 57 professionals; 29 reported themselves as belonging to a minority population; 86 reported barriers indicative of “low socioeconomic status”.

Education
• Virginia State Trauma Registry (VSTR): Mailed outreach mailing to 378 individuals in 4th quarter; response rate unavailable. For Year 2, sent outreach mailing to 3,569 individuals reported to the Trauma Registry with a response rate of 4.95% (1-2 considered excellent).

• BIAV held its Annual Conference on Saturday, March 12 with 149 attendees: Persons with Brain Injury (24); Family Caregivers (36); Students (13); Professionals (76). Conference Planning Committee held regular meetings with participation of Family Ombudsman.

Targeted Area: Infrastructure Expansion
Education
• Distributed 369 brochures to professionals attending the VA-CSB Conference.

Outreach
• Posting information on Facebook as appropriate;
• One Family Ombudsman attended Grantee Meeting; both are actively engaged in fed grant activities and team meetings;
• Attended Virginia Injury Community Planning Group meeting
• Continued participation in state and local Virginia Wounded Warrior Program initiatives.

Federal Grant Report: “Closing the Gap”: Best Practices for Incarcerated Youth with Brain Injury (CNI Grant #10-168)
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. (VCU)
Co-Primary Investigator: Juan Carlos Arango-Lasprilla, Ph.D. (VCU)
Contact: Elizabeth Nicholls, MT, Research Coordinator, egnichol@vcu.edu or (804) 828-2617 (VCU)
________________________________________

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 system

 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 injury.

Project Accomplishments:

 DJJ Behavioral Services staff have been trained to administer, score, and interpret the results of a series of four sensitive neuropsychological tests; brain injury screening instrument; and medical records review.

 Complete data has been collected on over 500 subjects and VCU staff has submitted an IRB proposal to analyze this data. When the proposal has been approved, VCU will submit an application to DJJ’s IRB to obtain data.

 Comprehensive literature review re. best practices for child and adolescent TBI screening in correctional and general medical settings is ongoing, with planned submission for publication in early 2011.

 Brain Injury Association of Virginia and VCU are planning a national Brain Injury and Juvenile Justice Policy summit to bring together HRSA staff, leading researchers, state agency stakeholders, policy makers, and advocacy professionals from all over the country to discuss best practices and policy alternatives. A summary document describing challenges, discussions, plans, and recommendations will be prepared and circulated after the meeting.