The Virginia Department for Aging and Rehabilitative Services

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Meeting Minutes

Virginia Brain Injury Council

Virginia Brain Injury Council April, 2014 Minutes FINAL
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Friday, April 25, 2014
1:00 p.m.
Members Present:
Mark Bender, Ph.D. Tree of Life, Neuropsychologist
Gayl Brunk Valley Associates for Independent Living
John Butrick Survivor, Member of Denbigh House Clubhouse
Susan Elmore Dept Behavioral Health & Developmental Services
Lorraine Enright Family Member
Aaron Goldmann Survivor
John Heath Family Ombudsman, DARS Federal TBI Grant
Kimberly Hemphill, R.N., Ph.D. Tucker Pavilion, HCA
Deborah Johnson Department of Education
Katherine Lawson Virginia Board for People with Disabilities
Amy Marschean DARS Alzheimer’s Disease & Related Disorders Commission
Anne McDonnell Brain Injury Association of Virginia
Cynthia O’Donoghue, Ph.D. (Vice-Chair) James Madison University
Patricia Goodall Department for Aging and Rehabilitative Services
Brian Pearce Survivor
Jodi Power, R.N., JD (Secretary) Department of Health Professions / Board of Nursing
Barbara Seymour Department of Medical Assistance Services
Brian Shenal, Ph.D. (Chair) Salem Veterans Administration Medical Center
Michelle Witt Virginia Alliance of Brain Injury Service Providers

Members Absent:
Charlotte Arbogast DARS Dementia Services Coordinator
Jeffrey Barth, Ph.D. University of Virginia School of Medicine
Heather Funkhouser Board Department of Health / Injury Prevention
Lisa Bradford Salem Veterans Administration Medical Center
Jocelyn Johnson Survivor
Paul Sharpe, R.N. Department of Health / Statewide Trauma Registry
Mark Salisbury (Immediate Past-Chair) Family Member
Camilla Schwoebel Virginia Wounded Warrior Program
Julie Triplett Virginia Office for Protection and Advocacy

Others in Attendance:
Becky Bowers-Lanier Lobbyist, Brain Injury Association of Virginia
Marcia Dubois Department for Aging and Rehabilitative Services
Kristie Chamberlain (Staff) Department for Aging and Rehabilitative Services
Mary-Margaret Cash Department for Aging and Rehabilitative Services
Angie Pearce Family Member
Jason Young Community Brain Injury Services

OPENING PROTOCOL - Brian Shenal, Ph.D., Chair
Brian Shenal, Chair, called the quarterly meeting of the Virginia Brain Injury Council to order at 1:05 p.m. The meeting was held in Conference Room 101-103-105 at the Virginia Department for Aging and Rehabilitative Services, 8004 Franklin Farms Drive, Henrico, Virginia 23229. The Chair welcomed three newly appointed Council members: Mark Bender, PhD, re habilitation neuropsychologist; Kimberly Hemphill, Ph.D, RN, Director of Nursing for Tucker’s Pavilion at CJW Hospital in Richmond; and Brian Pearce, veteran and brain-injury survivor. Dr. Shenal asked all members and guests to introduce themselves.

Approval of April 25, 2014 Meeting Agenda
The agenda was approved after Patti Goodall requested that “Remarks from the DARS Commissioner” be struck from the agenda, since Commissioner Rothrock was not able to be present at the meeting.

Approval of January 24, 2014 Meeting Minutes
The January 24, 2014 meeting minutes were approved with corrections after changes were made to reflect Lorraine Enright was absent at the meeting, and an edit was made to properly reflect the BIAV acronym on page 3.

Recognition of Service
Dr. Shenal recognized Commissioner’s Designee Aaron Goldmann for his service on the Virginia Brain Injury Council since 2011. He was presented with a certificate thanking him for his three years of service on the Council.

Announcement of Staff Change
Patti Goodall announced that DARS staff member Kristie Chamberlain would be leaving her position after 11 years of service, effective May 30, 2014. She was presented with a plant and gift card, and Council members expressed their gratitude for Ms. Chamberlain’s excellent work and support through the years.

Public Comment Period
A public comment period was offered. Jason Young offered public comment regarding potential state funding for brain injury service providers in Virginia. He indicated that there has been no increase in state funding for brain injury service providers in seven years, putting a strain on the 3,000 individuals with brain injury needs. The lack of increase has resulted in an actual loss of funding because providers’ costs have increased. For example the cost to run Denbigh House in 2008-2009 was $240,000 per year; the current cost to run that program is $300,000 per year. He indicated that nine full-time positions have been lost during these years with level funding, while waiting lists have grown. Since there is potential brain injury funding this year if a state budget agreement is reached, Mr. Young requested the Virginia Brain Injury Council provide input to the Commissioner to support a general contract allocation increase to the ten contracted organizations for 13 program providers so they can each address their needs. Patti Goodall clarified that the state budget could provide for anything from no new funding to $500,000 allocated for brain injury services, with $150,000 already designated for case management.


Virginia Alliance of Brain Injury Service Providers / Brain Injury Association of Virginia: Legislative Agenda Update
Michelle Witt, Chair of the Virginia Alliance of Brain Injury Service Providers (VABISP) provided an update of a face-to-face meeting held by members of the VABISP. She reported the VABISP and Brain Injury Association of Virginia (BIAV) worked collaboratively during the 2014 legislative session given the potential $150,000 in funding for case management and $350,000 for other purposes, but it is difficult to know where things stand with no budget passed and in place. She that VABISP and BIAV established three funding priorities: registry outreach; general contract allocation increases for brain injury service providers (to ensure infrastructure and services remain despite rising costs), and ensuring unserved/underserved areas receive services. Ms. Witt indicated that following a scheduled teleconference, a formal letter will be developed to communicate the recommendations regarding these funding priorities to the Virginia Brain Injury Council. Patti Goodall stated that she had consulted with Commissioner Rothrock, and DARS anticipates issuing contract extensions to existing contracted brain injury service providers in Virginia to ensure that services continue uninterrupted.

Educational Topic
Dr. Shenal reported that the Executive Committee decided to move the Council’s annual education topic that is typically held during each April meeting to the July meeting this year. This decision was based upon other items that needed to be covered at this April meeting, and the additional time necessary to put together a panel on the requested topic of legal and educational issues for brain injured clients, and/or receiving an update on the Mental Health Task Force workgroups and how this may impact the brain injured population.


Funds Dissemination Committee
This ad hoc committee was formed in response to anticipated new funding to be allocated by the General Assembly for State FY ’15, since DARS is required to “consider the recommendations of the Virginia Brain Injury Council when disseminating new funding for brain injury services.” Committee Chair Mark Salisbury reported that in light of no state budget outcome thus far, the Committee had no information to provide to the Council at this time He indicated the Funds Dissemination Committee members (including Dr. Brian Shenal, Lisa Bradford, Susan Elmore and himself) will meet and develop recommendations once a budget agreement is reached.

Priorities Committees
Michelle Witt, Chair of the Priorities Committee presented a PowerPoint presentation to the Council on the history and background of the Priorities Committee, which was established to identify and provide input to the Commissioner on the top issues and recommendations for funding and the federal grant. She indicated the Priorities Committee members (including Anne McDonnell, Camilla Schwoebel, Barbara Seymour, and John Heath) identified their top 3-5 top priorities for funding, which were then presented at this meeting for direction from the full Council. The priorities presented and discussed included: neurobehavioral treatment options; collaboration and coalition with and educating community partners; and legislative funding for systems changes.

After discussion, the Council members determined that the top priority should be improving access to the full range of neurobehavioral services from crisis stabilization to hospitalization to behavioral and cognitive therapies and community support in Virginia. (Currently, most facilities that offer these services are outside of Virginia; Virginia nursing homes are unable to handle people with brain injury and most end up in mental health facilities in Virginia. Medical insurance will not pay for these services and there is no public funding.) The Council indicated that neurobehavioral services should also be better defined, noting that a “white paper” on neurobehavioral access in Virginia is in process with the James Madison University study that is the focus of a current CNI Trust Fund grant. Other top priorities determined by the full Council in descending order included: 2) education/coalition building to include education of other providers on brain injury and screening for brain injury, as well as available resources and referral processes; 3) implementation of system changes in support a universal waiver so that funding follows the person; and 4) preservation and expansion of core services and supports.

Jodi Power moved to request the Priorities Committee draft a letter on behalf of the Virginia Brain Injury Council for presentation to Commissioner Rothrock including the above four identified items as the top priorities for funding and policies. The motion was seconded by Mark Salisbury and passed unanimously.

Bylaws Committee
Jodi Power, Chair of the Bylaws Committee presented an overview of the changes that will be proposed to the full Council for consideration. She indicated the Bylaws Committee members (Dr. Jeffrey Barth, Susan Elmore and herself) along with Patti Goodall and Kristie Chamberlain (DARS staff) met by conference call in late February and determined suggested revisions to the bylaws, but they had not yet been drafted and disseminated to the full Council for consideration in advance of this meeting. Thus, the bylaw revisions will be presented and considered either by electronic vote subsequent to this meeting or be deferred until the July 2014 meeting.

She reported the revisions being recommended by the Bylaws Committee will include:
• Making the volunteer family ombudsman a permanent standing member not tied to the federal TBI Grant (which can be designated by the Council);
• Adding a term limit for Commissioner’s special designees, to be for 3 years consistent with at-large members, but which may be reappointed for a second term. This change would not preclude special designees from serving longer if in an officer capacity.
• Removing the ten-day timeframe for the Commissioner to select appointees from the slate presented by the Council;
• Ensuring any official termination of members be in writing; and
• Making other minor editorial changes to address punctuation and typos in existing bylaws.

Update on Federal TBI Grant
Patti Goodall from the Department for Aging and Rehabilitative Services (DARS) provided a brief update on the status of the federal TBI Grant. The current DARS grant ended March 31, 2014. DARS submitted an RFP response for the 2014-2018 HRSA Federal TBI Grant. As part of the process, DARS met with BIAV and hosted a brainstorm session meeting in April, which included several Council members and representatives of the state-funded Brain Injury Services Programs. The federal grant Request For Proposals (RFP) required that applicants address all four of the identified systems-change priorities described in the guidance documents: 1) information and referral; 2) professional training; 3) screening; and 4) resource facilitation. She indicated the submitted proposal included six sites to implement and pilot brain injury screening at Community Service Boards (CSBs) in Virginia. One full-time grant position at DARS was written into the proposal. Additionally, a Commonwealth Neurotrauma Initiative (CNI) Trust Fund grant project will provide state cash match for the first year of the federal grant (a contract with JMU Is in place to develop a comprehensive update of the Council’s 2010 Neurobehavioral Services “white paper”). It was noted that VBIC serves as the advisory group for Virginia’s federal grant. If awarded, the Federal TBI Grant project would begin June 1, 2014.

Anne McDonnell added that the last deliverable for the prior Federal TBI Grant was a mailing sent to 40 CSBs in April. A performance review is also still due on this grant.

Update on RFP Process for State FY 2015
Patti Goodall reiterated that the RFP for state-funded Brain Injury Services (BIS) programs has not yet been issued by DARS due to the lack of a finalized state budget. Meanwhile, contract extensions with current providers will be executive to ensure that brain injury services continue statewide. She explained that applicants responding to the RFP must address one or a combination of three core services: regional resource coordination; case management (adult and pediatric); and clubhouse or day programs.
John Heath shared that he had received a letter from the Senate appointing him to the Community Integration Advisory Commission.

CLOSING PROTOCOL – Dr. Brian Shenal, Chair
Dr. Shenal noted that future quarterly meetings of the Council in 2014 are scheduled for July 18th (noting this to be earlier in the month than usual) which will be held at the Department for Aging and Rehabilitative Services offices in Henrico, and October 24th which will be held at Woodrow Wilson Rehabilitation Center in Fishersville. Brian Pearce noted that the 2014 Wounded Warrior Project’s retreat conflicts with the July 18th meeting, which will prevent his attendance at the Council meeting.

The meeting was adjourned at 2:48 p.m.