The Virginia Department for Aging and Rehabilitative Services

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Meeting Minutes

Virginia Brain Injury Council

Virginia Brain Injury Council Meeting Minutes February 26, 2016 FINAL
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Friday, February 26, 2016
1:00 p.m.

Members Present:
Jodi Power, RN, JD (Chair) Department of Health Professions
Cynthia O’Donoghue, Ph.D. (Vice-Chair) James Madison University
Mark Bender, Ph.D. (Secretary) Tree of Life/Concussion Care Centre
Dawn Adams, R.N., Ph.D. Department of Behavioral Health and Developmental Services
Barbara Seymour, R.N. Department of Medical Assistance Services
Devin Bowers Dementia Services, Department for Aging and Rehabilitative Services
John Heath Family Ombudsman
Anne McDonnell Brain Injury Association of Virginia
Tony Schaffer Survivor (Leesburg)
Frankie Brewster Family Member (Charlottesville)
Patricia Goodall Brain Injury Services, Department for Aging and Rehabilitative Services
William Carter, III, MD, MPH VCU Health System
Mark Murphy Department of Juvenile Justice
Maria Stransky Department of Corrections

Members Absent:
Brian Shenal, Ph.D. (Immediate Past Chair) Salem Veterans Administration Medical Center
Lisa Bradford (Vice Chair) Salem Veterans Administration Medical Center
Katherine Lawson Virginia Board for People with Disabilities
Krystal Thompson VA Alliance of Brain Injury Service Providers
Gayl Brunk Valley Associates for Independent Living
Deborah Johnson Department of Education
Brian Pearce Survivor (Richmond)
Lorraine Enright Family Member (Yorktown)
Brandi Jancaitis Virginia Veteran and Family Support
Heather Board Virginia Department of Health
Lynne Seward Alzheimer’s and Related Disorders Commission

Others in Attendance:
Karen Brown Brain Injury Services, Inc.
Donna Cantrell Department for Aging & Rehabilitative Services
Mary-Margaret Cash Department for Aging & Rehabilitative Services
Debra Holloway Brain Injury Association of Virginia
Marina Jones Intern, James Madison University
James Rothrock Department for Aging & Rehabilitative Services
Laurie Silva Neurorestorative, Inc.
Trish Smith Intern, Brain Injury Association of Virginia
Leigh Wion The BridgeLine

Jodi Power, Chair, called the quarterly meeting of the Virginia Brain Injury Council (VBIC) to order at 1:12 p.m. The meeting was held in Conference Room 103/105 at the Virginia Department for Aging and Rehabilitative Services, 8004 Franklin Farms Drive, Henrico, Virginia 23229. Ms. Power noted that the last scheduled meeting had been cancelled due to inclement weather, and welcomed all in attendance. Ms. Power asked those present to introduce themselves.

Approval of the October 23, 2015 Meeting Minutes
Corrections were made to the minutes (Frankie Brewster had originally volunteered for the Nominations and Elections subcommittee, but had to withdraw due to a conflict; minutes should read 10/23/15 not 10/24/15). Following these changes, Frankie Brewster made a motion that the October 23, 2015 meeting minutes be approved with these changes; John Health seconded the motion and it passed.

Approval of April 24, 2015 Meeting Agenda
The agenda for the February 26, 2016 meeting was approved by consensus.

Public Comment Period
No members of the public provided public comment.

• Delegate Chris Peace, representative from Hanover, introduced legislation asking DARS to conduct a study on the exploitation of vulnerable adults. The bill involves a study to assess the frequency of exploitation and to develop a plan for identifying, addressing, and preventing it. The deadline for completion of the study is December 2016; discussions will likely begin in spring/summer with actual writing in the fall so that it can be delivered by the December 2016.
• The Commissioner expressed congratulations to brain injury advocates for a successful Brain Injury Awareness Day on February 10 at the General Assembly. He noted that DARS acknowledges delays in getting state funds to brain injury service providers and stated that staff are working to disseminate the remaining funds in a timely and efficient manner.
• Commissioner Rothrock reported that, although the agency provides vocational rehabilitation services to individuals with acquired brain injury, DARS been in an Order of Selection, which means that only those with the most significant disabilities are prioritized for services. The goal is to expand services to those with less severe disabilities (i.e., individuals with mild to moderate brain injury) in addition to those with more severe disabilities who are currently being served. Efforts to increase the effectiveness of services for Veterans are also ongoing.
• The Commissioner noted that discussions involving neurobehavioral care and other issues between DBHDS and DARS have been going well. Dawn Adams of DBHDS completed the task force report which was submitted to DBHDS and DARS commissioners, as well as to members of the General Assembly.
• The Commonwealth Neurotrauma Initiative (CNI) Trust Fund received 14 proposals in response to the latest RFP, and is in the process of setting up contracts with out of state reviewers, in anticipation of awarding contracts as of 7/1/16. A minimum of three awards will be made. Additionally, DARS is planning to hire a full-time Program Specialist to staff the CNI Trust Fund, as the part-time staff person has taken another position.
• Tony Schaffer asked about gathering incidence / prevalence data from the Virginia Statewide Trauma Registry (VSTR) or another source (this was brought up during a previous council meeting). The Commissioner commented on the difficulties with data collection for brain injury over the years, primarily due to lack of enforcement authority over hospitals and other treatment/provider entities in Virginia. The Commonwealth relies on VSTR – as well as various other sources such as the Centers for Disease Control’s formula for estimating incidence / prevalence of brain injury in each state. We combine it with some of the research and needs assessment that has been conducted and come up with a best guess possible. DARS and its outreach subcontractor, the Brain Injury Association of Virginia (BIAV), continue to work on a data collection effort with the Department of Health. Patti Goodall stated that she, Donna Cantrell, and Christine Baggini of BIAV attended the VDH Office of Emergency Services’ Trauma Oversight Committee meeting in February to ask for increased access to the VSTR database and to include “shaken baby syndrome” as one of the diagnostic categories on the Registry. There are also efforts to look at other states for guidance regarding how they collect and share data with interested parties.

Other members (Anne McDonnell and Cynthia O’Donoghue) noted further challenges stemming from the relatively recent release of the ICD 10, and that even the CDC has difficulty generating accurate estimates. It is also noted that the Virginia Statewide Trauma Registry captures those admitted to the hospital – visits to hospital Emergency Departments are not mandated for report to VSTR (though some hospitals do report ED visits). In Virginia, we get only a few reports of ED visits, and no reports from community urgent care centers (e.g., Patient First) or from private physicians.

Commissioner Rothrock thanked Cynthia O’Donoghue, Ph.D., outgoing Vice Chair, for her many years of service and her valuable contributions to the Virginia Brain Injury Council as a member, as Vice Chair, and as a frequent chair of the Nominations and Elections Committee. Commissioner Rothrock then presented Dr. O’Donoghue with a Certificate of Appreciation on behalf of DARS and the Council.

Lorraine Enright, At-Large Member, is also rotating off of the Virginia Brain Injury Council, effective March, 2016. She was not able to attend today; a Certificate of Appreciation will be mailed to her.

The Council has three (3) at-large vacancies to fill: a survivor / family member / caretaker; a licensed/certified healthcare professional; and an individual employed by an organization that does not receive DARS-administered state general funds. Dr. Cynthia O’Donoghue served as the chair of the Nominations and Elections Committee; other Committee members included Brian Pearce, Lisa Bradford, Tony Schaffer, and William Carter. Dr. O’Donoghue explained that the Committee solicited nominations from the Council and from other outside entities throughout the fall and winter. The committee met via conference call to discuss each nominee.

Dr. O’Donoghue presented the slate of candidates developed by the committee for Council approval. Anne McDonnell made a motion that the slate be approved and submitted to the Commissioner without changes; Cynthia O’Donoghue seconded the motion. The motion carried, and the slate was approved by Council for presentation to Commissioner Rothrock.

John Health reminded Council to make sure that a survivor or family member is included on every committee. He also requested that the Nominations and Elections Committee encourage nominations of individuals in the athletic training / sports concussion field, as this is a strong topic for Council to continue to address.

• Federal Grant Update in Brief – Patti Goodall
o The Traumatic Brain Injury Act Grant program is being moved administratively from the Health Resources and Services Administration (HRSA) to the Administration for Community Living (ACL). The process seems relatively smooth at this point, but it is early in the process. The good news is that ACL seems very enthusiastic about working with the TBI programs.
o Administrator and Direct Care Retreats – Donna Cantrell is working to develop dates / locations for the retreats for the state-funded Brain Injury Services (BIS) Programs and will provide further details as available.
o UVA Memorandum of Agreement (MOA) – UVA is in the process of receiving a CNI grant for years 2, 3, and 4 of the TBIA grant cycle. Current iteration of the MOA is with UVA, waiting for the final approval and sign-off; DARS signs last.
o In-kind Hours – Donna is collecting information on the number of hours each Council member provides to DARS and Council by way of “in-kind” (volunteer) hours. She distributed a form to capture this information and will follow up electronically.

• Legislative Agenda Update from the Virginia Alliance of Brain Injury Service Providers and the Brain Injury Association of Virginia (BIAV) –Anne McDonnell
o Anne McDonnell provided a summary of legislation that is currently still in play. See attached handout for more information.
o Guide for Legislative Contact – Patti Goodall provided a handout with brief guidelines for Council members, cautioning that members may lobby, but only as private citizens. DARS employees and VBIC Members cannot lobby in an official capacity, i.e., as a representative of DARS or the Council. Brain Injury Awareness Month Proclamation & Activities – The Governor proclaimed March as Brain Injury Awareness Month. A copy of the proclamation will be posted on the VBIC web-site.
o Other Bills currently circulating include: a bill from Delegate Mark King proposing a policy that will allow return to learn for all students, athletes, and non-athletes. This is a direct result of the Commission on Youth’s work.

• Neurobehavioral Services Project Update – Cynthia O’Donoghue and Cara Meixner, JMU

• State-funded Expanded Services – The Brain Injury Services Coordination Unit is currently working closely with state-funded programs to expend remaining funds that were allocated for brain injury during State Fiscal Year (SFY) 2016.


• Appointment of By-Laws Committee – Jodi Power
ï‚ Mark Bender to serve as Chair
ï‚ Maria Stransky
ï‚ Barbara Seymour
ï‚ Jodi Power

• Appointment of the Priorities Committee - Jodi Power
ï‚ John Heath to serve as Chair
ï‚ Tony Schaffer
ï‚ William Carter
ï‚ Krystal Thompson
ï‚ Brandi Jancaitis

• Appointment of Funds Dissemination Committee – Jodi Power
ï‚ Gayl Brunk to serve as Chair (nominated in absentia)
ï‚ Anne McDonnell (will recuse self from vote due to potential funding conflict)
ï‚ Dawn Adams
ï‚ Frankie Brewster
ï‚ Devin Bowers

• Discussion of April’s Educational Meeting Topics – Jodi Power
Jodi Power, Chair, facilitated a discussion of potential topics for consideration at April’s Educational Meeting. The following topics were identified:
o Portia Cole from Joint Commission on Health Care (JCHC) to present an update on the brain injury / neurobehavioral services.
o Worker’s Compensation and TBI issues.
o DAR Vocational Rehabilitation Program and vocational resources (Council as a whole responded to this enthusiastically).
o Crisis Intervention (good topic any time, consider Community Services Board employee to present).
o Maryland State TBI providers on their programs.
o Dr. Dan Cohen of Norfolk on Behavioral Neurology.

Staff will follow up with these topics, as they were most often endorsed by members: JCHC’s BI / Neurobehavioral Services Study, DARS Vocational Rehabilitation /Resources, and Crisis Intervention as potential topics for the April meeting.

• New Member Orientation– April 22nd at 11:00-12:30 preceding VBIC Meeting. Lunch will be provided. Donna will contact new members and the Executive Committee with details. All Council members are invited to attend if they would like a “refresher “orientation.


• Donna Cantrell provided copies of the Council letter sent to Mr. Bill Hunter, a Virginia resident who asked for financial assistance for his son who is in a facility in Tennessee. In its letter, the Council thanked Mr. Hunter for bringing this matter to its attention, but stated that, unfortunately, it was not aware of any funding available for that purpose.
• TBI Waiver Workgroup Report: Dawn Adams summarized the work of the TBI Services Work Group, noting that it was productive and that some of the recommendations in the resulting paper were incorporated into current legislative language addressing neurobehavioral services for individuals with brain injury. The DBHDS led Work Group completed its assignment and no additional meetings are scheduled.
• disability Law Center of Virginia (dLCV) Report on TBI: Copies of report were distributed. A representative from dLCV will be invited to the April meeting.
• Installation of New Officers
o Vice Chair, Lisa Bradford, January, 2016- January 2018
o Secretary, Mark Bender, January 2016-January 2017 (second term)

Jodi Power, Chair, adjourned the quarterly meeting of the Virginia Brain Injury Council (VBIC) at 4:00 p.m. after reviewing future meeting dates of the Council through the end of 2016:
o April 22, 2016 (New Member Orientation begins at 11:00 a.m.)
o July 22, 2016
o October 21, 2016 (October meeting is held in Fishersville at WWRC)