The Virginia Department for Aging and Rehabilitative Services

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Meeting Minutes

Virginia Brain Injury Council

Virginia Brain Injury Council February Minutes 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, PhD (Vice-Chair), James Madison University
Mark Bender, PhD (Secretary), Tree of Life
Dawn Adams, RN, PhD, Department of Behavioral Health and Developmental Services
Barbara Seymour, BSW, Department of Medical Assistance Services
Brandi Jancaitis, Virginia Veteran and Family Support
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)
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 December 2016.
• The Commissioner expressed congratulations to brain injury advocates for a successful Brain Injury Awareness Day on February 10 at the General Assembly. Their success was reflected in funding for brain injury in the budget. 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 has been in an Order of Selection status, which means that only those with the most significant disabilities are prioritized for services. The goal is to expand services to serve more of 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, DMAS and DARS have been going well. Dawn Adams of DBHDS completed the task force report which was submitted to DBHDS, DMAS 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 efforts 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 (ED) 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’s meeting; staff will mail the Certificate of Appreciation to her.

As Chair of the Nominations and Elections Committee, Dr. Cynthia O’Donoghue reported that 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 thanked other Committee members for their work, including 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 without changes for submission to the Commissioner. Dr. O’Donoghue seconded the motion and the motion carried. The slate will be presented to Commissioner Rothrock for his consideration.

As a new Chair will be needed for the Nominations and Elections Committee, John Health reminded Council to make sure that a survivor or family member is included on every committee and 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 the Council to continue to address.

• Federal Grant Update in Brief – Patti Goodall reported on the following:
o The Traumatic Brain Injury (TBI) 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 and 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 SPELL OUT Commonwealth Neurotrauma Initiative (CNI) grant for years 2, 3, and 4 of the TBI Act grant cycle. The current iteration of the MOA is with UVA, waiting for the final approval and sign-off; DARS signs last.
o In-kind Hours – Donna Cantrell 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 with Council members.

• State-funded Expanded Services – The Brain Injury Services Coordination Unit is currently working with state-funded programs to expend remaining funds allocated for brain injury services during State Fiscal Year (SFY) 2016, including consideration of four additional case manager positions.

• 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. She added that both House and Senate versions of the budget included $250,000 and $500,000 per year respectively for brain injury services.
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 legislation currently circulating includes: 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 Virginia’s Commission on Youth’s work.

• Neurobehavioral Services Project Update –Dr. Cynthia O’Donoghue provided a PowerPoint presentation to the Council regarding the James Madison University study regarding Access to Neurobehavioral Services in Virginia, in the absence of partner Dr. Cara Meixner. This research project was funded by the CNI Trust Fund.


Jodi Power called for volunteers to serve on each of the following Committees, outlining the scope of work for each committee and stating that, historically, committees are comprised of 3-5 members. Ms. Power reminded members that, all members are expected to serve on at least one committee, and that each committee shall include a survivor/family member/representative according the bylaws. The following members volunteered to serve and were appointed by Jodi Power to the listed committees:

• The By-Laws Committee includes:
ï‚ Mark Bender - to serve as Chair, per bylaws
ï‚ Maria Stransky
ï‚ Barbara Seymour
ï‚ Jodi Power

• The Priorities Committee includes:
ï‚ John Heath – agreed to serve as Chair
ï‚ Tony Schaffer
ï‚ William Carter
ï‚ Krystal Thompson
ï‚ Brandi Jancaitis

• The Funds Dissemination Committee includes:
ï‚ Gayl Brunk - nominated in absentia to serve as Chair
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, 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 in Virginia.
o Worker’s Compensation and TBI issues.
o DARS Vocational Rehabilitation Program and vocational resources (Council as a whole endorsed this topic enthusiastically).
o Crisis Intervention - which was determined to be good topic any time (Could consider Community Services Board employee to present, and/or Sheila Gavin from Quantico for military perspective).
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 - Jodi Power and Donna Cantrell indicated that New Member Orientation for those appointed by Commissioner Rothrock is scheduled for April 22nd at 11:00-12:30, preceding the next VBIC Meeting. Lunch will be provided. Donna Cantrell will contact new members and the Executive Committee with details. Staff noted that 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 the Council 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 statewide TBI Services Waiver Work Group since summer 2015, 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 this January 2016 report regarding deficiencies in Virginia’s Adult TBI Services were distributed to Council members; a representative from dLCV will be invited to the April Council meeting to answer questions about the report, etc. dLCV distributed the report to General Assembly member to highlight funding priorities and convey a sense of urgency.
• Installation of New Officers
Jodi Power thanked Dr. Cynthia O’Donoughue for her service as Vice-Chair for the past two years, and thanked Mark Bender for his service during the past year as Secretary. In accordance with VBIC bylaw, she noted that the following new officers are to begin their terms at the first Council meeting of the calendar year (which is this February meeting, as the January meeting was cancelled due to inclement weather: Lisa Bradford, who will serve as Vice-Chair for the two-year term of 2016-2018, and Mark Bender who will serve another one-year term as Secretary from 2016-2017.

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 (noting this is a change from the date previously provided to Council members)
o October 21, 2016 (which is scheduled to be held in Fishersville at Wilson Workforce and Rehabilitation Center (WWRC)