The Virginia Department for Aging and Rehabilitative Services

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Meeting Minutes

Virginia Brain Injury Council

Virginia Brain Injury Council July 2016
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Friday, July 22, 2016  1-4:00 p.m.

Members Present:

James Rothrock (via conference phone) Dept for Aging and Rehabilitative Services
Jodi Power, RN, JD (Chair) Dept of Health Professions - Board of Nursing
Lisa Bradford, LCSW (Vice Chair) Salem Veterans Administration Medical Center
Brian Shenal (Immediate Past Chair) Salem Veterans Administration Medical Center
Deborah Johnson Dept of Education
Barbara Seymour Dept of Medical Assistance Services
Betty Ann Liddell Virginia Veteran and Family Support
Anne McDonnell Brain Injury Association of Virginia
Tony Schaffer Schaffer Construction, Survivor
Frankie Brewster UVA Medical Center, Family Member
Devin Bowers DARS Dementia Services Coordinator
Patricia Goodall Dept for Aging and Rehabilitative Services
Maria Stransky VA Department of Corrections
Thomas Campbell, PhD McGuire VA Medical Center
Lynn Seward Alzheimer’s Disease & Related Disorders Comm
Laurie Silva NeuroRestorative
Cara Meixner James Madison University
Shasmin Asbury Denbigh House
John Cimino Virginia Board for People with Disabilities

Members Absent:

Mark C. Bender, PhD (Secretary) Tree of Life, Rehabilitation Neuropsychologist
John Heath DARS Federal TBI Grant (Family Ombudsman)
Heather Funkhouser Board Dept of Health / Injury Prevention
Krystal Thompson Virginia Alliance of Brain Injury Service Providers
Brian Pearce Survivor (Richmond)
Mark Murphy VA Department of Juvenile Justice
Gayl Brunk Valley Association for Independent Living
William Carter, MD Virginia Commonwealth University

Others in Attendance:

Cathy Shenal Public
Mary Strawderman Dept for Aging and Rehabilitative Services
Donna Cantrell (Staff to Council) Dept for Aging and Rehabilitative Services
Wanda Allen Dept for Aging and Rehabilitative Services
Tracy Topolosky Dept for Aging and Rehabilitative Services
Marie Worley Dept for Aging and Rehabilitative Services
Elizabeth Horn disABILITY Law Center of Virginia
Amanda Lineberry University of Richmond
Opening Protocol: Jodi Power, RN, JD, Chair
Jodi Power, Chair, called the quarterly meeting of the Virginia Brain Injury Council to order at 1:02 p.m. The meeting was held in Conference Room 103/105 at the Virginia Department for Aging and Rehabilitative Services (DARS), 8004 Franklin Farms Drive, Henrico, Virginia 23229. Ms. Power asked all members and guests in attendance to introduce themselves. New VBIC members who were present included Shasmin Asbury from the Denbigh House in Newport News and Cara Meixner, PhD, from James Madison University. John Cimino, a newly designated Advisory Member representing the Virginia Board for People with Disabilities, attended his first Quarterly Meeting as well.

Approval of the April 22, 2016 Meeting Minutes

The minutes from the April 22, 2016 meeting minutes were identified as in need of one correction:
• Thomas Campbell’s degree is PhD rather than MD

ACTION ITEM: Brian Shenal moved that the Minutes be approved with that one correction. Lynne Seward seconded the motion. The April 22, 2016 VBIC meeting minutes were approved with the aforementioned correction.

Public Comment Period:

There was no public comment.

Unfinished Business:

Earlier in the year, Council requested that DARS formally respond in writing to members of the public who speak during the Public Comment Period of each meeting. DARS agreed to do that. Effective this meeting, DARS implemented a sign-in process that would collect more detailed contact information (mailing address, e-mail) so that formal letters of acknowledgement or follow-up can be sent.

New Business:

DARS Brain Injury Services Update
Patti Goodall, Program Director of Brain Injury Services Unit (BISU), introduced Wanda Allen. Ms. Allen is the new Program Specialist who will provide staff support to the Commonwealth Neurotrauma Initiative (CNI) Trust Fund Advisory Board. She comes to us from the VCU Department of Physical Medicine and Rehabilitation where she worked for the past 15 years with medical residents assigned to the brain and spinal cord units. Ms. Allen began working at DARS on June 27, 2016.

Patti Goodall further reported that a Memorandum of Agreement (MOA) was finalized and executed with the University of Virginia to implement a 3-year, Brain Injury Screening project. This project, which is funded by the CNI Trust Fund, also serves as the required State cash match for DARS’ Federal TBI Act Grant. The Principal Investigators (PIs), Doctors Donna Broshek and Jeffrey Barth, will work with intake staff at the following sites: Community Services Boards, Centers for independent Living, Area Agencies on Aging, and Free and Charitable Clinics (2 each) to implement an easy-to-use brain injury screening tool. This project will help to identify the number of people with brain injury who are seen at these community sites, but have not been diagnosed with a possible brain injury. The PIs will report to Council on the progress of their screening project at regular intervals.

Donna Cantrell reported that state-funded Brain Injury Services Programs all had their contracts signed and executed before the July 1, 2016, the start of the new contract period. A portion of the remaining dollars allocated by the General Assembly for this fiscal year will be used to support a dedicated brain injury case manager in the Virginia Beach area. This case management position is currently posted and applications are being considered. The remainder of these state dollars will be awarded based on the proposals received as a result of an RFP that is expected to be released early this Fall.

Patti Goodall noted that the next CNI Advisory Board Meeting is scheduled for August 31st and that she anticipates that the reviews of CNI proposals will be on the agenda (to make final award decisions).

Patti Goodall also noted that because of some contractual issues, we had some state dollars left over in fiscal year 2016. As a result, the Brain Injury Services Coordination Unit received approval from Commissioner Rothrock to purchase (or provide funding toward the purchase of) three accessible vehicles for community Brain Injury Services Programs. The vehicles will be used by state-funded Brain Injury Services programs on the Eastern Shore, in Newport News, and in Charlottesville.

Community brain injury programs are also being asked to submit video clips that DARS can broadcast on the large television monitor in the lobby of Central Office. It is important that all consents for individuals appearing in the video clips be obtained prior to that submission because without them, the videos can’t be used.

Commissioner’s Update:
DARS Commissioner Rothrock called into the meeting to provide an update on the legislative environment, noting that revenue looks like it will be $266 million short of projections for next year. Virginia has lots of jobs, but they aren’t high paying jobs therefore the Governor is adjusting revenue projections. He anticipates that agencies will be asked to submit budget reductions in early/mid-August. Commissioner still feels that advocates need to go to the General Assembly as usual, and do what they do, but he doesn’t think DARS will be invited to put forth legislation asking for more money. Nor does he feel that requests for funding will be approved, but he did note that in this environment, if the advocates ask for more money, they should be very specific or not do it.

Anne McDonnell noted that state funding for brain injury services money is an easy cut because it is all state dollars and is not tied to federal matching dollars. The Commissioner agreed.

The Commissioner also noted that the Division for Rehabilitation Services (DRS) is working to identify business needs to recreate training opportunities at WWRC like CVS has done. In partnership with DARS, CVS worked with WWRC to recreate the inside of a CVS store, allowing the student/clients at WWRC to be trained on CVS skill-sets in a realistic setting. This partnership and training program have been very successful and DARS would like to expand that project to other employers.

Patti Goodall asked the Commissioner about the timing of the Council’s Priorities letter and the Funds Dissemination letter. The Commissioner noted that the Funds Dissemination letter is to give him some guidance on how funds should be allocated and dispersed come July 1st each year. So getting that letter in April is appropriate for the decision-making that generally occurs in April and May. The Priorities letter is approved by the Council at the July meeting and is used to develop legislative priorities which are due in August and September for the upcoming year so that timing is also appropriate. The Annual Calendar will not be revised.

Updates from the Brain Injury Association of Virginia and Virginia Alliance of Brain Injury Service Providers:
Anne McDonnell, Executive Director of the Brain Injury Association of Virginia (BIAV), gave an update on some of their activities related to their state funding from DARS, as well as their subcontract on DARS’ Federal TBI Grant. BIAV Federal grant deliverables included an Information and Referral (I&R) component that involved accessing contact information for those who sustained a brain injury (and were admitted to hospital emergency rooms and trauma centers). The outreach effort is now funded by state general dollars through DARS and therefore was moved as a grant deliverable from the Federal TBI Grant to BIAV’s state contract. However, I & R is still a requirement of the Federal Grant. A second-level I & R process that involves providing follow-up to individuals who appear to have more intense needs and who agree to the follow-up contacts, will be implemented by BIAV staff. This will satisfy the Information and Referral requirement in DARS’ Federal TBI Grant.

BIAV’s Annual Conference will be held March 10-11, 2017 (it has been increased from one day to two days based on evaluation feedback). March 10 (Friday) will focus on advanced practice in the morning and support group leaders in the afternoon. The Saturday portion of the program will remain largely the same, targeting survivors, family members, professionals.

On August 2, BIAV will conduct its last ACBIS (Association for the Certification of Brain Injury Specialists) training under the old protocol. ACBIS has changed the certification process for Certified Brain Injury Specialists / Certified Brain Injury Specialist Trainers (e.g., the ACBIS manual has increased from 7 chapters to 21); new testing protocols go into effect September 1, 2016.

Anne McDonnell also gave an update for the Virginia Alliance of Brain Injury Services Providers (VABISP). They are holding a Legislative Retreat on September 6, 2016, at which time the Alliance will develop its legislative priorities for working with the General Assembly. At the recent Disability Commission meeting, members asked that legislative requests be submitted to them now. She added that consideration should be given to provide a copy of the Council’s Priorities Letter to the Disability Commission. In addition, Senator David Marsden has asked that the Joint Commission on Health Care (JCHC) report on its current brain injury study to the Commission in September. This meeting is open to the public.

Ms. McDonnell is on the Virginia Stroke Systems Task Force and noted that from meetings she’s attended that the committee very much needs to hear about the community side of what happens to people after they are released from the hospital. Anne suggested that DARS and BIAV speak at their next meeting. She also wants us to consider inviting a presentation from this group at Report Out Day in 2017.

Funds Dissemination Committee Report Update:

Patti Goodall updated the Council on this topic. At the April 22, 2016 quarterly meeting, the Council approved significant edits to the proposed Funds Dissemination letter, recommending that DARS take the $375,000 and make the 2 part-time case management positions full-time, and adding an across the board increase to address waitlists and expand current services, which aligned with the Virginia Alliance’s version and proposal. If ancillary services are to be proposed, an RFP would need to be released. The Funds Dissemination letter was amended while simultaneous conversations were going on between Council staff and DARS Commissioner about the Council’s recommendations regarding funding decisions. At the same time, the Alliance was communicating with the Commissioner about funding decisions. Essentially, funding decisions were made and implementation before the Funds Dissemination letter was formally sent to the Commissioner. The Virginia Brain Injury Council’s recommendations were represented by Staff on numerous occasions and in the end, those recommendations were implemented within State guidelines.

Priorities Committee Report:

The Priorities Committee, made up of John Heath (chair), Krystal Thompson, Tony Schaffer, William Carter, and Betty Liddell, met in June and finalized a Priorities Letter to be sent to DARS Commissioner Rothrock. Tony Schaffer represented the Committee and presented the letter to the Council for a vote.

ACTION ITEM: Lynne Seward moved that the letter be accepted; Tom Campbell seconded; discussion of the issue ensued. Lynne Seward amended her motion proposing the letter be amended as discussed (summarizing the 4 priority areas at the beginning of the letter and removing detailed bullet points within the Data Collection and Analysis sections) and sent to the Commissioner. Brian Shenal seconded and the motion passed unanimously.

ACTION ITEM: Anne McDonnell suggested that the Priorities Letter should be sent to the Disability Commission. Patti Goodall stated that she agrees with this suggestion, but would like to have staff check with the Commissioner first. Frankie moved that pending the Commissioner’s approval, the Priorities Letter should be sent to members of the Disability Commission. Lisa Bradford seconded and the motion passed unanimously.

Nominations and Elections Committee

Jodi Power, Chair, called for volunteers to serve on the Council’s Nominations and Elections Committee. She noted that two officer positions are being vacated in January (chair and secretary) and that three (3) At-Large member positions expire in March. The Committee will solicit nominations, evaluate applicants, and develop a slate of nominees for election in October by the Council (officer positions). A slate of At-Large members will be developed for a vote by the Council in January, and then forwarded to DARS Commissioner for appointment, effective at April meeting.

Ms. Power reminded the Council that everyone is asked to serve on at least one committee during their tenure. Staff to Council (Donna Cantrell) will set up meetings via conference call and the majority of communications will be via email. She thanked the following Council members who volunteered to serve on the Nominations and Elections Committee:

Lisa Bradford, Chair
Tom Campbell
Tony Schaffer
Lynne Seward
Brian Shenal

Educational Presentations

Following a break, the Council heard three excellent presentations:
• Amanda Lineberry – Capstone Project on Sharing of Brain Injury Data
• Elizabeth Horn – disability Law Center of Virginia (dLCV) Report on Brain Injury
• Tracy Topolosky – Post-Acute Caseload/Vocational Rehabilitation Initiative.

ACTION ITEM: Patti Goodall suggested that the Council could send a letter to Commissioner Rothrock endorsing this “earlier intervention” approach to serving individuals through the Vocational Rehabilitation agency. The letter could express great interest in this promising approach and ask DARS to continue to collect and monitor data on its effectiveness, with the possibility of replicating these services in all geographic areas of Virginia. The Council agreed to this by consensus, and DARS staff will draft a letter to be sent to Commissioner Rothrock.

Closing Protocol - Jodi Power, RN, JD, Chair

Jodi Power noted the 2016-17 quarterly meetings of the Council (typically held on Fridays at DARS Central Office from 1-4:00 p.m. unless noted otherwise). Donna Cantrell stated that the 2017 Brain Injury Report Out Day will serve as the Council’s regular quarterly meeting for July. Council Members are encouraged to note these important dates on their calendars:

• October 21, 2016, is to be held at an alternative location – information will be forthcoming.
• Friday, January 27, 2017 (location will be at DARS Central Office)
• Friday, April 28, 2017 (location will be at DARS Central Office)
• Friday, July 28, 2017 (this will be Brain Injury Report Out Day)
Friday, October 21, 2017 (this will be held at the Virginia War Memorial - further details will be provided)

The meeting was adjourned at 4:05 p.m.