The Virginia Department for Aging and Rehabilitative Services

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Meeting Minutes

Virginia Brain Injury Council

Virginia Brain Injury Council April 2017 Minutes DRAFT
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VIRGINIA BRAIN INJURY COUNCIL MEETING MINUTES Friday, January 27, 2017 1:00 p.m. to 4:00 p.m. Members Present: Mark C. Bender, PhD (Chair) Tree of Life (TOL) Jodi Power, RN, JD (Immediate Past Chair) Department of Health Professions (DHP) Lisa Bradford (Vice Chair) Salem Veterans Administration Medical Center John Heath Family Ombudsman Krystal Thompson (via phone) VA Alliance of Brain Injury Service Providers (VABISP) Frankie Brewster Family Member (Charlottesville) Devin Bowers Department for Aging and Rehabilitative Services (DARS) Jo Chan Survivor (Southwest Virginia) Anne McDonnell Brain Injury Association of Virginia (BIAV) Maria Stransky Department of Corrections (DOC) Cara Meixner, PhD (via phone) James Madison University (JMU) Shasmin Asbury Community Brain Injury Services (CBIS) / Denbigh House Patricia Goodall, Department for Aging and Rehabilitative Services (DARS) Deborah Johnson Department of Education (DOE) Gayl Brunk Valley Associates for Independent Living (VAIL) Nia Harrison (for John Cimino, JD) Virginia Board for People with Disabilities (VBPD) Susan Rudolph (for Dawn Adams) Behavioral Health and Developmental Services (DBHDS) Mike Puglia Thomas Dale High School Monique Wilson, PhD Western State Hospital (WSH) Barbara Seymour Department of Medical Assistance Services (DMAS) Mark Murphy Department of Juvenile Justice (DJJ) Members Absent: Laurie Silva (Secretary) NeuroRestorative Thomas Campbell, PhD McGuire Veterans Medical Center Lisa Wooten Virginia Department of Health (VDH) Betty Ann Liddell Department of Veterans Services (DVS) / Virginia Veteran and Family Support (VVFS) Program Tony Shaffer Survivor (Northern Virginia) Julie Triplett disAbility Law Center of Virginia (dLCV) Others in Attendance: Donna Cantrell (Staff to Council) Department for Aging and Rehabilitative Services (DARS) Mary Margaret Cash Department for Aging and Rehabilitative Services (DARS) Debra Holloway Brain Injury Association of Virginia (BIAV) Bryan Pugh Brain Injury Association of Maryland (BIAM) Paula Margolis, PhD Joint Commission on Health Care (JCHC) Max Quillen Caregiver Jason Young Community Brain Injury Services OPENING PROTOCOL: Mark Bender, Chair Mark Bender, Chair, called the quarterly business meeting of the Virginia Brain Injury Council to order at 1:01 p.m. Approval of the January 27, 2017 Meeting Minutes Lisa Bradford made a motion to accept the minutes of the January 27, 2017 meeting; Jodi Power seconded the motion, noting a small correction to her name on the last page. The minutes were approved unanimously, with the noted change. Approval of April 28, 2017 Meeting Agenda Jodi Power made a motion to approve the agenda for the April 28, 2017 meeting; Frankie Brewster seconded the motion. The agenda was approved unanimously. Public Comment Period Mark Bender, Chair, opened a public comment period by asking if there were any members of the public present who wished to make comments before Council. No one came forward to provide comments. UNFINISHED BUSINESS Nominations and Elections Committee – Lisa Bradford, Committee Chair • DARS’ Commissioner Rothrock appointed three members, with terms of April 2017 - March 2020:  Jo Chan, Survivor (Lyndhurst)  Monique Wilson, PhD, Neuropsychologist, Western State Hospital (Staunton) – Individual affiliated with hospital or healthcare setting  Mike Puglia, Athletic Trainer, Thomas Dale High School (Chester) - Individual representing organization that does NOT receive state general funds • Lisa Bradford, Chair of the Nominations and Elections Committee, noted that at the January meeting the full Council approved the slate of candidates prepared by the Committee, and it was then forwarded to DARS Commissioner for final approval / appointment. Of the five (5) candidates included on the slate to fill three vacancies, Commissioner Rothrock appointed only one new member, and sent the slate back to the Committee, requesting that it seek out candidates who are more representative of Virginia’s diverse population. • Anne McDonnell asked if the second slate of more diverse nominees came from Council members, or from external contacts; Donna Cantrell noted that the second round of nominations came mostly from solicitation of external sources. Ms. McDonnell stated that she sees nothing wrong with the Council’s current method of soliciting nominees, but there is a clear need to implement a more effective approach that results in a greater diversity of candidates for appointment. Monique Wilson discussed the possibility that Council perhaps get more involved in local communities and in underserved areas of the state, thereby extending its network of potential nominees in the future. Lisa Bradford noted that the Nominations and Elections Committee looked at the credentials, qualifications, and experiences of all candidates, but admitted that the Committee did not necessarily consider demographics beyond region, veteran status, and vacant position on the Council. John Heath stated that he felt qualifications and experiences were the most important factors when selecting nominees to serve on Council, and that race / ethnicity should be a consideration during the initial solicitation phase only. • John Heath asked Council to formally express its intent and commitment to filling Council vacancies by enhancing outreach to more diverse candidates for nomination, better reflecting Virginia’s population. Anne McDonnell made the motion that “Council formally express its intent and commitment to implement a nominations process that results in more diverse and inclusive candidates to fill vacancies.” Jodi Power seconded the motion. The motion passed unanimously. DARS staff will draft a letter to be sent to the Commissioner from the Chair. • Mark Bender noted that Dr. Will Carter, a Commissioner Designee member, resigned his appointment this past winter due to competing work activities, but he expressed appreciation and admiration for the work of the Council. DARS staff will prepare a letter of appreciation for Mark Bender’s and Commissioner’s signatures, to be sent to Dr. Carter. • DARS staff noted that an updated Council member roster will be posted on the VBIC website. DARS Lead State Agency Update – Patti Goodall and Donna Cantrell • DARS staff discussed that DARS’ Federal TBI Grant moved from its original home with the Health Resources and Services Administration (HRSA) to the Administration on Community Living (ACL). They noted that it has been a good move – TBI is a better “fit” under ACL – and that ACL has been very supportive and committed to getting up to speed in TBI issues, concerns, and activities. ACL has opened up communication channels through telephone calls, list serves, newsletters, and face-to-face meetings. There is one year left on DARS’ federal TBI Grant, and ACL plans to release a Request For Proposals (RFP) near the end of this grant cycle (ending May 31st). • Brain Injury Report Out Day (BIROD) will be held on Friday, July 28, 2017 at the University of Richmond (UR) Jepson Alumni Center. Related to BIROD, the Council needed to choose the recipient of the Council’s Brain Injury Champion Award, to be presented at the event. Council discussed several names, including Delegate Chris Peace, who is an Eastern Hanover Republican and a strong supporter of brain injury. Anne McDonnell made a motion to nominate Delegate Chris Peace for the Council’s 2017 Brain Injury Champion Award; John Heath seconded the motion. Motion passed unanimously. • The General Assembly approved $375,000 in restored funds which will be added to the DARS budget and returned to the BIS Programs during State Fiscal Year 2017 (ending 6/30/17). DARS anticipates that it will receive final confirmation of availability of funds in early May. Funds that cannot be expended prior to June 30th by the BIS Programs will be used by DARS for brain injury related activities and purchases (e.g., professional training, retreats for BIS Programs directors/administrators and for direct services staff). Brain Injury Association of Virginia (BIAV) / Virginia Alliance of Brain Injury Service Providers (VABISP) –Anne McDonnell • Anne McDonnell discussed several legislative studies and initiatives over the past few years that involved DARS, DBHDS, and DMAS. Two years ago, DBHDS led a workgroup to explore the creation of a demonstration waiver for neurobehavioral care.The Joint Commission on Health Care report lead to a DMAS workgroup to look at methods to improve data capture on the annual incidence of brain injury and the cost of out of state placements for neurobehavioral care. This year, the Joint Commission on Health Care (JCHC) assigned further brain injury related studies to both DARS and DMAS, with due dates of November 1, 2017. • Anne also discussed legislative / funding for federal brain injury programs; including potential reductions to funds that support the TBI Act grants and TBI Model Systems programs. • Barbara Seymour provided an overview of DMAS’ Joint Commission on Heath Care (JCHC) study which directs the agency to “1) determine Medicaid payment rates / methods that will incent the opening / ongoing operation of in-state neurobehavioral /nursing facility units for individuals with brain injury and dementias with challenging and aggressive behaviors; and (2) determine a plan, including budget estimates, to add new services to the Medicaid Elderly and Disabled with Consumer Direction (EDCD) Waiver to provide needed long-term services and supports for Medicaid beneficiaries.” Council members Patti Goodall of DARS and Anne McDonnell of BIAV serve on DMAS’ work group. • Ms. Seymour was asked to explain the term “Medicaid Waiver” for new members. She stated that Medicaid historically pays for individuals who reside in institutional settings such as long-term care facilities. A Medicaid Waivers essentially allows Medicaid funds to be used to pay for alternatives to institutionalization, thus “waiving” the requirement that the Medicaid funds be used only for institutional options. Medicaid requirements are “waived” to allow individuals with certain disabilities to remain in or re-enter community settings versus institutions, although there are numerous federal guidelines / requirements that a state must follow in order to be able to offer Medicaid Waivers (e.g., cost neutrality: the community services cannot exceed the cost of the institutional services). • Patti Goodall provided an overview of DARS’ Joint Commission on Health Care (JCHC) study which directs the agency to form an “Implementation Team to identify unmet needs, determine solutions for meeting unmet needs, establish priorities for implementing the solutions, develop an implementation plan and timeline, and most importantly, implement the plan. The JCHC envisions that the first task of the team will be to determine the desired program components, identify needed federal, state and local authorities, develop cost estimates and potential cost offsets, and report the results to the JCHC by November 1, 2017.” Council members Barbara Seymour of DMAS, Susan Rudolph of DBHDS, and Anne McDonnell of BIAV serve on the work group, along with a few other state agency representatives. DARS is scheduling an initial conference call, and anticipates that the group will likely meet 3-5 times over the next six months. • Patti Goodall expressed her gratitude to Cara Meixner and Cynthia O’Donoghue from James Madison University (JMU) and to Paula Margolis (JCHC) for their past work, noting that their exhaustive research efforts helped to propel this issue forward. Council was in unanimous agreement. NEW BUSINESS • Jason Young, Executive Director of Community Brain Injury Services (CBIS) in Richmond - which operates two clubhouse programs in Richmond and Newport News - presented an overview of the clubhouse model of day program, including history and current status. Slides available upon request. • By-Laws Committee Report – Laurie Silva, Chair o Since Laurie Silva was out sick, Donna Cantrell reported on her behalf that the By-Laws Committee has not met yet, but that dates are being scheduled. Committee activities will be conducted via e-mail/conference call. Council will vote on revisions prior to the July meeting. • Priorities Committee – John Heath, Chair o John Heath stated that the Priorities Committee is beginning its work and that a final draft of the 2017 Annual Priorities Letter will be reviewed at the July Meeting. • Funds Dissemination Committee – Gayl Brunk, Chair o On behalf of DARS, Patti Goodall noted for the Council’s information that the Funds Dissemination Committee does not need to convene this year, as there are no new state general funds for brain injury services to be considered. • Devin Bowers, DARS Dementia Services, reported that she and Donna Cantrell are co-chairing the Education Subcommittee of the Virginia Caregiver Coalition, a statewide group whose mission is to advocate and educate for and about caregivers / caregiver issues. As co-chairs, Devin and Donna are seeking input from Council on developing a roster of speakers/presentations, which could include brain injury specific topics, and broader caregiver-related topics such as crisis intervention protocols or services for respite and self-care. Council members are invited to attend meetings; DARS staff will e-mail Council members notifying them of the date / time / location of the next quarterly meeting (May 11th in Richmond). Staff will also send e-mail to Council soliciting suggestions on speakers and topics for the Virginia Caregiver Coalition meetings, although members may submit immediately. • Anne McDonnell asked to address Council and noted that Karen Brown, Executive Director of Brain Injury Services, Inc. in Northern Virginia is retiring this summer. She noted her longevity and leadership in brain injury in Virginia, reminded Council members that she also served as Chair of the Council, and asked the Council to consider formally thanking Karen for her many years of dedicated and innovative services to person with brain injury and their families. Jodi Power motioned that “Council formally recognize Ms. Karen Brown, Executive Director of Brain Injury Services, Inc. in Springfield, for her leadership and significant accomplishments in brain injury services in the Commonwealth of Virginia”; Anne seconded the motion. Patti Goodall asked, as clarification, if Council wished to prepare a formal letter to be presented on its behalf to Karen at her retirement event. John Heath asked if the motion could be amended with “prepare a formal letter to be presented on its behalf to Ms. Brown at her retirement even in June 2017”; Frankie seconded the amended motion. The motion, with the amendment, passed unanimously. • Since the next meeting of the Virginia Brain Injury Council on July 28, 2017 will be Brain Injury Report Out Day, there was a question about whether or not there would be a business meeting of the Council that day. There was consensus that at some point during the day, the full Council should convene briefly to address business items. Donna will consider this as the final agenda is prepared. CLOSING PROTOCOL: Mark Bender, Chair • Future meeting dates:  July 28, 2017 (DARS/VBIC’s Brain Injury Report Out Day, University of Richmond)  October 27, 2017 (October meeting to be held at Wilson Workforce and Rehabilitation Center – WWRC - in Fishersville) • Mark Bender adjourned the meeting at 3:25 p.m.