Brain Injury Advisory Committee Meeting Minutes Date: July 21, 2016 Place: Ohio Union Columbus, Ohio 43210

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Brain Injury Advisory Committee Meeting Minutes Date: July 21, 2016 Place: Ohio Union Columbus, Ohio 43210 Attendees Members: Dan Arnold, Jo Ann Boggs, Steven Cuff, Ryan Frick, Amy Horner, Jeffery Leonard, Diana Pollock, Stephanie Ramsey, Elizabeth Sammons, Kathy Stachowski Brain Injury Program Staff: John Corrigan, Monica Lichi, Hannah Thompson, Dominic Sauer Volunteers: Cathy Csanyi, Danny Eakins, Carol Fowler, Joseph Hill, Laura Holtsberry, Donna Rudderow, Teri Smith, Ty Smith Guest: Lance E. Trexler Old Business - Minutes approved with one correction - Diana Pollock attended last meeting but her name was not on the list of attendees. She will be added. Welcome and Introductions - Dr. Corrigan started the meeting with the introduction of Lance Trexler, PhD, HSSP, FACRM o Dr. Trexler is the Executive Director, Departments of Rehabilitation Neuropsychology and Resource Facilitation, Rehabilitation Hospital of Indiana Dr. Trexler s Presentation on Resource Facilitation - Resource Facilitation o To provide brain injury specific education and promote awareness of resources to individuals with TBI, their families, other providers and the community o To proactively navigate the person and their family to needed instrumental, brain injury specific, community and vocational support and services such as housing, transportation and community supports o To ensure collaboration, integration and coordination between providers and community based resources - Review of Dr. Trexler s seven-year research and program development, resource facilitation model o The program started as collaboration between Indiana VRS and RHI in 2008. Since then, there have been three HRSA grants and one Indiana Spinal Cord and Brain Injury research board grant. Oversight has been provided by the Indiana Brain Injury Leadership Board

- Studies o o Between 35%-40% of people with traumatic brain injuries return to work within 2-5 years o Barriers to return to work involving the individual and family are persisting cognitive and behavioral impairments caused by brain injury and certain percent of individuals become more disabled over time Started out in central Indiana and eventually spread throughout the entire state Indiana Vocational Rehabilitation Group 67% of the people were returned to work or school Expansion to Ball State Found the total economic impact in lost wages to be 31,017,775 (Based on 64% return to work rate) Replicating findings in the ARC with a larger sample size Individuals were able to return to work quicker as well as perform workplace duties successfully Individuals were 7 times more likely to participate in community-based work Developed policy position to fund resource facilitation services with two qualifications o Have acquired brain injury o Desire to return to work or school - Q&A Topics o Question regarding Dr. Trexler s Referral System Want to refer individuals as soon as they complete rehabilitation Local support networks get referrals from the community and connect the individual with a brain injury rehabilitation specialist in the area, they then follow up with the patient and family so they can ensure the patient/family gets the help they desire o Policy changes that needed to occur in Indiana A policy decision came out of Dr. Trexler s group in Indiana. Had a Senator and a Legislator actively involved throughout the entire process. Between the Senate, House and government agencies at the table, they made a fairly easy policy This policy saved 70 million dollars a year and put 655 people back to work - Dr. Corrigan noted that this is an example of taking a model, testing it for its efficacy, using the data to convince policy makers and turning it into a state wide program o It starts with expertise about the condition and having the leeway to navigate the other systems needed by the individual o It s a holistic approach, working on the patients injury, life, housing, family ties and financial ties. This can be an issue for some as it means working with someone before they are officially a client

- Our own strategic directives include 3 areas similar to those in Dr. Trexler s model - Home and Community Based, Return-To-Learn, and Behavioral Health best practices Strategic Plan - Infrastructure to support the plan o Still looking into how we will obtain the resources to implement the plan o Updates for the Ohio TBI Act Main focus of the biennium is on our one-pager explaining why we need the Ohio TBI Act We need additional legislation and resources. We did not try to tackle every area. The plan itself lays out a few modest goals with focus on specific areas We proposed to expand our annual funding from $127,000 to $500,000 The back of the form explains how we plan to use the new funds on a series of projects. It is a restating of the strategic plan o Using the $500,000 expanded funding Continue the SBHP Program, continue the BRFSS module New program capability, 40% of the money - $200,000 Fund 1 FTE Return to Learn specialist o A system change effort Fund 1 FTE TBI and behavioral health specialist o A system change effort Materials for public awareness campaign o We will need funding for people as well as materials Add 1 FTE office manager o To work on brain injury program alone - Where we are o Ohio Brain Injury program staff, along with Danny Eakins and Adreana Tartt, met with the Ohio Department of Mental Health and Addiction Services, Department of Veteran s Services and Ohio National Guard to figure out how to keep the SBHP Program going funding ended June 30 th. Developing plans to touch base with other places to acquire funding, especially for this current fiscal year. Made a commitment to keep the doors open enough to maintain the registry o The meeting was positive, and people are interested in supporting the long term and short term funding needs Workgroup Summaries - Services Workgroup o The Services Workgroup is continuing to talk to different representatives in different states on the issues of community integration resources o Already talked to Dr. Trexler, who spoke at this meeting, and Tonia Wells, director of TBI program in Kentucky

o Also talked to representatives in Colorado, Minnesota and Alabama. The idea is to learn from the other states, learning from their successes and challenges - Communications Workgroup o The Communications Workgroup is working on preservice training o Additionally, this group is looking at the 5 th edition of The Essential Brain Injury Guide o Gathering information and contacts on key groups for issues and support, and exploring what can be done to better awareness of all the resources within the state - Data Workgroup o The Data Workgroup has settled on a set of elements in the report, including incidence of injury, severity of injury, longitudinal analysis, prevalence data and personal narratives from individuals with TBI or family members of individuals with TBI o Attempting to do environmental scan of other states that have done cost benefits - it will include the 2013 and 2014 data o The next biennial report is due September 2017 - Training Workgroup o The Training Workgroup focused on Return-to-Learn Dr. Susan Davies talked about the pilot project at the last BIAC meeting Next step is rolling it out state wide Dr. Davies developed a couple webinars for administrative teams and teachers, still continuously looking for more ways to get the information out State Agency Updates - Department of Medicaid o Approval to change eligibility determination. Moved from 209b to 1634 o This is beneficial for those that have to make use of spend-down o Work is going forward on behavioral health redesign o Date of effect is changed from January 1 st to July 1 st of 2017 - Department of Mental Health and Addiction Services o Behavioral redesign doing trainings with providers, face to face and web-based o Changes have brought about a lot of questions and the questions have been robust o A lot of focus on suicide prevention and trauma trainings - Department of Public Safety o Data based, EMS has been in a 3 year transition into data systems o 2015 data is looking good in terms of submission, getting back on 2013 and 2014 - Department of Education o Review of the brain injury document that was given out in June o An interesting piece from the article is the federal government is being asked to expand PBIS to include interventions and supports for children with TBI problems as well as work with guidance counselors and schools to assist students with TBI - Department of Aging o Have not yet identified a replacement member for this Committee

- Opportunities for Ohioans with Disabilities o Every year the Governor s council offers awards to businesses, nonprofits etc. but the deadline for applications is the first week of August o Go to the www.ood.ohio.gov website and click the Ohio Governor s council link and it will give you details on the awards News & Announcements Smith Connections - Partnered with Notre Dame to start a nonprofit - Organizing a 5k; details will be sent via the listserv Diana Pollock BIAOH - Distributed information: Stay Out of Nursing Home, Seniors Guide to Prevent Falls - Actively recruiting new members - Met with the Ohio Coalition on Domestic Violence to do a presentation discussing TBI - Wexner Center for the Arts has started a new support group program, Art on the Brain TBI Resource Center in Toledo - The center is really taking off they have added a lot of programming during the day and now have therapists rotating every hour - Adding in a software company that donated IPads to help with therapeutic exercises Meeting Adjourned Date for Upcoming Meetings - October 20 th, 2016-2017: January 19, April 19, June 20, October 19