medicaid independence plus may 9, 2002

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Brain Injury Association of America

MedicaidIndependence Plus

May 9, 2002A Demonstration Program for Family or

Individual Directed Community Services

• Person-Centered Planning;

• Individual Budgets;

• Group Living No More Than 4 Persons;

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Independence Plus, cont.

• Target Groups: NEW, first time ever listed on a Medicaid Waiver Form…………….

Brain Injury (Acquired)

Brain Injury (Trauma)

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Nursing Home Residents

Age Distribution:Under 65 years - 8.5%65-74 years - 12.3%75-84 years - 32.8%85 years and over - 45.9%

Source: National Center for Health Statistics March 1, 2000

All families-1997Total: 1,608,700

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Self Determination 2001

• People With Brain Injury Are

“Speaking Out”

About Quality in Services

National Center on Outcomes Resources

(410) 583-0060

Info@the council.org

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Speaking Out

• “I don’t want to feel that I am just getting the same prepackaged deal as everyone else. Make it about ME.”

• “My goals should be just that…MY choice.”

• “Before you ‘release’ me to the community, help me to build a support network.”

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Speaking Out

• “I still have a vision for my future. Don’t take that from me. Rather, help me make it clearer.”

• “Invite me to the table where decisions are made about me. Welcome me and adapt my environment so that I can function at my maximum potential.”

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Speaking Out

• “Please be honest about what you can and cannot offer me. If there are limits and caps, let’s negotiate priorities together. Take the time to know me as a person. Take the time to find out who I was before the accident. My self-esteem is tied to who I was yesterday and who I am today.”

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Speaking Out AboutQuality of Life

• “Quality of life is freedom and independence.”

• “Quality of life is having the opportunity to wake up in the morning with a purpose and the ability to pursue it.”

• “Quality of life is having the opportunity and tools to achieve my goals.”

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NIH Consensus Development Conference, October 1998

Rehabilitation of Persons with

Traumatic Brain Injury

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NIH Panel Recommendations

• Rehabilitation Services should be matched to the needs, strengths, and capacities of each person with TBI and modified as those needs change over time.

• Rehabilitation Programs for persons with moderate or severe TBI Should be interdisciplinary and comprehensive.

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NIH Panel Recommendations-2

• Families and significant others provide support for many people with TBI. To do so effectively, they themselves should receive support. This can include in-home assistance from home health aides or personal care attendants, daytime and overnight respite care, and ongoing

counseling.

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NIH Recommendations-3

• Rehabilitation efforts should include modifications of the individual’s home, social and work environments to enable fuller participation in all venues.

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• Community-based nonmedical services should be components of the extended care and rehabilitation available to persons with TBI. These include but are not necessarily limited to clubhouses for socialization, day programs and social skills development programs, supported living programs and

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• Independent living centers, supported employment programs, formal education programs at all levels, case manager programs to support practical life skill redevelopment and to help navigate through the public assistance and medical rehabilitative care systems, and consumer,

• peer support programs.

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Medical “Model”

VS

Psychosocial “Model”

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Brain Injury Association of America Brain Injury Association,

Inc.

FROM A CONTINUUM OF

CARE TO AN ARRAY OF

INDIVIDUAL AND FAMILY

SUPPORTS

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PRINCIPLES OF SELF DETERMINATION

• FREEDOM

to plan a real life• AUTHORITY

to control a limited amount of resources• SUPPORT

for building a life in one’s community• RESPONSIBILITY

to give back to one’s community

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Goals of the ADA

• Equality of Opportunity

• Full Participation

• Independent Living

• Economic Self Sufficiency

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ADA Integration Mandate

“A public entity shall administer services, programs and activities in the

most integrated setting appropriate to the needs of qualified individuals with

disabilities” 28 CFR Section 35.130(d)

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Belonging

be-long, v. 1: to feel and be a part of …i.e. of a community, a workplace, a neighborhood or school 2: to enjoy a sense of contribution, value, self-worth 3: to truly believe one is a natural and equal part of the whole 4: comfortable, safe, cared for, welcome.

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A Successful Community Life

• Housing

• Health Care and Appropriate Medical Services

• Mental Health/Behavioral Health Services

• Education/Higher Education

• Employment/Supported Employment

• Transportation

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Successful Community Life - 2• Assistive Technology and Devices

• Leisure and Recreational Activities

• Friends and Relationships; Support Circles

• Community Support Workers

• Customer Choice and Control

• System Infrastructure

• Quality Assurance

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Any item, piece of equipment or product system whether acquired commercially off the shelf, modified or customized that is used to increase, maintain or improve functional capabilities of individuals with disabilities.

Assistive Technology Device

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Assistive Technology and People with Cognitive Disabilities

• Brain Injury Association of America

• Moss Rehabilitation

• Temple University

• University of Akron

• Spaulding Rehabilitation

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Falls and TBIAmong Older Adults Aged >65

• Two-thirds of all fall-related TBI deaths occur among older adults

• One-half of all fall-related TBI hospitalizations occur among older adults

Pacific Inst. For R&D, Unpub. Data, 1997

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Costs of Fall-Related TBI’s inOlder US Adults Aged>65(1997)

• Estimated total lifetime costs for fall related TBI’s were $3,300,000,000 ($3.3Billion)

- Two-thirds of these costs were among those aged 75 and older

• The average lifetime cost per person was $180,000

Pacific Inst. For R&D, Unpub. Data, 1997

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Percentage of US Population Over 65 Years of Age

0

5

10

15

20

25

1950 1970 1990 *2010 *2030 *2050 *2070

Percentageof US

population over 65

* projections

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Elder Fall Prevention Act of 2003

S. 1217 June 9, 2003• Senators Enzi and Mikulski• To develop effective public education

strategies carried out by the National Safety Council

• To expand needed services and conduct research in prevention and treatment

• To evaluate the costs to Medicare and Medicaid and potential for cost reduction

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Family Helpline1-800-444-6443

Over 17,000 calls in 2002

Se Habla Espanol

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Centers for Disease Control & Prevention

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National Information Center for Traumatic Brain Injury

• Three year cooperative agreement• $250,000 in year 1• Pilot in Mississippi and Wisconsin• Opportunities to leverage private corporate

dollars• One universal 800 number widely

advertised and disseminated; uniform data base; information and linkage to services

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AACBIS Corporate Advisory Council

• Bancroft Neurohealth

• Casa Colina Centers for Rehabilitation

• Centre For Neuro Skills

• Gentiva Rehab Without walls

• Lakeview NeuroRehabilitation Centers

• Learning Services Corporation

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AACBIS Corporate Advisory Council (cont.)

• The May Institute, Inc.

• The Mentor ABI Group

• Rainbow Rehabilitation Centers Inc.

• ReMed

• Robert Voogt & Associates

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A world where all preventable

brain injuries are prevented, all

unpreventable brain injuries are minimized and all individuals who

have experienced brain injury maximize

their quality of life

Vision Statement

medicaid independence plus may 9, 2002

Documents