North Carolina
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BRAIN INJURY ADVISORY COUNCIL (BIAC)
Date: 9/7/2016 Time: 9:30-3:30 pm Location: Alliance Behavioral
Healthcare – Wake Site
5000 Falls of Neuse Rd; Raleigh, NC
|TYPE OF MEETING | Quarterly Meeting |
|FACILITATOR |Holly Heath-Shepard, Chairperson |
|ATTENDEES |
| NAME |PRESENT |NAME |PRESENT | |
|Voting Council Members | |Non-Voting Council Members | |GUESTS |
|Holly Heath-Shepard, Chair | |Jeanne Preisler | |Carol Ornitz |
|Jerry Villemain | |Jenny Still | |David Forsythe |
|Carol Gouge | |Jim Swain | |Courtney Schenck |
|Lynn Makor | |Alan Dellapenna | |Laura O’Neal |
|Craig Fitzgerald | |Spencer Clark | |Diane Harrison |
|Martin Foil | |Deb Goda-Kenneth Bausell, Rep | |Erin Whitely |
|Ana Messler | |Amy Douglas | |Betsy MacMichael |
|Thomas Henson | |Cindy DePorter | |Norman Case |
|Ken Jones | |Chris Egan | |Thomas Goldsmith |
|Evelyn McMahon | |Michele Elliott | |Laurie Stickney |
|Sara Stroud | |Dreama McCoy | |April Groff |
|Kenneth Wilkins | |Jim Prosser | |Sara Wilson |
|Vicki Smith | |Jerome Frederick | |Donald McDonald |
|Carmaletta Henson | | | |Marilyn Lash |
|Brandon Tankersley | | | |Susan Johnson |
|Janice White | | | | |
|Donna White | |Staff to Council | | |
|Jean Anderson | |Scott Pokorny | | |
|Pier Protz | |Travis Williams | | |
|Karen McCulloch | |Sandy Pendergraft | | |
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1. Agenda topic: Welcome, Review of Minutes and Introductions Holly Heath Shepard
|Discussion |The Chair welcomed the attendees and introductions were made by all the Council members and guests. |
| |Minutes from the previous Council Meeting (6-8-16) were reviewed and approved by all with a motion from Thomas Henson and |
| |seconded by Brandon Tankersly. |
| |Holly Heath-Shepard, Chair gave an update on current Council seats, which she stated that all seats are currently filled with |
| |the exception of the last two, which include Spencer Clarks’ seat – Spencer stated that he is unable to attend the meetings, but |
| |is interested in continued involvement by working “behind the scenes” with Scott Pokorny. Scott Pokorny talked to group about |
| |the person from DMH/DD/SAS who may be filling this seat. Scott spoke with the acting Director of DMH/DD/SAS to identify staff |
| |member within the substance abuse section who works with the veteran population. The position is currently being filled. |
| |Hopefully, this person will be hired and available for the seat by the council’s next meeting. The other seat is one left by Dr.|
| |Erwin Manalo – he moved to Kentucky. Will be looking for a MD with expertise in trauma, neurosurgery, neuro-psychology, |
| |physical, medical, rehabilitation or emergency medicine. New appointments: Jerome Frederick has been approved as a council |
| |member. Carol Gouge is a survivor of brain injury from eastern North Carolina is filling the seat left vacant by Brian Volk and |
| |Jim Prosser, Assistant Secretary of Veterans Affairs is filling the seat left vacant by Ilario Pantano. |
| |Ken Jones from BIANC announced the annual professional conference, “Life after TBI – It takes a Community” on October 28, 2016 at|
| |Wake Med Hospital. He also announced the CBIS course coming up November 30, December 1 & 2, 2016. More information available on |
| |the BIANC website – . |
| |Holly reminded everyone that according to the Council’s bylaws we will follow Robert’s Rules of Order. If you have |
| |questions/comments, please raise your hand and wait to be acknowledged. |
|Conclusions |The minutes were adopted as presented. |
| |Two seats to be filled on BIAC. |
|Action Items |Person(s) Responsible |Deadline |
|Two BIAC seats to be filled |Holly Heath-Shepard & Scott Pokorny |12/7/16 |
2. Agenda topic: State Fund Expenditures for fiscal year to date; Annual data from LME/MCOs; Claims data reviews; ACL Grant Update; TBI State Plan Scott Pokorny
|Discussion |Scott Pokorny presented information on the TBI Program Report, which included: |
| |TBI State Funds |
| |Total TBI state funds legislative appropriation for SFY15-16 was $2,373,086. This includes all LME/MCO allocations, BIANC and TBI|
| |Project Star contracts. |
| |Out of this total amount, $2,013,868 was allocated to the LME/MCO’s for individuals with TBI in each of their catchment areas. |
| |Most LME/MCO’s used their total allocation amount. |
| |Out of the total LME/MCO allocation, $1,938,409.40 was spent. This leaves $75,458.60 unspent. |
| |Reasons for unexpended funds: |
| |provider staff turnover/open positions |
| |consumer hospitalizations during times services were scheduled to be delivered |
| |services provided but provider agency did not submit invoices by billing cut-off date |
| |money transferred from one LME/MCO to another did not get expended |
| |A combined total of $1,001,330.78 was used from other funds in order to meet consumer service and support needs. |
| |Most common services and supports provided through the TBI state funds allocations |
| |Transportation |
| |Residential Facility |
| |Personal Care |
| |Day Program/Day Treatment |
| |Respite |
| |Vocational Supports |
| |Clubhouse |
| |Equipment |
| |Developmental Therapy |
| |Other Therapy |
| |Medication/Supplies |
| |Van Repair |
| |New annual TBI program report - Purpose |
| |To obtain data from the LME/MCO’s to better understand demographic information about the TBI state funds programming. |
| |Data elements |
| |Total amount of funding being requested for the upcoming fiscal year |
| |Total number of people projected to be served in the upcoming fiscal year |
| |Services to be funded |
| |Total number of people served in the previous fiscal year |
| |Total number of people unable to be served in the previous fiscal year |
| |How is this data helpful? |
| |Identifies number of individuals that access this program per catchment area in a given year. |
| |Identifies challenges in funding levels statewide. |
| |Provides information about the numbers of individuals that could benefit from the program if increased funding was available. |
| |Provides information about the funding level needed in order to serve the identified number of individuals with TBI per catchment|
| |area. |
| |Provides information about the specific types of services that are being funded through the program. |
| |SFY 15-16 Contracts – Brain Injury Association of NC |
| |HRSA Grant Contract (June 1, 2015 - May 31, 2016) |
| |83% expended |
| |Primary reason for reduced expenditure: trainer position vacant for majority of the contract year. |
| |All deliverables were met |
| |State Contract (July 1, 2015 - June 30, 2016) |
| |98% expended |
| |All deliverables were met |
| |Carolina’s Healthcare/TBI Project Star |
| |State Contract (July 1, 2015 - June 30, 2016) |
| |82% expended |
| |Primary reason for reduced expenditure: coordinator position vacant for six months of the contract year. |
| |All deliverables were met. |
| |ACL Grant Contract - $246,984 |
| |State Contract - $359,218 |
| |SFY 16-17 LME/MCO allocations |
| |All LME/MCO’s will maintain the same allocation they had last fiscal year except Cardinal. That LME/MCO will receive their |
| |previous allocation plus the allocation that had gone to CenterPoint last year as a result of the merger. |
| |HRSA grant highlights |
| |BIANC website |
| |2308 contacts -- 62% from professionals and 32% from survivors and family members |
| |17,169 sessions by 11,954 users -- 67% were new visitors and 33% returning visitors |
| |Screening data |
| |Alliance |
| |May 1, 2015 through May 31, 2016 - 210 individuals screened as possibly having a TBI. |
| |June 1, 2016 through August 31, 2016 - 31 individuals screened as possibly having a TBI. |
| |Resource Facilitation |
| |June 1, 2015 to May 31, 2016 there were 228 technical assistance contacts. |
| |Provided to Alliance, CommWell FQHC and providers within the pilot area. |
| |Collaboration |
| |New partnerships continue to be developed with NC Governor’s Group for Veterans, Independent Living Council, NC Coalition on |
| |Aging and many others. |
| |Regular Steering Committee and Evaluation Committee meetings occur. |
| |Education/Training |
| |Trainings continue to be provided regularly to mental health/substance use providers, residential providers, medical centers, |
| |LME/MCO’s and many other entities. |
| |Training curricula have been updated. |
| |Training library is being developed. |
| |Proposals submitted to present at conferences and workshops. |
| |The updated online TBI training at is being managed by BIANC effective July 1, 2016. |
| |Sustain |
| |BIANC will continue to maintain and update the website, including online resource guide. |
| |BIANC offers Neuro-Resource Facilitation statewide through each satellite office. This statewide service has been integrated into|
| |their contract. |
| |All four BIANC Education and Resource Coordinators offer training statewide. This is an integral part of their contract. |
| |TBI screening is being integrated into all LME/MCO systems. |
| |Additional sustainability activity will be explored. |
| |Other grant updates |
| |TBI grant moved from HRSA to ACL effective June 1, 2016. |
| |NC began Year 3 of the grant on June 1, 2016. |
| |ACL has advised that state grantees are required to continue to execute the plan they provided in their HRSA grant applications |
| |to provide information and referral services, professional training, screening for TBI, and resource facilitation to increase |
| |access to these services |
| |There have been four core components to a TBI infrastructure that include: |
| |A statewide TBI advisory board, |
| |A lead state agency for TBI, |
| |A statewide assessment of TBI needs and resources, and |
| |A statewide TBI action plan. |
| | |
| |Establishing or sustaining these four core components was required by previous Implementation Partnership Grant Program funding, |
| |but is not required by the funding released in 2014. However, federal statue continues to require these from states. |
| |Other TBI program initiatives |
| |TBI Screening |
| |Will occur at most of the LME/MCO’s. Some will conduct the screening through their access centers while others will implement |
| |through their contracted assessment agencies throughout their catchment area. |
| |The participating LME/MCO’s will use the Ohio State Screening Tool. |
| |Data will be submitted to the TBI program at DMH/DD/SAS quarterly. |
| |DMH/DD/SAS will provide the data to the legislature as has been requested, BIAC, stakeholders and any other entities or |
| |individuals that are interested. |
| |TBI screening – implementation schedule |
| |Alliance – May 1, 2015 |
| |Eastpointe – July 15, 2016 |
| |Trillium – October 1, 2016 |
| |Sandhills – September 1, 2016 |
| |Cardinal – December 1, 2016 |
| |Partners – Unknown |
| |Smoky – Will not be participating |
| |Behavioral Risk Factor Surveillance System (BRFSS) |
| |BRFSS is a random telephone survey of state residents aged 18 and older in households with telephones. Information is collected |
| |in a routine, standardized manner at the state level on a variety of health behaviors and preventive health practices related to |
| |the leading causes of death and disability such as cardiovascular disease, cancer, diabetes and injuries. |
| |BRFSS interviews are conducted monthly and data are analyzed annually (on a calendar-year basis). |
| |TBI program has submitted application to have two questions included in survey related to TBI for the 2017 calendar year survey |
| |period. |
| |There have been questions asked in prior years. |
| |The proposed TBI questions were suggested by the CDC who plans to use them for other surveys at a national level. |
| |BRFSS TBI Questions Submitted for Consideration |
| |Thinking across your entire life, has a doctor, nurse, or other medical professional ever told you that you had a concussion or |
| |any other type of brain injury caused by a blow to the head? |
| |1. Yes |
| |2. No |
| |97. Don’t Know/Not sure |
| |99. REFUSED |
| |A concussion has occurred anytime a blow to the head caused you to have one or more symptoms, whether just momentarily or lasting|
| |a while. Symptoms include: blurred or double vision, seeing stars, sensitivity to light or noise, headaches, dizziness or balance|
| |problems, nausea, vomiting, trouble sleeping, fatigue, confusion, difficulty remembering, difficulty concentrating, or being |
| |knocked out. |
| |In your lifetime, do you believe that you have ever had a concussion or other type of brain injury other than those diagnosed by |
| |a medical professional? |
| |1. YES |
| |2. NO |
| |97. DON’T KNOW/NOT SURE |
| |99. REFUSED |
| |TBI Claims Data Analysis |
| |Primary purpose is to determine how many individuals with a documented TBI are accessing service systems such as Mental Health |
| |(MH) and Substance Use Disorder (SUD). |
| |In collaboration with an epidemiologist from the DMH/DD/SAS Quality Management Section. |
| |Source of data will be NCTracks (July, 2013 forward). |
| |We will identify persons who had at least 1 TBI diagnosis during this period (based on the first 6 diagnoses on the claim in |
| |NCTracks). |
| |CDC supplied list of diagnosis codes that correspond to TBI (ICD-9-CM and ICD-10-CM). |
| |ICD-10-CM code list is provisional so we will look at results for ICD-9 and ICD-10 both separately and combined. |
| |Some of the LME/MCO’s will also be conducting claims data analysis. |
| |In the process of updating the 2010 NC TBI State Action Plan with Council subgroup and other stakeholders. |
| |Have held two meetings so far. |
| |The plan will have three to five overall goals with corresponding objectives. |
| |Council will review the final draft. Then it will be submitted to upper management at DMH/DD/SAS for final review/approval. |
| |The plan will be reviewed annually with possible updates/changes made. |
| |The plan will be formally updated every five years. |
| |Online training module development |
| |Goal is to create online training modules for professionals, family members and individuals with TBI across the State (online |
| |training resource library). |
| |Offer Continuing Education Credits (CE’s) for professionals when they complete each training module. |
| |Met with representatives from Michigan to discuss potential and logistics for tailoring their current online training modules for|
| |North Carolina. Michigan Online training includes: |
| |TBI and Public Services |
| |Pediatric TBI |
| |Cognitive and Behavioral Consequences of TBI in Adults |
| |TBI and Substance Use |
| |Discussions have occurred regarding the TBI and professionals module we will be developing as part of ACL grant. |
| |Meeting with AHEC and discussions with BIANC continue to occur on |
| |where to host the modules, who will be responsible for administering the CE’s and other related topics. |
| |TBI and Money Follows the Person (MFP) |
| |MFP is a state project that assists Medicaid eligible North Carolinians who live in in-patient facilities to move into their own |
| |homes and communities with supports. |
| |A TBI specific MFP workgroup meets almost monthly. The objectives of the group include: |
| |To clarify processes, from the TBI beneficiary’s perspective, about accessing appropriate coordinated services across different |
| |service delivery systems. |
| |To identify “low hanging fruit” opportunities for improving/streamlining service access and coordination. |
| |To clarify systemic issues that impede effective coordination that require additional information/policy change. |
| |To develop preliminary guidance for “entry points,” such as DSS and hospital discharge, on how to effectively navigate TBI |
| |service delivery system. |
| |To collaborate with efforts in place to improve TBI screening methods. |
| |Surveys are being sent out to providers and individuals with TBI/family members to get feedback on knowledge about TBI, current |
| |service processes and service access challenges. |
| |TBI Waiver |
| |Meetings with DMA and Alliance weekly to discuss TBI waiver preparation and roll-out logistics. |
| |Meetings with BIANC to discuss how they can assist with waiver activity such as providing training and resource facilitation to |
| |Alliance staff and service providers throughout the Alliance catchment area. |
| |Collaboration with DMA on waiver preparation activity. |
|Conclusions |Questions/Comments: |
| | |
| |There were questions regarding the TBI eligibility criteria. Vicki Smith asked that historical information about eligibility for|
| |services be made available to the TBI Specialist – wants the council to put something in place so that this information is |
| |available to whomever is in the TBI Specialist position. Also, recommended that this information be stored in a central location|
| |for easy access. This information should be available not only to the TBI Specialist but also to the Brain Injury Advisory |
| |Council. |
| | |
| |Need to make sure there are strategies in place to make sure all LME/MCO allocated money is spent. |
| | |
| |TBI Waiver – people who can’t get services. Has it been noted somewhere - the services that are needed and where the people are|
| |who need the services? |
| | |
| |Any State restrictions on grant – regarding reallocating money? |
| | |
| |What about individuals on the waitlist – LME/MCO – will these individuals be served? |
| | |
| |Accurate data/TBI Screening – new individuals who call in – what about individuals who are already in the system – make sure |
| |individuals are not counted twice or many times. |
| | |
| |Adhoc Committee – to look at issues (money not spent) (LME/MCO not screening) (should the screening be required) leaving money on|
| |table – figure out why. |
| | |
| |Motion – Vicki Smith – This Council should recommend that the money from the waiver be allocated for TBI Screening and be part of|
| |their contract. To be addressed by the Adhoc Committee (Adhoc Committee to be formed) |
| | |
|Action Items |Person(s) Responsible |Deadline |
|At next BIAC meeting – will be discussing the TBI State Plan; the Bylaws; the Statutes; and what this |Holly Heath-Shepard |12/7/16 |
|Council wants to recommend to the legislators (LME/MCO). Specific goals, and what this Council should be | | |
|working towards. | | |
| | | |
|Form Adhoc Committee by the end of this meeting (9/7/16). |Holly Heath-Shepard |9/7/16 |
3. Agenda topic: TBI Waiver Rollout; Medicaid Reform vs. Medicaid Expansion vs. TBI Waiver; CAP C Waitlist Kenneth Bausell
|Discussion |CapC Waiver/Waitlist – For children who are medically fragile and under 21 years of age. Fiver year waiver from July 1, 2010 – |
| |June 30, 2015. CMS granted DMA a temporary extension to allow waiver recipients to continue receiving services without |
| |interruption while DMA works to amend the waiver for another five years. The extension allows DMA to continue administering the |
| |CAP/C program using the projections and regulations approved in the fifth year of the five-year waiver cycle. During the waiver |
| |extension, utilization limits, such as unduplicated participant count and limits on vehicle and home modification must be |
| |followed. An analysis conducted by DMA confirmed the number of waiver participants currently served exceeded the 2010-2015 |
| |projected unduplicated participant count in the CAP/C waiver. Therefore, a temporary statewide waitlist for individuals seeking |
| |approval to participate in the CAP/C program was implemented. The waitlist became effective August 15, 2016. Individuals |
| |applying for CAP/C services on or after August 15, 2016 will be placed on a statewide waitlist if the referral and level of care |
| |requirements are met. DMA will make an announcement with instructions when the statewide waitlist is lifted. DMA has several |
| |ways to share comments and recommendations: One-one meetings; listening sessions; webinars; and work group meetings. |
| | |
| |Medicaid Reform vs. Medicaid Expansion vs. TBI Waiver |
| |Medicaid Reform – In September, 2015 the NC General Assembly enacted legislation for historic reform of its Medicaid Program. |
| |Medicaid is a state and federal program providing medical coverage for low-income and disabled citizens. Seeks to transform and |
| |reorganize NC’s Medicaid and NC Health Choice programs. Bings innovation and new tools into the health system to ensure the |
| |system puts people first, and rewards health plans and providers for making beneficiaries healthier while containing costs. |
| | |
| |Medicaid Expansion – Federal initiative that NC chose not to opt into. NC remains one of 19 states that have thus far declined |
| |to expand Medicaid, which was allowed for under the Affordable Care Act. This expansion would extend health coverage to |
| |individuals at or below 138 percent federal poverty level, which is an annual income of $16,394 for an individual and $33,534 for|
| |a family of four in 2016. In NC, Medicaid remains the same. |
| | |
| |TBI Waiver – 1915 (b) – Waiver; 1915 (c) – Innovation Waiver; 1915 (c) – NC TBI Waiver. TBI Waiver will be administered by the |
| |LME/MCO’s. The TBI Waiver is designed to provide an array of community-based services and community alternatives for individuals|
| |with TBI who are currently in nursing facilities or specialty rehabilitation hospitals or who are in the community and at risk |
| |for placement in nursing facilities or specialized rehabilitation hospitals. The waiver is designed to provide an array of |
| |community-based rehabilitative services and supports that facilitates recovery and promotes choice, independence, and community |
| |involvement. These services provide a community-based alternative to institutional care for persons who continue to require |
| |Neuro-Behavioral level of care or require a Skilled Nursing Facility (SNF) level of care. |
| | |
| |TBI Waiver Update/Rollout – Meeting with DMA and Alliance weekly for preparation of rollout. We know that the definitions and |
| |general structure will remain the same. CMS has reviewed and are generally happy with basic services. May look a little |
| |different as far as specialized services. |
|Conclusions |N/A |
|Action Items |Person(s) Responsible |Deadline |
|N/A | | |
4. Agenda topic: House Bill that Creates a Demonstration P&A for Veterans Vicki Smith
|Discussion |H.R. 5128 – 114th Congress (2015-2016) |
| |Introduced in House (04/29/2016) |
| |Protection and Advocacy for Veterans Act |
| |This bill directs the Department of Veterans Affairs (VA) to establish a five-year grant program to improve the monitoring of VA |
| |mental health and substance abuse treatment programs. |
| | |
| |The VA shall award a grant to four protection and advocacy systems under which each recipient shall investigate and monitor VA |
| |facilities care and treatment of veterans with mental illness or substance abuse issues. Criteria for selecting recipients shall |
| |include whether the state in which the protection and advocacy system operates has low mental health, performance, and access |
| |scores. |
| | |
| |During each year in which a protection and advocacy system carries out a demonstration project, the VA shall award a joint grant |
| |to a national organization with extensive knowledge of the protection and advocacy system and a veterans service organization to:|
| |(1) coordinate training and technical assistance, and (2) provide for related data collection, reporting, and analysis. |
| | |
| |"Protection and advocacy system" means the state-established system to protect and advocate the rights of persons with |
| |developmental disabilities. |
|Conclusions |N/A |
|Action Items |Person(s) Responsible |Deadline |
|N/A | | |
5. Agenda topic: “Their War Came Home” Marilyn Lash
|Discussion |Ms. Lash gave an overview of the video and then presented the Video – “Their War Came Home” to group. Transitioning from military to|
| |civilian life can mean searching for a new identity. Who am I now? This video was developed to help veterans and their families |
| |recognize and understand the invisible wounds of post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). This |
| |50-minute documentary produced by Korean and Vietnam veterans Norm Seider, Carl Ohlson, and John Drinkard features the voices of |
| |veterans who have returned home from the wars in Iraq and Afghanistan. View for free at watch?v;BKCmu7nsp5Y. |
| | |
| |Interviews showed how the use of alcohol, illegal drugs, and prescription meds numb and calm the anxiety, hypervigilance, and |
| |flashbacks that are symptoms of PTSD. PTSD can lead to downward spiral of depression, isolation, homelessness, and suicide. Often |
| |coupled with TBI resulting in memory loss, changed thinking, and explosive anger, their combined effects are “the perfect storm” |
| |making it difficult to navigate daily life. Asking for help and seeking treatment can be hard because, “no one wants to admit they |
| |have a problem.” Various choices of treatment and methods of healing are described by veterans, social workers, and counselors – all|
| |searching for a “new normal” after the devastation of war. |
| | |
| |The impact of war spreads to the family. The effects of secondary traumatic stress or compassion fatigue can directly affect the |
| |physical and emotional health of caregivers. A spouse reveals, “we walked on eggshells 24/7. There were times we did not feel |
| |safe.” The emotional pain of what is unfolding on the home front can lead spouses to ask, “what’s happening to me? Am I crazy?” |
| |Those who love and live with someone who has been traumatized can’t help but be affected by it. The process of getting to know this |
| |“new person” who has come home from war while saying goodbye to the old person is what is called “living grief” and can be confusing |
| |because there is no end to it. |
| | |
|Conclusions |To watch “Their War Came Home” on YouTube – watch?v:BKCmu7nsp5Y |
|Action Items |Person(s) Responsible |Deadline |
|N/A |N/A |N/A |
6. Agenda topic: Overview of VA’s Pilot project/funding treatment for Veterans; Outcome data using the Mayo Portland Jerry Villemain
|Discussion |Veterans Healthcare Administration Assisted Living Pilot Program for Veterans with TBI |
| |The Veterans Administration has made available, a “pilot program” to determine how the VA may have a relationship with private |
| |providers to fund the provision of private (non VA or DoD) community based TBI supports and services. |
| |Congressionally mandated. |
| |There will be a report back to Congress at the conclusion of the Pilot. |
| |NeuroRestorative is one of 21 “contracted providers” |
| |Admission Criteria: |
| |To be eligible for the program, the Veteran |
| |must be enrolled in the patient enrollment system of the Department of Veterans Affairs |
| |must have received hospital care or medical services provided by the VA for a Traumatic Brain Injury |
| |must be unable to manage routine activities of daily living without supervision and assistance |
| |can reasonably be expected to receive ongoing services after the end of the pilot program under this section under another |
| |program of the Federal Government or through other means, as determined by the Secretary. |
| |Must be approved for participation by the Pilot |
| |Program |
| |Ineligibility of Veteran: |
| |A Veteran is ineligible for the program if s/he: |
| |Requires 24 hour nursing care |
| |Is suicidal |
| |Is homicidal |
| |Is a “chronic eloper” |
| |Is actively using drugs or alcohol |
| |Has been charged with a violent crime |
| |Provision of Services |
| |The local Veterans Administration remains the primary provider. |
| |Each participant will continue to have an active VA Case Manager who remains active in the member’s coordination of supports and |
| |services. |
| |The VA Case Manager is an active member of the rehabilitation team, together with the individual, the family and the contracted |
| |provider |
| |The VA Case Manager receives all communication regarding the Veteran’s progress |
| |The VA Case Manager will receive at least monthly reports of progress including measurable goals |
| |Recommended Plan of Care |
| |A Recommended Plan of Care due to VA Case Manager not more than 10 calendar days following referral. |
| |Requires determination of a CLIN No. (level of service we recommend) and approval of the CLIN No. by the referring VA |
| |Levels of Care |
| |0001AA – At least 6 documented hours (i.e. frequency, type, intensity of services) of therapeutic intervention per day with |
| |specific community reintegration goals; must include a minimum of 3 hours of individual therapy interventions, as approved by VA.|
| | |
| |0001AB - At least 4 documented hours (i.e., frequency, type, intensity of services) of therapeutic intervention per day with |
| |specific community reintegration goals; must include a minimum of 2 hours of individual therapy interventions, as approved by VA.|
| | |
| |0001AC - At least 2 documented hours (i.e., frequency, type, intensity of services) of therapeutic intervention per day with |
| |specific community reintegration goals, as approved by VA. |
| | |
| |0002 – Bed hold services |
| | |
| |Mayo-Portland Adaptability Inventory – 4 (to be completed by staff or professional) |
| |Deliverables |
| |Full range of rehabilitation Services as Indicated by the ICP: |
| |PT, OT, ST, Nursing, Social Work, Case Management |
| |Psychology/ NeuroPsychology if requires counseling for PTSD or other combat related stress disorders |
| |Cognitive Therapy |
| |Medication Management |
| |Behavioral Management |
| |Independent Living Skills |
| |Vocational Counseling |
| |Social and Recreational Activities |
| |24 hour security and staff availability |
| |Transportation with Attended Services to appointments and community activity |
| |Cable, computer and internet services available |
| |Access to gym and exercise facilities |
| |Family support services |
| |All DME provided by VA |
| |All Primary Care provided by VA |
| |All prescription medication provided by VA |
| |(note – med changes which require a new Rx may take up to two weeks to process. If an immediate med change is necessary, NR |
| |assumes the responsibility for cost for supplying until the VA is able to process the new Rx request.) |
|Conclusions |N/A |
| | |
| | |
| | |
|Action Items |Person(s) Responsible |Deadline |
|N/A |N/A |N/A |
7. Agenda topic: Recovery Communities of North Carolina – Reducing the Stigma and Treating the Soil
Donald McDonald
|Discussion |Mr. McDonald, who is the Director of Programs and Services talked about Recovery Communities for NC, which promotes addiction |
| |recovery, wellness, and citizenship through advocacy, education, and support. He talked about addiction as a chronic illness |
| |(comparable to hypertension, asthma, and diabetes) and discussed causes and treatment for each. Discussed and defined stigma and|
| |also talked about internalized stigma. Talked about public perception of addiction (junkies, lushes, crack heads; treatment |
| |doesn’t work; and self-inflicted). |
| |Vision |
| |NC promotes a culture that supports addiction recovery for individuals, families, and communities. |
| |North Carolinians seeking addiction recovery have access to the highest quality care, services, and supports. |
| |North Carolinians in addiction recovery are equal and valued members of our State. |
| |North Carolinians in addiction recovery have opportunities to achieve their fullest educational, occupational, and civic |
| |potential. |
| |Recovery from addiction is a celebrated reality. |
| |Advocacy Events |
| |Capital Area Rally for Recovery |
| |Community Recovery Advocacy Day |
| |Access to Recovery |
| |What is ATR? |
| |NC Access to Recovery (NCATR) is a voucher program that extends the current array of services and availability of providers in |
| |the State by providing recovery support services through the use of grant funds so participants can choose their services and |
| |providers freely and independently. |
| |Recovery Support Services |
| |Life Skills Coaching, Employment Services, and Job Training |
| |Peer-to-peer services and Recovery Coaching |
| |Fun & Healthy Sober Living Activities |
| |Spiritual Counseling or Counseling offered by American Indian Tribes |
| |Transportation (Bus/Gas Cards) |
| |Nutritional Counseling |
| |ATR Eligibility |
| |In order to participate in this program, individuals must meet the following requirements: |
| |Be at least 18 years old |
| |Live in Wake, Orange, or Robeson County |
| |Have an annual income of less than $23,500 |
| |Have a current substance use disorder or have been diagnosed with one in the past 12 months |
| |Seeking support for your recovery from addiction to alcohol and/or other drugs |
| |Willing to meet with a NC ATR services staff or authorized provider for an intake interview, create a recovery plan, select up to|
| |three support options, and continue on your path furthering your recovery |
| |Recovery Community Center – You are in the right place. You are with others like yourself. We understand you and the world you |
| |come from. We accept who you are and who you can become. This is a place where magic (change) can happen. |
|Conclusions |For more information contact: |
| |Donald McDonald, MSW, LCAS |
| |Director of Programs and Services |
| |dmcdonald@ |
| |919-231-0248 ext. 105 |
| | |
|Action Items |Person(s) Responsible |Deadline |
|N/A |N/A |N/A |
8. Agenda topic: Committee Updates
|Discussion |Children & Youth Committee | |
| |Brochure – Return to Learn – Speaking at several conferences – article in | |
| |pediatric medical journal – goal to get information out to medical providers | |
| | | |
| |Health Services Committee | |
| |Met 35 times last year – licensure rules for specific TBI programs – right now | |
| |no decision – meeting set up for 9/22/16 to review this issue. | |
| | | |
| |Legislative Committee | |
| |Post session just setting up committees. Suggesting to Legislative Oversight | |
| |Committee a presentation on status of waiver and request a presentation on the| |
| |scope of available services for persons with TBI to include group homes, | |
| |treatment centers, providers availability and current rules– monitoring | |
| |progress of waiver – Medicaid reform – public safety. Want to stay in their | |
| |minds – we want them to know the issues persons with TBI and families are | |
| |confronting. | |
| | | |
| |Veterans Committee | |
| |Looking for a Chair for the Veterans Committee. | |
|Conclusions | | |
|Action Items |Person(s) Responsible |Deadline | |
| | | | |
9. Agenda topic: Adhoc Committee (Added to Agenda)
|Discussion |Adhoc Committee was formed to look at the TBI State Plan; the Bylaws; the Statutes; and what this Council wants to recommend to |
| |the legislators regarding the TBI screening process at the LME/MCO’s. Also, committee will recommend specific goals for the |
| |Council. Holly asked for volunteers from the Council members. The following will be on the committee: Carol Ornitz, Ken Jones,|
| |Jan White, and Holly Heath-Shepard. Holly will chair this committee. |
| |Health Services Committee, along with Scott Pokorny and Kenneth Bausell to evaluate data and how it should be broken down. |
|Conclusions |Adhoc committee to review issues regarding the TBI screening process, LME/MCO requirements, etc. |
|Action Items |Person(s) Responsible |Deadline |
|Adhoc Committee and Health Services Committee to present findings/recommendations to BIAC at next meeting. |Adhoc Committee |12/716 |
Ms. Heath-Shepard thanked everyone for their participation. There being no further business, the meeting was adjourned at 3:47 p.m. Respectfully submitted: Sandy Pendergraft, Scott Pokorny, and Travis Williams.
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