TBIAC Report December 2018



86851224672Texas Brain Injury Advisory Council 2020 Report to the Health and Human Services Commission Executive CommissionerAs Required by TAC §351.825(d)(1)Texas Brain Injury Advisory CouncilDecember 2020ContentsContentsiBackground2Council Dates and Attendance3Council Actions and Accomplishments5Future Council Activities10Council Associated Cost12Acronyms13DisclaimerThis report was prepared by members of the Texas Brain Injury Advisory Council. The opinions and recommendations expressed in this report are the members’ own and do not reflect the views of the Texas Health and Human Services Commission Executive Council or the Texas Health and Human Services Commission. BackgroundThe Texas Brain Injury Advisory Council (TBIAC) was established as the Texas Traumatic Brain Injury Advisory Board in 1997 by former Governor George Bush to give brain injury survivors, their families and caregivers, service providers, and state agencies a voice in identifying and meeting the needs of people with brain injury. In 2003, the Texas Traumatic Brain Injury Advisory Council was established in statute by the 78th Texas Legislature. In 2015, the 84th Texas Legislature removed most Health and Human Services Advisory Councils from statute and authorized the Health and Human Services Commission (HHSC) to reestablish the TBIAC in rule. With advocacy from the TBIAC, the scope of the Council was expanded to include all acquired brain injuries and the name was changed to the Texas Brain Injury Advisory Council. The Texas Brain Injury Advisory Council advises HHSC and state leaders on the prevention of brain injury and improving the quality of life of individuals who have survived brain injuries and their families and caregivers. The TBIAC:Informs state leadership (the Governor and Legislature) of the needs of people with brain injuries and their familiesRecommends policies and practices to meet those needsEncourages research into the causes, prevention, and treatment of brain injuriesProvides long-term services and supports for people with brain injuriesPromotes brain injury prevention and awareness throughout the stateFacilitates the development and implementation of sustainable supports and services to meet the complex needs of persons who have survived a brain injury Council Dates and AttendanceThe following table includes a listing of Texas Brain Injury Advisory Council meeting dates and attendance (Y=attended, N=did not attend, NA=not applicable). PositionNameOCT 21, 2019Jan 27, 2020APR 20, 2020 CanceledJul 20, 2020Person with a Brain InjuryJim BatchelorYYNANFamily MemberMarivel BaysdenYYNAYPost-Acute RehabilitationJane BoutteYYNAYFamily MemberHeather CookYYNANLong Term Care FacilityGlyn CraneYYNANPerson with a Brain InjuryPatti FosterYYNAYPerson with a Brain InjuryDonna KunzYYNAYHealthcare PractitionerJames MoodyYYNAYPerson with a Brain InjuryAustin MorganNNNAYPerson with a Brain InjuryDr. Benjamin NguyenYYNANStroke StakeholderMikael SimpsonYYNAYFamily MemberLarry SwiftYYNAYAcute Hospital or Trauma UnitDr. John ThottakaraYYNAYFamily MemberChristi WilsonYYNANInstitution of Higher EducationDr. George WolfYYNAY Council Actions and AccomplishmentsThe Texas Brain Injury Advisory Council is the only State of Texas entity exclusively dedicated to serving Texans with acquired brain injuries, their families, service providers, and state agencies. Through its twenty-plus years of service to Texas, the TBIAC has helped the State improve and expand its services to Texans with brain injuries and their caregivers. Among these are:Improving and expanding the Comprehensive Rehabilitation Service programDeveloping an insurance mandate that requires health insurers to meet the needs of individuals with brain injuryAdding Cognitive Rehabilitation Therapy to Medicaid Waiver ProgramsAssisting HHSC in establishing the Office of Acquired Brain InjuryAssisting the Texas Department of Education in helping Texas schools better serve students with brain injuriesHelping the Texas Juvenile Justice System better identify and serve young offenders with brain injuriesHelped establish law that protects Texas drivers diagnosed with autism, deaf, or hard of hearing. Improve deescalating training for officers.Promoting prevention of brain injuries through use of bicycle helmets, helmets in rodeos, and use of concussion protocols in school athleticsHelping the Department of State Health Services maintain and improve a brain injury registry to have data for informing policy makers about the needs of Texans with brain injuries and their familiesHB 4533 passed 2019 and amends Government Code Chapter 534 and directs the following?Development and implementation of a pilot through the STAR+PLUS Medicaid managed care program to test person-centered managed care strategies and improvements based on capitation;Establishment of a Pilot Program Workgroup (PPW) to help develop and advise HHSC on the operation of the pilot program; Coordination and collaboration throughout development and implementation of the pilot program with the Intellectual Developmental Disabilities System Redesign Advisory Committee (IDD SRAC) and PPW; and Dental evaluation to determine the most cost-effective dental services for pilot program participants.2020 TBIAC Accomplishments:Support and education for continued full funding for the Office of Acquired Brain InjuryThe council provided subject matter expertise and referrals to the Office of Acquired Brain Injury and other Health and Human Services Commission officesDiscussions with the Texas Worker’s Compensation Department of Insurance regarding worker’s compensation for individuals with brain injuryRoutine stakeholder meetings with Texas Workforce Commission Vocational Rehabilitation Services for outreach effortsDiscussions with the Department of State Health Services Epidemiology Department for accurate data collection and data expansion in order to accurately represent the number of brain injuries in the state of Texas. Good teamwork in capabilities resulting with data request for Legislation Report submitted 26 Jul 20.Continued collaboration efforts with non-profit organizations who also support brain injury survivorsNumerous discussions with legislative offices providing education materials on the incidence of brain injuries and the journeys of brain injury survivorsProvided member panel experts and booth presenters for the March Brain Injury Awareness Month Celebration at the Texas Health and Human Services, Brown-Heatly Building, however cancelled due to Covid 19Successfully requested a proclamation from Governor Greg Abbot declaring March as Brain Injury Awareness Month.2020 TBIAC CommitteesThe TBIAC has four standing committees: Executive Committee, Legislative and Policy Committee, the Education and Awareness and Services and Supports, and the Database Review Committee. The Bylaws Committee is an ad hoc committee appointed by the TBIAC Chair to review and make recommendations regarding the TBIAC bylaws and rules.The Executive Committee meets twice a quarter to lead, coordinate, and develop the council agenda based upon guidance from committee chairs and input from council members. The Executive Committee was abolished by HDIS in Sep 20.The Executive committee chair is Jane Boutte. Current committee members are: Patti Foster, Dr. John Thottakara, Christi Wilson, and Dr. George Wolf.The Legislative and Policy Committee meets on a quarterly basis to follow and/or identify legislation that may impact Texas brain injury services, prepare position papers, and provide resource information as requested.The Committee Chair was transitioned from Christi Wilson to Dr. John Thottakara in July 2020. Current committee members are: Jane Boutte, Heather Cook, Larry Swift, and Dr. George Wolf.The Education and Awareness and Services and Supports meets quarterly. The purpose of the committee is to provide input regarding appropriate services and supports for Texans with a brain injury to enhance health, recovery, and living with a brain injury. In addition, this committee identifies gaps and opportunities to provide effective and timely information, education, and training regarding prevention and resources to improve outcomes and help survivors and families.The Committee Chair is Patti Foster. Current committee members are: Jim Batchelor, Marivel Baysden, Glyn Crane, Donna Kunz, Austin Morgan, and Dr. Benjamin Nguyen.The Database Review Committee was formed in 2019 by the TBIAC Chair. The purpose of this committee is to identify and review current database collections in order to evaluate and make recommendations to more accurately collection brain injury data. ICD-10 medical diagnosis codes related to acquire brain injury have been completed. These codes will focus different etiologies for database requests. Various Texas and CDC databases have been identified and database queries completed and ongoing.The Committee Chair is Dr. George Wolf. Current committee members are: Jane Boutte, James Moody, Mikael Simpson, Larry Swift, and Christi Wilson.TBIAC members focused on activities to promote brain injury awareness, education, health promotion, and prevention. Council activities are summarized below:Council members provided subject matter expert testimony and education to improve the lives of those living with brain injury. Council members frequently participate in activities to promote education and awareness as a private citizen and on occasion as a representative of the Council. A few examples are listed below:Joe Perez, Deputy Associate Commissioner, Rehabilitative & Independence Services (RIS), Health and Human Services Commission. He provided the Executive Committee with a brief overview of his division and advised that the Office of Acquired Brain Injury officially transferred to RIS. He asked committee chairs their roles and processes for collaboration.Ms. Lisa Kalakanis, Director, Data Dissemination, HHSC Center for Analytics & Decision Support (CADS) presented on data requests process and Agency Circular C-061 was disseminated to DR committee members for reference regarding external data sharing process. For the 2020 Legislative Report, accessing the data via websites provided by DSHS to explore all related aspects of brain injury; hypoxic events, impacts, cognitive and mental health functions that develop due to the initial injury.Texas Health Steps and Medicaid system presentation by Mr. Schoenfelder Participated in and made educational presentations to in various support groups and state advocacy organizations.TBIAC received quarterly updates from OABI and HHSC staff regarding events related to brain injury, brain injury programs, processes, and the state budget. These invaluable updates provided opportunities for collaboration and council assistance to educate others on important programs and services offered by the state and to increase awareness regarding areas of focus to enhance brain injury recovery.TBIAC completed the 2018 TBIAC Report to the Governor of Texas, the Lieutenant Governor, The Speaker of the Texas House of Representatives, The Texas Legislature. TBIAC completed the 2019 the Executive Commissioner of the Health and Human Services Commission.TBIAC facilitated partnership development with and invited presentations from brain injury providers, groups, and advocacy organizations.Ms. Joy Kearney, Program Specialist, HHSC Policy and Program, provided members with an overview of the handout, House Bill 4533 STAR+PLUS Pilot ProgramMs. Joy Kearney, Program Specialist, HHSC Policy and Program, provided members with an overview of the handout, House Bill 4533 STAR+PLUS Pilot ProgramMs. Joy Kearney, Program Specialist, HHSC Policy and Program, provided members with an overview of the handout, House Bill 4533 STAR+PLUS Pilot ProgramMs. Joy Kearney, Program Specialist, HHSC Policy and Program, provided members with an overview of the handout, House Bill 4533 STAR+PLUS Pilot Program Mr. Will Dane, Brain Injury Association of America – Texas, presented regarding brain injury legislation specifically supported by the Brain Injury Association of America. Future Council ActivitiesWork with the Texas Legislature to: Connect with Texas Department of Insurance regarding provision rule language for stop loss prevention. Recommendation is to come up with ideas to bridge the gap between expiration of primary insurance and Medicaid coverage.Add Cognitive Rehabilitation Therapy to the State Medicaid Plan.Require Texas Workforce Commission, in collaboration with the Office of Acquired Brain Injury and the Texas Brain Injury Advisory Council, to develop a Vocational Rehabilitation plan for individuals with Acquired Brain Injury across all levels of functioning.Require the Texas Health and Human Services Commission (HHSC), in collaboration with TBIAC and the HHSC Office of Acquired Brain Injury, to submit to the legislature by November 2022 a comprehensive plan to improve long term outcomes, reduce disability, and decrease long term healthcare costs for Texans with acquired brain injuries.Connect with the Department of Public Safety to discuss brain injury and other illnesses.Add non-traumatic brain injuries to the Brain Injury Registry maintained by the Department of State Health Services.Evaluate other states’ brain injury programs for best practices, including public education for individuals with Acquired Brain Injury.Require HHSC to evaluate and develop a system to ensure Acquired Brain Injury data is collected even when ABI is not listed as a primary diagnosis.Continue to support CRS and OABICollaborate with the OABI to develop English and Spanish Information Fact Sheet regarding Acquired Brain Injury Myths and Facts and Fall Prevention Tips.Develop legislative briefs and other educational fact sheets as required.Partnered with EMS and CONTEX database reports to obtain accurate data to identify occurrence of brain injury in Texas.Continue to build and extend partnerships with state brain injury groups, agencies, departments, and providers.HHSC TBIAC rule (§351.825) amended effective 1 Jul 20 2020, 45 TexReg plete the TBIAC Governors plete and submit the TBIAC report to the Governor and State LegislatureMeet with the Executive Commissioner to review the TBIAC recommendations for Health and Human Services.Work with HHSC to:Pursue a federal Traumatic Brain Injury Act grant to fund the Family Navigator Program through the Office of Acquired Brain Injury and in conjunction with a state advocacy group. Suggestions include improving navigation outside of the ER, distinguishing between Traumatic Brain Injury and mental health, Acquired Brain Injury website update, and acrostic for the word Navigator with a training focus.Continue valuable collaboration between the TBIAC, OABI, and HHSC staff. Suggestions for collaboration on current and future projects, brain injury fact sheets, brain injury conferences, promoting Brain Injury Awareness Month, and brain injury training for first responders and law enforcement personnel.Build a network of brain injury focused social media sites, resources, and contacts to promote education and prevention through the Office of Acquired Brain Injury website, including contacts and information available on a 24/7 basis.Add state agencies as non-voting members to the TBIAC.Involve the Council in TBIAC membership recruitment, development and recommendations for appointment by the Executive Commissioner, including transparency by OABI and HHSC in the member selection.Develop a plan to address the long term needs of Texans with brain injury.Data collection methods regarding the identification of Texans with ABI has been updated with more current statistics. Council Associated CostCouncil members serve on a volunteer basis and receive no reimbursement for their travel, overnight accommodations, or time. However, effective September 1, 2019, the 86th Legislature added the TBIAC to the General Appropriations Act. TBIAC members serving as a brain injury survivor or a family member actively involved in the care of loved one who sustained a brain injury are now eligible to receive travel reimbursement within the terms set forth in the General Appropriations Act.Quarterly meetings are held at the HHSC Brown-Heatly building in Austin. State employees provide support services to the Council and may also attend the Council meetings.According to HHSC, the fiscal year 2020 total cost estimate is $41,061.96. The cost estimate was based on a formula of 4 hours per 1 hour of TBIAC meeting time and included 11 employees and $3,723.04 for travel reimbursement of specific TBIAC members as allowable by law. AcronymsAcronymFull NameHHSCHealth and Human Services CommissionTBIACTexas Brain Injury Advisory CouncilABIAcquired Brain InjuryCRSComprehensive Rehabilitation ServicesCRTCognitive Rehabilitation TherapyOABIOffice of Acquired Brain InjuryBIAABrain Injury Association of America RIS Rehabilitative & Independence Services CADS Center for Analytics & Decision Support PPW Pilot Program Workgroup ................
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