Department of Rehabilitation Traumatic Brain



Department of Rehabilitation Traumatic Brain Injury Registry Subcommittee Meeting MinutesMonday, November 16, 20202:00 pm. – 3:00 p.m., VideoconferenceCommittee Members (present):Daniel Ignacio, St. Jude Brain Injury Network and TBI Survivor (Chair)Dr. Katie Shinoda, Dignity Health and Mercy General HospitalDr. Henry Huie, Santa Clara Valley Medical Center Dr. Steven T. Chan, Physical Medicine and Rehabilitation at Kaiser PermanenteCommittee Members (not present):Dr. Maheen Adamson, Stanford School of Medicine and VA Palo Alto Health Care SystemDOR Staff (present):Tanya Thee, TBI Program AdministratorMegan Sampson, Independent Living and Assistive Technology Section Chief and TBI Survivor Margaret Balistreri, Office TechnicianMembers of the Public: Jerry Chen, Santa Clara Valley Medical Center and TBI Survivor Vincent Martinez, Santa Clara Valley Medical Center and TBI SurvivorCall to OrderChair Ignacio called meeting to order at 11:05 a.m. Agenda Item 1: Welcome and IntroductionsChair Ignacio led introductions. Quorum was established.Agenda Item 2: October 5, 2020 Meeting MinutesChair Ignacio asked for any discussion on October 5., 2020. No discussion.Motion/Second to approve Members Chan/Shinoda. (Yes votes) – Members Ignacio, Shinoda, Chan, Huie (No votes) – 0 (Abstain votes) – 0Agenda Item 3: CA TBI Service Grant Request for Application (RFA) Stakeholder Input Chief Sampson, DOR is considering awarding six grants instead of seven and offering additional funds to the six sites. Asking grantees to consider boundary free services with potential consideration that awarded grants are not bound by regions but that they can provide services regardless of where they are located. Potentially provide incentive scoring and increase grant award to top scoring grants as extra incentive to be more creative in the delivery systems and their partnerships with organizations outside of DOR. Not scoring based on historical performance but on current. Term of the grants will be for three years with potential to extend one additional year. Questions:Member Huie ask if they have access to criteria and scoring? It is still being internally reviewed. The RFA itself will have scoring criteria as well as any specific items to be reviewed.Lead Ignacio gave feedback from St. Jude Director Jack Light, stating they would support the six site grants rather than seven.Agenda Item 4: Data for the CA Trauma RegistryLead, Ignacio presented the geographic data for CA Trauma Registry. There is still a lot of data tied up in billing records. Department of Finance has a state data center that has data from TBI, non-fatal hospitalizations/emergency room visits.Green numbers are from CA Trauma Registry. Numbers in red are non-fatal EDR visits, and those in black are non- fatal hospitalizations. This data is from 2015. Ignacio will continue to track down more current data. Ignacio continued to review the data and where certain counties stand. This information does not reflect any fatalities, only survivors.Questions:Chief Sampson ask what are we supposed to do with this data? Looking for incident loads, and then break down by counties. Boundary free services would not need the county information but knowing where the areas with the most survivors will tell us where the most survivors that may be silently struggling. Chief Sampson asked what the plan is for utilizing this data? The numbers on the data give us something concrete if we needed to present something to the legislature to show what these numbers look like that could help support us with funding. We could better define what the problem looks like, and who and how many are affected. It can help us to identify funding streams such as the fact that many TBI’s are related to alcohol use. We can use the data to quickly present facts such as 1 in 20 California’s experienced TBI’s in 2015. Chief Sampson shared that the question was presented to her in a meeting and wanting to have us be able to share how this data helps us. The process should be:IdentificationServicesData CollectionFundingChief Sampson mentioned to committee members that part of the ACL requirement is to provide a Registry which identifies people with TBI’s and link them to services. Member Shinoda responded that we are still in the process of establishing a TBI Registry and currently looking at how past data will help us in establishing it. Member Huie explained that by reviewing data it can help us in our goal to find funding by knowing what past trends are. Chief Sampson stated that we have reached out to CA Trauma Registry and so far have had no information from them except past data from 2018. Member Ignacio responded that with the limited information we have we can identify that certain counties are underfunded and under serviced because there are a lot of zero’s reported from central California downward. Either Northern California does a better job of reporting or because the office is in Sacramento which tell us the data may not be fully reflective. Also, possible that some rural counties do not have level one trauma centers. San Diego County has zero reporting which shows that there are needs that can be filled if we had additional funding. Member Ignacio asked for suggestions on where we should look next. Member Shinoda responded that we need to coordinate with the State Plan Committee to help us lay out this committee’s long-term goals. Probably should be put to the full advisory board. Chief Sampson pointed out that all the committees are doing great work, but so far have nothing implementable because all are working in a silo. We have not completed any one piece because they are all dependable on other pieces. We know we need funding, but we do not have answers on where that funding might be. This is frustrating because we do not have definitive answers on what are the next steps. Lead Ignacio agrees that it all comes down to the funding piece. We have the data saying to pursue funding thru the alcohol relationship, but how do we begin the process and is this enough information. How do we tie ourselves to taxes? Can we talk to lobbyists? Chief Sampson stated that as an authority of the state DOR, its’ employees cannot lobby for anything. Individuals have the right to lobby and do as they choose. Member Shinoda asked as a TBI Advisory Board, how can we recommend to the state legislature or Governor that we want this issue addressed? Chief Sampson stated that other state advisory boards have websites that could help us to find funding sources. It identifies the area of power that the TBI board is not a state entity but can do things that the state cannot do. This will be shared with the group. Agenda Item 5: Project Plan TrackerGrant Administrator Thee reviewed the project planner that has had the RFA benchmarks added to it that we are still working on along with the RFA feedback and the map that was discussed earlier.Agenda Item 6: TBI Advisory Board MeetingThe next TBI Advisory Board meeting is November 23, 2020. The following updates will be provided:Rural vs. urban heat map of reported TBI injuriesA full board discussion on preparing a white paper, although it seems like we are working form the bottom up, the information we are gathering will help us reach our goal. Program Administrator Thee shared how we will include the needs of all the committees into the State Plan to help us to be better connected working together instead of working as individual committees. Agenda Item 7: Other/New Business/Action ItemsProgram Administrator Thee let members know that we need to start addressing in our current meetings what are goals for the next meetings are so that we have something new to present at each new meeting. What should our goal be for December?Lead Ignacio will reach out to Alberto Torrico, who does state work, and talk to someone from another registry to see if we can get a figure on what kind of funding we might need. Possibly Begin compiling a list of people to reach out to (state legislatures who have ties with the medical field or brain injuries). Lead Ignacio will talk to Elizabeth to get us an update on CA Trauma Registry at next meeting. . Next year, will first Monday still work for everyone for meeting? Members agreed that they work and mornings 11:00 a.m. would be preferred. Agenda Item 8: Public CommentNoneAgenda Item 9: AdjournmentMotion/Second to adjourn Members Huie/Shinoda at 12:15 p.m.. ................
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