On August 5th NAPAS, with financial and logistical support from the Human Resources and Services Administration, hosted a free webcast for P&As entitled Working with Medical Professionals to Enhance PATBI advocacy. The webcast was an opportunity for the 51 individuals registered, to hear about innovative and successful PATBI initiatives in Delaware and New Hampshire, follow along with powerpoint slides, and ask follow up questions of the five member panel. Anyone with access to the world wide web can listen to a full re-broadcast by going to www.mchcom.com and clicking on "live broadcasts." Below is a summary of some of the tips for P&As and PATBI initiatives shared by the five member panel.
Brian Hartman, Director, at Delaware Community Legal Aid, Disability law Program, (the Delaware P&A)Mr. Hartman briefly explained the P&As role in establishing a TBI Advisory Committee which has worked to obtain passage of an impressive array of state laws and regulations in the areas of TBI prevention, TBI assessment, and service expansion. Mr. Hartman explained that when the PATBI program began, Delaware had no viable interagency group or committee to engage in systemic planning on behalf of persons with TBI. The P&A convinced an existing cross-disability council to establish a Brain Injury Committee. It is chaired by a Board member of the Delaware chapter of the Brain Injury Association and the P&A serves as Vice-chair.
The Brain Injury Committee includes several members representing public and private health care agencies, including 3 private hospitals; a neurohealth provider; Easter Seal; and multiple state divisions (public health; child mental health; adult mental health; developmental disabilities; aging and physical disabilities; and vocational rehabilitation). The Committee benefits from this set of health care representatives when analyzing State legislation, regulations, policies, and initiatives and promoting training events. To learn more about the Committee and its membership go to: www2.state.de.us/scpdMr. Hartman explained that prevention initiatives have been of particular interest to the health care providers on the Committee, Just a few prevention initiatives spearheaded by the Committee, include: To read the individual Delaware bills and regulations mentioned in this article go to: [www.delregs.state.de.us/index/html] or Legislation www.legis.state.de.us/Legislature.nsf]
Ms. Julia Freeman Woolpert, PATBI Advocate at the Disability Rights Center (the New Hampshire P&A).Ms Freeman Woolpert explained a variety of P&A projects focusing on collaboration to develop state capacity to assist people with the neurobehavioral consequences of TBI. She had the benefit of returning to the NH P&A after working for several years as the Coordinator of the State TBI Grant Program, Project RESPONSE. She has used her knowledge of TBI resources in the state to promote information sharing across agencies and multi-agency support for system change.Examples of New Hampshire PATBI collaboration includes:
Ms. Amy Messer, Attorney at the Disability Rights Center (the NH P&A)
Ms. Messer focused on the P&As campaign to train medical professionals to write prescriptions so that individuals are more likely to be found eligible for services covered by the state acquired brain disorder waiver. The training advised doctors to focus their attention on ability to perform daily living skills, intellectual functioning, judgment, behavior, disinhibitions, hygiene, and ability to manage money, ability to monitor medications, physical limitations and needs. A major theme was to ask doctors to get beyond test data and evaluate needs in the "real world".
Ms. Messer also emphasized that physicians can be extremely helpful in looking at ADA and Olmstead issues. In New Hampshire, they arranged for a physician to complete a tour of facilities where P&A clients reside. The physician reviewed client records, speak to clients, guardians, and staff members. The physician than determined the level of treatment or services necessary and estimated the consequences of the absence of community-based care, i.e.- physical deterioration, declining mood, depression, lack of access to peers, increasing passivity or increasing aggression, etc.
Dr Warren Lux, Medical Director, at the Defense and Veterans Brain Injury Center.Dr. Lux spoke about some of the characteristics and consequences of TBI that might create a need for P&A advocacy. One such example, was the inadequacies of typical TBI assessment tests. Dr. Lux, explained that even though an individual with TBI may be able to score high on assessment tests, given in a structured environment, these tests often fail to measure these skills in a "real world" context. Dr Lux , suggested that advocates go beyond assessment tests to get a better picture, such as talking to friends and family about the individual's skills prior to the TBI. Dr. Lux also spoke of efforts to accredit ate TBI professionals, by the Brain Injury Association and The Center for Accreditation of Rehabilitation Professionals.
Mr. Kenneth Currier, Director at the TBI Technical Assistance Center
Mr. Currier spoke generally on the various funding options that are used to finance services and supports for individuals with TBI. In addition he mentioned some of the funding issues TBITAC sees as they support State TBI Programs in developing State systems of services and supports. Most importantly, Mr. Currier encouraged P&As to read the NASHIA Guide to State Government Brain Injury Policies, Funding and Services. It is a compilation of a 2002 survey of the States that was funded by the Federal TBI Program. The Guide is available at www.nashia.org. He also encouraged PATBI programs to develop relationships with their state TBI Lead Agency and TBI Advisory Councils.