HD2 - The Needs of Head and Spinal Cord Injured Citizens, the Need for Research, and the Needs of All Physically Handicapped Persons

  • Published: 1991
  • Author: Joint Subcommittee
  • Enabling Authority: House Joint Resolution 287 (Regular Session, 1989)

Executive Summary:
I. AUTHORITY FOR THE STUDY

During the 1988 Session of the Virginia General Assembly, House Joint Resolution No. 135 (Marks) and House Joint Resolution No. 149 (Mayer) were introduced to request the creation of a joint subcommittee to study the needs of head and spinal cord injured citizens and head injured citizens, respectively. After reviewing the resolutions, the General Assembly determined that a broader perspective of the issues would better serve and assist the Commonwealth in developing sound health and social policies to meet their needs. To facilitate an examination of these issues, the General Assembly incorporated House Joint Resolution No. 149 into House Joint Resolution No. 135, which was passed to create a joint subcommittee to study the needs of head and spinal cord injured citizens, and related research needs in the Commonwealth. The 1989 General Assembly continued the study for one year under House Joint Resolution No. 287, which incorporated Senate Joint Resolution No. 143 (Colgan), to provide that the Joint Subcommittee also study the needs of all physically handicapped persons.

The members of the Joint Subcommittee are Alan E. Mayer, Chairman; Arthur R. Giesen, Jr., Vice Chairman; Delegates E. Hatcher Crenshaw, Jr.; George H. Heilig, Jr.; and Senators Virgil H. Goode, Jr.; Kevin G. Miller; and Richard L. Saslaw. Altamont Dickerson, Jr., Ed.D., Commissioner of the Department of Rehabilitative Services, served ex officio. Ms. Susan Urofsky succeeded Dr. Altamont Dickerson as Commissioner of Rehabilitative Services and served in that capacity as an ex officio member of the Joint Subcommittee.

II. ACTIVITIES OF THE JOINT SUBCOMMITTEE

During the second year of its study, the Joint Subcommittee focused its attention on the issues which it had continued for further examination and the needs of all physically handicapped persons. The Joint Subcommittee included the following issues in its deliberations:

• The extent to which persons with traumatic brain injury are misdiagnosed and inappropriately placed in state mental health institutions;

• The relationship between traumatic brain injury and crime;

• The needs of head and spinal cord injured children, particularly those between the age of fifteen and twenty-one;

• The need for a community coordinator at the state's medical schools;

• The need for regional demonstration projects for the long-term care of low-level functioning head injury survivors and demonstration behavioral treatment programs;

• The adequacy of coverage and benefits of health insurance for central nervous system disorders;

• The need for establishing revenue generating initiatives to fund services and research for persons with central nervous system disorders;

• The need to request the Medical Society of Virginia to encourage practicing physicians to increase their patient education efforts to individuals with central nervous system disorders, particularly those with head and spinal cord injuries, and to provide more information to the families of such individuals concerning the nature of the disability and care of the patient upon discharge; and

• The review of the provisions and status of implementation of the "Technology-Related Assistance for Individuals with Disabilities Act of 1988" to ensure that Virginians of all ages may avail themselves of assistive technology devices that would enable them to "participate independently in the tasks of daily living."

To accomplish its objectives, the Joint Subcommittee conducted meetings and a public hearing to solicit public comment concerning the needs of head and spinal cord injured and physically handicapped citizens. It combined its discussions on the needs of such individuals and other relevant issues with presentations from persons with expertise in such areas and conferred extensively with the medical community, state agency heads, advocacy groups, caregivers, and other interested parties concerning the needs of persons with traumatic brain injury, spinal cord injury, and physically handicapping conditions in order that it might offer feasible alternatives to state health and :'social policies" where appropriate, and develop recommendations which would address the needs of such persons effectively and efficiently.

The Joint Subcommittee categorized the issues and organized its meetings such that each meeting would be devoted to an in-depth review of certain issues. The first meeting included a staff review of the Joint Subcommittee's activities during its first year of the study, its findings and recommendations to the 1989 General Assembly, including a status report on the implementation of House Bill No. 1486, the Long-Term Rehabilitative Case Management System, and a presentation concerning the needs of the physically handicapped.

Subsequent meetings were devoted to discussions of the following issues: the educational needs of traumatically brain injured, spinal cord injured, and physically handicapped persons; the need to increase and improve transportation services for the physically handicapped; initiatives for assessing the rehabilitation, social, housing, employment and behavioral treatment needs of these persons; an evaluation of the level of medical assistance and health care services to the handicapped population with particular emphasis on the need to increase and improve such services; an examination of insurance issues, including the need for coverage of rehabilitative and other appropriate medical services; and a review of fund-generating initiatives.