RD291 - 2008 Annual Report of the Commonwealth Neurotrauma Initiative Trust Fund


Executive Summary:
In December 2007, the current CNI Advisory Board chair, David B. Reid, Psy.D., was re-elected for an additional one-year term as Chair of the Advisory Board (per the bylaws of the Advisory Board, the Chair is eligible for re-election after a term of one-year).

During this reporting period, the Fund had fifteen (15) active community-based and research grants totaling $1,866,108.

The Board approved funding to two grantees, the Brain Injury Association of Virginia ($141,666.67) and Virginia Commonwealth University ($22,756) under the Commissioner’s authority given in State Fiscal Year (SFY) 2004: budget Item 349#3c allows the Commissioner of the Department of Rehabilitative Services (DRS) to “… reallocate up to $500,000 from unexpended balances in the Commonwealth Neurotrauma Initiative Trust Fund to fund new grant awards for research on traumatic brain and spinal cord injuries.” The Brain Injury Association of Virginia (BIAV) was awarded funding from November 1, 2007-June 30, 2009 in the amount of $141,666.67 ($56,667 in State Fiscal Year 2008 and $85,000 in State Fiscal Year 2009). BIAV is conducting a study of various methods to determine an effective way of providing outreach to people in the Commonwealth who sustain brain injuries. In March 2008, the Board approved funding for one year (April 2008-March 2009) in the amount of $22,756 to Virginia Commonwealth University (VCU). Principal Investigator, Tony Gentry, Ph.D., OTR/L, is researching the effectiveness of the concept of a “Smart Home” for people who experience cognitive impairment due to brain injury.

One Option-B Community Based Rehabilitative Services grantee, Woodrow Wilson Rehabilitation Center’s very successful grant using the ERGYS electrical stimulation machine for people with spinal cord injury, completed its grant contract. The grant was originally slated to end June 30, 2007; however, a six-month no-cost extension through December 31, 2007 was approved to allow them to finish up their grant activities.

Two Option-B Community Based Rehabilitative Services grantees, the Brain Injury Resource & Development Center, Inc.’s grant to develop a clubhouse program for people with brain injury in the Roanoke area and Woodrow Wilson Rehabilitation Center’s grant to investigate the feasibility of establishing a specialized residential substance abuse treatment program for people with spinal cord injury and brain injury, were approved to carry grant funds forward from State Fiscal Year 2008 to State Fiscal Year 2009 in the amount of $192,000.

It is anticipated that three additional grantees under Option-B which were funded in July 2006 will also request carryover from Year Two to Year Three of their grant contracts. This will not be known until their final Year Two reimbursements are submitted, which occurs in State Fiscal Year 2009 based on the reimbursement process for the grant awards. It is expected that all six Option-A Research grantees will be requesting carryover from Year One (July 1, 2007-June 30, 2008) to Year Two (July 1, 2008-June 30, 2009) once final Year One reimbursements are submitted (again, this will occur in State Fiscal Year 2009 based on the grant reimbursement process). Requests to “carry forward” unexpended funds from one grant year to the next are common due to inevitable delays or changes in late start-up, hiring staff, ordering and equipping an office or laboratory, and similar challenges. In addition, grantees often request “no cost extensions” that allow them additional time to analyze data and prepare final reports at the conclusion of their active funding period.

Also, one Option-B Community-Based Rehabilitative Services grantee, Wintergreen Adaptive Skiing, was awarded an additional $13,800 for the third year of their grant contract due to an expansion in their scope of services involving accommodations for their consumers’ caregivers which was not originally anticipated as a requirement to execute grant activities.

Program Operations

The Advisory Board of the Commonwealth Neurotrauma Initiative (CNI) Trust Fund held four quarterly meetings, per bylaws, in State Fiscal Year 2008: September 21, 2007; December 14, 2007, March 14, 2008 and June 13, 2008.

The four-year terms of two CNI Advisory Board members ended on June 30, 2008. Gregory Helm, M.D., Ph.D. of University of Virginia (UVA) Medical Center in Charlottesville, was eligible for, and requested (and was granted) re-appointment to, a second term (“one person licensed to practice medicine in Virginia experienced with brain or spinal cord injury”) beginning July 1, 2008 and ending June 30, 2012. Richard Bendall, M.D. of Lynchburg did not request reappointment. A new member, Page Melton, was appointed as of July 1, 2008 to fill this vacancy (“one Virginian with a traumatic brain injury or caretaker thereof”).

The Department of Rehabilitative Services (DRS) began the formal review process of the State Regulations for the CNI Trust Fund in the fall of 2007, continuing through June of 2008. This is the first review of the CNI Regulations since they were originally developed ten years ago by the Virginia Department of Health (VDH), the state agency that had initial responsibility for managing the Trust Fund. The agency’s review resulted in minor changes proposed by DRS (there were no public comments received during the mandatory public comment period) to “clean up” the format and content of the Regulations, and to bring them into line with operational procedures for issuing Requests For Proposals (RFPs) and managing grant contracts. Kristie Chamberlain, CNI Trust Fund Program Specialist and staff to the Board; Patti Goodall, Manager of DRS Brain Injury Services Coordination Unit; and Vanessa Rakestraw, Policy Specialist with DRS Policy & Planning, met with two staff from the Department of Planning and Budgets (DPB) to review the proposed changes. The modifications to the Regulations do not affect the operation of the Trust Fund program and DPB had no objections to any of the proposed changes. Due to the lengthy and complicated process, reviews of State Regulations are conducted infrequently, with only necessary changes proposed.

At its December 14, 2007 meeting in Richmond, the Advisory Board re-elected David B. Reid, Psy.D. as Chair. Dr. Reid, Clinical Psychologist at Augusta Psychological Associates in Waynesboro, Virginia will serve as Chair for an additional one-year period (December 2007 through November 2008). Dr. Reid was originally appointed to the Board in July 2005 to serve a four-year term, filling the Board vacancy for a ”person licensed by a health regulatory board within the Department of Health Professions with experience in brain or spinal cord injury rehabilitative programs or services.” He was initially elected as Board Chair in December 2005 for a one-year term. Per bylaws,”…the chairperson shall be elected from the membership of the Advisory Board for a term of one year and shall be eligible for reelection.”

Administrative staff for the fund consists of one full time position (Kristie Chamberlain, CNI Trust Fund Program Specialist and staff to the Advisory Board); and two part-time (15%) positions (Patti Goodall, Manager of the DRS Brain Injury Services Coordination Unit, and Anneice Skipper, Administrative and Fiscal Specialist in the Brain Injury Services Coordination Unit). Ms. Goodall provides supervisory oversight for the operation and management of the CNI Trust Fund program, and Ms. Skipper provides fiscal and administrative support to the Fund.

Program Funds

Moneys have been collected and deposited into the CNI Trust Fund since 1998, when a citizen donated $25 to the Fund. The funding mechanism for CNI (a reinstatement fee charged to restore an operator's license when it has been revoked or suspended for specified dangerous driving offenses) was established by legislation in 1998, a year after the Trust Fund and the Advisory Board were established in the Code of Virginia. The CNI Trust Fund is a special nonreverting fund in the state treasury. The Fund balance has continually increased by operation of the statutory funding mechanism in which a portion of the reinstatement fee is deposited into the Fund ($25 out of the $30 fee collected).

The fund consists of grants, donations, and bequests from the public or private sources and funds collected as provided in § 46.2-411 of the Code. The revenue in State Fiscal Year 2008 averaged about $102,800 per month, or about $1.23 million for the year. Though the money coming into the Fund has remained relatively stable since it was established, there is always the possibility that revenue will increase or decrease during any given fiscal year. In State Fiscal Year 2008, staff and other administrative costs were budgeted at $83,892; $75,036 was actually expended. Administrative costs for State Fiscal Year 2009 have been budgeted at $93,892. The increase in funds will cover the cost of a Community Grants Colloquium to be sponsored by the CNI Advisory Board during SFY 2009.