RD79 - Annual Report of the Virginia Department of Rehabilitative Services Brain Injury & Spinal Cord Injury Services For State Fiscal Year 2007-08


Executive Summary:
The 2008 General Assembly appropriated an increase of $200,000 for brain injury services for State Fiscal Year (SFY) 2009 (as well as an additional $200,000 for SFY 2010). Since the early 1980’s when it was designated in the Code of Virginia as the “lead agency” for coordinating services for people with brain injury, the Department of Rehabilitative Services (DRS) has recognized the need to develop, improve, and expand community-based rehabilitation services for Virginians with brain injuries, particularly in unserved and underserved areas of the state. The first appropriation of General Assembly funding designated specifically for brain injury services was made in 1989, when $235,000 was awarded to Fairfax County. As funding for brain injury services began to increase in the 1990s as the result of increased advocacy on the part of the Brain Injury Association of Virginia (BIAV) and the Virginia Alliance of Brain Injury Services Providers (VABISP), the Division of Legislative Services (DLS) requested in 2004 that DRS describe a foundation or “footprint” of services that could be funded and established in unserved and underserved communities. These “core services” would serve as the initial infrastructure for a developing network of brain injury programs statewide. DRS worked collaboratively with the Virginia Brain Injury Council (VBIC) and the Virginia Alliance of Brain Injury Services Providers to achieve consensus on a footprint comprised of three core services: case management services for adults and children, clubhouse / day program, and regional resource coordination. General costs associated with these services were conservatively estimated at that time to be a minimum of $150,000 for a clubhouse/day program model, and $75,000 each for a case manager or a regional resource coordinator. Specific information about the “core services” is available through the DRS Brain Injury Services Coordination (BISC) Unit or on the DRS website. A link to the October 2007 report by the Joint Legislative and Audit Review Commission on “access to brain injury services in the Commonwealth” (discussed later in this document) is also available on the DRS website.

Through a SFY 2006 budget amendment, DRS was required to “consider the recommendations of the Virginia Brain Injury Council when disseminating new funds for brain injury services.” The Council has served as the advisory group to the DRS Commissioner since the late 1980s and also agreed to serve as the “official” advisory body for Virginia’s federal Traumatic Brain Injury (TBI) Planning Grant (1998-2000) and subsequent TBI Act Implementation Grants (2001-present). A statewide advisory group for brain injury is a requirement under the federal TBI Act funding. Through the 2004 budget amendment, the Council was given added authority to provide a recommendation or plan for dissemination of funding allocated by the General Assembly for brain injury services. Although DRS has always striven to work collaboratively with the Council in identifying effective approaches for dissemination of General Assembly funding, this relationship is now formalized.

No new programs were funded in SFY 2008 with the $200,000 allocated by the General Assembly; however, funding was used to support and strengthen the state’s infrastructure for the delivery of brain injury services. The plan submitted by the Council for dissemination of the SFY 2008 funding was approved by DRS with only minor changes. Funds were awarded to the nine (9) existing organizations which operate a total of (13) brain injury services programs statewide, using a formula based primarily on longevity of program funding and other considerations. Over 5,000 individuals with brain injury, family members, and professionals received services supported by state funding during SFY 2008. This includes 3,888 people with brain injury who received case management, clubhouse/day program, and regional resource coordination services, as well as 800 consumers and family members served through brain injury support groups statewide. Additionally, 2,600 people received Consultation, Education/Training & Information/Referral services through the state-funded programs (all state-funded programs are required to conduct and report these “community impact” activities). Note that these numbers do not reflect an additional 9,200 people who received the Brain Injury Association of Virginia newsletter and the 200,000 “hits” on the Association’s website. These numbers reflect a breadth and depth of direct service, education/training, and consultation/information/referral that encompasses survivors, family members, and professionals across the state, resulting in enhanced quality of life for survivors and their families.

This report also does not include the “in house” programs administered directly by DRS (i.e., Brain Injury Discretionary Services Fund, Community Rehabilitation Case Management Services, Personal Assistance Services for People with Brain Injury, Vocational Rehabilitation Program and the Woodrow Wilson Rehabilitation Center), which served approximately 1,200 people with brain injury during SFY 2008 (note that numbers served may be duplicated, as consumers sometimes receive services from more than one “in house” program, a contracted program, or a combination of internal and external DRS programs).