RD452 - Annual Report of the Virginia Department for Aging and Rehabilitative Services (DARS) Brain Injury & Spinal Cord Injury Services for State Fiscal Year 2014-16 (July 1, 2014 to June 30, 2015)


Executive Summary:
*This report was replaced in its entirety by the Department for Aging and Rehabilitative Services on December 17, 2015.

When the 2004 General Assembly appropriated funds for brain injury services for State Fiscal Years 2005 and 2006 in Item 327.4 of the Appropriations Act, it also directed that

“…the Department of Rehabilitative Services shall submit an annual report to the Chairmen of the Senate Finance and House Appropriations Committees documenting the number of individuals served, services provided, and success in attracting non-state resources.”

The information contained herein constitutes the 2015 Annual Report of State-Funded Brain Injury Services Programs from the Department for Aging and Rehabilitative Services (DARS) to the Chairmen of the Senate Finance and House Appropriations Committees. The State Fiscal Year 2015 allocation of state general funding for DARS-contracted brain injury services was $3,804,343. The ten (10) organizations that contracted with the State to operate 13 community-based programs for Virginians with brain injury statewide brought in $2,485,349 in non-state resources, including cash and donated goods/services (see chart below).

During the latter part of FY ’15, there were programmatic budget reductions taken from the state general dollars allocated for brain injury services: the state-funded Brain Injury Services (BIS) Programs / Contractors were cut by $122,124 for FY ’15. Although initially anticipated, additional reductions were not taken in FY ’16 and, in fact, the brain injury advocacy community successfully garnered increased funding for FY ’16 (including a restoration of the FY ’15 reduction amount, additional overall increase, as well as funding for new services). The reductions taken in FY ’15 did have a small negative effect on the programs’ abilities to operate at full capacity (total numbers served were slightly lower than previous years). However, it is worth noting that the BIS Programs were creative in managing the reduced funding amounts so that the effect on service provision was negligible. Further, the programs successfully brought in $2.5 million in nonstate funding and resources.

Another significant issue during this reporting period is that the General Assembly directed the Joint Commission on Health Care, effective July 2014, to undertake a study evaluating existing resources and access to brain injury services in Virginia. This effort, which will take two years, is currently underway and DARS has met with JCHC staff multiple times, as well as facilitated access to the Virginia Brain Injury Council, state-funded BIS Programs, and other stakeholders. DARS is working to provide JCHC with requested information and data. DARS is also coordinating JCHC reporting to the Virginia Brain Injury Council, the Commonwealth Neurotrauma Initiative Trust Fund, and other community partners such as the Department for Behavioral Health and Developmental Services (DBHDS).

HISTORY OF FUNDING OF BRAIN INJURY SERVICES

In 1989, the Department of Rehabilitative Services was designated in the Code of Virginia as the “lead agency to coordinate services” for individuals with physical and sensory disabilities, including people with traumatic brain injury. The 1989 General Assembly also appropriated the initial allocation of funding specifically designated for brain injury services: $235,000 to Fairfax County for the development of a nonprofit organization to provide a continuum of State-contracted brain injury services in Northern Virginia (primarily specialized brain injury case management). This resulted in the establishment of Head Injury Services Partnership (HISP), a nonprofit in Springfield, Virginia now called Brain Injury Services, Inc. The DARS’ Brain Injury Services Coordination (BISC) Unit, which manages specialized programs, services, grants and contracts for people with brain injury, was established by the agency in 1992, along with a State brain injury coordinator position.

Although funding for brain injury services has increased steadily albeit slowly since 1989, the most dramatic increases occurred during State Fiscal Year 2005, an historic year for funding of brain injury services in Virginia. A total biennial appropriation of $1.9 million ($825,000 in 2005 and $1,075,000 in 2006) represented the single largest allocation of State funding designated for services to people with brain injury. No additional funding was allocated until State Fiscal Year 2009, when $200,000 was appropriated for the purpose of supporting the infrastructure of existing State-funded programs, to strengthen their ability to operate at maximum level. No new funding was appropriated by the General Assembly in State Fiscal Year 2010; a 5% reduction was taken in State Fiscal Year 2011 ($191,050), which was then restored in State Fiscal Year 2012 via a budget amendment (Item 320 #4c, which added $194,931 to the General Fund the second year to restore funding for brain injury services that was reduced in Chapter 874 of the 2010 Virginia Acts of Assembly). No new funding was allocated for brain injury services in State Fiscal Year 2013. A modest allocation of $105,000 to address existing wait lists was appropriated by the General Assembly for State Fiscal Year 2014. A small reduction of $122,124 was taken out of the budget in the middle of the fiscal year, necessitating some cost cutting measures by the programs (reduced hours, etc.).

Since the initial allocation of State funding in 1989 ($235,000) to the current State Fiscal Year 2015 level of $3,804,343, brain injury services funding has increased an average of only $146,321 per year. As directed in the 2005 Appropriations Act, and as documented in this report, state-funded Brain Injury Services Programs work hard to attract non-state resources to supplement the contracted state general funds which do not fully support their operating costs. This additional nonstate funding helps to relieve, but does not eliminate, wait lists and the inability to expand types of services or geographic areas served. As the cost of doing business continues to rise against a backdrop of level and decreased funding, several programs have reduced, or delayed filling, a number of staff positions. Adequate funding to support the infrastructure of existing programs remains an ongoing challenge, and funds to create new programs that serve Virginians with brain injury also remains a crucial need.