Idaho State University

TBI Implementation Grant Abstract

PROBLEM:
Idaho is ranked 7th for per capita hospitalization and rate of disability due to TBI. As a rural state, Idaho is characterized by a widely dispersed population with varying access to services. Recent statistics indicate that 98% of Idaho’s counties are Health and Mental Health Professional Shortage Areas. Formal supports, therefore, are extremely limited and informal support networks are critical to both civilian and military personnel with a TBI. Idahoans have a significant number of active-duty service personnel returning from duty, and study estimates suggest that nearly one-third of patients evacuated from current combat areas may have TBI.

GOALS AND OBJECTIVES:
Specific goals are to:

1. establish a trust fund,
2. solidify Advisory Council,
3. provide a support system to families of returning soldiers, and
4. monitor the TBI Medicaid waiver and trauma registry.

Objectives for goal 1 include a feasibility study, documentation of trust fund need, identification of funding sources, and trust fund education for citizens. Objectives for the 2nd goal involve seeking authority for the Advisory Council. Third goal objectives are to establish support groups, provide training materials, connect family members, and advance TBI education. A new needs and resources assessment is also included. Finally, goal 4 objectives include promotion of TBI to planners, increasing awareness/access, and supporting increased funding and new rate methodology.

METHODOLOGY:
To improve service/support access establishment of a trust fund will occur by identifying funding sources, documenting need and building momentum among people. The team will work toward legislative approval for Advisory Council. The virtual program center (VPC) will be augmented under contract with AGIS Network to support families of returning service members. Their expertise is invaluable as the team strives for high quality, user-friendly features. The Advisory Council will assist with all project objectives including trust fund establishment and monitoring of Waiver use promoting TBI to registry planners. The program continues its use of strategic alliances, assessment, and policy review. Development methodology rests on improving access to services through public policy work and improving access to information through the VPC and Virtual Grand Rounds (VGR). These tools provide current TBI information, treatment approaches, service information, best practice standards, and consumer empowerment guides. Sustaining requires knowledge of policy, economic, and health services aspects of the healthcare system.

COORDINATION:
Collaboration is at the core of Idaho’s work for TBI. The action plan was designed to build on existing systems that serve people, as opposed to creating separate systems of care. Idaho has strong inter-agency and stakeholder collaborative ties. The TBI program has brought together service providers, state agencies, persons with a TBI and family members. This proposal builds on this momentum and includes service members and their families. The TBI Advisory Council represents state agencies, service providers, individuals and family members.

EVALUATION:
Quantitative and qualitative methods will be used to track steps toward securing advisory council legislative authority, changes in waiver reimbursement and utilization, and trust fund research. VPC usage statistics will be analyzed on an ongoing basis. Via the 3rd year needs and resource assessment, service type, availability, and quality will be tracked across time to determine if system changes have impacted type, availability and quality of services. VGR sessions will be evaluated for quality, timeliness, and effectiveness. These data will serve to address Healthy People 2010 goals.