Idaho State University

TBI Implementation Grant Abstract

PROBLEM:
The CDC ranks Idaho seventh in the nation for per capita hospitalization and rate of disability due to TBI. Idaho is characterized by a widely dispersed population with varying access to generic services. Professionals and persons with a TBI may not be able to locate appropriate services in the generic system. In addition to difficult geography, the low population density translates to fewer people with TBIs for professionals to see.

The Idaho Department of Health and Welfare (IDHW) includes Divisions of Health, Medicaid, Family and Community Services (FACS), and Self-Reliance. The proposed project will be administered by FACS, which directs state social service programs. IDHW will contract with the Idaho State University Institute of Rural Health (ISU-IRH). The principals have worked together on TBI Planning and Implementation Grants. ISU-IRH will subcontract with Assist Guide, Inc. for the Virtual Program Center (VPC).

GOALS AND OBJECTIVES:
The overarching goal is to move forward with a sustainable, comprehensive, coordinated, community-based system of support for individuals with a TBI and their families. The following goals and objectives are proposed.

Goal 1: Continue the annual Needs and Resources Assessment

1. 1.1  Collect data 2006-2008
2. 1.2  Provide annual summary of results to IDHW/FACS

Goal 2: Sustain TBI Virtual Program Center (VPC)

1. 2.1   Maintain the VPC contract with AssistGuide
2. 2.2   Market the VPC
3. 2.3   Track VPC user statistics
4. 2.4   Determine and monitor likelihood of provider support for VPC
5. 2.5   Examine and establish a private location for the VPC

Goal 3: Move TBI Advisory Council forward

1. 3.1  Work toward gubernatorial or legislative authority

Goal 4: Advance TBI Virtual Grand Rounds/Educational Activities

1. 4.1  Continue VGR series
2. 4.2  Move toward technological advancement

Goal 5: Monitor the implementation of the State Trauma Registry and use of the TBI Medicaid Waiver

1. 5.1  Assist with promoting TBI to Registry planners
2. 5.2  Partner with key stakeholders to increase access to the waiver.

METHODOLOGY:
Through the 5 goals listed above we propose to move TBI forward in the state of Idaho. We intend to continue to collect information about people who have a TBI or a family member to compare and contrast services/supports they need and receive, with those they are able to receive at a later time. To improve service/support access, we propose, by collaborating with AssistGuide, to augment the TBI VPC created under the earlier Implementation Grant (2003-2006). Their expertise in creating and supporting similar endeavors will be valuable as the team strives for a high quality design, user friendly features, and attention to special detail necessary for the targeted consumer group. Ultimate goals of the VPC are: (1) to make the service/support system available to all people by providing information and skill development to providers, thus strengthening their ability to work with persons with TBI, and (2) to empower consumers by providing resources. Over the next 3 years we propose to maintain the VPC system with the ultimate goal of finding a permanent and appropriate home at the end of the grant term. The Advisory Group will assist with grant objectives including monitoring of VPC support, and assisting with promoting TBI to registry personnel.

The program will be continued using strategic alliances, ongoing assessment, and policy review and planning. The method of development rests on improving access to services by improving access to information through the VPC and the Virtual Grand Rounds (VGR). The VPC and VGRs give providers current knowledge of TBI, best approaches to treatment, information on services, best practice standards, and consumer empowerment guides. A key element of sustaining the project is based on understanding policy, economic, and health services aspects of the healthcare system.

COORDINATION:
Collaboration is at the core of Idaho's work to improve the services systems for TBI. The design of Idaho's action plan has been to build the capacity of existing systems to serve persons with a TBI as opposed to creating separate systems of care. Idaho has strong inter-agency and stakeholder collaborative processes. The TBI Planning Grant and subsequent Implementation Grant brought together representatives of major service providers, state agencies, and persons with a TBI and family members. This new initiative continues to build upon this momentum. The state TBI Advisory Council has representation from core state agencies, service providers, and persons with a TBI and family members.

EVALUATION:
The evaluation will have two aspects (a) a process evaluation and (b) quantitative evaluations. Usage statistics generated via the VPC will be analyzed on an ongoing basis. Through the annual Needs and Resource Assessment, service type, availability, and quality will be tracked across time to determine if changes made to the system through these grants are actually changing the type, availability and quality of services for people with TBIs and family members. In addition, quality of life will be compared across time to see if change results. Data will be collected and analyzed to evaluate the effectiveness of the project in addressing two Healthy People 2010 goals: 1) to improve access to comprehensive, high quality health care services, and 2) to increase the quality, availability, and effectiveness of educational and community-based programs designed to improve health and quality of life. The project will generate data as it relates to the TBI State Grant Program goals.