Evaluating the HRSA Traumatic Brain Injury Program (2006) / Chapter Skim
Currently Skimming:
Appendix E: Stakeholders Assess the HRSA TBI Program: A Report on National Interviews and Interviews in Seven States
Appendix E: Stakeholders Assess the HRSA TBI Program: A Report on National Interviews and Interviews in Seven States
Pages 291-321
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 291... ...
APPENDIX E Stakeholders Assess the HRSA TBI Program: A Report on National Interviews and Interviews in Seven States Holly Korda, M.A., Ph.D. Health Systems Research Associates Chevy Chase, Maryland S takeholder interviews were conducted during the summer of 2005 in a sample of seven states: Alabama, California, Colorado, Georgia, New Jersey, Ohio, and Washington State.
|
From page 292... ...
292 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM resentatives of key state agencies, TBI trust funds, Medicaid waivers, and related interests. State TBI lead agency representatives helped to identify appropriate representatives to be contacted in their states.
|
From page 293... ...
APPENDIX E 293 4 6 18 6 7 16 9 FIGURE E-1 TBI study respondents. gists and staff (n=6)
|
From page 294... ...
294 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM was subsequently expanded to 2 years, and Implementation grant funding was expanded to 3 years. After reauthorization of the Federal TBI Program in 2000, Post-Demonstration grants were introduced and became available, as 1-year awards.
|
From page 295... ...
APPENDIX E 295 and its Vocational Rehabilitation programs. California and Washington State also noted early efforts to address TBI through their states.
|
From page 296... ...
296 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM II. HRSA TBI Grant Experience The seven study states used diverse approaches and met with varied results implementing their HRSA TBI Program grants.
|
From page 297... ...
APPENDIX E 297 Board described it as "unwieldy, with 5060 members." Another added, "It's hard to work with a group that large .
|
From page 298... ...
298 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM States often change lead agencies in search of an appropriate "home" for TBI in state government. Placement of the lead agency is closely tied to the political and programmatic leadership, commitment, and focus of the state's TBI activities.
|
From page 299... ...
APPENDIX E 299 Approaches used by the four sample states that developed Needs and Resources Assessments for their Planning grants are included below. · California used multiple methods to obtain information for their Needs and Resources Assessment, including provider and public assessments, public meetings, and extensive networking throughout the state.
|
From page 300... ...
300 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM Often, states must refine or revisit their planning as resources and conditions in the state change. California reportedly made great strides pulling together different constituents in developing its State Action Plan, resulting in "a very democratic process .
|
From page 301... ...
APPENDIX E 301 edly achieved only modest success completing tasks proposed under the grant, with an ambitious agenda, changes in states government, and difficulties pulling together the Lead Agency and Advisory Board. Georgia's TBI Advisory Board disbanded after the Implementation grant was completed.
|
From page 302... ...
302 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM Post-Demonstration Grants States found the 1-year award cycle and the $100,000 funding cap on Post-Demonstration grants to be too short a time, and too limited in support for meaningful TBI projects. While some states were able to pilot projects that otherwise would not have been funded through the program, most respondents noted that these grants were difficult to develop and implement.
|
From page 303... ...
APPENDIX E 303 Respondents in the five states that received Post-Demonstration grants noted that the grants had helped them develop TBI projects in new and underdeveloped areas -- but most found it difficult to work within the grant's time frames and funding limits. Respondents commented, "The Post-Demonstration grants we've seen as helpful but also frustrat ing.
|
From page 304... ...
304 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM P&A respondents used their HRSA grants to "raise the visibility of the P&A" as a provider of advocacy for persons with TBI, and looked for ways to leverage limited funding, starting at $50,000, to achieve this goal. Respondents reported providing education, outreach, and training about TBI within their own organizations, in the provider community and the public.
|
From page 305... ...
APPENDIX E 305 III. TBI Service and Systems Coordination States described a spectrum of service system coordination, col laboration, and fragmentation.
|
From page 306... ...
306 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM TABLE E-3 TBI Services and Systems Coordination in Study States Alabama AL has an established core service delivery network -- the Interactive Community-Based Model (ICBM) -- that uses care coordinators to help individuals with TBI and their families access services and supports across state agencies and organizations.
|
From page 307... ...
APPENDIX E 307 TABLE E-3 Continued Washington Many people reportedly receive in-home services in WA. The Seattle area is location to a cluster of facilities with services for persons with TBI, including University of Washington's Harborview Hospital, but Seattle-based services are not readily accessible to the state's rural residents.
|
From page 308... ...
308 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM waivers. In Ohio, the P&A developed a model waiver and has played a key role advising the state on related issues.
|
From page 309... ...
APPENDIX E 309 TABLE E-5 TBI Trust Funds in Study States Year State Established Amount Description Alabama 1993 $1.2 million The Impaired Driver's Trust Fund is supported through fines on DUI convictions @ $100 per conviction. A portion of the revenues is used to support the TBI registry; remaining funds provide direct or purchased services.
|
From page 310... ...
310 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM State and Colorado also identified Native Americans in their states among those difficult to reach and serve. Both states and P&As have initiated activities to reach out to these populations, with varying success.
|
From page 311... ...
APPENDIX E 311 disabled .
|
From page 312... ...
312 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM (SCI) registry.
|
From page 313... ...
APPENDIX E 313 comes and service use and difficulties obtaining funding to sustaining data collection efforts are among respondents' top concerns. Respondents commented: "We don't know a lot about outcomes regarding TBI.
|
From page 314... ...
314 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM take, demographics, and the type of inquiry. It also includes the attorney notes." National leaders including the Executive Director of the P&A association are working to identify measures for TBI and disability advocacy that can be used by P&As nationwide through DAD.
|
From page 315... ...
APPENDIX E 315 has also engaged two evaluators to assess the state's Implementation grant activities. The evaluators also serve as program consultants, sharing results with the state and its TBI Advisory Board.
|
From page 316... ...
316 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM 8. TBI Program Benchmarks 8 6 7.
|
From page 317... ...
APPENDIX E 317 While states praised the services provided by the TBI TAC, one national stakeholder raised concerns about the level of resources provided to the TBI TAC. This respondent noted that the TBI TAC receives a generous portion of HRSA's TBI Program appropriation2 compared with the limited funding provided to states and the P&As, stating .
|
From page 318... ...
318 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM efits and drawbacks of their states' participation. Respondents were also asked to provide comments and suggestions for program improvement.
|
From page 319... ...
APPENDIX E 319 commitment. Many called out for formula funding, on a regular schedule to allow program continuity.
|
From page 320... ...
320 EVALUATING THE HRSA TRAUMATIC BRAIN INJURY PROGRAM pansions, trust fund development, and other activities. Some examples include: · New Jersey developed the core components of its state TBI program in anticipation of the state's receiving their first HRSA grant award.
|
From page 321... ...
APPENDIX E 321 the same, including discretionary support and mechanisms to help sustain their TBI programs. Some example comments include: "We are glad the TBI program is there, grateful for funding and support.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.