Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Table of Contents
Collaborative Effort 2
Arkansas TBI Registry 3
Understanding Traumatic Brain Injury 4
Understanding Traumatic Brain Injury in Arkansas 5
Traumatic Brain Injuries by Arkansas County 6
Top Needs in Arkansas 7
Focus Area 1: Case Management and Appropriate Referral to Rehabilitative Services and
Facilitation Resources 8
Focus Area 2: Resource Facilitation 11
Focus Area 3: Employment and Job Training Advocacy 18
Focus Area 4: Development of a Trust Fund and/or Medicaid Waiver Program 19
Appendix A – Arkansas TBI Advisory Board Workgroup 22
Arkansas State Plan Development Sub-Workgroup 23
Trust Fund, Waiver Program, and Financial Strategies Sub-Workgroup 24
Underserved Populations Sub-Workgroup 25
References 26
Acknowledgements 27
1
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Collaborative Effort
The Arkansas State Plan for Traumatic Brain Injuries is a collaborative effort to identify specific
needs and gaps in services within the Arkansas TBI population and a commitment to work
together to meet the needs of survivors, caregivers, family members, and health care providers.
While the adult population is the focus of this plan, there is an understanding that TBI affects
individuals across their lifespans. Additional focus is needed on the impact of mild concussions
to improve the care, coordination, and outcomes for Arkansans of all ages.
Collaborating partners include:
• Administration for Community Living, TBI State Partnership Program (ACL TBI SPP)
• University of Arkansas for Medical Sciences (UAMS)
• Institute for Digital Health & Innovation (UAMS)
• Arkansas Department of Health (ADH)
• Trauma Rehabilitation Resources Program (TRRP)
• All the volunteers that comprise the Arkansas TBI Advisory Board Workgroup
The Arkansas State Plan for Traumatic Brain Injuries is a grant deliverable. In June, 2018, IDHI
UAMS received a $450,000 grant from the U.S. Department of Health and Human Services,
Administration for Community Living (ACL). The Traumatic Brain Injury State Partnership
Program State Funding Opportunity was awarded in the amount of $150,000 a year for three
years. The Arkansas Department of Health (ADH) provides $75,000 annually through an “in
kind” match with the TRRP.
Efforts and outcomes of the TBI SPP grant support the goals of the TRRP, which houses the
Arkansas TBI Registry. An overview of the grant and status of deliverables is available in
Appendix A.
The goals of this plan include: (1) Identify needs and ways to address needs within the Arkansas
TBI population; (2) Promote awareness and education of TBI; (3) Motivate others to support
infrastructure and resource development for this vulnerable population.
It is the hope of the TBI Advisory Board Workgroup, organized through the ACL TBI SPP grant, to
gain recognition by the Arkansas Governor’s Office. This recognition would help to further
conversations about the legislation needed to develop a trust fund and/or waiver program and
other infrastructure needs within the TBI community in Arkansas. A TBI Advisory Board
Workgroup Directory of participants is available on the TBI SPP in Arkansas website.
2
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Arkansas TBI Registry
412 moderate-to-severe traumatic brain injuries were reported
to the Arkansas TBI Registry in 2019. ~ AR TBI Registry Data
Individuals living in Arkansas who sustained a Traumatic Brain Injury (TBI) went mostly
unnoticed prior to the development of the Arkansas Trauma System (ATS)
1
. The Arkansas
Department of Health (ADH) is the agency responsible for implementing and maintaining the
Trauma System, which originated from Act 393.
2
The ATS and the ADH began mandating reporting through Statute 20-14-703,
3
which requires
that public and private health, social agencies, and attending physicians refer Arkansans who
have sustained newly-identified, moderate-to-severe traumatic brain injuries to the Arkansas
Traumatic Brain Injury Registry.
The registry was created under a 2014 memorandum of agreement with the Brain Injury
Alliance of Arkansas (BIAA, which is no longer active in the state) and a contract with the
Arkansas Spinal Cord Commission (SCC) who subcontracted with the University of Arkansas for
Medical Sciences (UAMS). After a year of subcontracting, UAMS formed the Arkansas Trauma
Rehabilitation Program (ATRP) under the direction of the Institute for Digital Health and
Innovation (IDHI). The grant was then awarded to IDHI. The registry was rebuilt in house at
UAMS and is currently managed by the Trauma Rehabilitation Resources Program (TRRP).
The Trauma Rehabilitation Resources Program shares registry data to plan for future TBI
prevention and recovery efforts and provides resource facilitation to the TBI community. While
the registry collects data across all ages, TRRP’s focus is the adult population of those
individuals over the age of 18. Currently, mild concussions are not documented in the Arkansas
TBI Registry. (https://atrp.ar.gov/)
Arkansas Trauma
Mandated
System Formed
reporting of head
through Act 393
injuries, Arkansas
Statute 20-14-03
Registry created by a
Memorandum of
Agreement with the BIAA
and a sub-contract with
the Arkansas Spinal Cord
Commission
Sub-contract with the Arkansas
Department of Health moved
maintenance of the Registry to
the UAMS IDHI Trauma
Rehabilitation Resources
Program
3
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Understanding Traumatic Brain Injury
Traumatic brain injury (TBI) is a major cause of death and disability in the U.S. Approximately
2.5 million Americans visit emergency departments with TBI-related injuries each year. Those
who survive TBI can face effects that last a few days, or the rest of their lives. ~ CDC
Traumatic brain injury (TBI) is defined as a blow, jolt or penetration to the head that disrupts
the function of the brain. Most TBIs are caused by falls, jumps, motor vehicle traffic crashes,
being struck by a person or a blunt object, and assault. Blast injuries sustained in combat have
been a growing cause of TBI.
4
TBI can range from mild to severe, and the effects can be temporary or permanent. Many
people who experience a TBI have long-term effects, which can result in lifelong, disabilities and
impairments in a number of areas, including:
5
Thinking and Reasoning
Attention
Speech
Physical Activities
Vision
Memory
Behavior
Understanding Words
Problem Solving
Hearing
Improvements in health care and technology have resulted in people with TBI living longer with
the opportunity for a healthier life. With the improved prognosis, the need for services for
those living with TBI and assistance for their families and caregivers is increasing. Equally
important is education for the public in regards to TBI. Individuals living with TBI have an
invisible injury and the lack of understanding of the changes in the person who is now living
with the effects can cause that person to be isolated even more. There is a greater need to
provide community resources than ever before.
There is no cure for TBI; however, prevention is the most prevailing factor. Improving efforts to
promote the use of seatbelts, child safety seats, helmets, reduction in the occurrence of child
abuse, domestic violence, and other non-accidental injuries are vital to reducing the number of
lives impacted by a TBI.
Many states, including Arkansas, have taken steps to prevent long-term harm to student
athletes who sustain concussions. Prevention measures are essential to reducing the social and
economic burden caused by TBI.
6
4
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Understanding Traumatic Brain Injury in Arkansas
There were 3,014 cases of significant head trauma with a 22% readmission rate
to Arkansas hospitals from2010-2014.
~ 2018 Arkansas Study
7
In Arkansas, resources that provide assistance for people living with brain injuries, their family
members, caregivers, and health care providers are needed to properly care for the
underserved TBI population. In addition to the injury-related challenges, those impacted by
brain injury may have difficulty navigating, accessing, receiving, and paying for services, partly
due to the lack of funding but also to the rurality and lack of resources in their communities.
To address the needs of the TBI population, almost half of the states have enacted legislation to
designate funding. Funding in many of the states is associated with traffic fines and/or
surcharges to vehicle registration and motor vehicle licenses, which supports an array of
programs and services for those living with TBI and their families. Arkansas is one of the few
states that does not have a fund generator. Arkansas also lacks a Medicaid Waiver program
specifically for people living with brain injuries.
7
Arkansas’s aging population also faces risk of resources and services related to TBI. Data
collected by the National Council on Aging indicates that falls are the leading cause of TBI
among adults over the age of 65. The Arkansas State Plan on Aging (2020-20
22) cites U.S.
Census Bureau estimates for 2013 that ranked Arkansas 10
8
in the nation for percentage of
persons aged 60 and above.
th
Between January 1, 2020 and July 16, 2020, 398 referrals to the
TBI Registry or 41.46% of TBIs in Arkansas have occurred in citizens aged 61
9
and older.
10, 11
Without access to appropriate resources and services, people living with brain injury and their
family members often experience unemployment, social isolation, re-occurring hospitalizations,
institutionalization, and homelessness. The Arkansas TBI Registry currently documents 103
rehabilitation or long-term care facilities within the state by patients discharged from hospital
care. The Arkansas Department of Health documents 26 inpatient rehabilitative facilities on
the
ir
12
website.
13
5
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Traumatic Brain Injuries by Arkansas County
Arkansas currently has more than 2,300* people living with brain injury documented in the TBI
Registry. The registry has been in existence since 2013 and documents moderate to severe
injury. TBI by county is provided on the map below, with the exception of 13 with an unknown
county designation.
*Through December 31, 2019
6
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Top Needs in Arkansas
Top needs in Arkansas are currently being identified through online and in-person surveys. In
addition, individuals entered into the Arkansas TBI Registry are contacted by a TRRP staff
member within 30 days of discharge from the hospital to assess needs. TBI survivors,
caregivers, family members, and healthcare providers can provide a broader view into each TBI
survivor’s needs.
By identifying the top needs and working to meet those needs, our goal is to help TBI survivors
forge a path to resources that can allow them to return to work, school, or even relearn the
skills needed to live independently. Meeting some of their needs can improve the quality of life
for those living with the life-long effects of TBI.
The top needs currently identified through data collection are listed below:
• Case management and appropriate referral to rehabilitative services
• Resource facilitation
• Employment supports and job training advocacy
• Trust fund and/or Medicaid waiver program
Surveys are available on the TBI SPP in Arkansas website:
(https://idhi.uams.edu/programs/trauma-telemedicine-programs/tbi-state-partnership-
program/).
7
Focus Area 1: Case Management and Appropriate Referral
to Rehabilitative Services and Facilitation Resources
The goal of rehabilitation after a head injury is successful reintegration back into community
and improved quality of life. Services and needs vary by TBI survivor. While some TBI survivors
need little assistance to regain function, others need ongoing support. Currently, case
management resources are sparse for the TBI population in Arkansas. In fact, there is no
dedicated case management support for TBI survivors. Lack of case management is a major
barrier to success because the medical system can be difficult to navigate. Many TBI survivors
may not be aware of or have access to the services and supports needed to live their most
productive lives within their communities.
Goal 1: Develop a sub-workgroup to focus on the needs of the underserved populations,
including case management and resource facilitation, employment and job training advocacy,
awareness/educational events
Step Year Action Status
1.1.1 1
Organize sub-workgroup
November, 2018
Complete
1.1.2 1, 2, 3 Meet quarterly Ongoing
1.1.3 2, 3 Develop educational and awareness events
• PASSE – Provider-led Arkansas Shared Savings
Entity – public meeting
August, 2019
• Legal Aid of Arkansas
August, 2019
Ongoing
Goal 2: Identify and benchmark case management resources in Arkansas and programs
within the
TBI SPP partner/mentor states to gain input for a statewide
TBI case management
program
Step
Year
Action
Status
1.2.1
2, 3
Identify case management programs and set up
meetings
Ongoing
1.2.2
2
Meet with Tennessee Case Management Program
Leaders – TBI SPP
Complete
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
8
1.2.3
2
Meet with Missouri Case Management Program Leaders
– TBI SPP
Complete
1.2.4
3
Meet with the Arkansas Spinal Cord Commission to
discuss case management and their existing case
management program
July, 2020
Complete
1.2.5
3
Meet with UAMS case management leaders to discuss
case management and follow up available to discharged
patients
July, 2020
Complete
1.2.6
3
Meet with community case management resource
leaders- Sources, etc.
Upcoming
Goal 3: Create a report of findings and outline a proposed plan for case management of TBI in
Arkansas
Step
Year
Action
Status
1.3.1
3
Draft a report based on the information received from
case management meetings, including preliminary
outline for an Arkansas case management program
Upcoming
1.3.2
3
Present findings to the TBI Advisory Board Workgroup in
a public forum (potentially virtual) and gather feedback
Upcoming
1.3.3
3
Incorporate feedback and produce a final report that will
be available to the public on the TBI SPP website
Upcoming
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
9
Goal 4: Develop a proposed plan for case management of TBI in Arkansas
Step
Year
Action
Status
1.4.1
3
Develop a proposed plan for case management,
including identification of existing resources and gaps in
services and infrastructure
Upcoming
1.4.2
3
Present proposed plan to the TBI Advisory Board
Workgroup in a public forum (potentially virtual) and
gather feedback
Upcoming
1.4.3
3
Incorporate feedback and produce a final case
management proposed plan that will be available to the
public on the TBI SPP website
Upcoming
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
10
Focus Area 2: Resource Facilitation
Resource facilitation provides TBI survivors, caregivers, and family members with information
and connections to successfully integrate back into their communities and their lives. Resource
facilitation includes independent living assistance, access to Medicaid, Social Security,
workforce services, home health, assistive technology, nurse-staffed call center, and even apps
that can be accessed on a phone or tablet. Resource facilitation can be done by phone, in-
person visit, email, and regular mail.
Goal 1: Develop a sub-workgroup to focus on the development of a needs assessment and a
state plan
Step
Year
Action
Status
2.1.1
1
Organize sub-workgroup
November, 2018
Complete
2.1.2
1, 2, 3
Meet quarterly
Ongoing
Goal 2: Develop and implement online and in-person needs assessments to identify gaps in
services and supports and to collect data for the TBI State Plan
Step
Year
Action
Status
2.2.1
1
Benchmark needs assessments from partner and
mentor states
Complete
2.2.2
1
Develop online and paper needs assessments
Complete
2.2.3
2, 3
Implement survey
Ongoing
2.1.4
2, 3
Collect and analyze data for inclusion into the state
plan
Ongoing
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
11
Goal 3: Develop and promote awareness and resources, including CE when available, for the
TBI community, including TBI survivors, caregivers, family members, and health care providers
Step
Year
Action
Status
2.3.1
2, 3
Host a minimum of four brain injury regional workshops
• Batesville – May, 2019
• Springdale – May, 2019
• Helena – October, 2019
• Jacksonville – December, 2019
Ongoing
Note: Workshops are currently on hold due to COVID-19.
2.3.2
2, 3
Host teleconferences with CE and store as enduring
material on LearnonDemand.org
• Serving Arkansans Living with Brain Injuries –
July, 2019
• Legal Aid for Low Income Arkansans –
October, 2019
• Assistive Technology – September, 2020
• Workforce Rehabilitation Services –
October, 2020
Ongoing
2.3.3
1, 2, 3
Work with TRRP to develop a TBI community resource
newsletter and provide the survivor story for each
edition – BrainWaves
Ongoing
• The Parker Family (Winter, 2019)
• Joe Page (Spring, 2019)
• Kerrie Snyder (Summer, 2019)
• Tony Thornton (Autumn, 2019)
• Miracles for Mary (Winter, 2020)
• Crystal Payne (Spring, 2020)
• Kim Knight (Summer, 2020)
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
12
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
2.3.4
1, 2, 3
Participate on conference committees
• Arkansas Survivor’s Day Conference
• Arkansas Trauma Symposium
• Brain Injury Conference
• Miracles for Mary – MaryThon
Ongoing
2.3.5
1, 2,
Participate in partner events
• 7
th
Annual Day at the Capitol for Individuals in
Partnership with Arkansas State Independent Living
Services – April, 2019
Ongoing
2.3.6
1, 2, 3
Create repository on the TBI SPP website and document
TBI survivors, family members, and caregivers sharing
their stories to support the TBI community and efforts
toward the need for a trust fund/waiver program
• Tony Thornton
• Crystal Payne
Note: Filming on hold due to COVID-19.
Ongoing
2.3.7
1, 2, 3
Manage media requests
• UAMS Awarded $450,000 Telemedicine Grant to
Serve Traumatic Brain Injury Survivors
(Press Release – July, 2018)
• Traumatic Brain Injury Program Seeks Input Through
Online Survey, Workshops
(Press Release – August, 2019)
• Local Groups Form Alliance to Build Brain Injury
Awareness Through Inaugural Walk
(Press Release – January, 2020)
• UAMS Expands Brain Injury Resources for Rural
Communities Across the State
(KTHV TV Interview – August, 2019)
• TBI State Partnership Program Hosts Brain Injury
Regional Workshops
(DigiHealth Newsletter – Fall, 2019)
Ongoing
13
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
• Update on Traumatic Brain Injury Resources in
Arkansas (AFMC Journal – August, 2020)
2.3.8
2, 3
Seek Brain Injury Awareness Month Proclamation from
Arkansas Governor
Ongoing
Goal 4: Participate with an Arkansas TBI survivor in the Annual ACL Meeting and NASHIA Hill
Day to share the needs of Arkansans living with brain injury and to gain support for needed
services
Step
Year
Action
Status
2.4.1
1, 2, 3
Annual Event
Ongoing
Joe Page, Warden, Arkansas Department of Corrections
(2018, 2019)
2.4.2
3
TBI SPP to sponsor NASHIA memberships for three
TRRP staff members
Complete
2.4.3
3
TBI SPP to sponsor travel to ACL annual meeting for
two TRRP staff members
Upcoming
Goal 5: Provide TBI SPP updates at the quarterly meetings of the Arkansas Trauma Council
(TAC) and the TAC Rehabilitation Sub-Committee to support awareness of resource
facilitation and to promote awareness of accomplishments
Step
Year
Action
Status
2.5.1
2, 3
Share a quarterly letter of accomplishments from the
TBI Advisory Board Workgroup for inclusion in the
Rehabilitation Sub-Committee minutes
Ongoing
2.5.2
2, 3
Share TBI SPP update at the quarterly TAC meeting
Ongoing
14
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Goal 6: Promote the use of telemedicine and the nurse-staffed call center, especially for TBI
survivors living in rural areas within Arkansas and with TBI SPP partner/mentor states
through presentations, publications, and events
15
Step
Year
Action
Status
2.6.1
2, 3
Conduct presentations at conferences
• Telemedicine with SCI & TBI Patients Today and in
the Future – Arkansas Trauma Symposium,
May 2019
• Using Telemedicine to Meet the Needs of the
Arkansas TBI Population – NASHIA SOS,
September, 2019
• Arkansas Rural Outreach Plan presented to the ACL
Underserved Populations Group for inclusion in
Year 3 toolkit deliverable – October, 2019
Ongoing
2.6.2
2, 3
Conduct presentations at Brain Injury Regional
Workshops
• Batesville – May, 2019
• Springdale – May, 2019
• Helena – October, 2019
• Jacksonville – December, 2019
Ongoing
2.6.3
2, 3
Publish articles to promote awareness and available
resources
Ongoing
• Resources Update for Traumatic Brain Injury
Patients, Arkansas Foundation for Medical Care,
August, 2020
2.6.4
2, 3
Conduct media interviews to promote resources
Ongoing
2.6.5
2, 3
Organize teleconferences through Connecting Across
Professions (CAP) that incorporate telemedicine
Ongoing
Goal 7: Participate in ACL workgroups to gather ideas and improve resources availability
Step
Year
Action
Status
2.7.1
1, 2, 3
Advisory Board and Survivor Engagement
Monthly
Ongoing
2.7.2
1, 2, 3
Underserved Populations
Monthly
Ongoing
2.7.3
1, 2, 3
Trust Fund/Waiver Program
Monthly
Ongoing
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Goal 8: Develop Arkansas presence for a national brain injury organization
Step
Year
Action
Status
2.8.1
1, 2, 3
Research national brain injury associations and make
contacts to gain information about bringing a national
organization to Arkansas
Ongoing
2.8.2
2, 3
Meet with David King, Chief Executive Officer,
Minnesota Brain Injury Alliance
Complete
2.8.3
2, 3
Identify a champion
Ongoing
2.8.4
3
Complete the paperwork to create the organization
Upcoming
2, 3
Outreach to Amy Zellmer (Brain & Life Magazine)
Ongoing
Goal 9: Provide support for resource materials provided to families leaving acute care and
rehabilitation facilities and share resources for inclusion on the TRRP website
Step
Year
Action
Status
2.9.1
1, 2, 3
Share new resources for inclusion on the TRRP website
Ongoing
2.9.2
1, 2, 3
Review and provide feedback for the TRRP Family
Resource Guide
Ongoing
2.9.3
2
Provide 500 BIAA Family Resource Guides
Complete
16
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Goal 10: Provide 30-Day follow up for resource facilitation by TRRP for individuals entered
into the Arkansas TBI Registry
Step
Year
Action
Status
2.10.1
1, 2, 3
Phone contact
Ongoing
Goal 11: Assist TBI community through the services and support of the outreach nurse
education, including coordination of telemedicine visits with the TBI population during COVID
and others who have difficulty traveling to see their doctors
Step
Year
Action
Status
2.11.1
1, 2, 3
Phone and in-person contact
Ongoing
Goal 12: Provide input into the development and maintenance of the Arkansas TBI Registry by
making benchmarking connections with other states in the TBI SPP program and through
knowledge gained by working with the TBI community
Step
Year
Action
Status
2.12.1
1, 2, 3
Provide feedback and enhancements through
knowledge gained by working with the TBI community
Ongoing
2.12.2
2
Benchmark other state registries to make connections
and gain ideas to improve the Arkansas TBI Registry
• Alabama
February, 2020
Ongoing
17
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Focus Area 3: Employment and Job Training Advocacy
Employment and job training advocacy can help those living with brain injuries prepare for and
maintain meaningful employment. Needs can range from training and education to job
placement services.
Goal 1: Develop relationships with agencies and organizations that provide employment and
job training advocacy
Step
Year
Action
Status
3.1.1
1, 2, 3
Develop relationships with agencies and organizations
that provide employment supports and job training
advocacy
• Sources
• Arkansas Department of Career Services
Ongoing
Goal 2: Promote awareness of resources
Step
Year
Action
Status
3.2.1
1, 2, 3
Brain Injury Regional Workshops
Ongoing
3.2.2
2, 3
Brain Waves Newsletter
Ongoing
3.2.3
3
Teleconferences
• ICAN and Assistive Technology
September, 2020
• Arkansas Department of Career Services
October, 2020
Upcoming
18
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Focus Area 4: Development of a Trust Fund and/or Medicaid
Waiver Program
A trust fund and/or waiver program can help those living with disabilities receive the services
and supports needed while addressing financial need.
Goal 1: Develop a sub-workgroup to focus on trust fund and/or waiver program
Step
Year
Action
Status
4.1.1
1
Organize sub-workgroup
November, 2018
Complete
4.1.2
1
Meet quarterly
Ongoing
Goal 2: Identify and benchmark trust funds and waiver programs that exist across the country
to help support the development of these resources in Arkansas
Step
Year
Action
Status
4.2.1
2, 3
Research programs in other states
Ongoing
• NASHIA
• Meeting with Judy Detmer, Colorado
February, 2019
4.2.2
2, 3
Ongoing
spokesperson(s) from the TBI community
Identify a champion legislator and possibly a
19
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Goal 3: Create a report of findings and outline a potential plan for a trust fund and/or waiver
program in Arkansas
Step
Year
Action
Status
4.3.1
3
Draft a report based on the information received from
research
Upcoming
4.3.2
3
Present findings to the TBI Advisory Board Workgroup in
a public forum (potentially virtual) and gather feedback
Upcoming
4.3.3
3
Incorporate feedback and produce a final report that will
be available to the public on the TBI SPP website
Upcoming
Goal 4: Develop a roadmap plan for a trust fund and/or waiver program in Arkansas
Step
Year
Action
Status
4.4.1
3
Develop a potential trust fund and/or waiver program
roadmap
Upcoming
4.4.2
3
Present proposed roadmap plan to the TBI Advisory
Board Workgroup in a public forum (potentially virtual)
and gather feedback
Upcoming
4.4.3
3
Incorporate feedback and produce a final trust fund
and/or waiver program roadmap that will be available to
the public on the TBI SPP website
Upcoming
Goal 5: Implement the trust fund and/or waiver plan
Step
Year
Action
Status
4.5.1
3+
To be determined
To be
Determined
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Goal 6: Ensure communication and seek input with appropriate resources
Step Year Action Status
4.6.3 1
Meet with UAMS government relations liaison to
discuss need for a trust fund/waiver and governor
involvement; ensure that the office is informed of TBI
Advisory Board Workgroup efforts
Ongoing
4.6.3 3 Engage NASHIA technical assistance for guidance Upcoming
4.6.4 1, 2, 3 Brain Waves newsletter, and social media Ongoing
21
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Appendix A –
Arkansas TBI Advisory Board Workgroup
The mission of the Arkansas TBI Advisory Board Workgroup is to improve upon Arkansas’s TBI
infrastructure in an effort to maximize independence, wellbeing, and health of persons with
TBI, their family members, caregivers, and providers.
Identifying ways to achieve goals set within the focus areas outlined in the plan, each
participant of the TBI Advisory Board Workgroup also contributes their expertise and
knowledge to a sub-workgroup. The efforts of these sub-workgroups are outlined in this
working plan.
Program leaders and the Arkansas TBI Advisory Board Workgroup will continue to identify
partnerships that can leverage outcomes consistent with those identified in the working plan.
The Arkansas TBI Advisory Board Workgroup does not have the resources to accomplish this
plan alone, but rather identifies itself through its mission as the organization that must lead in
the establishment of these collaborative partnerships.
TBI Advisory Board Workgroup participants are currently engaging on a volunteer basis with
plans for ongoing recruitment and expansion for TBI survivors, families, and caregivers. The TBI
Advisory Board Workgroup seeks to promote engagement of all members and recognition at a
state level.
As previously mentioned, participants in the TBI Advisory Board Workgroup also volunteer to
serve in a specific sub-workgroup based on their interests and expertise. The sub-workgroups
meet at least once per quarter and are tasked with providing updates at the quarterly TBI
Advisory Board Workgroup meeting.
The sub-workgroups are listed below.
• TBI State Plan Development
• Trust Fund, Waiver Program, Financial Strategies
• Underserved Populations
It is the hope of the TBI Advisory Board Workgroup, organized through the ACL TBI SPP grant, to
gain recognition by the Arkansas Governor’s Office. This recognition would help to further
conversations about the legislation needed to develop a trust fund and/or waiver program and
other infrastructure needs within the TBI community in Arkansas.
22
Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Arkansas State Plan Development Sub-Workgroup
The mission of the State Plan Development sub-workgroup is to guide public communication for
the TBI Advisory Board workgroup and sub-workgroup efforts and the Arkansas State Plan and
to determine the structure of the Arkansas State Plan.
Tasks:
• Benchmark states with existing plans
• Determine a framework for the Arkansas State Plan
• Benchmark assessment tools used by partner and mentor states
• Develop and identify ways to implement assessment tools in Arkansas
• Incorporate the outcomes of sub-workgroups and Advisory Board Workgroup
feedback into the plan
• Provide updates at quarterly Advisory Board Workgroup meetings
• Other tasks identified by the sub-workgroup
Resources Reviewed:
Traumatic Brain Injury in Missouri State Plan
https://health.mo.gov/living/healthcondiseases/tbi/pdf/tbistateplan2012-2017.pdf
Missouri Green Book: Living with Brain Injury
http://www.nashia.org/pdf/hotopics/mo-tbi-guide-green-book.pdf
West Virginia Traumatic Brain Injury (TBI) Social Service Model 2018-2018
http://tbi.cedwvu.org/media/3366/wv-tbi-social-services-model-plan-2018-2019.pdf
Iowa State Plan for Brain Injury (2013-2017)
http://publications.iowa.gov/17257/1/Brain%20Injury%20Plan%20final.pdf
Colorado State Plan
https://mindsourcecolorado.org/wp-content/uploads/2020/02/MINDSOURCE-Strategic-Plan-
FINAL-010120-with-updates.pdf
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Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Trust Fund, Waiver Program, and Financial Strategies
Sub-Workgroup
The mission of the Trust Fund, Waiver Program, and Financial Strategies sub-workgroup is to
research and identify ways to develop and implement a trust fund and/or waiver program(s),
and to identify financial strategies for the state’s underserved populations, including those over
the age of 18 and those who receive Medicaid benefits.
Tasks:
• Benchmark states with existing trust fund and waiver programs
• Work toward development of a trust fund and/or waiver program by identifying funding
sources and opportunities
• Promote understanding of service coverage (i.e., Medicaid, Medicare, Money Follows
the Person, Social Security, and private insurance)
• Identify specific areas of need within the TBI community (i.e., respite assistance,
transportation, education, etc.)
• Provide updates at quarterly Advisory Board Workgroup meetings
• Other tasks identified by the sub-workgroup
Resources Reviewed:
• TBI/ABI HCBS Waiver Programs and Other Options for Long-Term Services and Supports
(LTSS)
https://www.nashia.org/pdf/tbi_hcbs_waiver_ltss_overview_update_sept_2018.pdf
• State Brain Injury Trust Fund Programs: Overview
https://www.nashia.org/pdf/state_trust_fund_overview_listing2018.pdf
• Resource Facilitation Program – Missouri
Meeting with Jennifer Braun, TBI SPP
• Case Management Program – Tennessee
Meeting with Paula Denslow, TBI SPP
• TBI Registry Design – Alabama
Meeting with April Turner, TBI SPP
• Medicaid Waiver Program – Iowa
• Medicaid Waiver Proposal – Oregon
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Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Underserved Populations Sub-Workgroup
The mission of the Underserved Populations Sub-Workgroup is to identify ways to promote and
disseminate resources, services, education, and information within the TBI community,
especially in the underserved populations identified by the ACL TBI SPP for 2018 – 2021.
Tasks:
• Benchmark states with existing plans
• Identify gaps in resources and services that are needed to integrate TBI survivors back
into their communities
• Brainstorm ideas and develop solutions to fill the gaps
• Identify community and survivor engagement opportunities and events to provide
support and information on resources and education
• Provide updates at quarterly Advisory Board Workgroup meetings
• Other tasks identified by the sub-group
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Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
References
1. Your Arkansas Trauma System. Nov. 2012.
http://www.nphic.org/Content/Awards/2013/Print/ANNR-IH-AR-Your_Arkansa.pdf
2. Arkansas Trauma System Act 393.
3. 2010 Arkansas Code. Title 20 – Public Health and Welfare, Subtitle 2, Health and Safety,
Chapter 14 – Individuals with Disabilities, Subchapter 7 – Head Injuries. Statute 20-14-703
Central registry reports.
4. Center for Disease Control and Prevention. Traumatic Brain Injury & Concussion.
5. Moderate to Severe Brain Injury: A Practical Guide for Families. Brain Injury Association of
America.
6. Pediatric mTBI (concussion) CDC Guidelines. Laura Hobart-Porter. October 23, 2019.
7. National Council on Aging. Falls Prevention Facts. Accessed July 16, 2020.
8. Ark
ansas State Plan on Aging (2020 – 2022).
9. FY2020 Quarter 3 Report, January 1, 2020 – March 31, 2020, submitted to the Arkansas
Department of Health.
10. Arkansas TBI Registry data. Accessed July 16, 2020.
12. Arkansas Department of Health, In-Patient Rehabilitation Facilities. Accessed7/17/2020.
13. Arkansas TBI Registry. Rehabilitation facilities within the state by patients discharged from
hospital care. Accessed 7/17/2020
https://www.healthy.arkansas.gov/images/uploads/Act393.pdf
https://law.justia.com/codes/arkansas/2010/title-20/subtitle-
2/chapter-14/subchapter-7/20-14-703/
https://www.cdc.gov/traumaticbraininjury/index.html
ht
tps://familymedicine.uams.edu/wp-content/uploads/sites/57/2019/10/Traumatic-Brain-
Injury-Pediatric-Concussions.pdf
Defining severe traumatic brain injury readmission rates and
reasons in a rural state. 8-6-18. Trauma Surg Acute Care Open,
http://tsaco.bmj.com/content/3/1/e000186
https://www.ncoa.org/news/resources-for-reporters/get-the-facts/falls-prevention-facts/
http://hs.ar.gov/images/uploads/daas/Arkansas_State_Plan_on_Aging_2020-2022.pdf
https://www.healthy.arkansas.gov/programs-services/topics/hfs-provider-lists
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Arkansas State Plan for Traumatic Brain Injuries 2018 – 2021 | September 15, 2020
Acknowledgements
We would like to extend a special thanks to our partners, the University of Arkansas for Medical
Sciences, Institute for Digital Health & Innovation, Arkansas Department of Health, Trauma
Rehabilitation Resources Program, and the participants of the Arkansas TBI Advisory Board
Workgroup. These agencies, organizations and individuals are contributing resources,
knowledge, time, and efforts to the development of a working plan that helps to meet the
needs of Arkansas TBI population, including family members, caregivers, and providers.
This plan was funded in part through grant number 90TBSG0026-01-00 from the U.S. Administration for
Community Living (ACL), Department of Health and Human Services (DHHS). Grantees undertraining
projects under government sponsorship are encouraged to express freely their findings and conclusions.
Points of view or opinions do not, therefore, necessarily represent official ACL policy.
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28
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https://idhi.uams.edu/programs/trauma-telemedi
programs/tbi-state-partnership-program/
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