Adult Brain Injury Program Guidebook


Table of Contents

Foreword

The purpose of the Guidebook is to provide practical written guidance for the ABI Service Coordinators who implement the Adult Brain Injury (ABI) Program, a program that serves eligible adults age twenty-one (21) up to sixty-five (65) years of age and have a traumatic brain injury medical diagnosis as defined in State Statute RSMo Section 192.735.

ABI service coordination is provided through partnerships between Local Public Health Agencies (LPHA), and the Bureau of Special Health Care Needs (SHCN) through contractual agreements. Service coordination is provided throughout all counties of the state of Missouri.

In an effort to provide condensed practical guidance, sections of the Guidebook merely provide a brief overview of content areas that have established written detailed information used for training and reference. All additional detailed training manuals, forms, and letters referenced throughout the Guidebook will be maintained on a link provided on the ABI Program web page for use by the ABI Service Coordinators. ABI Service Coordinators are encouraged to reference ABI Program memos and web resources forcurrent information. ABI Program staff are available for individual training needs.

The guidance provided has been developed and structured in a manner which will enhance the success of the ABI Program. The ABI Program framework assists in meeting the Program Philosophy, the SHCN Operational Plan, meets state and federal requirements of the ABI Program, the Mission of the Missouri Department of Health and Senior Services (DHSS) and the mission of SHCN.

The mission of SHCN is to develop, promote, and support community-based systems that enable the best possible health and greatest degree of independence for Missourians with special health care needs.

The ABI Program is funded by Missouri state general revenue and the Brain Injury Fund.

Adult Brain Injury (ABI) Program Description

The ABI Program provides assistance in locating, coordinating, and authorizing rehabilitation and psychological services for individuals who have a traumatic brain injury medical diagnosis as defined in State Statute RSMo Section 192.735. The ABI Program is not an entitlement program nor entitlement to lifelong care and treatment. The statutes governing the ABI Program are: RSMo 199.003 and RSMo 199.009.

Eligibility

To be eligible for the ABI Program the participant shall:

  • Be a resident of the State of Missouri;
  • Be age twenty-one (21) up to sixty-five (65); and
  • Have a medically diagnosed TBI defined as: “a sudden insult or damage to the brain or its coverings,not of a degenerative nature. Such insult may produce an altered state of consciousness and may result in a decrease of one (1) or more of the following:mental, cognitive, behavioral, or physical functioning resulting in partial or total disability. Cerebral vascular accidents, aneurysms, and congenital deficits shall be specifically excluded from this definition.” (RSMo 192.735). Examples of conditions not included in the ABI Program definition of TBI are: birth asphyxia, cerebral vascular accidents, aneurisms, congenital deficits, disease-induced hypoxia, tumors, and lead poisoning.
  • Lawful presence (provide proof of lawful presence)
  • Positive ABI Screener

Services

The ABI Program provides service coordination and rehabilitation services. Service Coordination is provided to all ABI Program participants, regardless of financial status. Service Coordination includes:

  • Evaluation and assessment of needs, information and education regarding the causes and effects of TBI, and prevention of secondary clinical conditions;
  • Development of a service plan;
  • Assistance in locating and accessing medical care, housing, counseling, transportation, rehabilitation, vocational training, and cognitive/behavior training; and
  • Regular evaluation and updates of the service plan

Rehabilitation services are available to individuals who are eligible for the ABI Program, and whose income is at or below 185 percent of Federal Poverty Guidelines. Rehabilitation services are provided to eligible participants when necessary to facilitate the participant’s achievement of a long-term goal as indicated in the ABI Service Plan.

The provision of rehabilitation services is subject to availability of funds, which are appropriated annually. All rehabilitation services must be prior authorized. Rehabilitation Services includes:

  • Neuropsychological Evaluation and Consultation;
    • Neuropsychological evaluation and consultation consists of the administration and interpretation of a standardized battery of neuropsychological tests to provide information about a client’s cognitive strengths and weaknesses following a Traumatic Brain Injury (TBI).
  • Adjustment Counseling;
    • Adjustment counseling services are brief, skilled therapeutic face-to-face interventions provided to the client/family to address specific goals related to the experience of adjusting to the effects of Traumatic Brain Injury (TBI). This service may be provided to an individual or an individual and key family/significant other.
  • Transitional Home and Community Support;
    • This service provides training and practice with activities related to daily living and maintenance of a household. The assumption is that the natural environment of a survivor’s home and community can afford effective opportunities for learning and practicing skills. Survivors may acquire and retain functional living skills best when these skills are taught in an environment that most closely resembles, or is the environment in which they will use these skills. Actual home and community-based activities shall be used in training.
  • Pre-vocational/Pre-employment Training;
    • This service uses actual work experience to promote the client’s utilization of behavioral and/or cognitive compensatory strategies in a facility-based or a community site work setting. Specific target goals are identified for interventions such as production rate, inappropriate social behavior, or fatigue that are barriers to direct vocational placement or entry into Division of Vocational Rehabilitation (DVR) services. The Qualified Head Injury Professional (QHIP) directly supervises the client at all times. Supervision may be provided for a group of clients, however, the staff/client ratio must allow for individualized feedback to each client regarding specific behavioral objectives.
  • Supported Employment/Follow Along;
    • Supported Employment/Follow Along is a service that provides continued support and training in an integrated work setting for clients who have completed the Supported Employment Program through the Division of Vocational Rehabilitation (DVR) and require additional intervention. Written documentation of the client’s completion of the DVR Supported Employment Program, Employment Services Plus (ESP) or have an accepted business plan by DVR is required.
  • Special Instruction;
    • This service consists of tutoring/instruction by qualified staff for specific subjects, targeted compensatory strategies, or skills related to achievement of the long-term goal in Program Service Plan.

The Department of Health and Senior Services is payer of last resort. The ABI Service Coordinator will assist the participant to apply for any other payment resources before submitting requests for use of ABI Program funds.

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