Colorado Department of Education, Concussion Management Guidelines

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1 2013 Federal TBI Program Awards In 2006, HRSA began recognizing Federal TBI Program grantees with awards for outstanding accomplishments in the areas of collaboration and coalition building, impacting systems change and product development. Accomplishments for exceptional advocacy on behalf of individuals with TBI, as well as outreach and training, are awarded to the Protection and Advocacy Systems. Additionally, individuals or family members who have represented the TBI Program in an exemplary manner are also recognized with a specific award highlighting their efforts on behalf of the Program. In 2010, the Big Strides award was initiated for unfunded that have sustained TBI efforts. HRSA is pleased to announce the following Federal TBI Program awards for 2013: Most Popular Grant Product Award This award recognizes a State that has developed a widely used or recognized grant product; criteria for this award is determined by the number of downloads from the Federal TBI Program s TBI Collaboration Space (TBICS). Colorado Department of Education, Concussion Management Guidelines Colorado was selected for this award with the highest number of downloads of a State product in TBICS from January December The Colorado Department of Education developed Concussion Management Guidelines to educate school districts on Senate Bill , and to provide guidance to superintendents as they work to implement concussion management guidelines within their districts. The national trends with education of concussion identification, removal from play for suspected concussion, and return to play under medical supervision are promoted in the guide by recommending best practices for implementation within Colorado s school districts. Congratulations to Colorado for creating a comprehensive sports concussion management guide thereby assisting school districts as they implement concussion management policies and protocols. Collaboration & Coalition Building Awards This award recognizes a State that has established partnerships which support joint strategies and sharing of resources. The winner will have developed processes to evaluate and strengthen the effectiveness of the collaboration and will have worked with other organizations on Federal program applications relevant to TBI. Criteria for this award may include the number of formalized partnerships, outcome/output metrics in place to gauge success, or methods for evaluating and improving partnerships. Texas Health and Human Services Commission, Office of Acquired Brain Injury Texas has been successful in building collaborations within multiple levels and aspects of the State s juvenile justice system and other law enforcement entities by:

2 Incorporating statewide professional development and training for correctional officers, mental health and substance abuse professionals, physicians, educators, school administrators, counselors and special educators within Texas Juvenile Justice system; Additionally training 504 evaluators and other educational components of the Texas Juvenile Justice Department high security, state-operated facilities school systems (elementary through higher education); Screening over three thousand youth in the juvenile justice system for brain injury; Collaborating with the Texas Education Agency and the statewide Education Service Centers in developing and providing online training with continuing education credits for school personnel and other professionals involved with juvenile offenders as they return to the classroom and community; Partnering with the El Paso Probation Department in providing behavioral and cognitive programs for youth in El Paso County that are not enrolled in the pilot project, resulting in local systemic change benefitting hundreds of probationers in the county; and Developing a Veterans Tactical Response training: Keeping Police Officers and Veterans Safe A Law Enforcement Guide to Working with Veterans with TBI, PTSD and Homelessness with the Austin Police Department and other police departments throughout the State, which has expanded to training on a Federal level for Alcohol, Firearms and Tobacco (ATF) officers. Congratulations to Texas for building collaborations and strategies to meet the needs of at-risk populations in diverse and complex law enforcement and criminal justice systems. Utah Department of Health, Division of Disease Control and Prevention In Utah s initial Implementation Partnership grant application, the State identified roles and responsibilities for each of the partnership relationships resulting in flourishing collaborations which have produced: An effective and sustained Utah Brain Injury Council (UBIC); Comprehensive sports concussion management legislation requiring the development of sports concussion policies in schools and sports organizations, along with education for parents about concussion management including county parks and recreation centers; Growing partnerships with local health departments whereby providing access to County Parks and Recreation entities, local hospitals and school districts; Enhanced collaboration with the Brain Injury Alliance of Utah in developing and implementing training for full time recreation center staff, who in turn are training other staff and volunteers; The development and embedding of interagency brain injury training in: the State s juvenile justice system, Division of Child and Family Services, providers and private agencies contracted with the Division of Services for People with Disabilities, along with selected mental health providers; The development of provider training on an introduction to TBI focused on children ages zero to four at Centro de la Familia de Utah;

3 A pilot brain injury training module for faculty and staff of institutions of higher learning who are working with veterans and returning service members, resulting in Utah State University mandating the training for all university staff throughout the State; A regenerating TBI/SCI Rehabilitation Fund with monies to fund non-profit service providers, enabling them to provide direct services for individuals with TBI/SCI, direct therapies and/or the purchase of equipment; Additional State general revenue funding for the Utah Brain Injury Fund, which provides resource facilitation, brain injury awareness through public education and training, and information and referral services. Congratulations to Utah for developing collaborative partnerships working across systems to meet the needs of individuals with brain injury. Impacting Systems Change Awards This award recognizes a State that has developed a product or process that has been incorporated into the State s systems of services and supports for individuals with TBI and their families. Criteria for this award may include: number and types of training/educational protocols formalized within various service delivery systems, legislative and/or policy changes, TBI representation on other systems Boards/Councils or the implementation of the State TBI Action Plan in building and maintaining interagency support, planning and problem solving. Massachusetts Rehabilitation Commission One of the current goals of Massachusetts Implementation Partnership grant is to increase the number of participants in the State Head Injury Program (SHIP). The State has been successful accomplishing this by: Initiating screening clinics throughout the State at Veteran s Centers, VFW posts, and Veterans homeless shelters. These screening clinics are staffed by senior level clinical neuropsychologists, who conduct confidential, diagnostic interviews and administer neuropsychological screening tests, specifically developed for the assessment of concussion and related sequelae (e.g., ImPACT). When indicated, veterans with positive findings on screening were referred for more comprehensive assessments and an application to the Statewide Head Injury Program (SHIP) was facilitated by Veteran Program Coordinators present at these events; additionally, they were available to provide additional resource information, which included information regarding research projects currently underway in Massachusetts; Successfully identifying and enrolling veterans and returning service members into the State Head Injury Program (SHIP) resulting in a 100% increase in the number of veterans receiving services; Establishing referral linkages with VA Medical Center research clinicians; Realizing an increase of applications for SHIP services from women and minority veterans as well as those served in the Vietnam and Gulf War conflicts; Responding to the significant drop-out rates of veterans participating in Upward Bound and college/university programs with the development of a training symposium in partnership with Salem State College focusing on neurobehavioral, psychological, and in particular the neurocognitive consequences of TBI; the target audience was educators, counselors, disability and veteran services staff of colleges and universities within the New England region;

4 Providing the training symposia for a growing number of colleges and universities requesting the brain injury training for their faculty and staff members. Congratulations to Massachusetts for developing and implementing an innovative approach to meeting the needs of veterans and returning service members and working to assure they receive needed services and supports. Minnesota State Department of Human Services Minnesota has impacted systems change through the Minnesota Department of Corrections (DOC) by: Implementing a TBI Release Planner position as an important link to support the successful return to community of individuals known to have functional limitations due to TBI; Planning by the Department of Corrections release affords opportunities to foster community linkages within probation, parole and other services by developing specialized plans as well as opportunities to develop and standardize new release strategies and protocols; Implementing the MN DOC TBI Screening Tool at two facilities for 45 working days with 796 complete screens; screening information has been entered into the DOC I-Share system for review/analyses with information being utilized to refine the decision tree/process, design and improve DOC systems and develop TBI-specific release planning models; Developing a Native American Cultural Awareness training, Opening the Dialogue: Sharing a Native American s Journey in all adult DOC facilities with a Native American Resource Guide nearing completion. Congratulations to Minnesota for implementing innovative programs with Minnesota s Department of Corrections. Virginia Department for Aging and Rehabilitative Services, Brain Injury Services Coordination Unit Virginia s Lead Agency for TBI, the Department for Aging and Rehabilitative Services (DARS) [formerly the Department of Rehabilitative Services (DRS)] proposed with its FY09 State TBI Implementation Partnership Grant, in partnership with Virginia Commonwealth University s TBI Model Systems Program and funding support from the Commonwealth Neurotrauma Initiative Trust Fund via DARS to: 1. Study the incidence of brain injury among juvenile offenders, 2. Develop an effective screening tool for administration by intake staff at the Department of Juvenile Justice (DJJ), and 3. Provide staff training on appropriate treatment and intervention strategies. The intent of this proposal is that brain injury prevalence data and related service needs among youth entering the juvenile justice system will be systematically identified and reported through the development of an effective screening tool and that staff at DJJ will be trained to recognize and respond to the needs of juvenile offenders with brain injury. It is hoped that the screening tool developed through this project can be utilized by other agencies / providers serving juveniles and adults with unidentified brain injury. Finally, it is anticipated that increased awareness and knowledge of the needs of juveniles with brain injury will create intervention treatment and strategies to support their needs and prevent recidivism one of the most critical outcomes of the juvenile justice aspect of this proposal.

5 DRS has also sought to facilitate the increased involvement of DJJ personnel on the Virginia Brain Injury Council and in other brain injury related State activities, to raise awareness within DJJ and to encourage the agency to make statewide systems change policies that will benefit youth with brain injury within their system. Accomplishments: The screening initiative including preliminary data analysis and dissemination of available results was completed during the past grant year; screening has been instituted with all juveniles entering the VA DJJ system. VA convened a TBI/Juvenile Justice Policy Summit in 2012 that was attended by four other States addressing this area (MN, NE, TX, and UT); a Proceedings Manual has been developed with a summary and recommendations for future action. Outreach is planned for the juvenile court system and with juvenile judges. Congratulations to Virginia for implementing a partnership with the Department of Juvenile Justice to identify and meet the needs of juvenile offenders with brain injury within their service system. Most Adapted Grant Product Award This award recognizes a State that has developed a widely used or recognized grant product which has been adapted for use in other States. Criteria for this award is determined by the number of States or other entities that have utilized the grant product. Michigan Department of Community Health Understanding the difficulty individuals face connecting to TBI services in Michigan, the Michigan TBI Services and Prevention Council (SPC) established by the Michigan Department of Community Health as Lead State Agency for TBI, needed a way to help service providers learn the complex system of care in Michigan and better connect their clients to the proper services. In order to meet this need, the SPC s Training Committee decided to implement a sustainable, person-centered, culturally competent, online training that service providers could access on their own time and complete at their own pace. In 2005, the TBI Training Committee created a four-module web-based training for public service providers. The Committee also worked collaboratively with other TBI professionals including the Brain Injury Association of Michigan, educators, rehabilitation experts, and representatives from each of the primary public agencies to create the curriculum. The training was also developed with participation from other TBI program leaders in Nebraska; permission was granted to incorporate multi-media materials provided by Florida; and cultural competence content was drawn heavily on the work of Minnesota. Materials referenced in the training include those prepared by the Centers for Disease Control and Prevention, as well as published research articles and texts. Traumatic Brain Injury and Public Services in Michigan, administered via contract by the Michigan Public Health Institute, was officially launched in 2006 and continues to be popular and well-received. Two new trainings Pediatric Traumatic Brain Injury and Cognitive and Behavioral Consequences of TBI in Adults were officially launched in Approximately 30% of users reside outside of Michigan; individuals from 48 States and Puerto Rico have registered for the training as well as citizens from Canada and Australia. Michigan first customized the online training for North Carolina in 2010 and continues to host its site.

6 Michigan collaborated with Iowa to modify the online training in 2012; Iowa is in the process of further developing its site prior to launch. Michigan also provided Kansas with the online training code and database for potential replication. Congratulations to Michigan for maximizing educational opportunities and building awareness of TBI nationwide. TBI Advocacy Award This award recognizes a Protection & Advocacy System that has successfully advocated either on behalf of an individual with TBI or group, worked to set a precedent, or impact policy or legislative changes in the State. Delaware Community Legal Aid Society, Inc (CLASI) CLASI has assisted numerous individuals with TBI to resolve legal concerns and engaged in systemic work and trainings with the potential to assist hundreds more individuals through legally-based advocacy examples include: CLASI assisted a forty-nine year old woman injured in car crash resulting in TBI and spinal cord injury. She used a wheelchair and was assisted by a service dog for both retrieval and blackout intervention. Security guards in a retail store approached her and demanded that she leave because there were "no dogs allowed, unless seeing-eye dog." Management was un-persuaded by her description of service dog. Police were called who told her to leave because she had no "State certification" of dog as service animal. As there is no "State certification" for service animals, CLASI was able to file an administrative complaint with the Human Relations Commission under the Equal Accommodations law, which was settled for monetary damages and police training. The Delaware Department of Education (DOE) published program "physical" examination and screening regulations. Based on their legal expertise, CLASI issued comments which recommended substituting "health examination" for "physical examination" to clarify coverage of mental health impairments, ADHD, depression, and TBI. The comment was shared with the DOE, which agreed with CLASI s recommendation and adopted a revised final regulation. This is a highly significant achievement since the forms are completed on behalf of all public school students in Delaware (130,610 during the school year) and will promote identification of students with TBI. CLASI staff served on a committee which provided legally-relevant information on "employment-first" legislation and edited sequential drafts of the proposed legislation. The final legislation (H.B. No. 319) requires all State agencies that provide services to individuals with disabilities consider, as the first option, competitive employment in an integrated setting. The bill was enacted and signed by the Governor on July 16, Congratulations to CLASI for successfully advocating for the needs of individuals with TBI and for working to affect systems change in the State of Delaware. Outreach/Training Award for P&As This award recognizes a P&A who has done outstanding TBI outreach and training. Criteria for this award may include the number of training sessions conducted, the number of people trained, customer satisfaction feedback from outreach and training events, data demonstrating how trainings are being implemented into service provision or practice and/or formulized within training protocols.

7 Georgia Advocacy Office (GAO) The Georgia PATBI program conducted 93 trainings that reached over 8300 people. The P&A also engages in extensive outreach and collaborative work beyond trainings, below are just a few examples: The Children and Youth Committee of the Brain and Spinal Injury Trust Foundation (BSITF) is working to develop training for school staff in support of children returning to school following a brain injury. This includes outreach though organizing town hall meetings, public forums, and training to emphasize brain injury topics with a focus on youth with brain injuries. This Committee made a "Transition to School" checklist and a TBI fact sheet to give parents whose children are newly injured. The P&A provided legal expertise in the development of the fact sheet. GAO is the lead partner on the Children's Freedom Initiative (CFI) to ensure that all children live in permanent, loving homes, not in institutions. GAO has identified children in facilities, provided individual legally-based advocacy, deflected institutional placement, provided technical assistance to facility administrators, State agencies, and child protection caseworkers regarding available community-based resources including early periodic screening and diagnostic testing (EPSDT), prepared necessary litigation, and provided oversight of discharge to homes in the community. In early 2012, the CFI participated in a model coherency evaluation to determine who the young people are that CFI will specifically advocate for, what those young people specifically need, and how their needs will be met through the CFI. In CFI s priorities and goals, a decision was made to broaden the collaborative by inviting other child advocacy agencies to participate as a means of strengthening the collective children s advocacy and as a way to gain more allies in the prevention of institutionalization of children with disabilities. CFI has hosted several meetings with a larger group of child advocates and has developed a logic model to guide the process. GAO participates on the Georgia Emergency Preparedness Coalition for Individuals with Disabilities and the Elderly. Participation in this coalition is changing the way emergency management professionals design emergency response systems for individuals with disabilities, reducing the risk they face during times of natural disaster and crisis. In 2012, the Coalition disseminated 130 copies of the Coalition's Get Ready Tool Kit (Household Emergency Plan, Emergency Plan Checklist and the instructions) at the People First of Georgia annual conference. In addition to the general emergency brochure, an Assistive Technology (AT) Brochure has been developed and is now accessible on the State ADA Coordinator's website. GAO is a member of the Unlock the Waiting List campaign to address the State's failure to implement the Olmstead decision. There are approximately 190,000 Georgians with disabilities who require assistance from a family member or caregiver every day, and thousands of people living in nursing facilities that would prefer to live in the community. GAO and partners formed a committee with the goal of expanding community based supports and services for Georgians with disabilities. The Unlock campaign currently has over 300 member organizations and over 500 individual members throughout the State. Congratulations to Georgia Advocacy Office on their outreach and training efforts on behalf of individuals with TBI and their representation into cross-disability efforts to infuse TBI issues into the larger disability community. Exemplary Participation in the Federal TBI Program Award This award recognizes an individual who has represented the Federal TBI Program among diverse stakeholders. Criteria for this award may include grantee to grantee mentorship, provision of technical assistance to other grantees on behalf of the Program, representation or presentations on behalf or support of the Program at national meetings or participation in Program committees or work groups.

8 Russell Spearman Idaho State University, Institute of Rural Health Russ has consistently supported and participated in the various aspects of the Federal TBI Program with great competency and boundless enthusiasm. He has served on many committees and has been a presenter on webinars and meetings sponsored by the Federal TBI Program and/or by HRSA s TBI Technical Assistance Center. Russ has used the data from the longitudinal TBI needs and resources assessment process in the State of Idaho to present at various national conferences and seminars which has further increased the visibility of the Federal TBI Program. With the development and implementation of Idaho s TBI Virtual Program Center and Grand Rounds approach to public education and training on the issues of brain injury, the rural areas of Idaho and beyond have been offered state of the art brain injury information and resources. Congratulations to Russ Spearman for his tireless work on behalf of individuals with brain injury and family members. Individual with Brain Injury/Family Participation Award This award recognizes an individual with brain injury or a family member who has participated in TBI infrastructure planning or grant-related activities. Criteria for this award may include the Ombudsman s role in the extent and frequency of training delivered to individuals with brain injury and family members; significant outreach to individuals and family members or the development of individual and family member self-advocacy. Melissa Slater (Alabama) As the parent of a young man with a TBI, Melissa Slater was hired as Alabama s TBI Ombudsman to represent individuals with TBI and family members through participation in Alabama Head Injury Task Force meetings, working groups, committees and teams. Melissa has been involved with all project activities by providing consumer/family input, attending Federal TBI Program Leadership Meetings, and actively developing partnerships and resources. Melissa also assisted in planning and implementing Alabama s Advocacy Institutes, created to provide consumers and families with advocacy skills to affect systems change; she gathered information and developed An Inventory of Advocacy Initiatives, Organizations and Groups for use in designing advocacy initiatives. Congratulations to Melissa Slater for exemplifying excellence in advocacy. Big Strides Award In 2010, the Big Strides award was initiated for unfunded States that have sustained TBI efforts by building partnerships and collaborations which have led to an increase in the Lead Agency s influence within the State. Maine Department of Health & Human Services, Office of Aging & Disability Services Maine has been able to achieve big strides in providing coordinated and competent services and supports for individuals with TBI by:

9 Recently clarifying and streamlining the statutes defining brain injury and the responsibilities of the Department of Health & Human Services; thereby, maintaining a safety net for individuals with significant disabilities due to brain injury; Folding brain injury into the new Aging and Disability Services agency which houses six of the seven waivers in the State; Expanding the brain injury expertise of the Lead Agency through the promotion of the previous manager of the Brain Injury Services program to Associate Director within the new agency, and hiring a new program manager to coordinate activities for Brain Injury Services; The Governor submitting a request to the legislature to create a TBI Medicaid Waiver, which may be patterned from the new disability waiver being implemented by the Office of Aging & Disability Services; Increased progress of sports concussion management with over 80 high schools and middle schools voluntarily screening all students in sports for TBI, with data being collected from the concussion screenings; Studying the effectiveness of appropriate training for neurorehabilitation providers as it has demonstrated ongoing improvement and increased functional independence of individuals with brain injury receiving neurorehabilitation services, resulting in over 150 ME clinicians and direct service providers now accredited as Certified Brain Injury Specialists (CBIS); all State supported neurorehabilitation staff are mandated to become CBIS certified; Returning all nursing level patients to Maine from out-of-state placements over the past three years resulting in improved independence for these individuals along with decreased costs for DHHS. Congratulations to the State of Maine in making the Big Strides needed to move forward and developing sustainable TBI services and supports for individuals with TBI and families. TBISERV is the listserv for the Federal TBI Program. TBISERV is moderated by the Federal TBI Program's Technical Assistance Center. To post to the list, TBISERV@list.nih.gov. Join, leave, or change your subscription settings, visit To change your TBISERV NIH Listserv Web Interface password, visit To search the TBISERV archives, visit