Francie Streich Wilder Research Manfred Tatzmann DHS TBI Advisory Committee Purpose of the study Study components Overview of results Information about full report Agenda Determine the capacity of Minnesotas local service system to meet the needs of people with brain ID: 623524
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Slide1
2015 Statewide Brain Injury Needs and Resources Assessment
Francie Streich
Wilder Research
Manfred Tatzmann
DHS TBI Advisory CommitteeSlide2
Purpose of the studyStudy componentsOverview of
results
Information about full report
AgendaSlide3
Determine the capacity of Minnesota’s local service system to meet the needs of people with brain injuries.
Inform
state agencies, stakeholders, advocates, people with brain injuries, as well as their family members or caregivers about the current state of services in
Minnesota.
Provide information that can be used to inform policy, service development, and future research.
Purpose of the studySlide4
Survey, focus groups, and interviews with brain injury survivors and caregiversSurvey of service providers
Survey of county and tribal representatives
Interviews with key brain injury stakeholdersAnalysis of existing data
Minnesota Hospital Association
Wilder Research’s Statewide Homelessness study
Components of the studySlide5
The Minnesota Department of Human Services contracted with Wilder Research to conduct the study.
This
project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number #H21MC17234, TBI in Minnesota Correctional Facilities: Systems Change for Successful Return to Community, a Traumatic Brain Injury State Implementation Partnership Grant (Federal Funding Total: $990,385. No nongovernmental funding financed this project).
This information or content and conclusions included in this report are those of the author(s) and should not be construed as the official position or policy of, nor should any endorsements be inferred by, HRSA, HHS, the U.S. Government, or the Minnesota Department of Human Services (DHS)
.
Other important informationSlide6
The assessment sought to understand the needs and resources of Minnesotans who live with all types of
ABIs.
What is brain injury?
An
acquired brain injury (ABI)
is an injury to the brain that occurs after birth
.
Can occur in many ways, including
during surgery, stroke, near drowning, or exposure to drugs, alcohol, or toxic
chemicals.
Traumatic brain injuries (TBI)
are a subset of all ABIs. A TBI is an
injury to the brain caused by a “bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.”Slide7
In 2014, approximately 12,300 people
were hospitalized or treated in an emergency department with
traumatic brain injury.
The leading causes of these TBIs include:Falls (41%)Sports/recreation (23%)
Source
:
MDH analysis of Minnesota Hospital Association data.
Frequency of brain injurySlide8
Frequency of brain injury
Rates of TBI are highest among
youth age 11-17
and
older adults age 81+. Rate of TBI cases (out of 100,000) by age group, 2014
Source:
MDH analysis of Minnesota Hospital Association data and U.S. Census Bureau population counts and estimates.Slide9
These statistics only tell us about newly occurring TBIs.They
do not include other types of ABIs.
They are
underestimates
because they do not include individuals who do not seek treatment for a TBI or who get treatment in a doctor’s office or clinic.They do not tell us how many Minnesotans are brain injury survivors.
MN Department of Health estimates that
2% of the state’s population (~100,000 people)
live with the long-term effects of
TBI.
Frequency of brain injurySlide10
Some populations are considered to be at especially high risk of brain injury.
The include but are not limited to:
People experiencing homelessness
Incarcerated people
Military personnel or veteransAmerican IndiansLittle data is available about the frequency of brain injury among these populations in MN.
Frequency of brain injurySlide11
34% of Minnesota’s adult homeless population has either been told by a doctor or nurse that they have sustained a TBI, or their history indicates that they are likely to have had a
TBI.
Rates
of
significant mental illness, chronic health conditions, and substance abuse were found to be especially high among homeless adults who have had a
TBI.
TBI among the homeless population
Source:
Wilder statewide homelessness study (2012
).Slide12
How well do people with brain injuries feel service providers understand their injury?
Providers’ understanding of brain injury
Source:
Gaps Analysis Consumer
Survey,
N=140Slide13
There is a need for additional training and education for professionals who work with people with brain injuries. Lack of understanding of complexity of BI
Need exists among both direct service providers and those who assist people seeking access to services
This need was stated in all past needs and resources assessments.
Providers’ understanding of brain injury
Source:
Brain injury stakeholder interviewsSlide14
Do people with brain injuries feel their services and supports meet their needs?
Meeting people’s needs
Source:
Gaps Analysis Consumer
Survey,
N=142Slide15
A common concern was that services were not accessible enough.“Allowing
me to make choices about my care and services instead of "bundling" services so I can only get certain services along with other services or only get services from specific providers
.”
“Difficulty
making immediate appointments--usually have to book months in advance
.”
“A
lot of the burden falls on parents to fill in the gaps in their child's care when it is needed. Transportation, housing, appointments, arranging medical care, finances, etc. Services don't necessarily meet all the needs in these areas
.”
Meeting people’s needs
Source:
Gaps Analysis Consumer
SurveySlide16
Focus group and interview participants commonly expressed that services were not an appropriate fit or were not flexible.
“It
feels like the approach is everybody fits this little category. You have a brain injury…therefore you fit into this group of people with cognitive disabilities and these are the services we are going to provide and this is the direction we are going to encourage you to go. It just doesn’t fit well.
They
just don’t know what to do with people with a brain injury
.”
“It’s
not an additional
service,
but I would like to see a little more flexibility in the
services.”
Meeting people’s needs
Source:
Focus groups and interviews with brain injury
survivors and caregiversSlide17
Top services people with brain injuries feel
they need but are not able to get
Significant service gaps
Source:
Gaps Analysis Consumer
Survey,
N=81
Caregiver or family training/support
Respite care
Chore service
Personal support/companion services
Supported employment or help finding a jobSlide18
County and tribal representatives and services providers also commonly ranked respite care services
among the services with the largest or most significant
shortages.
Both groups also commonly ranked the following as having significant gaps:Foster careNon-medical transportation
Significant service gapsSlide19
How easy it is for people with brain injuries to access their most valuable services
Barriers to accessing services
Source:
Gaps Analysis Consumer
Survey,
N=146Slide20
Most common barriers to accessing most needed services among people with brain injuries
Barriers to accessing services
Source:
Gaps Analysis Consumer
Survey,
N=79
I cannot afford it
It is too hard to get it
It is not available near me
There is a long waiting list for it
I am not eligible for itSlide21
County and tribal representatives commonly indicated the following barriers:
Geographic
location of providers or the distance to services as a significant barrier (59%)
Access
to transportation (54%)
Lack of service availability on short notice or during crisis (34%)
Lack
of housing (32%)
Lack
of capacity to access service or navigate the system (23%)
Barriers to accessing services
Source:
Gaps Analysis
Lead Agency Survey,
N=79Slide22
When brain injury survivors, or their caregivers, were asked how they learned about services:48% said through a health care provider
40% said from family or friends
40% said from a case manager, care planner, or social worker
31% said via service or advocacy organizations, such as the Minnesota Brain Injury Alliance or Centers for Independent Living
Information about services
Source:
Gaps Analysis
Consumer Survey,
N=139Slide23
Transportation is an important area of need.County and tribal representatives
and service providers indicated that
non-medical transportation
was among the top service gaps faced by people with disabilities, including those with brain
injuries.
TransportationSlide24
Transportation is an important area of need.36
%
of brain injury
survivors
said there was at least one time in the past month when they could not get where they wanted or needed to go because they did not have
transportation.
Most often, they were unable to get
transportation for non-medical reasons such as running errands or social, spiritual, or recreational activities.
TransportationSlide25
Transportation is an important area of need. Focus group and interview respondents commonly expressed
frustration with their
transportation
options. Common themes for the frustration were unreliable transportation and a need for increased availability and flexibility of transportation options.
TransportationSlide26
When people with brain injuries were asked about their agreement with a series of statements about their
housing choices
, the majority
felt
they could:Choose where they live (57%)Choose who they live with (51%)Get the help they need to stay in or maintain the place where they want to live (57%)
Nearly half (47%) agreed that they had
more than one choice
of places to live when they were making their housing
decision.
HousingSlide27
In addition to improved supports related to housing, transportation, and employment, people with brain injuries indicated
two additional areas where supports could be improved to allow them to be
more integrated in their
communities
:More education and understanding in the community regarding brain injuries More
social opportunities that are appropriate for
them
Community integrationSlide28
Many people with brain injuries had
positive things
to say about how their services and supports affect their
quality of life
and expressed appreciation and gratitude for what they were receiving.
“
The help I receive adds greatly to my quality of life. [My service provider] has given me quality of life, to be honest
.”
“
I would like to state HOW MUCH I APPRECIATE WHAT IS IN PLACE AND THE HELP
I
DO RECEIVE from the system as it is. I am very grateful for
it.”
Quality of lifeSlide29
Others offered suggestions for changes
, including:
having more knowledgeable staff to provide help and services
improving the accessibility and quality of assistance they receive
enabling better access to social and recreational activities that are appropriate for themhaving better housing options
Quality of lifeSlide30
Questions?The full report can be found at:
https://edocs.dhs.state.mn.us/lfserver/Public/DHS-7301M-ENG
Thank you!