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Alaska Brain Injury Network, Inc.

Grace Snider Resource Navigator Program Director 907-274-2824 toll free: 888-574-2824 grace@alaskabraininjury.net. Alaska Brain Injury Network, Inc. ABIN Mission: Educate, plan, coordinate, and advocate on behalf of survivors of TBI and their families. Track needs of Alaskans

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Alaska Brain Injury Network, Inc.

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  1. Grace SniderResource Navigator Program Director907-274-2824toll free: 888-574-2824grace@alaskabraininjury.net

  2. Alaska Brain Injury Network, Inc. ABIN Mission: Educate, plan, coordinate, and advocate on behalf of survivors of TBI and their families • Track needs of Alaskans • TBI survivors/family members are the experts. • Make recommendations to Department of Health and Social Services and the Alaska Mental Health Trust • Bring brain injury services close to home • Prevention First! • Information and Referral • Online Resource Directory and Library Materials • Online Discussion Group • Library • Advocacy • Network of consumers, professionals, policy makers, and advocates to make systems change!

  3. Special thank you to:Alaska Native Tribal Health Consortium Injury Prevention Program

  4. Traumatic Brain Injury in Alaska: Who, How and Where Alaska Native Tribal Health Consortium Injury Prevention Program

  5. What is a Traumatic Brain Injury? CDC describes it as: “…caused by a bump, blow, or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.”

  6. How do you get a TBI? • Many different kinds of events, some that are almost everyday events, can cause a TBI: • Hitting your head when you fall or trip • Crashing your bike, snow machine or ATV • Being in a motor vehicle crash • Injure your head during sports • Being near an explosion

  7. How does a TBI affect you? • If you or someone else gets a TBI, it can cause temporary or permanent changes in: • Thinking (remembering and reasoning) • Physical abilities (walking, coordination) • Sensation (touch, taste, smell) • Language (understanding, communication) • Emotion (depression, aggression, anxiety)

  8. Increased Risk of TBI Who?

  9. The Gender GapNon-fatal TBI Hospitalizations in Alaska 2004-2008

  10. Age DifferencesNon-fatal TBI Hospitalizations in Alaska 2004-2008

  11. Age groups and Activities Different age groups have different activities that result in the highest numbers of TBI: Ages (years)Activities with the most TBI 0-9 Falls 10-19 Motor vehicle, ATV/Snowmachine 20-39 Motor vehicle, Assault 40+ Falls, Motor vehicle

  12. Increased Risk of TBI Where?

  13. Region of Patient ResidenceNon-fatal TBI Hospitalizations in Alaska 2004-2008* All U.S. Rate**: 93 All Alaska Rate*: 92 Alaska Native Rate*: 174 * Crude rates, reported as TBI per 100,000 people ** All U.S. rate for 2002-2006, per CDC.

  14. Specific places of occurrence Non-fatal TBI Hospitalizations in Alaska 2004-2008

  15. Increased Risk of TBI Is Alcohol a Risk Factor?

  16. Yes

  17. Alcohol Association by Age Non-fatal TBI Hospitalizations in Alaska 2004-2008

  18. Alcohol by Activity Non-fatal TBI Hospitalizations in Alaska, 2004-2008 Cases associated ACTIVITY with alcohol Assault 3 out of every 4 Suicide attempt and Snow machine 1 out of every 2 Pedestrian and All-terrain vehicle 2 out of every 5 Motor vehicle traffic 1 out of every 3 All other 1 out of every 5

  19. Alcohol by Activity Non-fatal TBI Hospitalizations in Alaska2004-2008 Percent of cases ACTIVITY Total Cases associated with alcohol Assault 375 72% Snow machine 121 49% Suicide attempt 27 48% Pedestrian 108 41% All-terrain vehicle 240 39% Motor vehicle traffic 644 32% Bicycle 132 23% Falls 1034 18% All other 408 18%

  20. Increased Risk of TBI How severe?

  21. Time in Hospital For TBI hospitalizations from 2004-2008, the length of time patients spent in the hospital: Average: 5.6 days (compared to 3.9 for non-TBI injuries) Maximum: 305 days (10 months)

  22. Patient destination at dischargeNon-fatal TBI Hospitalizations in Alaska 2004-2008

  23. Patient’s General Condition on Discharge Condition Frequency % Good, Return to Previous Level of Function 861 28 Temporary Disability, Expected to Return 1111 36 to Previous Level of Function Moderate Disability with Self Care 133 4 Severe Disability, Dependent 155 5 Persistent Vegetative State 4 .1 Unknown 825 27

  24. Risks of TBI How much $$?

  25. Hospitalization costs • Hospitalization costs for TBI in all Alaska averages $29,000 per injury, compared to the $20,000 average for all injury hospitalizations • Estimated total per year: • $16.7 million • Highest hospitalization cost for TBI: $1,010,000

  26. Medivac costs • These costs vary dramatically depending on the contract with the Medivac company. • These are cost ranges Alaska companies provided for actual trips taken: • Juneau to Seattle: $17,000 to $37,000 • Anchorage to Seattle: $27,000 to $56,000 • Nome to Seattle: $37,000 to $75,000 • Anchorage to Richmond, VA: $63,000 to $124,000

  27. Prevention What is being done?

  28. Snowmachine, ATV, and Motorcycle Safety

  29. Child Motor Vehicle Safety

  30. Reducing harm from guns Gun Safes

  31. Ice cleats Raising awareness Home modification

  32. Bike Safety

  33. Pedestrian Safety

  34. ANTHC Traumatic Brain InjuryContacts Jaylene Wheeler, Injury Prevention Coordinator (907) 729-3799 jzwheeler@anthc.org Hillary Strayer, Senior Injury Prevention Specialist (907) 729-3513 hdstrayer@anthc.org Website: http://www.anthc.org/chs/wp/injprev/

  35. Once an injury occurs… • Ideal system of care vs. Alaska’s

  36. CASE MANAGEMENT/ CASE MANAGEMENT/ SERVICE COORDINATION SERVICE COORDINATION trauma COMMUNITY COMMUNITY Pre Pre - - Hospital, Hospital, Trauma Alaskans suffer TBI 28% more than the lower 48 Acute care Out Patient Rehab Emergency Emergency Acute Emergency Emergency Education -Training -Resource Navigator Department Department Care Out Patient Rehab Medical Medical Post Acute Care Services Services Prevention Prevention Education Family Support Services Family Support Services Housing Housing Vocational Vocational Training/Employment Physicians Physicians Training/Employment Long Term Services and Long Term Services and Supports Supports Inpatient Inpatient Rehabilitation Rehabilitation Screening RESEARCH RESEARCH

  37. Locating needed services… • Information and Referral • Care Coordination (Case Management) • Acute and Post-acute Rehab • Education and Related Supports • Vocational Training and Rehabilitation • Long-Term Community Supports

  38. Alaska Brain Injury Network’s Resource Navigation Program Available to ANYONE in the State looking for resources for brain injury. Helping people find… • Information about brain injuries • Services to help them recover • Help brainstorming solutions • Someone to listen and understand.

  39. How ABIN can help you? • Information and Referral • Aka Resource Navigation! • Online Discussion Group • Website • Resource Directory • Online Resource Library

  40. Resource #1: Alaskan Brain Matters • Online Discussion Group – Email Group • Group for survivors, caregivers, and providers to share information and offer support • Dialogues that make a difference • Urgent needs met immediately (case example) • Advocacy Works! Your voices make a difference • To join, email contact@alaskabraininjury.net

  41. Resource #2: Website • Website www.alaskabraininjury.net • Resource Directory • Find community resources: physical therapists, occupational therapists, speech therapists, vision therapy, biofeedback, counseling, assessment, independent living centers, accessibility, state agency programs, vocational rehab, and more. • Library of articles • Find educational materials for various topics.

  42. Head Injury Support Groups • Juneau: Margie Thomson/SAIL (907) 796-6465 • Anchorage: Frank Box, Access Alaska (907) 263-1905 • Fairbanks: Access Alaska (907) 479-7940 • Mat-Su: Angie Boardman Access Alaska/Mat-Su Health Serv.(888) 574-2824 • Homer: Cathy Stingley, Thoughtful Therapies (907) 235-6226 • Ketchikan: Pat Chapman (907) 617-5704

  43. Mentoring • Similar Experiences • Share what resources and supports that have worked for them • Don’t feel so alone • A Friend

  44. Information about brain injuries • Trust Training Cooperative • Acquired Traumatic Brain Injury Case Management training • https://www.ttclms.org/class_detail.php?z_classid=101877 • Lash and Associates • www.lapublishing.com • Tip cards, books, DVD’s • 3rd Thursday Teleconference Training lrivard@lakeview.ws • American Academy of Certified Brain Injury Specialists, www.aacbis.net • National Websites

  45. What is being done to improve the system of care in Alaska:

  46. Developing Initiatives • Information and Referral (ABIN, ADRC, 211) • Case Management DHSS, Senior and Disabilities Services (2009) • State ATBI Program (2010) • TBI Program Coordinator • Data collection • Expand Care Coordination • TBI Training-Intro to TBI course, Advance Management in Brain Disorders (2008) • ImPACT-concussion management, Alaska Neuro Associates • Public Awareness- Callan Chylook-Sifsof, television commercials, newspaper ads, posters.

  47. The Alaska Acquired and TraumaticBrain Injury ProgramSB 219 – ATBI Program • "An Act establishing a traumatic or acquired brain injury program and registry within the Department of Health and Social Services; and relating to medical assistance coverage for traumatic or acquired brain injury services." • SB 219 Introduced by Senator Lesil McGuire, family member of a TBI survivor, January 19, 2010, added “acquired” brain injury - ATBI

  48. The Alaska Acquired and TraumaticBrain Injury ProgramSB 219 – ATBI Program • State responsibilities under SB 219 • Assessment of the scope, availability and effectiveness of current ATBI services • Supervision, coordination and expansion of ATBI services • Development of standards for prevention and treatment of ATBI

  49. The Alaska Acquired and TraumaticBrain Injury ProgramSB 219 – ATBI Program • State responsibilities under SB 219 • Development and maintenance of an ATBI Registry to track the status and outcomes for people served by the ATBI Program • The addition of targeted case management as a Medicaid service for people with ATBI, which will require SDS to develop standards and regulations for delivery of this service ($1.2 million fiscal note)

  50. What works for you?

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