Developing and Translating a Statewide System of Support and Collaboration Into Local Support Networks Integrated Through Resource Facilitation

Lance Trexler, PhD (PI), Laura Trexler, OTR, Alan Neuenschwander, Christa Peters and Carol Baker

Following acquired brain injury (ABI) and acute hospitalization and rehabilitation, the survivor and their families are challenged to discover what resources are available through various public and private sector organizations.  Each organization has different accessibility criteria, priorities, and processes.  Each survivor and family is left to rediscover how to navigate the maze to recovery and re-integration into the community following brain injury. As a consequence, work outcomes following moderate to severe brain injury are typically less than 40%, and typically around 30% for working age patients.  Access to coordination of resources is intended to increase access and appropriate use of services, and to improve vocational outcome.

This is a four year grant from the Human Resources and Services Administration through the Indiana Bureau of Vocational Rehabilitation with the Rehabilitation Hospital of Indiana Foundation.  The goal of this project is to establish brain injury specific integrated, proactive and coordinated systems of supports and services at state and local levels to improve vocational outcomes for individuals after a brain injury. This project calls for the establishment of the Indiana Brain Injury Leadership Board which will oversee the development of the community based Local Support Networks (LSN).  The LSNs will provide an integrated and coordinated network of support from participating private and public resources.  The LSNs will also link the survivor and their family to Resource Facilitation services. 

Resource Facilitation methods and activities include:

•  Assessment to identify current status, needs and resources in life domains;
• Planning and documentation mutually agreed upon, person-centered goals and service/resource needs;
• Identification of community-based resources, whenever possible, for services and supports, including emotional supports. Evaluate, through subjective report from participants, effectiveness of what has been utilized in the past;
• Facilitation of access to resources through education and advocacy;
• Proactive monitoring of the status of the plan as well as the quality and appropriateness of the services and supports, and resources through telephone or internet contact, or personal contact when able.  Contact with either the caregiver or the individual with a brain injury occurred, at a minimum of, every two weeks; and
• Provision of education to the individual with a brain injury and principal support/caregiver.  Education will include information on Brain Injury, personal advocacy and partnership development and the development and maintenance of a personalized Resource Facilitation Handbook including a projected discharge plan. 
  

The Rehabilitation Hospital of Indiana research group has recently completed the first randomized controlled trial of Resource Facilitation for people with ABI beginning immediately after discharge from acute rehabilitation. People who received Resource Facilitation services were found to have significantly better outcomes in terms of return to work and participation in activities at home and in the community compared to those who received regular follow-up services.  As a consequence, Indiana Vocational Rehabilitation Services has agreed to fund Resource Facilitation services for people with brain injury under certain circumstances. Through continued research efforts and collaboration with Indiana Vocational Rehabilitation Services Resource Facilitation will be expanded and integrated through the LSNs. There are currently three LSNs being developed in Indianapolis, Bloomington, and Fort Wayne with two additional LSNs to be developed over the course of the Grant period.