Definition of Family (for the purpose of receiving individual and family/caregiver training
Services) includes a statement that it shall not include persons who are compensated to care for an individual. However in some rural areas, where caregiving providers are in short supply, spouses, parents and/or other relatives may be paid through Consumer Directed Care as a matter of necessity.
Definition of Mayo Portland Adaptability Inventory: at the end it cites “three clinical areas” Recommend listing the subscales: Ability, Adjustment and Participation
“Qualified Brain Injury Support Provider (QBISP)” A more comprehensive training is required for Targeted CMs. The Brain Injury Association of Virginia has curriculum expertise and can be contracted to create an appropriate training program.
Qualifications for BIS Case Managers should include that within 6 months of employments, a TCM provider should attain a higher certification than QBISP - The Brain Injury Association of Virginia can provide this training
Case manager must have skills in:
As part of the intake process, the case manager must collect existing medical documentation that demonstrates the member’s diagnosis of a traumatic brain injury. If there is no documented diagnosis, then the case manager shall assist the member in accessing a physician who can document whether the member has a diagnosis that is eligible for receipt of the brain injury case management service. – This can include a Neuropsychological Evaluation. An evaluation needed to confirm a BI diagnosis will be (should be) covered by Medicaid.
Additionally, the case manager must complete the Mayo-Portland Adaptive Index-4 screening to determine whether the member meets the required severity threshold for BIS case management service. The MPAI-4 screening should be done in person with the support of family member(s) or others who know the individual well. This is not an appropriate tool for someone with severe cognitive impairment.
Exclusions are contradictory to the state definition of brain injury as defined in the Code of VA:
§ 37.2-403. Definitions.
"Brain injury" means any injury to the brain that occurs after birth that is acquired through traumatic or non-traumatic insults. Non-traumatic insults may include but are not limited to anoxia, hypoxia, aneurysm, toxic exposure, encephalopathy, surgical interventions, tumor, and stroke. "Brain injury" does not include hereditary, congenital, or degenerative brain disorders, or injuries induced by birth trauma.
Person Centered Planning Requirements