BINGHAMTON - SOUTHERN TIER TRAUMATIC BRAIN INJURY (TBI)
REGIONAL RESOURCE DEVELOPMENT CENTER (RRDC)
Serving the New York counties of:
Under contract to: New York State Department of Health
Phone & Fax Numbers:
(607) 724-2111 (Voice/TTY) or toll free at (877) 722-9150
(607) 238-2694 (VP)
(607) 772-3609 (Fax)
Belinda Turck – Lead Regional Resource Development Specialist (RRDS)
Ellen Rury – Nurse Evaluator / Regional Resource Development Specialist
Stacey Bischoff – Regional Resource Development Specialist
Janese McElwain – Regional Resource Development Specialist
Jamie Haywood – Regional Resource Development Specialist / Assistant RRDS
Betsy Giannicchi – Administrative Assistant
The Home and Community-Based Services Medicaid Waiver for Individuals with Traumatic Brain Injury (HCBS/TBI) is one component of a comprehensive strategy developed by the New York State Department of Health to assure that New Yorkers with a traumatic brain injury could receive services within New York in the most integrated setting.
The TBI waiver is an opportunity for comprehensive services to be available in the community rather than in an institution, allows the state to assemble a package of carefully tailored services to meet the needs of a targeted group in a community-based setting, maintains the waiver participant’s health and welfare through an individualized service plan, and assures the overall cost of serving waiver participants in the community is less than the cost of serving a similar group in an institution.
Expected Outcomes from the HCBS/TBI Waiver
• Individuals with TBI will be able to choose where and with whom they live.
• Individuals with TBI will be able to live self-satisfying lives.
• With a decrease in reliance on expensive nursing facility care, the State Medicaid program will realize significant savings.
To be Eligible for the HCBS/TBI Waiver an Individual Must:
• Have a diagnosis of TBI or a related diagnosis
• Be eligible for nursing facility level of care as determined by a Patient Review Instrument (PRI) and SCREEN
• Be a Medicaid recipient
• Be 18-64 years old
• Choose to live in the community rather than a nursing facility
• Have or find a living arrangement which meets the individual’s needs
• Be able to be served with the funds and services available under the HCBS/TBI waiver and New York State Medicaid State Plan
• Not participate in another HCBS waiver.
Click here for DOH Eligibility Criteria
Regional Resource Development Centers (RRDC)
The HCBS/TBI waiver is administered through a network of RRDCs, each covering specific counties throughout the State. The contact person at the RRDC is the Regional Resource Development Specialist (RRDS).
The RRDS is responsible for:
• Interviewing potential waiver participants
• Assisting participants to access approved providers
• Approving Service Plans
• Reviewing Incident Reports
• Maintaining regional budgets for waiver services
Additionally, the RRDC employs a Nurse Evaluator (NE). Responsibilities of the NE include:
• Utilizing clinical expertise to review medically complex Service Plans,
• Providing technical assistance to the RRDS and waiver service providers,
• Resolving issues associated with level of care determinations.
TBI Waiver Services
The key to individual choice and satisfaction is person-centered service coordination. The Service Coordinator:
• Is responsive to the individual and helps the waiver participant identify his or her unique needs;
• Promotes activities which will increase the individual’s independence and life satisfaction;
• Assists in the integration of the individual in the community of his/her choice;
• Helps in increasing the individual’s productivity and participation in meaningful activities; and
• Assists in arranging for daily living supports and services to meet the individual’s needs.
2.Independent Living Skills Training and Development
Improves and maintains the individual’s community living skills so that the individual can live as independently as possible. This will be done primarily in one-on-one training, and focuses on practical needs such as shopping, cooking, money management, use of public transportation, etc. This service is provided in the individual’s residence and in the community.
3.Structured Day Programs
Improves and maintains the individual’s community living skills in a congregate non-residential, non-medical setting. The focus will be on the development of social, problem-solving and task-oriented skills.
4.Substance Abuse Programs
Reduces and/or eliminates substance abuse which may interfere with the individual’s ability to be maintained in the community. This service will be specifically designed to meet the needs of individuals with cognitive deficits, and will work with existing community support systems, such as AA or Al-Anon, to assist them in becoming more responsive to people with traumatic brain injuries.
5.Positive Behavioral Interventions and Supports
Eliminates and/or reduces an individual’s severe maladaptive behavior(s) which, if not modified, will interfere with the individual’s ability to remain in the community.
These services are provided in the individual’s residence and in the community and are provided by a highly trained team to an individual, his/her family, or anyone else having significant contact with the individual.
6.Community Integration Counseling
Assists the waiver to adjust to the participant and family members to more effectively manage the stresses and difficulties associated with the waiver participant living in the community.
7.Home and Community Support Services (HCSS)
Home and Community Support Services (HCSS) are only appropriate when oversight and/or supervision is necessary as a discrete service to maintain the health and welfare of a participant living in the community. HCSS may also include personal care assistance with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). HCSS is not a companion service. The service must be provided under the direction and supervision of a Registered Professional Nurse (RN) based on an assessment of the individual’s needs and supported by physicians orders.
Provide for physical adaptations to the individual’s residence and primary vehicle which ensure the individual’s health, safety and welfare and which increase the individual’s independence and integration in the community.
Provides short-term relief for informal caregivers of individuals who are unable to care for themselves. This service will be provided primarily in the individual’s residence.
Provides durable and non-durable medical equipment not usually funded under the Medicaid State Plan. An example of the equipment available through this service is a three wheel cart for mobility purposes.
Provides the means to access non-medical services in the community in order to improve the individual’s ability to make use of needed services, and to improve the individual’s integration in the community.
12.Community Transition Services
Assists individuals leaving nursing homes by providing assistance with payment of a Security deposit, utility set up fees, moving expenses, purchase of essential furniture, and initial cleaning service. This service has a budget cap.
Room and Board
The federal government does not allow funds provided under any Medicaid waiver to be used for housing or food. These necessities must be paid for through other funds including:
• Family or personal funds
• Subsidized housing
• HCBS/TBI waiver housing funds
• Food Stamps
TBI Housing Subsidy
The TBI Housing Subsidy Program is a limited funding resource. Active, eligible TBI waiver participants may qualify for housing subsidy assistance. Housing subsidy is not a waiver service and all other funding sources must be exhausted prior to requesting a subsidy from the program. Subsidies are calculated based on individual income and need.