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The mission of Brain Injury Services of SWVA is to help children and adults living with brain injury improve the quality of their lives and reintegrate into family and community.
Frequently Asked Questions About Adult Case Management

1. What Are The Common Symptoms of Persons Who Have Survived Brain Injuries?
It is important to remember that each person who sustains a brain injury will experience a unique set of symptoms. Some symptoms may last for a few weeks while others may last for a lifetime. The following is a list of common physical, cognitive and emotional symptoms of persons who have survived brain injuries. The following information has been gathered from the Brain Injury Association of America, Inc.

Cognitive Impairments Involve:

  • Communication and language
  • Memory, especially for learning new information
  • Perception, sensory integration
  • Attention and concentration
  • Judgment, planning, and decision making
  • Ability to adjust to change (flexibility)
  • Organizational skills
  • Initiation

Social and Behavioral Impairments Involve:

  • Mood swings
  • Denial
  • Depression and/or anxiety
  • Lowered self esteem
  • Sexual dysfunction
  • Restlessness and /or impatience
  • Inability to self-monitor
  • Inappropriate social responses
  • Difficulty with emotional control and anger management. Abrupt unexpected acts of violence
  • Inability to cope
  • Excessive laughing or crying
  • Agitation
  • Delusions, paranoia, mania
  • Non-Age appropriate behavior

Neuromotor-Physical Impairments Involve:

  • Vision, hearing, speech and other sensory impairments
  • Headaches
  • Lack of coordination and speed of movement
  • Muscle spasticity (a condition that causes stiff, tight muscles, especially in the arms and legs, making movements stiff jerky or uncontrollable)
  • Paralysis
  • Seizure disorders
  • Sleep disorders
  • Dysphagia (a disorder of swallowing)
  • Dysarthria (a disorder of articulation and the muscular/motor control of speech)
  • Balance, strength, and equilibrium
  • Motor function

2. Does Brain Injury Services of SWVA Provide Employment Services?We do not directly provide services such as job coaching, job seeking, and supportive employment. We do, however, collaborate with other agencies such as the Department of Rehabilitative Services (DARS) and supported employment agencies. They are the “experts” in employment and vocational services, and we work along with them to help individuals find jobs.

3. Will Brain Injury Services of SWVA Pay for Services Such As Transportation, Therapies, Medication, etc.?
Each individual works with a Case Manager to develop a Case Management Plan specific to his/her own needs. Brain Injury Services of SWVA may pay for a limited amount of needed services related to the Case Management Plan once all other options are exhausted (the individual, family, other service providers).

4. Is There a Cost for Services?
There is no cost for case management services directly provided by a Case Manager. If a person receives Life Skills Training Services from our trained staff, or a service that is contracted by the Case Manager, then a Financial Eligibility Form is completed with the Case Manager. This will determine whether the individual will be required to contribute towards the particular services (for example: speech therapy).

5. Will I Still Have A Case Manager Even After I Get A Job?
Brain Injury Services of SWVA does not necessarily close a case once an individual is employed. It all depends on the individual’s goals. If someone has met all of his/her goals and is functioning well independently, the individual and the Case Manager may discuss closing the case. The individual, however, is always welcome to call Brain Injury Services for information/referrals or brief consultations.

6. Who Has Access to My Files?
You always have the right to look at anything in your file that was created by Brain Injury Services of SWVA. Some information received from outside sources may not be released. Your Case Manager, the Program Director, the Director of Administration, and the Executive Director will have access to your file, but it will be inaccessible to any other Brain Injury Services staff, volunteers, or clients without your prior consent.

7. What Will Be My Family's Involvement?
Your family — individuals significant to your support system — in so much as their involvement is consistent with your goals and desires are integrated into the services we provide.

8. How Do I Make A Referral?
Anyone can make a referral. The process is simple. You may call Brain Injury Services of SWVA and state that you would like to make a referral. The receptionist will explain our intake process then get your name, phone number, and address to send out an application for services and a medical consent form. Once a completed application form has been submitted to BISSWVA and the requested medical information received, then the information will be presented to the Intake Review Board. That Board will determine whether the person referred is eligible for services.

9. How Often Do I See My Case Manager?
This varies from client to client. Each individual is seen as often as needed to continue to make progress toward the goals in their Case Management Plan. A minimum of one contact every month is required to keep your case active.

10. How Long Can Services Be Received?
The client and Case Manager develop a Case Management Plan together. The plan becomes the guiding document for delivery of case management services. The Case Management Plan is revised on an as needed basis. Goals may be developed in the following areas: housing, medical, vocational, transportation, social, recreational, financial, etc. Goals are specific, achievable, and measurable. Client tasks are identified with specific time frames for completion. As long as tasks and goals are identified and the client is participating in tasks, services can continue.

11. When Is A Case Closed?
A case will be closed when a client:

  • Moves out of Brain Injury Services of SWVA service area;
  • Does not participate for more than three months;
  • Has met all goals in the case management plan;
  • Is an active substance abuser and not receiving treatment;
  • Is a danger to self or others; or
  • Becomes institutionalized for 90 days.

12. What Programs Does Brain Injury Services of SWVA Provide?
In support of our person-centered philosophy, our services are individualized. You and your Case Manager evaluate your personal goals and needs, and services are set up using community resources that can help you reach your goals. We also provide Life Skills Training Services, at a rate that takes into consideration the client’s financial status as determined by a completed financial statement.

13. What Is “Person-Centered Philosophy?”
The most important thing to know about people who have experienced a brain injury is that just as each person is different, so is each person's rehabilitation different. Each person has different goals, different capabilities, different challenges, different resources, different interests, etc. A person-centered approach to setting goals, and planning strategies to achieve the goals, is a way of reminding those who are helping people with a brain injury, or other disability, that each person is different. Person-centered planning goes beyond the traditional planning process that occurs in the development of most rehabilitation or social service plans which typically focus on the services the "system" can offer. Rather than trying to fit a person into what the "system" can offer, the person-centered approach organizes truly individualized, natural, and creative supports to achieve meaningful goals based on the individual's strengths and preferences. According to experts in the field, Howard Garner and Lise Dietz, the person-centered approach creates a team of people who know and care about the individual with a brain injury, who come together to develop and share a dream for the person's future, and who work together to organize and provide the supports necessary to make that dream a reality. Brain Injury services of SWVA Case Managers employ the principles of person-centered planning, and we call this our “person-centered philosophy.”

14. Why Do I Need A Case Management Plan?
A Case Management Plan is a written document that not only summarizes your goals and how you can accomplish them, but also constitutes an agreement between you and your Case Manager of mutual responsibilities as you work together. It is a way to help keep you and your Case Manager focused on what your goal(s) is and how you plan on achieving it. This plan can be revised as you move through the process of attaining your goals, if deemed appropriate by you and your Case Manager.

15. What Is Acquired Brain Injury?
In 1997, the Brain Injury Association of America, Inc. adopted the following definition: an acquired brain injury is an injury to the brain that has occurred after birth. The injury commonly results in a change in neuronal activities that effects the physical integrity, the metabolic activity, or the functional ability of the cell. Causes of acquired brain injury include external forces applied to the head and/or neck (e.g., traumatic brain injury with or without skull fracture), anoxic/ hypoxic injury (e.g., cardiopulmonary arrest, carbon monoxide poisoning, airway obstruction, hemorrhage), intracranial surgery, vascular disruption (e.g.,arteriovenous malformation (AVM), thromboembolic events, fat emboli), infectious diseases, intracranial neoplasms, metabolic disorders (e.g., hypo/hyperglycemia, hepatic encephalopathy, uremic encephalopathy), seizure disorders and toxic exposure (e.g., substance abuse, ingestion of lead and inhalation of volatile agents). The term does not refer to brain injuries that are congenital or brain injuries induced by birth trauma.
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“Brain Injury Services of SWVA is funded in part by state general funds appropriated by the Virginia General Assembly and administered by the
Department for Aging and Rehabilitative Services”