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The State of Ohio's Needs and Resource Assessment
of Individuals with Brain Injuries and Their Families

Comparing Needs of Individuals with BI with Services Provided by Agencies

The Needs Assessment survey for individuals and families and the one completed by providers requested information about the same list of services. In addition, individuals and families were asked about their satisfaction with services received and about services they needed. Providers noted which services they provided, and whether each service was available to children and/or adults with brain injuries. In this way the levels of satisfaction and need obtained from individuals and families can be mapped to the services that providers report offering. While OLRS had intended to obtain larger samples than the 47 surveys regarding children (birth - 21 years old) and the 143 providers, this data pool nonetheless contains valuable information.

Services that individuals with brain injuries and families report they received were primarily traditional services. Services received by at least half of respondents include general medical care (68%), medical care for their brain injury (53%), dental care (51%) and support groups (50%). The next eight most received services range from 38% who had case managers to 23% receiving cognitive training.

People with BI and families: Top 12 most received services by percentage

  1. Medical - general (68 percent)
  2. Medical - for TBI (53 percent)
  3. Dental (51 percent)
  4. TBI support group (50 percent)
  5. Case management (38 percent)
  6. OT or PT (35 percent)
  7. Individual counseling (31 percent)
  8. Speech therapy (26 percent)
  9. Neuropsychology (26 percent)
  10. Vision for TBI (24 percent)
  11. Legal for TBI (24 percent)
  12. Cognitive training (23 percent)

Individuals with brain injuries and their families also noted the services they need. Many of these services, if provided, would improve the quality of everyday living, and provide more opportunities for community inclusion. The service most needed was cognitive training defined on the survey as "retraining your brain to improve everyday skills" (43%), and 40% want more opportunities for recreation and social activities. Also needed are family counseling (39%), individual counseling (35%), and behavioral supports, defined as "learning ways to reduce or avoid unwanted behavior" (38%).

People with BI and families: Top 12 most needed services by percentage

  1. Cognitive training (43 percent)
  2. Recreation (40 percent)
  3. Family counseling (39 percent)
  4. Behavioral (38 percent)
  5. Neuropsychology (37 percent)
  6. Individual counseling (35 percent)
  7. Social skills (31 percent)
  8. Case management (30 percent)
  9. Legal for injury (30 percent)
  10. Dental (29 percent)
  11. Money, budget training (29 percent)
  12. Support group (28 percent)

For many services, there is a disconnection between what agencies provide and what individuals with brain injuries and their families want. The chart below displays the services that agencies are most likely to provide.

Percent of providers offering top 12 services
Case management OT-PT Individual counseling Social skills Behavior support Speech therapy Cognitive training Communication skills Budget training Nursing Recreation Transportation
All providers 53% 40% 47% 50% 43% 38% 36% 42% 41% 38% 38% 43%
Select providers 72% 67% 65% 65% 64% 62% 61% 59% 55% 54% 49% 48%

(Select providers = The 69 providers listed as "pull-down" menu choices on the survey: ADAMH-MH Board, CBMRDD, Area Agency on Aging, Rehabilitation Hospital, Nursing Home, Outpatient)

This Needs Assessment identifies a number of services that individuals and families want that are not available to them. Through this report, individuals with brain injuries and families provide agencies with information about significant gaps in service provision. Providers can make a business case for developing customer-driven services, and fill niche markets valued by individuals and their families.

This table displays the similarities and differences for services that agencies reported they provided and those individuals and families wanted.

Providers are separated into two columns: all of the 143 providers, and the 69 providers (the "select providers") listed on the survey's pull-down menu that were likely to provide services to people with brain injuries.

The remaining 74 agencies ranged from those that provided services (for example, center for independent living, sheltered workshop, assisted living, health department); to vendors of durable medical equipment and van rentals; to organizations that serve the general public (for example, libraries, universities and departments of recreation).

The numbers may seem to show that providers provide the services that people with BI need to the degree that respondents report they need them. But, the individuals who answered the survey were primarily from rural areas (57%), while the providers who answered the survey primarily served people in urban areas (56%), and primarily served people in only one county (67%).

Percentages of agencies providing services to their client populations - Percentages of people with BI who need services
Services Provided by all 143 providers Provided by 69 select providers Needed by individuals and families (522)
cognitive training 36% 61% 43%
recreation 38% 49% 40%
family counseling 29% 41% 39%
behavioral supports 43% 64% 38%
neuropsychology 14% 22% 37%
individual counseling 47% 65% 35%
social skills 50% 65% 31%
case management 53% 72% 30%
legal for TBI 2% 4% 30%
dental 8% 16% 29%
money and budget training 41% 55% 29%
support group 20% 32% 28%
occupational or physical therapy 40% 67% 28%
vision for TBI 11% 16% 27%
community skills 42% 59% 27%
housing assistance 25% 29% 26%
medical services related to TBI 16% 29% 26%
assistive technology 19% 28% 26%
help getting job 31% 39% 25%
transportation 43% 48% 25%
learning supports after high school 20% 23% 24%
help keeping a job 30% 39% 22%
home modifications 22% 30% 21%
respite 31% 41% 20%
speech therapy 38% 62% 18%
medical services - general 22% 35% 15%
home care 22% 28% 12%
emergency shelter 13% 17% 8%
inpatient rehab 22% 38% 8%
learning supports through high school 25% 30% 7%
alcohol-drug treatment 17% 26% 6%
nursing 38% 54% 5%


Provision of services to adults and to children - All 143 providers
Services Number Percentage (%) Children Adults
case management 76 53% 44 69
home care 32 22% 14 31
housing 36 25% 13 34
home modifications 31 22% 18 31
emergency shelter 18 13% 5 17
respite 44 31% 19 42
learning through high school 36 25% 34 14
learning after high school 29 20% 12 25
inpatient rehab 31 22% 9 30
speech therapy 54 38% 29 47
cognitive training 52 36% 28 50
OT-PT 57 40% 30 51
nursing 54 38% 23 51
individual counseling 67 47% 37 61
family counseling 42 29% 27 36
neuropsychology 20 14% 6 19
alcohol-drug treatment 24 17% 7 24
behavioral supports 62 43% 39 53
vision for TBI 16 11% 7 16
vision - general 25 17% 8 23
medical for TBI 23 16% 8 22
medical - general 32 22% 10 32
dental 12 8% 4 12
assistive technology 27 19% 20 23
help getting job 44 31% 16 43
help keeping job 43 30% 11 43
community skills 60 42% 36 54
social skills 71 50% 42 65
budget training 59 41% 28 56
transportation 61 43% 30 60
support group 29 20% 7 28
recreation 54 38% 27 52
legal for TBI 3 2% 2 3


Provision of services to adults and to children - 69 select providers
Services Number Percentage (%) Children Adults
case management 50 72% 32 46
home care 19 28% 9 18
housing 20 29% 5 20
home modifications 21 30% 12 21
emergency shelter 12 17% 4 11
respite 28 41% 13 27
learning through high school 21 30% 20 7
learning after high school 16 23% 6 13
inpatient rehab 26 38% 8 25
speech therapy 43 62% 25 38
cognitive training 42 61% 24 41
OT-PT 46 67% 27 41
nursing 37 54% 19 36
individual counseling 45 65% 24 40
family counseling 28 41% 18 24
neuropsychology 15 22% 5 14
alcohol-drug treatment 18 26% 5 18
behavioral supports 44 64% 28 39
vision for TBI 11 16% 3 11
vision - general 16 23% 3 15
medical for TBI 20 29% 7 19
medical - general 24 35% 8 24
dental 11 16% 4 11
assistive technology 19 28% 14 18
help getting job 27 39% 10 26
help keeping job 27 39% 6 27
community skills 41 59% 23 37
social skills 45 65% 26 41
budget training 38 55% 14 37
transportation 33 48% 16 32
support group 22 32% 4 21
recreation 34 49% 13 34
legal for TBI 3 4% 2 3


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