OLRS had intended to obtain a larger sample than 143 providers, as well as better targeting of providers likely to serve individuals with brain injuries and their families. The provider mailing list from BIAOH reflected the fact that there are few services for individuals with BI and their families in Ohio. BIAOH included in its list all providers it has referred people to, but that database does not reflect the broader range of services reflected in the Needs Assessment survey for individuals and their families.
The Needs Assessment survey for providers contained a pull-down list with six categories for typical providers of services to individuals with brain injuries and their families. Of the 143 surveys received, 69 providers checked these categories: ADAMH - MH Board [county board of alcohol and drug addiction and/or mental health], CBMRDD [county board of mental retardation and developmental disabilities], area agency on aging, rehabilitation hospital, nursing home or outpatient. The rest of the respondents ranged from agencies 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 parameters of the grant OLRS operated under focused on people with traumatic brain injuries, known as TBI. This Needs Assessment was targeted to individuals with a TBI and their families. A number of individuals, families and providers commented that people with other types of brain injuries should be included in the Needs Assessment and subsequent Recommendations. Fortuitously, the Ohio Brain Injury Advisory Council reached the same conclusion.
Survey results would have been improved with the addition of a larger sample of the needs of children. OLRS received 47 surveys (9%) about children (birth - 21 years old). To address this, a focus group was held with parents of children with brain injuries. The focus group was helpful in obtaining more information about the needs of children with BI, but remained limited to the number of parents of children reached.
Needs Assessment results would similarly have improved with a larger sample of residents of facilities, giving a better picture of their needs. OLRS received 48 surveys (9%) about individuals living in group homes, nursing homes, hospitals and rehabilitation facilities. OLRS again addressed this issue with a focus group at a nursing facility that had a separate unit for individuals with BI. Efforts to convene a second focus group at a rehabilitation hospital were unsuccessful due in part to a merger that was in process. Contacts were also attempted with Veterans Medical centers. It is possible that residents of facilities were not inordinately underrepresented in Ohio's survey. The TBI National Data Center reported that 98% of people with TBI were sent to a private, noninstitutional residence after injury, in most cases their homes before injury. [Traumatic Brain Injury Facts and Figures, Database Update, S Millis, K Wood, Volume 11, Number 1, Winter 2005, p 8]
There were two survey questions about services that were not included in this analysis. The question about "general vision services" was included on the Provider Survey, but left off the Individual and Family Survey. Responses to the question about "general legal services" had data integrity problems due to a coding error; therefore, this service is also not included in this report.
Additional resources may have remediated some of these limitations. The amount allocated from the Rehabilitation Services Commissions' Ohio Brain Injury Advisory Council to OLRS to accomplish the Needs Assessment was $20,000. In addition, OLRS nearly matched grant funds dollar for dollar. Funding was used to develop and test the databases and web survey tools; conduct the three surveys of individuals and families, providers, and state agencies; plan, conduct, and travel to forums; and analyze data and compile this report.