This section of the Needs Assessment gives information about responses from all the provider agencies.
OLRS' assessment of provider agencies yielded a total of 143 returned surveys. The survey asked for the "Type of Agency" and provided a menu of six choices of providers who were likely to serve individuals with brain injuries: outpatient, rehabilitation hospitals, nursing homes, area agencies on aging, county boards of mental retardation and developmental disabilities (CBMRDD), and county mental health, drug and alcohol boards. About half (69 of 143) of the providers identified their agencies as one of these six agency types. This subset of 69 providers is analyzed in this section of the report as "select providers."
| Outpatient | CBMRDD | Rehab Hospital | Nursing Home | ADAMH - MH Board | Area Agency on Aging |
|---|---|---|---|---|---|
| 19 | 17 | 13 | 12 | 9 | 1 |
Providers that were not included in the six agency types listed were asked to write in their type of agency in two text boxes: "Other Public Agency" or "Other Private Agency:"
Four providers serve all 88 counties. Eight providers did not indicate the counties in which they provided services or the question was not applicable, (for example, locally based school districts or health clinics). The remaining 132 providers indicated they served a total of 345 counties; 88 of these providers reported that they provide services to 7 counties that include Ohio's largest urban areas (Cuyahoga, Franklin, Hamilton, Lucas, Montgomery, Stark and Summit).
| n/a - not given | 1 | 2 | 3 | 4-5 | 6-17 | statewide |
|---|---|---|---|---|---|---|
| 8 | 80 | 10 | 7 | 17 | 17 | 4 |
Eighty providers (56%) provide services in just one county. The chart above shows the remaining distribution of the numbers of counties served by providers.
Providers were asked to check all of the places services were provided for the eight categories noted on the Needs Assessment. This chart displays the results for the 69 "select providers" and for all providers.
| Outpatient | Community | Residential | Acute Rehab | Employment | School | Clinic | Home Health | |
|---|---|---|---|---|---|---|---|---|
| All providers (113 responses) | 41 | 52 | 47 | 20 | 30 | 26 | 12 | 14 |
| Select providers (59 responses) | 32 | 21 | 21 | 17 | 19 | 15 | 7 | 6 |
Providers were asked to write in other places where they provide services; 57 answers were received. These include: in people's homes, in group homes, hospital-based, sheltered workshops, community employment settings, recreation and parks departments, health departments, treatment programs, adult day programs, churches and mission buildings, club houses, crisis hotlines, free legal clinic and attorney's office, early intervention programs, family support programs, service coordination (case management), personal care and respite, foster homes, nursing facilities, libraries, universities, and university clinics.
Providers were asked to estimate what percentage of payment from clients comes from Medicaid, Medicare, private insurance, and other sources.
| None | 1 - 20 | 21 - 40 | 41 - 60 | 61 - 80 | 81 - 100 |
|---|---|---|---|---|---|
| 2% | 9% | 7% | 4% | 6% | 5% |
| None | 1 - 20 | 21 - 40 | 41 - 60 | 61 - 80 | 81 - 100 |
|---|---|---|---|---|---|
| 3% | 9% | 5% | 3% | 2% | 1% |
| None | 1 - 20 | 21 - 40 | 41 - 60 | 61 - 80 | 81 - 100 |
|---|---|---|---|---|---|
| 3% | 13% | 4% | 2% | 1% | 1% |
Other sources of payment included: federal dollars (Housing and Urban Development, Veteran's Administration, Individuals with Disabilities Education Act), state dollars (Bureau of Worker's Compensation, Bureau of Vocational Rehabilitation, Bureau of Children with Medical Handicaps), county dollars (county board of MRDD, county board of alcohol and drug and/or mental health, County Commissioners, public children service agencies), probate court, rent subsidies, private pay, grants (United Way,) pro bono, no charge for services, and donations.
| Number of providers (n = 143) |
All individuals served |
|---|---|
| 27 | no answer or not applicable |
| 19 | 1 - 50 |
| 10 | 51 - 100 |
| 11 | 101 - 200 |
| 22 | 201 - 500 |
| 22 | 501 - 1,000 |
| 20 | 1,001 - 5,000 |
| 6 | 5,001 - 20,000 |
| 5 | 20,001 - 62,600 |
| 1 | 395,000 |
| Number of providers (n = 75) |
Identified as TBI served |
|---|---|
| 7 | no answer or not applicable |
| 32 | 1 - 10 |
| 7 | 11 - 20 |
| 13 | 21 - 50 |
| 1 | 51 - 100 |
| 6 | 101 - 200 |
| 6 | 201 - 1,500 |
Note: Three providers reported in percentage served: 38 percent, 60 percent, 100 percent
Slightly more "select providers" (63%) identify people with brain injuries in their agency data than when percentages are run for all agencies who answered this question (57%).
| All providers | Select providers | |
|---|---|---|
| Yes | 70 | 36 |
| No | 53 | 21 |
Providers responding to this Needs Assessment ranged from those that provided other 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).
Organizations that serve the general public, for example, libraries or recreation and parks departments, have no reason to affirmatively identify individuals with disabilities unless individuals choose to self-disclose this information. While it would undoubtedly be helpful for some providers to identify individuals with brain injuries to better assure an appropriate level of service, disability rights laws, individuals' privacy and confidentiality, and the security of paper and electronic records, must be taken into account.
| Number of providers (n = 121) |
Total staff |
|---|---|
| 2 | not applicable or varies |
| 4 | 0 |
| 47 | 1 - 10 |
| 27 | 11 - 50 |
| 27 | 51 - 100 |
| 12 | 101 - 1,000 |
| 2 | 1,001 - 2,800 |
| Number of providers (n = 105) |
Dedicated TBI staff |
|---|---|
| 32 | not applicable or varies |
| 59 | 0 |
| 32 | .5 - 10 |
| 7 | 11 - 25 |
| 1 | 26 - 50 |
| 2 | 51 - 100 |
Note: One provider noted "all."
The survey asked, "If your agency has specific eligibility requirements that people must meet, regardless of their disability, check all that apply." Among the "select providers," 26% reported their eligibility criteria included people injured before the age of 22. We can speculate that most of these individuals would meet Ohio's definition of developmental disability that includes the caveat that the disability must have happened from birth through 21 years of age. One quarter of the "select providers" reported that having mental illness is a criterion for services.
| Injury before 22 | Mental illness | Homeless | Medicaid | Substance abuse | Inpatient | |
|---|---|---|---|---|---|---|
| All providers (45 responses) | 24 | 10 | 1 | 6 | 7 | 5 |
| Select providers (34 responses) | 18 | 7 | 1 | 6 | 5 | 3 |
Providers were given the option to write in "Other Eligibility." Answers included: no eligibility criteria, non-financial eligibility criteria, specific ages, alcohol or drug use, residency (for example, county, local school district), developmental disability, workplace injury, employment barrier due to disability, epilepsy/seizure disorder, eligible for special education, medical/psychiatric stability, Ohio Eligibility Determination Instrument (OEDI) or Children's OEDI (COEDI), primary diagnosis of brain injury, private pay, and criteria that varies with grants.
The "select providers" reported that 21% of individuals are referred to them within the first month of injury, 27% within the first six months, 16% from 7-12 months, 24% from 1-3 years, and 11% receive referrals four or more years post-injury.
| In 30 days | 1 - 6 months | 7 - 12 months | 1 - 3 years | 4 - 6 years | More | |
|---|---|---|---|---|---|---|
| All providers | 21 | 28 | 22 | 30 | 14 | 13 |
| Select providers | 15 | 19 | 11 | 17 | 4 | 4 |
Nearly equal numbers of all agencies and the subset of "select providers" offered education and training specific to brain injuries.
| All providers (129) | Select providers (63) | |
|---|---|---|
| Yes | 60 | 32 |
| No | 69 | 31 |
Of the agencies who answered the question about whether or not they are looking for education and training resources specific to brain injuries, 65% of the "select providers" sought resources, and 58% of all agencies sought them.
| All providers (126) | Select providers (62) | |
|---|---|---|
| Yes | 73 | 40 |
| No | 53 | 22 |
The survey asked, "If your agency offers education and training programs on TBI please check all that apply." Training was offered primarily to people with brain injuries and their families. Among the "select providers," 26% reported that they offered training to people with brain injuries, and 23% to families.
| People with TBI | Families | Professionals | Law enforcement | Teachers | |
|---|---|---|---|---|---|
| All providers (38) | 26 | 25 | 21 | 8 | 14 |
| Select providers (23) | 18 | 16 | 15 | 5 | 7 |
In addition, providers noted that they offer additional education and training: brain injury awareness, disability awareness provided in schools, students in rehabilitation professions, and support groups.
Not many agencies offered prevention services. Among the 69 "select providers," 13% (9) provided primary prevention of intentional injuries: Shaken Baby Syndrome, violence, etc.; 17% (12) offered prevention of unintentional injuries; and 20% (14) offered secondary prevention.
| Primary prevention | Unintended injury | Secondary prevention | |
|---|---|---|---|
| All providers (24) | 12 | 18 | 16 |
| Select providers (17) | 9 | 12 | 14 |
Providers were given the option to describe other prevention services that they offered. These included: cognitive safety after BI, community outreach through education, comprehensive eye exams, DNA testing, drug and alcohol prevention, stop smoking programs, Early Intervention, helmet safety, help with memory training, and proper approach and therapeutic de-escalation training.
| All providers (143) | Select providers (69) | |
|---|---|---|
| Case management | 76 | 50 |
| OT-PT | 57 | 46 |
| Social skills | 71 | 45 |
| Individual counseling | 67 | 45 |
| Behavior support | 62 | 44 |
| Speech therapy | 54 | 43 |
| Cognitive training | 52 | 42 |
| Communication skills | 60 | 41 |
| Budget training | 59 | 38 |
| Nursing | 54 | 37 |
| Recreation | 54 | 34 |
| Transportation | 61 | 33 |
| Respite | 44 | 28 |
| Family counseling | 42 | 28 |
| Help get job | 44 | 27 |
| Help keep job | 43 | 27 |
| Inpatient rehab | 31 | 26 |
| Medical - general | 32 | 24 |
| Support group | 29 | 22 |
| Learning - high school | 36 | 21 |
| Home modifications | 31 | 21 |
| Housing | 36 | 20 |
| Medical - TBI | 23 | 20 |
| Home care | 32 | 19 |
| Assistive technology | 27 | 19 |
| Alcohol-drug treatment | 24 | 18 |
| Learning post high school | 29 | 16 |
| Vision - general | 25 | 16 |
| Neuropsychology | 20 | 15 |
| Emergency shelter | 18 | 12 |
| Vision - TBI | 16 | 11 |
| Dental | 12 | 11 |
| Legal - TBI | 3 | 3 |
| Select providers (69) | All providers (143) | |
|---|---|---|
| Case management | 72 percent | 53 percent |
| OT-PT | 67 percent | 40 percent |
| Individual counseling | 65 percent | 47 percent |
| Social skills | 65 percent | 50 percent |
| Behavior support | 64 percent | 43 percent |
| Speech therapy | 62 percent | 38 percent |
| Cognitive training | 61 percent | 36 percent |
| Communication skills | 59 percent | 42 percent |
| Budget training | 55 percent | 41 percent |
| Nursing | 54 percent | 38 percent |
| Recreation | 49 percent | 38 percent |
| Transportation | 48 percent | 43 percent |
| Respite | 41 percent | 31 percent |
| Family counseling | 41 percent | 29 percent |
| Help get job | 39 percent | 31 percent |
| Help keep job | 39 percent | 30 percent |
| Inpatient rehab | 38 percent | 22 percent |
| Medical - general | 35 percent | 22 percent |
| Support group | 32 percent | 20 percent |
| Home modifications | 30 percent | 22 percent |
| Learning - high school | 30 percent | 25 percent |
| Housing | 29 percent | 25 percent |
| Medical - TBI | 29 percent | 16 percent |
| Home care | 28 percent | 22 percent |
| Assistive technology | 28 percent | 19 percent |
| Alcohol-drug treatment | 26 percent | 17 percent |
| Learning post high school | 23 percent | 20 percent |
| Vision - general | 23 percent | 17 percent |
| Neuropsychology | 22 percent | 14 percent |
| Emergency shelter | 17 percent | 13 percent |
| Vision - TBI | 16 percent | 1 percent |
| Dental | 16 percent | 8 percent |
| Legal - TBI | 34 percent | 2 percent |
Providers were asked to write in services they provide that were not on the list. These include: adult day care, guardianship and other protection services, independent living, residential, advocacy, assessment to identify readiness to work, biofeedback for head injuries, community education, community re-integration and volunteering, crisis and hotline, parenting, alcohol and drug prevention, driver rehabilitation, treatment of eating disorders, expert witnessing for liability cases, group counseling, psychiatry services, homeless outreach, housing for severely mentally disabled, information and referral, interpreting, audiology and hearing testing, equipment and toy library, camp, material assistance, medical equipment, nutrition support, help with activities of daily living, recreation, socialization, rental assistance, shelters, meals and clothing, foster care, behavioral treatment, and use of adaptive technology.