ACL Traumatic Brain Injury Partners Day

February 28, 2023

TBI TARC is supported by contract number 

HHSP233201500119I from the U.S. Administration for 

Community Living, Department of Health and Human 

Services, Washington, D.C. 20201
Webinar Logistics

• Participants will be in listen-only mode during the webinar. 

Please use the chat feature in Zoom to post questions and 

communicate with the hosts. 

• During specific times in the webinar, we will have opportunity 

to respond to questions that have been entered into chat.

• The webinar will be live captioned in English and live 

interpreted in Spanish.

• Live English captions can be accessed by clicking the “CC” 

button at the bottom of your Zoom screen.

• Live Spanish interpretation can be accessed by clicking the 

“interpretation” button at the bottom of your Zoom screen 

(world icon). Once in the Spanish channel, please silence the 

original audio. 

• Se puede acceder a la interpretación en español en vivo 

haciendo clic en el botón "interpretation" en la parte inferior de 

la pantalla de Zoom (icono del mundo). Una vez en el canal 

español, por favor silencie el audio original.

• This live webinar includes polls and evaluation questions. 

Please be prepared to interact during polling times. 2
Feedback and Follow-Up

• After the webinar, you can send follow-up questions 

and feedback to tbitarc@hsri.org

(Please note: This email address will not be monitored 

during the webinar.)

• A recording, including a pdf version of the slides, will 

be available on the ACL website (acl.gov)

3
Who’s Here?

“In what role(s) do you self-identify? Select all that apply.”

1. Person with a traumatic brain injury 

(TBI) or other disability

2. Family member or friend of

a person with a TBI or other 

disability 

3. Self-advocate / advocate

4. Peer-specialist / peer-mentor

5. Social worker, counselor, or care 

manager

6. Researcher / analyst

7. Service provider organization 

employee

8. Government employee 

(federal, state, tribal, or municipal)

4
Welcome & Introduction

Elizabeth Leef

Project Officer

Administration for Community 

Living

5
OPENING 

REMARKS
Meet Our Speaker

Jill Jacobs

Commissioner

Administration on Disabilities 

Administration for Community 

Living

7
SESSION 1: AGING
Season 1 Speakers 

Edwin Walker, JD

Deputy Assistant 

Secretary for Aging

Administration for 

Community Living

John D. 

Corrigan, PhD

Director 

Ohio Brain Injury 

Program 

9
Edwin Walker, JD

10
Administration for Community Living 

• ACL was initially established in April 2012 by bringing together the 

Administration on Aging, the Office on Disability and the Administration on 

Developmental Disabilities. In the years since, additional research, service, 

and information and referral programs have been transferred to ACL from other 

agencies. ACL is responsible for increasing access to community supports, 

while focusing attention and resources on the unique needs of older Americans 

and people with disabilities across the lifespan. 

• Mission

• Maximize the independence, well-being, and health of older adults, people with disabilities 

across the lifespan, and their families and caregivers.

• Vision

• All people, regardless of age and disability, live with dignity, make their own choices, and 

participate fully in society.
Administration on Aging (AoA)

1965: Three Important Programs Enacted

• Medicare

• Medicaid

• Older Americans Act

“Every State and every community can now move toward a coordinated program of 

services and opportunities for our older citizens.” 

• President Lyndon B. Johnson, July 1965
OAA - Seven Titles

• Title I: Objectives

• Title II: Establishes AoA and National Aging Service Network

• Title III B: Supportive Services & Senior Centers

• Title III C: Nutrition Services

• Title III D: Disease Prevention and Health Promotion

• Title III E: National Family Caregiver Support Program
OAA - Seven Titles - Continued

• Title IV: Discretionary Projects and Programs 

• (Program Innovations, Training, Demonstrations)

• Title V: Community Service Employment for Older Americans 

• (Administered by the Department of Labor)

• Subsidized Employment & Training for Low Income Seniors 55 and over. 

• Title VI: Programs and Services for American Indians, Alaska Natives & Native 

Hawaiian Elders 

• Title VII: Vulnerable Elder Rights Protections
The Older Americans Act, Administered by the Administration on Aging (AoA), 

Helps Nearly 11 Million Seniors (1 in 5)

Remain at Home through Low-Cost, Community-Based Services

($3 to $1 Return on Federal Investment)

AoA

56 State Units & 

282 Tribal Organizations

618 Area Agencies on Aging

More than 20,000 Service Providers & Hundreds of Thousands of Volunteers

Provides Services and Supports to Nearly 1 in 5 Seniors

358 

million 

meals

24 

million 

rides

42 million hours of personal 

care, homemaker & chore 

services

716,000 

caregivers 

assisted

6.3 million 

hours of 

respite care

Over 398,000 

ombudsman 

consultations

3.6 million 

hours of case 

management
The Older Americans Act

• Assures that preference will be given to providing services to 

older individuals:

• With greatest economic need; and

• With greatest social need;

• With particular attention to: 

• Low-income;

• Low-income minority older individuals;

• With limited English proficiency;

• Older individuals residing in rural areas; and 

• Those at risk of institutionalization.
Who We Serve

• Poor and Near Poor (below 150% Poverty) 

• Frail and Vulnerable

• Lives Alone; Diabetes; Heart Condition; Minority; Rural

• At Risk for ER visits & Hospitalization:

• Over 92% of OAA Clients have Multiple Chronic Conditions 

• Compared to 73% of general older adult population (age = 65+)

• 69% of Case Management Clients take 5 or more medications daily

• At Risk for Nursing Home Admission:

• 40% of Home-Delivered Nutrition Clients have 3+ Activities of Daily Living (ADL) Impairments

• 72% of Home-Delivered Nutrition Clients have 3+ Instrumental Activities of Daily Living (IADL) 

Impairments
Health & Independence: 

Home & Community-Based Supportive Services

Key Service Data

• 9.9 million hours of adult day care

• More than 3.6 million hours of case management

• 12.6 million calls answered for information about 

and assistance obtaining services

• Augmented by National Eldercare Locator & Support 

Center 

• Complemented by Evidence-Based Interventions:

• Falls Prevention

• Chronic Disease Self Management Education

• Diabetes Self Management Training

• Alzheimer’s Disease Supportive Services

• Collaborating with Business Acumen Initiative to 

transform aging & disability grant recipients into 

strategic business partners with the healthcare 

sector

Targeting: Transportation Service Example

• More than half (53%) of seniors using transportation services 

rely on them for the majority of their transportation needs and 

would otherwise be homebound.

• Nationally, about 27% of individuals 60 and older live alone. 

Two-thirds (68%) of OAA transportation users lived alone. 

• 14% of transportation riders take 10 or more daily prescriptions, 

increasing their safety risk of driving

• Nearly three-fourths of transportation clients have annual 

incomes at or below $20,000
Health & Independence: Nutrition Services

Congregate (Formula Grant): Meals at Group Sites, Such as Senior Centers

Home-Delivered (Formula Grant): Delivery of Meals & Related Services to Frail Seniors Who Are Homebound

Nutrition Services Incentives Program: Funds Awarded Based on # Meals Served in Previous Year

• Adequate nutrition is necessary for health, functionality and 

the ability to remain at home in the community. 

• Provide Nutrition Services, Education and Counseling

• 60% of Home-Delivered & 52% of Congregate Nutrition Clients 

report the meal is half or more of their food for the day. 

• OAA meals are nutritious and meet the needs of seniors 

with nutrition ameliorated chronic illnesses (diabetes, 

hypertension, congestive heart failure)

• Provide 33% of Dietary Reference Intake 

• Adhere to the Dietary Guidelines for Americans.

• Home-Delivered Nutrition Services provided 140 million meals 

to nearly 850,000 seniors.

• Congregate Nutrition Services provided 79 million meals to 

nearly 1.6 million seniors in a variety of community settings.

• Nine out of ten home-delivered meal clients reported that 

receiving meals helped them to continue to live in their own 

home. 

• Researchers estimate that food insecure older adults are so 

functionally impaired it is as if they are chronologically 14 

years older; a 65 year-old food insecure individual is like a 79 

year-old person chronologically.
Caregivers: National Family Caregiver Support Program

Serving 715,000 Caregivers Annually 

• Respite Care Services provided caregivers with 6.2 million 

hours of temporary relief from their caregiving 

responsibilities.

• Coordinated with Lifespan Respite Care Program for 

systems development

• Access Assistance Services provided 1.15 million contacts 

to caregivers assisting them in locating services from a 

variety of private and voluntary agencies.

• 85% of caregiver clients indicate that without OAA services 

the care recipient would most likely be living in a nursing 

home or assisted living.

• 80% of all community-based long-term care is provided by 

family and friends.

• In 2014, approximately 34.2 million adult caregivers, or 

approximately 15 percent of all adults, provided 

uncompensated care to those 50 years of age and older.

• A 2014 study by the Rand Corporation estimates the 

economic value of replacing unpaid caregiving to be about 

$522 billion annually (cost if that care had to be replaced 

with paid services).

• Coordinating the RAISE Family Caregiving and Supporting 

Grandparents Raising Grandchildren Advisory Councils
American Indian, Alaska Native, 

Native Hawaiian Programs

Purpose

o Promote home and community-based supportive services to Native American, Alaskan Native and Native Hawaiian elders. 

o Help to reduce the need for costly institutional care and medical interventions; 

o Responsive to the cultural diversity of Native American communities; and

o Represent an important part of the communities’ comprehensive services. 

Native American Nutrition and Supportive Services

• Congregate and Home-Delivered Meals; Information and Referral; Transportation; Personal care; Chores; Health Promotion 

and Disease Prevention; and other Supportive Services.

Native American Caregiver Support Services

• Assist families and grandparents caring for grandchildren. 

• Services that meet a range of caregivers’ needs, including information and outreach, access assistance, individual 

counseling, support groups and training, respite care, and other supplemental services.
Protection of Vulnerable Elders

Long-Term Care 

Ombudsman

• 1,301 professional 

ombudsman and 7,734 

volunteers: 

• monitor conditions,

• investigate complaints,

• represent resident 

interests;

• made quarterly visits to 

63% of nursing homes;

• 26% of assisted living, 

board and care, and other 

facilities.

• Ombudsman handled 199,238 

resident complaints, 74% 

were partially or fully resolved.

• Improved consistency with 

implementation of 

• Regulation (2015);

• Reauthorization (2016);

• Data System (2017)

Prevention of 

Abuse, Neglect & 

Exploitation

• A minimum 5 million elders are 

abused, neglected and/or exploited 

annually.

• Older victims of even modest forms 

of abuse have a dramatically higher 

(300%) morbidity and mortality 

rates. 

• OAA focuses on training, education, 

and coordination with local law 

enforcement officials, community 

coalitions, and multidisciplinary 

teams.

• Elder Justice Act Implementation

• EJ Coordinating Council

• National Framework

• National Center on Elder 

Abuse

• National Adult Maltreatment 

Reporting System

• APS Guidelines

Legal Services

• Provided more than 

933,000 hours of legal 

assistance. 

• Top Areas of Legal 

Assistance:

• Income Security

• Health Care Financing

• Housing

• Consumer Protection

• Elder Abuse

• Enhanced Training and 

Technical Assistance

• Enhanced Data Collection
The LTSS Puzzle: The Need for a 

Coordinated NWD System
Comprehensive & Coordinated Service Delivery Systems

Nursing 

Homes

Home Care 

Adult Day Care Agencies Programs

HUD Public 

Housing Projects

Local Health 

Department

Senior 

Centers

Transportation 

Agencies

Local 

Medicaid 

Offices

Assisted 

Living

Adult Protective 

Volunteer Services

Programs

Cooperative 

Extension 

Agencies

Alzheimer’s YM/WCA

Chapters

Social Security 

Offices

Community 

Health Centers

Veteran’s 

Centers

Hospital 

Discharge 

Planning Units

Area Agencies on Aging
The People We Serve

Seniors Family 

Caregivers

Medicare

Beneficiaries

Middle-Aged 

Individuals 

Planning 

Ahead

Younger 

People 

with 

Disabilities

Medicaid 

Eligibles

Nursing Home 

Residents

Dual 

Eligibles
Opportunities for Collaboration

• Core Home and Community-Based Supportive Services Programs

• Falls Prevention Demonstrations

• Falls Prevention Core Programming

• Caregiver Programs

• Support for Veterans

• Dementia-Friendly Systems of Care

• National Strategy to Support Family Caregivers
John D. 

Corrigan, PhD

11
Persons with Traumatic Brain Injury Contacting 

Ohio’s No Wrong Door Hotline

John D. Corrigan, PhD

Director, Ohio Brain Injury Program

Professor, The Ohio State University

12
Persons with TBI Contacting Ohio’s

No Wrong Door (NWD) Hotline

• With Ohio’s Balance Incentive Program initiated “No Wrong 

Door/Single Entry Point” for inquiries regarding supports to stay in 

the community.

• Area Agencies on Aging are hubs with nodes that include ILCs and 

other non-profits (e.g., Easter Seals, United Cerebral Palsy)

• Computer-assisted interview that elicits demographic and other 

information––also assesses a person’s needs.

• Launched in October 2017 and included a screener for lifetime TBI

13
Lifetime TBI Screening in NWD

Hotline Assessments

a. Thinking about any injuries you have had in your lifetime, were

you ever knocked out or did you lose consciousness?

____ Yes____ No (IF NO, STOP HERE)

b. What was the longest time you were knocked out or

unconscious? (Choose just one; if you are not sure please make

your best guess.)

___knocked out or lost consciousness for less than 30 min

___knocked out or lost consciousness between 30 min and 24

hrs

___knocked out or lost consciousness for 24 hrs or longer

c. How old were you the first time you were knocked out or lost

consciousness? ____ years old 14
The Continuum of TBI Severity

X

Least 

severe

Most 

severe

Loss of 

Consciousness 

(LOC)

Dazed, confused, Coma

gap in memory

Mild TBI 

(concussion)

Moderate 

TBI

Severe 

Any LOC TBI

15
Ohio NWD Hotline Screening

October 2017-February 2022

• 65,000 callers given screening questions

• 3 of 4 are 60 years old or older

• CAUTION: Approximately half of records did not have 

assessment data

• MORE CAUTION: Method for reimbursing providers for 

conducting the survey changed:

• More assessments administered after the change

• Prevalence of positive TBIs increased markedly

16
How Representative?

(respondents ≥ 21 years old)

All TBI 

with LOC

21-59 yrs. 

old

60+ yrs. 

old

Ohio 

BRFSS* 15.0% 16.4% 12.3%

Ohio NWD 16.3% 28.2% 12.0%

* 2018 & 2019 Ohio Behavioral Risk Factors Surveillance System

17
Utility?

•Not good for epidemiological inference (e.g., 

population prevalence)

•Can be examined for frequency of TBI among 

callers who are assessed

•Needs can be evaluated for their relationship 

with history of TBI

18
TBI among Ohio NWD Callers

March 2020-August 2022

(>28,000 callers assessed)

• 37 callers per week have a history of 

TBI with loss of consciousness

• 9 callers per week had at least 1 

moderate or severe TBI in their lifetime

19
Currently on Medicaid

50%

66%

75% 78%

0%

20%

40%

60%

80%

100%

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe

TBI

% on Medicaid

1.0

1.88

2.95

3.53

0.0

1.0

2.0

3.0

4.0

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe

TBI

Odds > no LOC

20
Activities of Daily Living

88% 90% 90% 92%

0%

20%

40%

60%

80%

100%

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe

TBI

% with need

1.0

1.31 1.22

1.71

0.0

0.5

1.0

1.5

2.0

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe

TBI

Odds > no LOC

21
Selected Activities of Daily Living

12%

6%

45%

59%

46%

21%

11%

56%

65%

52%

0%

10%

20%

30%

40%

50%

60%

70%

Brushing teeth or

dentures

Eating Getting in and out

of bed, chair or

wheelchair

Grooming

(toenails,

fingernails, hair)

Moving around

inside the house

no TBI

TBI

22
Instrumental Activities of Daily Living

98% 98% 98% 99%

0%

20%

40%

60%

80%

100%

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

% with need

1.0 1.07 0.99

1.94

0.0

0.5

1.0

1.5

2.0

2.5

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

Odds > no LOC

23
Selected Instrumental Activities of Daily Living

21%

15%

27% 24%

81%

25%

18%

50%

44%

87%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Managing money Making and

getting phone

calls

Opening food

packages

Cutting food Shopping for

groceries, clothes

or household

items

no TBI

TBI

24
Assistance Taking Medications

70% 73% 74%

78%

0%

20%

40%

60%

80%

100%

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

% with need

1.0

1.15 1.20

1.56

0.0

0.5

1.0

1.5

2.0

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

Odds > no LOC

25
Seizure Management

1%

5%

6%

9%

0%

5%

10%

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

% with need

1.0

4.97 5.49

8.46

0.0

4.0

8.0

12.0

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

Odds > no LOC

26
Requires Skilled Nursing Services

24%

39% 40%

45%

0%

10%

20%

30%

40%

50%

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

% with need

1.0

2.05 2.18

2.62

0.0

0.5

1.0

1.5

2.0

2.5

3.0

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

Odds > no LOC

27
CAGE Alcohol Addiction and

Kessler Psychological Distress

0.03

0.07

0.10

0.11

0.00

0.05

0.10

0.15

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

CAGE Score (0-4)

11.4

15.30

16.54 16.22

0.0

5.0

10.0

15.0

20.0

No TBI

with LOC

Mild TBI

with LOC

Moderate

TBI

Severe TBI

Kessler Score (0-24)

p<.0001 p<.0001

28
Bottomline: TBI among Ohio NWD Callers

March 2020-August 2022

(>28,000 callers assessed)

• 37 callers per week have a history of TBI 

with loss of consciousness

• 9 callers per week had at least 1 moderate 

or severe TBI in their lifetime

29
Implications for Partnerships

NETS: Network Engagement, Training & Support

• Identify existing health or social service system serving persons 

with brain injury (whether they know it or not)

• Engage the leadership regarding the need to increase staff 

competence for working with persons with brain injury

• Provide training to raise staff awareness and skills to identify 

and accommodate needs

• Support staff via consultation and on-going training

30
Partnerships

•Aging & Disability Resource Network

•Area Agencies on Aging

•Independent Living Centers

•Ohio Long-term Care Ombudsman Program

•Medicaid Managed Care Organizations

31
QUESTIONS: AGING SESSION

Session 2 Speakers

Amy Gonzalez, 

MS

Project Manager

Disability Employment 

Technical Assistance 

Center

Eileen Kelly

TBI Program Manager

Minnesota Department 

of Human Services

Jill Ferrington, 

CRC, CBIS

Technical Assistance 

Advisor

National Association of 

State Head Injury 

Administrators 

34
Amy 

Gonzalez, 

MS

35
Today’s 

Agenda • DETAC Overview • Employment Resources • New TA Opportunity • Wrap-up

36
What is the Disability Employment TA 

Center (DETAC)?

• Five-year contract, funded by the Administration on Disabilities

• Goals

• Increase CIE outcomes for people with disabilities touched by the 

grantee network

• Increase economic self-sufficiency

• Enhance grantee partnerships 

• Themes: Systems change, innovation, and collaboration 

• CILs, DD Councils, P&As, UCEDDs, TBI Programs 

and PNs-CCE 

Grantees:

37
The Beginning 

• Facilitated an environmental landscape assessment

• Met with AoD staff, grantees, families, and self-advocates

• Reviewed publicly available data

• Drafted landscape assessment report and 

appendices for each grantee

• Appendix V: Traumatic Brain Injury State Partnership 

Programs

• Additional Appendices 

38
Modes of Technical Assistance

• National Community of Practice 

Webinars

• Join the Community of Practice! 

• Podcasts

• Blogs

• Publications

• Learning Management System 

• Sign-up

• Results in Systems Excellence (RISE) eLearning Communities 

• Time-limited

• Topically focused

• Peer to peer involvement

• High-impact 

39
DETAC Resources – Briefs 

• You Can Work after Brain Injury, Improving your Employment Success

• Become a Champion for Employment! Guiding People with Brain 

Injuries Towards Work

• Building Capacity for Financial Well-Being

• Self-Employment Brief 

• Engaging Families and Raising Employment Expectations 

• Why Employment Matters: A Resource Guide by and for SelfAdvocates Interested in Pursuing Employment 

40
DETAC Resources – Podcasts and Blogs

• The Business Side of Things: Employment and Brain Injury

• The New Normal

• Reflecting Upon a Site Visit from Rhode Island’s Self-Employment 

Initiative 

• Job Retention After Brain Injury: Why it Makes Sense

• Assessing Brain Injury Needs – While Keeping the Job Seeker 

Engaged 

• The Power of Technological Accommodations 

41
Exciting New TA Opportunity: RISE eLearning Community – Coming Soon

Dates:

• July 20, 2023

• July 27, 2023

•August 3, 2023

•August 10, 2023

42
Reach Out!

Amy Gonzalez, M.S. 

Project Manager 

Email: Consultamg.llc@gmail.com

AodEmploymentTA@Gmail.com

Website

• Submit TA Requests 

• 

• 

+ 

• 

43 
Eileen Kelly

44
TBI TA Work 

Group Member • Systems Change: Build the 

competencies of professionals at all 

levels with lived experience

•Innovation: Build network capacity to 

focus on CIE and economic 

advancement strategies with 

experience

•Collaboration: Amazing unique talents 

and contributions of the AoD grantee 

network

45
Story (slide 1 of 2) 

Case example:

• Employment: A head of the household in 

their 40's worked happily as a machinist and 

carried all health insurance for his partner 

and 2 children.

• Brain Injury: This person suffered a stroke.

• Benefit counseling: Emergency Benefits

46
Story (slide 2 of 2) 

Case example continued:

• Customized employment development

• Economic stability through disability

• Re-employment

• Follow up, follow up, follow up

47
Jill 

Ferrington, 

CRC, CBIS

48
Employment Matters

49
Potential Employment Barriers –

People with Lived Experience

• Uncertainty about where to start the process

• Concerns about abilities after brain injury

• Myths about working while on benefits

• Frustrations with employment program paperwork 

and processes

• Confusion about what jobs might be a fit

50
“

There are many ways to 

be employed -- find out 

what fits for you!

https://aoddisabilityemploymenttacenter.com/youcan-work-after-brain-injury-improving-youremployment-success/ 51
Potential Barriers – Being Encouraged 

to work by Community Providers 

• Uncertain how to start a work conversation with 

people living with brain injury

• Unfamiliar with employment resources and potential 

accommodation strategies

• Unclear about what kind of job matching options exist

• Lack of available evidence to dispel the myths which 

discourage beneficiaries from working

52
“

People in the same situation as you have 

found that accommodations on the job help 

them manage brain injury difficulties or 

challenges. Let me show you a great on-line 

resource to learn more at the Job 

Accommodation Network. 

https://aoddisabilityemploymenttacenter.com/wpcontent/uploads/2021/10/DETAC-2021-TBI-2_Final_508.pdf

53
Potential Barriers – Employment 

Service Providers

• Concern about the need for a full neuropsychological 

evaluation for those identified with brain injury

• Unsure about the array of accommodations and assistive 

technology options

• Likelihood of working with a person who has experienced 

an unrecognized brain injury

• Uncertainty about how to address brain injury symptoms 

interfering with program participation or job search

54
“

Many individuals seeking employment 

support in publicly funded programs 

have undisclosed brain injuries. There 

are many reasons why a brain injury 

may not be known by a person 

seeking employment support.

https://aoddisabilityemploymenttacenter.com/wpcontent/uploads/2022/03/DETAC-TBI-Brief.pdf 55
BLOGS

Job Retention after 

Brain Injury – Why it 

Makes Sense

https://aoddisabilityemploy

menttacenter.com/job- retention-after-brain- injury-why-it-makes- sense/

Assessing Brain Injury 

Needs – While Keeping 

the Job Seeker 

Engaged

https://aoddisabilityemploy

menttacenter.com/assessin

g-brain-injury-needs-while- keeping-the-job-seeker- engaged/

56
PODCAST – THE BUSINESS SIDE OF 

THINGS: EMPLOYMENT AND BRAIN INJURY

Employer perspectives on challenges and 

successes related to people with brain injury 

getting and maintaining employment.

Contributors:

• Elizabeth Benton and Jessica Samuel with 

Opelika Power Services in AL 

• Anna Taylor and April Turner with the AL 

Department of Rehabilitation Services

• Kathy West-Evans with the Council of State 

Administrators of Vocational Rehabilitation

Moderated by:

Maria Crowley with the National Association of 

State Head Injury Administrators 

https://aoddisabilityemploymenttacenter.com/thebusiness-side-of-things-employment-and-braininjury/

57
WEBINAR - REALIZING EMPLOYMENT 

SUCCESS: A TAILORED APPROACH TO 

SERVING PEOPLE WITH BRAIN INJURIES

Innovative employment strategies 

and funding methods with 

presentations by:

• North Carolina Division of 

Vocational Rehabilitation Services

• Community Partnerships, Inc.

• National Association of State Head 

Injury Administrators

https://aoddisabilityemploymenttacenter.com/realizingemployment-success-a-tailored-approach-to-serving-peoplewith-brain-injuries/
What’s ahead...

• 4th Resource Guide on Employment and Brain Injury

• Target audience – Centers for Independent Living

• E-Learning/Learning Collaborative: ACL Grantee 

Collaborations from a Brain Injury & Employment 

Perspective

• Four consecutive Thursdays starting on July 20th

• Watch for registration information in late May/early June

59
QUESTIONS: EMPLOYMENT SESSION
BREAK 

Up Next: 

• Session 3: Peer Support

• Session 4: Intersectionality of TBI 

and other Medical and Social 

Issues 

61
SESSION 3: PEER 

SUPPORT
Session 3 Speakers

Clifford Hymowitz

BI Survivor, Advocate, 

and Peer Specialist

TBI Advisory Board and 

Leadership Group 

(TAL-Group)

Carole Starr

TBI Survivor, Speaker, 

Author & Advocate

TAL-Group

Maria Martinez

BI Survivor, Advocate 

and Peer Mentor

TAL-Group

63
Clifford 

Hymowitz

64
Background 

• Member of the New York State (NYS) 

Traumatic Brain Injury Services 

Coordinating Council

• NYS certified Mental Health PEER 

Specialist

• Acquired head injury 20 years ago in a car 

accident

• In a matter of hours in the Emergency 

Room life changed forever

65
Challenges Faced by People with a 

Traumatic Brain Injury (TBI)

• Physical/cognitive and psychological challenges that 

can impact everyday life and be barriers to living 

independently 

• Increased risk for developing mental disorders 

• Difficult time coping with injury 

• Loss of independence 

• Changes in role in family and society

• Changes in personal and professional relationships 66
What is a Peer Specialist/Mentor?

•Someone currently living with a TBI

•Offers support and advice to other TBI survivors 

•Introduces strategies to address challenges 

faced

•Shares their experiences

• Helps a TBI survivor cope and move forward

67
Being a Peer Specialist/Mentor means 

having the opportunity to:

• Have influence in a fellow survivors’ lives 

• Develop transferable and marketable skills to enhance professional 

experience

• Increase self-awareness and foster personal growth

• Cultivate leadership, organizational and self-management skills

• Improve communication and interpersonal skills

• Connect to the broader brain injury community

• Build your network

68
Benefits of Peers

• Increased community integration and independence

• Increased confidence with communication and interpersonal 

skills and perceived social support

• Increased satisfaction with life and self-empowerment

• Satisfaction in assisting others

• Increased self-confidence

• Decreased isolation

• Increased self-advocacy skill

Source: Zach Hudson, Program Manager- PEER Mentoring at Brain Injury Alliance of Colorado 

Denver, Colorado 69
Carole Starr

70
The Magic 

of Peer 

Support

This Photo by Unknown Author is licensed under CC BY-SA-NC

71
Being 

Mentored: 

Lessons 

Learned

• Timing of peer support matters

• Importance of matching peers—

chronological age, brain injury age, 

life stage when brain injury occurred, 

other life similarities

• Peer support can be informal too. 

Informal can be just as powerful. 

Look for opportunities to facilitate that

• Peers can support the treatment 

process

• Peers can be valuable throughout the 

brain injury journey, not only the early 

years 72
2010-2021

Group Statistics

• 22,000+ Hours Volunteered

• 2100+ Peer Mentoring Sessions

• 200+ Workshops, Presentations

& Keynotes

73
Being a 

Peer 

Mentor: 

Lessons 

Learned

• Importance of Mentor Training/Role 

Playing

• Recognize Boundaries as a Mentor

• “Stay in the correct lane”--peer, not a 

medical professional

• Share experience but not tell the 

mentee what to do

• Share resources but don’t make 

recommendations

• Resources for help if a situation is too 

much

• Rewards of using experience to help 

others

74
Running a 

Peer 

Mentor 

Program: 

Lessons 

Learned

•Importance of champions of the 

program

•System for mentees to be 

identified & paired with mentors

•Provide opportunities for peer 

mentors to share their struggles 

and successes

•Implement system for tracking 

formal & informal peer mentoring 

75
Ending a 

Peer 

Mentor 

Program: 

Lessons 

Learned

• Difficult to maintain program when 

champions leave/retire 

•Organizational changes can 

impact the process of identifying 

and referring survivors for 

mentoring

•Survivors who run peer programs 

need back-up and support

76
Maria 

Martinez

77
PEER SUPPORT WITH CREATIVITY

78
Lanes of lonely rural highways, changing 

landscape, and traditional cultural expressions.

• Lived experience, we overcome, 

and experience similar challenges

• Learned from our experience from 

those who have mentor us.
Peer Mentor Program & Informal Peer Mentoring

• Trained Volunteer

• Paid Certified Peer Specialist

• Supportive Relationships

• Outside organized programs

80
Chile, not one is alike, sound familiar. Culture is a 

palette of life.

• Diversity of mentoring 

• We are not alone, don’t have to navigate 

life challenges alone 

• Color wheel of human compassion 

brings collaboration

• Encourages community 81
THANK YOU

82
QUESTIONS: PEER SUPPORT SESSION
SESSION 4: 

INTERSECTIONALITY OF 

TBI AND OTHER MEDICAL 

AND SOCIAL ISSUES
Session 4 Speakers

Shawn Callaway

Project Officer

Administration for 

Community Living

Eric Washington

TBI Survivor

TBI Advisory Board 

and Leadership Group 

(TAL-Group)

Martin Kerrigan

BI Survivor and Teacher

TAL-Group

85
Shawn Callaway

86
Eric Washington

87
Martin Kerrigan

88
Back to Life...

One person’s return to “the real world” after a Traumatic Brain Injury (TBI)

89
Headline (1 of 2)

90
Headline (2 of 2)
Early prognosis

● Diagnosis of a severe Traumatic Brain Injury

● Minimally conscious state, coma, for approximately 8 days

● Also sustained orthopedic injuries, fractured humerus and 

cracked ribs, as well broken teeth, vision damage, and 

severe lacerations to hand

● Medical personnel were hesitant to make any long term 

prognosis but did their best to prepare the family for what 

life could possibly look like following an injury of this 

magnitude

92
Return to the “real world”

• Returned to college 4 months following TBI

- 2 months post inpatient hospitalization

• Started off by taking 1 class at the local community college 

• 6 months post injury started working again, first part time then full time

• Got driver’s license back, 7 months after accident 

• The following fall, 11 months after injury, returned to college as full-time 

student

93
Looking Good

• Return to Division 1 athletics

• Dean’s list every semester 

• Accepted into graduate school

• Began Dating again

• Living independently

• Working a full time job

94
What was really going on

• Trying to establish a new identity

• Pride/Ego played a huge role

• Difficulties with memory were a huge challenge

• Thinking they could do life the way they always had and still get 

the same results

• Struggles were just as much, if not more, from adjusting to life 

with a brain injury as they were being a student with a brain 

injury!

95
Struggles

• Learning who the “new you” is

• Coming to terms with the loss of old life

• Partying like they had prior to their injury

▪ Substance abuse

▪ Multiple arrests, legal trouble, 

damaged relationships, etc.
What happened

• Life was a mess and hit “rock bottom”

• Consequences included legal system and substance abuse rehabilitation

• Admitting when they needed help and then reaching out and getting that 

help

• Long term sobriety has included 12 step program

• Long term success has been as much the result of awareness of the 

impact of the TBI on my life as has educating others about brain injury 

and how it impacts me

97
QUESTIONS: INTERSECTIONALITY SESSION
Real-Time Evaluation Questions 

• Please take a moment to respond to these seven evaluation 

questions to help us deliver high-quality TBI TARC webinars

• If you have suggestions on how we might improve TBI TARC 

webinars, or if you have ideas or requests for future webinar topics, 

please send us a note at TBITARC@hsri.org

9999
Real-Time Evaluation Questions (cont.)

1. Overall, how would you rate the quality of this webinar?

2. How well did the webinar meet your expectations?

3. Do you think the webinar was too long, too short, or about right?

4. How likely are you to use this information in your work or day-to-day 

activities?

5. How likely are you to share the recording of this webinar or the PDF 

slides with colleagues, people you provide services to, or friends?

100
Thank You.

The Traumatic Brain Injury Technical Assistance and Resources Center (TBI TARC) is 

an initiative from the Administration for Community Living that helps TBI State 

Partnership Program grantees promote access to integrated, coordinated services 

and supports for people who have sustained a TBI, their families, and their 

caregivers. The Center also provides a variety of resources to non-grantee states, 

people affected by brain injury, policymakers, and providers.