HEADLINESA state affliate of the Brain Injury Association of America

WINTER 2005-06

Non-profit OrganizationU.S. Postage

PAIDMinneapolis, MN

Permit #16334 13th Ave NE, Suite B001Minneapolis, MN 55413

Time Dated MaterialAddress Service Requested

Brain InjuryAssociation of

Minnesota helpline:612-378-2742

1-800-669-6442

www.braininjurymn.org

IN THIS ISSUE:

In my opinion:Commentary from the

Executive Directorinside on page 3

Mild to moderate braininjury rehab programs

inside on page 6

New! Volunteer Spotlightinside on page 11

Service and therapy dogsinside on page 12

Legislative Corner withJeff Nachbar

inside on page 13

UPCOMING EVENTS:

Brain Injury Basics IJanuary 17March 21

2006 Discharge PlanningConferenceFebruary 1

Brain Injury Basics IIFebruary 21

4th AnnualXtreme Safety Fest

April 2

Check page 2 for moredetails on these events

Reinventing the systemVoc rehab sees another round of changes

Walk for Thought draws a thousand walkers

Participants rolled up their sleeves and enjoyed unseasonably warmweather at this year’s Walk for Thought

photo by Erin Mulcahy-Billig

Staff Report

The 2005 Walk for Thoughtdrew nearly 1,000 people at thewalks in the Twin Cities andBlackduck for a day of celebration,commemoration, and communityinvolvement. The two walks raised$70,000 to help persons with braininjury.

Nearly 1,000 people took theirtime, energy, and resources topromote the Association and theimportant issue of brain injury. In thecourse of this event, 1,000 peopleknocked on their neighbors’ doors,made telephone calls, sent emails andletters, and told their personal storiesabout brain injury to countlessMinnesotans. As with other BrainInjury Association of Minnesotaactivities, this was a tremendousgrassroots effort of which we can allbe very proud. Brain injury isconsidered the “silent epidemic” dueto the low public awareness on thisissue, but because of the efforts of a

growing number of individuals, weare making a difference.

This year, over 60 team captains,20 corporate sponsors, and 28volunteers went over and above thecall of duty. This level of support isimpressive and exciting as it

demonstrates the Association’sgrowing capabilities to reach abroader audience.

Walk for Thoughton page 8

By Sharon Rolenc

Minnesota VocationalRehabilitation (VR) made history inJanuary 2004 when they instituted awaiting list for all eligible consumers.No one came off that list for eightmonths.

“We had gotten ourselves into afinancial crunch where we couldn’twrite any new employment plans sopeople sat on a waiting list and ourwaiting list got built up to over 6,000folks,” said Connie Giles, Director ofVR/Workforce System Integration,for the Minnesota Department ofEmployment and EconomicDevelopment (DEED)

After several years of flat fundingfrom the state and federalgovernment and rising staffing andhealthcare costs, VR is again lookingat ways to reorganize its servicedelivery system to make the most oflimited resources.

“What we’re looking at is waysthat we can avoid shutting ourselvesdown again,” said Giles.

VR was also seeing a decline inproduction, and counselors withlarge, unmanageable case loads.“We’ve rehabilitated fewer andfewer and fewer people in the last

three years or so. That’s not thedirection we want to go. We need toturn that around and improve ourproduction and one of the wayswe’re going to do that is throughbetter quality of services,” said Giles.

A classification of “core services”versus “intensive services” wasestablished to determine the level ofeligibility. As well, an orientation tothe VR system has been introducedto catch people before they apply to

help them determine what level ofservice is needed.

To meet eligibility for intensiveservices, the individual is assessedaccording to “functional limitations.”These include: mobility, self-direction,self-care, interpersonal skills,communication, work tolerance andwork skills. A person must meet

Vocational Rehabilitationon page 10

MissionThe mission of the Brain Injury Association of Minnesota is to create abetter future through brain injury prevention, research, education andadvocacy.

Board of DirectorsRuss Philstrom, ChairKathy Anderson Emily Fuerste Jeff GagnonTom Gode Robin Landy Gwyn LederSue Lepore Dave Scott Kate ShannonMike Strand Quincy Stroeing Terri TraudtPat Winick Nancy Carlson, Past Chair

Association StaffAndi Billig, Public Awareness AssistantRaye Black, Multicultural Outreach CoordinatorMichelle Brandes, Case Manager SupervisorBrad Donaldson, Director of OperationsKimberly Ferencik, Volunteer CoordinatorPhil Gonzales, Administrative AssistantTom Gode, Executive DirectorMark Hahn, Senior Administrative AssistantDavid Holewinski, Resource FacilitatorKim Kang, Minnesota Advocacy ProjectEmma Kelty, Resource FacilitatorJackie Lothert, Outreach Case ManagerLena Moua, Resource FacilitatorJeff Nachbar, Public Policy DirectorSharon Rolenc, Public Awareness DirectorChristina Saby, Resource FacilitatorArdis Sandstrom, Associate DirectorSara Schlegelmilch, Case Manager/Relocation Service CoordinatorAnne Schuller, Education CoordinatorJennifer Taylor, Case ManagerJanis Carey Wack, Director of Consumer ServicesJanice Webster, Volunteer Program Assistant

Editorial PolicyHeadlines is published quarterly by the Brain Injury Association ofMinnesota. The Editor reserves the right to edit submitted materials forstyle and space. The Association does not endorse, support, orrecommend any specific method, facility, treatment, program, or supportgroup for persons with brain injury and their families. Please call foradvertising rates.

Letters to the Editor PolicyLetters to the Editor should be limited to 300 words. Letters may beedited for spelling, grammar and length. In order for letters to beconsidered, please include your name, address and the daytime phonenumber of the author. The Association reserves the right to refuse lettersfor publication, and submission of material does not guarantee publication.Opinions expressed in Letters to the Editor are solely those of the authorand do not represent the opinions or positions of the Association.

34 13th Ave NE, Suite B001Minneapolis, MN 55413

612-378-2742 or 800-669-6442fax: 612-378-2789

www.braininjurymn.orgEmail: info@braininjurymn.org

HEADLINES WINTER 2005-06

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CCCCCALENDALENDALENDALENDALENDAR of EVENTSAR of EVENTSAR of EVENTSAR of EVENTSAR of EVENTSTo register for any of the following classes, please call the Association at612-378-2742 or 1-800-669-6442 in greater Minnesota. Unless otherwisenoted, classes are held at the Association office, 34 13th Ave NE, Suite B001in Minneapolis.

February 21: Brain Injury Basics 2This class addresses the life

change that occurs with brain injury,including: major stages of adjustment,emotional aspects of the change, andadjustment difficulties.

Adjustment to disability may bedescribed as a series of stages ormajor tasks, which may not alwaysbe neat and orderly. Individualsprogress through the stages atdifferent rates, and adjustment is alife-long process. Emotional aspectsof disability can be a major factor inoutcomes. Class starts at 6:00 p.m.and runs until 8:30 p.m.

February 1: Discharge Planningin Today's World

The 2006 Discharge PlanningConference is designed for dischargeplanners, nurses, social workers,case managers, educators, vocationalcounselors, intake coordinators,residential managers andoccupational, speech, and physicaltherapists. All interested health careproviders are welcome to attend.

The 2006 Discharge PlanningConference will take place onFebruary 1, 2006 from 7:45 a.m. to3:30 p.m. at the MinnesotaDepartment of Health office at 1645Energy Park Drive in St. Paul.Registrants are responsible for theirown hotel arrangements. A block ofrooms is available for conferenceattendees. The rate for a doublequeen or king room is $69 plus tax atthe hotel listed below. (Rate effectiveas of publication date).

Registration is $90.00 forAssociation members, and $100 fornonmembers. Registration deadlineis January 25, 2006. Registrationafter this date or at the door is$110.00. The registration feeincludes course materials,continental breakfast, lunch andbreaks. Please call 612-378-2742for more information.

January 17, March 21: BrainInjury Basics 1

Confusion. Frustration. Sorrow.Anger. Fear. Isolation. These aresome emotions a person with braininjury may feel after injury. Families,friends & loved ones may feel thisway, too.

Learn about the impact of braininjuries caused by concussion,traumas such as crashes or falls,stroke, aneurysm & coma.

Learn about what brain injury is;the common side effects of braininjury; compensation techniques; andtips about how to relate to peoplewho have sustained brain injury.

Class starts at 6:00 p.m. and runsuntil 8:30 p.m.

April 2: 4th Annual Xtreme SafetyFest at the Mall of America

Save the date! The 4th AnnualXtreme Safety Fest is an excitingfamily event with live BMXdemonstrations, safety informationand helmet fittings. Send themessage to your children that theycan play it safe while playing hard!The event takes place from 1:00 -4:30 pm.

Memory challenges and the holidays

Staying on schedule for the tasksand duties we are always so willingto accept is a major challenge forthose of us who have experienced aTBI (traumatic brain injury). Whenwe start a task or agree to performone we need to be sure that thereare ways that we are remindedabout the job to be done. With theapproaching holiday season thereare so many things going on it is

very easy to forget the things wehave promised to do.

For some of us a notebook witha daily planning schedule is a greattool. For others we write down thejobs and then forget to read ournotebook each day. Ask forsomeone you have daily contactwith to help remind you of your jobsand the need to read your dailyplanner. Set a pattern of doing thesethings more than once each daybecause it is so easy to getsidetracked as your day progressesand those duties are forgotten. Ifyou check your planner in themorning and again after lunch,perhaps you can begin to finishmore of those tasks on time.

With the winter season here we

need to be prepared to handle thesnow and ice conditions with propercare. For some of us our balance isnot what it used to be and falling is aserious concern. Those of us whoare able to drive need to beprepared for all the problems thatwinter throws at us. We need towatch the road conditions and ofcourse drive defensively because theothers on the road may not bedriving as carefully as they should.

Holiday shopping andpreparations for all the upcomingdays have most of us not payingclose attention all the time as wetravel. We also need to be sure weare dressed for the weatherconditions and prepared for all thedifferent kinds of car problems the

cold weather can bring. Havingemergency necessities for survival inextreme cold weather in our vehiclesseems to be more work than it isworth until we find ourselves stuckmiles from anywhere and our cellphone has no signal and it is belowzero and dark. Now we look at thefuel tank and it is down to a fourthfull and we wish we had filled it.How are we going to make it?Better to ask those questions nowand make the decision to stay homeif at all possible when the winterstorms are threatening.

As we prepare for 2006 I wantto wish everyone HAPPYHOLIDAYS and HAPPY NEWYEAR.

From theBoard Chair

RussPhilstrom

In My Opinion: Question process when it restricts access

HEADLINESWINTER 2005-06

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PERSPECTIVE

Here & Now

MikeStrand

TBI and the last days of PompeiiIn 79 AD, Mount Vesuvius

erupted and all of Pompeii wasburied in an instant. Thousands ofpeople died in that instant. Mostpeople couldn’t imagine that, butsome of us have seen our life end andlived to tell about it.

I pause now, from time to time,and ask myself, “If I died right now,is everything in order?” Will my lovedones be able to sort through myaffairs with a minimum of difficulty?There is that very real practical sideand this must be given particularattention as we get older and fieldmore commitments; bills, mortgages,dependents, etc.

There is also dying with dignity –living as if each step were the end. IfI dropped dead right now would I beproud of the way I lived my last day?Some believe in a higher power; areyou ready to answer for youractions? As an Atheist I have no

other to hold as my ideal, I must livethe best life I know how according tothe dictates of my own conscience.There is no word that means “toknowingly deceive oneself.” Theperson we find hardest to forgive isour self.

I could tell myself “Yeah, I almostdied and now my life is ruined, it’snot fair.” I could go through my daysnursing my regrets. No one would bejustified in telling me I should dootherwise, because life after braininjury can be that bad. Because Icould choose to do that, and I couldalso choose not to do that.

If I chose to do that, then Iwould choose to live my life frozen ina death grip of regret. As dramaticand omnipoeic as that may seem, Idecided that I would not live my lifethat way.

Instead I wondered what I couldlearn from this - this tragedy, thistravesty...this tremendous learningopportunity. I decided the realtragedy and travesty would be tohave gone through what I wentthrough and have learned nothing.First and foremost I gained a rareviewpoint. I was like the titlecharacter from Laurence Sterne’sbook “Tristam Shandy” whose father“walked a path so far removed fromthe road traveled by others that hecould not help but see things fromanother angle.”

I’m living on bonus time. I nolonger fear death the way manypeople do because I have already

lived past my time. If life were avideo game I just got an extra life toextend play. If I die today I’ve livedsixteen years longer than I shouldhave; I got sixteen more years than aperson ordinarily gets. I feel like I’mviewing my life with the ghost ofChristmas future from Dickens’“Christmas Carol,” except I really amliving in this possible future.

So what I have I learned?What’s my secret to life, the universe,and everything?

I must give to get and get to give.

Strand, a regular newslettercontributor, has a book“Meditations on Brain Injury”now available on Amazon.com.The book is a collection of essays,many of which were printed inprevious editions of HEADLINES.

By Tom GodeExecutive Director

Minnesota has a strong history ofservices for people with disabilitiesand Vocational Rehabilitation (VR)has been one of the key players inmaking that happen. However, in2004 we saw the administration cutoff access, waiting lists explode andquite frankly a sad situation get worse.Now two years later we see whatappears to be a further restriction onaccess to employment services.

People with brain injury havetraditionally been underservedthrough the Minnesota VR program.Challenges with memory, struggleswith awareness, organizational andsocial skills are four of the obviouschallenges that VR counselorsfrequently misunderstand resulting inindividuals with brain injury not beingable to access employment servicesor failing to complete the process to

employment.Eligibility is spelled out

specifically in the federalrehabilitation act and yet theMinnesota program seems to haveadded the new “ability to maintainsubstantial employment” to the list.Note the federal conditions foreligibility are:

1. The presence of a physical ormental disability which for theindividual constitutes orresults in a substantialhandicap to employment; and

2. A reasonable expectationthat vocational rehabilitationservices may benefit theindividual in terms ofemployability.

The federal eligibility guidelinesdo not say the individual must be ableto work a minimum of 20 hours aweek, or otherwise define“substantial employment” as part ofthe eligibility criteria.

According to the 1999“Vocational Rehabilitation andEmployment Services Fact Sheet”put out by the National Associationof State Head Injury Administrators,“Nationally 75 percent of personswith traumatic brain injury (TBI) whoreturn to work will lose their jobwithin 90 days if they do not havesupports. Even after an individualwith TBI is successfully employedthrough vocational rehabilitationservices, he or she may later need

help when adapting to changes in thejob or life situations.” Mostindividuals who have sustained abrain injury want to return to work,but they may not be able to return atthe same level of job or the sameintensity as fatigue may require thatthey work a shorter day, work everyother day, etc.

The department has stated theyare there to serve employers. Theyhave taken staff positions to create anew business unit and from anoutsider it appears that federal fundsintended to enhance individuals’employment skills are being shifted tosupport businesses. Employers needto be at the table but not at theexpense of the individual needingservices.

The move to serve moreindividuals through the more genericgroup services of the workforcecenter will result in less individualswith brain injury receivingemployment supports. Research hasdemonstrated that generic or “coreservices” do not provide the supportsand cues needed for persons withbrain injury and ultimately theindividual will lose the opportunity foremployment.

There are many cases of peoplewith brain injury that have jobs toreturn to but need some assistance,and often minimal supports, whentransitioning back to work.According to VR’s Order ofSelection, these individuals do notmeet eligibility criteria. The lack ofappropriate supports will frequentlybegin the cycle of failure that manypeople experience following a lifechanging brain injury. This is a cyclethat often leads to dependency onSSI/SSDI and loss of production inthe workforce.

The Department is implementingmany changes; it is up to each of usto question the process when itrestricts access. If you have beendenied access to intensive VR services,had problems applying for VRservices, sat on a waiting list, pleasegive the Brain Injury Association ofMinnesota a call at 1-800-669-6442and ask for Christina.

It is not too late to get involved.Get engaged! There are advisorycommittees to participate on, thereare public hearings of proposedchanges and there is an appealprocess, but you must act.

Nationally, 75 percent of persons with traumatic braininjury (TBI) who return to work will lose their job within

90 days if they do not have supports.

HEADLINES WINTER 2005-06

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NEWS BRIEFSWhat’s new at the Association and in the brain injury community

Mark your calendars! A FamilyRetreat will be held the first weekendin May 2006 at Camp Courage. Theretreat is offered in collaboration withthe Minnesota Department ofEducation’s MN Low IncidenceProjects, and is geared towardsfamilies who have a school-age childwith brain injury. For moreinformation, contact Anne Schuller at612-378-2742 or 1-800-669-6442.

2006 Family Retreat

Feb. 1 DischargeConference

The Brain Injury Association ofMinnesota, in conjunction with theMinnesota Department of Health isoffering the 2006 DischargePlanner’s Conference onWednesday, February 1, 2006.

Keynote speaker Jim Stolz willkick off the conference. As aLicensed Independent Clinical SocialWorker with specialized training inHealth and Medical Social WorkServices, Stolz is the Director ofSocial Work Services atInterprofessional Center forCounseling and Legal Services inMinneapolis. He has provided socialwork and discharge planning servicesin various medical and psychiatrichospitals to clients dealing withpsychiatric problems, chemicaldependency, physical disabilities,strokes, orthopedic injuries, traumaticbrain and spinal cord injuries.

The conference breakout sessionsinclude topics of working withundocumented patients, relocationservices, county services and recentchanges, methamphetamine use in thecommunity, and a panel of ResourceFacilitation staff sharing importantissues and concerns.

Keynote speakers Bonnie andGene DeBoe will close out the eventby speaking about their life followingbrain injury. The DeBoes sharedtheir family story, “Where are thosesilver linings?” at last spring’s AnnualConference in St. Cloud, with greatreviews.

The Brain Injury Association ofMinnesota is accredited through theDepartment of Health for ContinuingEducation Units (CEU) for nursing,physical therapy, occupationaltherapy and speech therapy. Visithttp://www.braininjurymn.org/DischargePlanning.cfm for theDischarge Planning Conferencebrochure and registration form. Formore information, contact AnneSchuller at 612-378-2742.

New Info and ResourcesToll-Free Number1-800-444-6443

Brain injury information and helphas been expanded for all persons inMinnesota with the addition of theNational Brain Injury InformationCenter’s national toll free number.The National Brain InjuryInformation Center (NBIIC), incollaboration with the Brain InjuryAssociation of America, is a pilotproject to evaluate an 800 numberthat will be directly linked to theBrain Injury Association ofMinnesota.

The project will provideinformation and resources toindividuals with traumatic brain injury,family members, professionals, andthe general public. The project iscurrently being funded through theCenters for Disease Control andPrevention. A person calling theadditional 800 number in Minnesotawill link to her/his state affiliateResource Facilitation department toaccess local services, resources, andinformation. The NBIIC pilot projectwill support the standardizedprotocol for responding to calls, acustomized packet of information onbrain injury topics, consistent dataelement collection, and resources tobrain injury services for the caller’slocal community.

The importance of informationand resources in supporting peoplewith traumatic brain injury cannot beoverestimated. Studies funded bythe CDC and the Health Resourcesand Services Administration (HRSA)have shown repeatedly that access toinformation and resources is one ofthe greatest needs of people affectedby traumatic brain injury. Accordingto one study, people who wereinterviewed reported moving longdistances to obtain access toservices, not realizing thatappropriate services were availablenearby. The problem is particularlyacute for people in rural areas, wherefinancial hardships and limited accessto transportation make it difficult totravel to places where informationand resources might be available.These are among the biggestobstacles to rehabilitation and are allproblems that could be improvedwith appropriate access toinformation and resources.

Perhaps the most compellingevidence of the need for informationand resources comes from a study

that used traumatic brain injurysurveillance data to link persons withbrain injury to information andresources. The study confirmed “astrong need on the part of personswith traumatic brain injury to belinked in some formal way to asource of information aboutservices.”

Similarly, in 1998 the NationalInstitutes of Health (NIH) ConsensusPanel on the Rehabilitation ofPersons with traumatic brain injurynoted the need to educate familymembers to help them supportrehabilitation more effectively.Despite the absence of researchdocumenting the effectiveness ofinformation and resources forfamilies, the panel cited “substantialclinical experience” supporting theneed. The panel also recommendedservices to help persons withtraumatic brain injury “navigatethrough the public assistance andmedical-rehabilitative care systems”and education to make communitycare providers aware of theproblems people with traumatic braininjury experience.

The NBIIC project will be ableto evaluate the effectiveness of an800 number and begin to addresssome of the above questions posedby individuals with traumatic braininjury, their families andprofessionals. One of the goals is tocollect standardized data in severalstates to know what people need;what types of information are beingrequested and at what point in theirrecovery; and what further resourcesare recommended to meet the unmetneeds of our callers and to bestprovide the most accurate, reliableand individualized informationpossible. Also, the system will beevaluated in order to answer whetheran 800 number is the best way toconnect our callers to local servicesand supports.

If you would like more informationon the NBIIC, please contact JanisWack at 612-238-3246.

Los Primeros PasosImportantes al cuidara un ser querido conuna lesión cerebral

1. Comuniquese con grupos deapoyo de su localidad o con laAsociación de Lesión Cerebralde Minnesota

2. Mantega un registro diario de loscambios mentales y físicos delpaciente

3. Establezca un sistema de apoyocon familiares y amigos

4. Comuniquese con eladministrador de casos de suhospital

5. Presente inmediatamente unasolicitud para participar en elprograma Ingreso Suplementariode Seguridad

6. Solicite inmediatamente elSeguro por Discapacidad delSeguro Social

7. Hable con el administrador decasos del hospital sobre aquellosservicios a los que el pacientepueda tener derecho

Important First Stepsin supporting a lovedone with a brain injury1. Get in touch with local support

groups or contact the BrainInjury Association of Minnesotafor a list of support groups

2. Keep a daily journal of patient’smental and physical changes

3. Establish a support system offamily and friends

4. Contact the case manager atyour hospital

5. Apply for SSI/ Medicaidimmediately

6. Apply for SSDI/ Medicareimmediately

7. Talk with your hospital casemanager about services for whichthe patient may be eligible

Employment Reportfor Persons with

Disabilities ReleasedA recent report was released

examining the state of employment inMinnesota for persons withdisabilities. The objective of thereport was to conduct a customer-focused study among Minnesotaemployers to identify and measureissues and perceptions that constitute

barriers to employment forindividuals with disabilities.

The report was prepared for theMinnesota Governor’s Council onDevelopmental Disabilities, theMinnesota Department ofEmployment and EconomicDevelopment (DEED), theMinnesota Department of HumanServices and the Minnesota StateCouncil on Disability. To view thefull report, visit: www.mnddc.org/news/pdf/employer_survey_rpt.pdf

HEADLINESWINTER 2005-06

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Resource Facilitation adds more bi lingual capacityBy Janis Carey WackDirector of Consumer Services

Navigating our health care andcounty financial systems can beincredibly challenging for any of us,but if an individual’s native languageis something other than English it iseven more daunting. Accessing healthcare and financial systems becomesvery complicated when a newimmigrant’s cultural and languagedifferences present unique challengesin accessing the services that theyrequire.

Resource Facilitation is all aboutunderstanding people, buildingrelationships, identifying issues andneeds related to their injury andconnecting them with requiredservices. It provides long termfollow-up that can assist persons withbrain injury, their loved ones andprofessionals, with accessingknowledge, support and services tobenefit the transition back to home,community and work.

The Association is pleased tohave a staff person who is fluent inthe Hmong language and is able tohave one-on-one conversations withconsumers looking for assistance.Lena Moua has many years ofexperience providing support andnavigational assistance to new

arrivals to this country through herwork with immigration and refugeeservices through Catholic Charities.She also has experience workingwith both county systems and schooldistricts and will be able to use thisexperience to assist individuals andfamilies living with brain injury as theyencounter these systems.

Lena describes herself as bi-lingual and bi-cultural in the Hmonglanguage and culture. She has helpedmany organizations understand thecomplexities of working with theunique issues of language and culture.In her role as Resource Facilitator,Lena will cover the East Metroregion for the program. This areaencompasses Ramsey, Washington,Dakota, Scott and Carver counties.As the Hmong speaking ResourceFacilitator, Lena will also supportindividuals from Hmong communitiesthroughout the state of Minnesota.

Although the Brain InjuryAssociation of Minnesota hasprovided access to Spanish speakersfor over fours years, we also have aSpanish speaking ResourceFacilitator who has recently joinedour team. Emma Kelty becamefluent in Spanish between years ofstudy and several months living inValparaiso, Chile. Previous to herwork as a Resource Facilitator,

Emma worked for the MNAdvocates for Human Rights, whichis a program that matched volunteerlawyers with people seeking asylumin the United States.

Emma supports individuals withbrain injury and their families whoseprimary language is Spanishthroughout Minnesota. Emma’sregion of the state is the North regioncomprising 42 counties with majorpopulation clusters in the Duluth,Brainerd and St. Cloud areas.

Both Lena and Emma arewelcome additions to the staff here atthe Association as they open thedoor for persons who speak Hmongand Spanish to receive theinformation, support and servicesneeded to navigate life after braininjury. If you would like to learn moreabout the Resource Facilitationprogram please contact theAssociation at 612-378-2742 or 1-800-669-6442 in greater Minnesota.Lena and Emma can also be reachedat these numbers.

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Mild to moderate traumatic brain injury rehabilitationBy Christine A. Hill

Mild to moderate traumatic braininjury (TBI) programs are uniquesystems of diagnosing, treating, andcaring for patients who experiencepost-traumatic effects of an injury tothe brain.

“Any time there’s a sudden,violent movement of the head, atraumatic brain injury can occur,”explains Sarah Rockswold, MD,physical medicine specialist andprogram director for the Mild toModerate Traumatic Brain InjuryClinic at Hennepin County MedicalCenter (HCMC).

“This happens when there’sobvious head trauma, but it also canoccur inside the skull when the brainabsorbs impact as it hits the inside ofthe skull.”

There are many reasons whymild to moderate brain injuries canbe overlooked, including the patient’smore apparent injuries.

“All I remember is waking up atthe hospital,” says ChristopherWeiss, a 34-year-old firefighter andcaptain with the Ramsey FireDepartment. “I guess I kept asking‘what happened?’ at the scene, but Idon’t remember saying a word.”

Weiss was ejected from a hookand ladder truck during a trainingexercise in Minneapolis in May of2004. While attempting a maneuver,the vehicle struck a light pole andWeiss was thrown a distance of 10feet, striking his head on thepavement and losing consciousness.He was brought by ambulance toHCMC where a CT scan of his brainindicated that he had some bleedingin his brain. He had also separatedboth of his shoulders and fracturedhis breastbone. After being seen bya neurosurgeon, Weiss was evaluatedby both occupational and physicaltherapists and was discharged threedays after his head struck thepavement.

Like Weiss, many patients withmild to moderate TBI are seen byphysicians immediately after theinjury; but from the doctors’standpoint, there are not many majorneurological deficits. In fact,especially with patients with mildbrain injury, problems don’t seem tosurface until the patient begins to

return to regular activities and findsthat “something just isn’t right.”

“Something just doesn’t ‘feel’right.”

This is one of the most commonreasons patients call a mild tomoderate brain injury rehabilitationprogram. The patient may look fine;he or she is recovering from obviousinjuries and can perform activities ofdaily living, but things just “don’tseem right.”

“Like so many patients whoexperienced a brain injury, Weiss hadthe ‘classic’ symptoms typical of amild or moderate traumatic braininjury including short term memorydeficit, impaired attention andconcentration, word-findingdifficulties, headaches, dizziness,balance and coordination problems,trouble sleeping, irritability, andfatigue,” explains Dr. Rockswold.

“For patients and families alreadytrying to adjust through recoveryissues, it’s very frustrating to dealwith these unexpected symptomsfrom a mild to moderate brain injury.In the past, many of the problemspatients with TBI experience havenot been recognized by the medicalcommunity, so they have beengrossly underserved. That’s whymild to moderate traumatic braininjury rehabilitation programs are sosuccessful.”

Diagnosis and treatment

It takes an experiencedprofessional to know the rightquestions to ask so that an accuratediagnosis of mild to moderatetraumatic brain injury can be made.

A successful, comprehensive mildto moderate TBI program has a teamthat includes professionals fromphysical medicine and rehabilitation,neurosurgery, neurology, ear noseand throat (ENT), sleep medicine,neuroradiology, pediatrics,psychiatry, psychology,neuropsychology, occupational andphysical therapy, speech pathology,therapeutic recreation, audiology,vestibular medicine social services,nursing and interpreter services (ifnecessary).

This multidisciplinary approach isthe hallmark of a successful mild tomoderate traumatic brain injuryprogram, and every professional onthe team must be very familiar withtraumatic brain injuries. The mild tomoderate TBI rehabilitation beginswith a thorough history and physicalexamination by a skilled physicianspecializing in traumatic brain injury,which leads to the development of acustomized plan of care, addressingeach specific area of concern.

Weiss was referred to a mild tomoderate TBI clinic in June 2004.He was given medications to helpwith his headaches and sleepimpairment, and was sent forneuropsychological testing to see ifhe had objective cognitive deficits.This neuropsychological testingshowed that he had difficultyprocessing information and someshort-term memory problems. Weissalso was found to have problemswith his balance as well as withmotor coordination with his left hand,which was consistent with his right-sided brain bleed. He receivedphysical therapy to help with boththese problems.

Over the next few months afterhis injury, Weiss’ symptoms slowlyresolved, but he continued to beirritable and have post-traumaticflashbacks typical of a traumaticbrain injury. He was sent to apsychologist who specializes intraumatic brain injury to help him dealwith the symptoms and two months

later, they had resolved. Weiss alsowas sent to Courage Center for adriving evaluation to make sure hewas safe to drive a fire truck, whichhe passed. He slowly returned towork as a carpenter, and threemonths after his injury, he wasallowed to participate in fire drills,but could not directly fight fires. Fivemonths after his injury, all hissymptoms had resolved and hereturned to firefighting withoutrestrictions.

“I wanted to get back to doingmy job and feeling the way I didbefore the injury. Going to the mild tomoderate brain injury clinic andgetting help from a variety ofprofessionals really made thedifference,” he said.

Like Weiss, most people withthis kind of injury recover with time;however, during the recovery timepatients can have many problems.

“Mild to moderate traumaticbrain injury rehabilitation programstry to get patients through that timeperiod, by helping with symptoms,teaching them how to deal with theircognitive deficits, and educating thepatient,” says Dr. Rockswold. “Thiskeeps people from feeling like theyare going crazy and also allows theother people in their lives tounderstand what they are goingthrough.”

Contributing author Christine Hillis a writer at Hennepin CountyMedical Center in Minneapolis.

“In the past, many of the problems patients with TBIexperience have not been recognized by the medicalcommunity, so they have been grossly underserved.That’s why mild to moderate traumatic brain injury

rehabilitation programs are so successful.”

- Sarah Rockswold, MD

Mild to moderate brain injury rehabilitation helped Christopher Weiss getback to work doing what he loves best - fighting fires.

Submitted photo

HEADLINESWINTER 2005-06

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At Bethesda, we reconnect patients to their lives through science and sensitivity.

With devoted, one-on-one care; the latest advancements in technology;

and a holistic approach to healing, we help body and soul work together

to achieve greater independence.WHEN LIFE IS INTERRUPTED, WE HELP OUR PATIENTS

LIVE AGAIN.

21st Annual Statewide Conference on Brain InjuryStaff report

Mark your calendars for the2006 Annual Conference, “ReachingOut, Growing Together.” The eventwill take place at Earle BrownHeritage Center in Brooklyn Centeron May 19 and 20. Keynotespeakers for the event includeRoberta DePompei and HollyKostrzewski.

Roberta DePompei will providekeynote presentations each morning,as well as breakout sessions eachday. Dr. DePompei’s professionalpositions have included speech/language pathologist/ audiologist inhospitals, rehabilitation facilities,

home health agencies, public schooland private practice. She is currentlyemployed as school director,professor and clinical supervisor atThe University of Akron.

Dr. DePompei’s major area ofresearch is traumatic brain injury(TBI) in children and adults andresultant cognitive-communicativedisorders. She collaboratesnationally, and has conductedresearch on the impact of TBI on thefamily system and communication.Her research also includes home,community and school reintegrationfor people with TBI, including schoolage through college levels. She hasconducted numerous workshops and presented papers on these topics at

international, national, state, and localconferences.

Holly Kostrzewski, of Duluth,will be closing the conference onSaturday by sharing her experiencesof living with brain injury. In 1999,she sustained a life-changing braininjury during a motor vehicle crash,and has faced significant challengesduring her on-going recovery.

Through determination, faith anda positive attitude, Kostrzewskigraduated college with honors andnow serves as the Injury PreventionProgram Coordinator for the Fonddu Lac Band of Lake SuperiorHolly Kostrzewski

Chippewa. Kostrzewski alsofounded the HUGS (Helmet Use andGrab your Seatbelt) program. Shehas appeared at events andconferences nationwide and inCanada, inspiring thousands with hermessage of hope and inspiration.

For more information aboutconference sponsorship and exhibitopportunities, call 612-378-2742 or1-800-669-6442. Registrationmaterials will be available in lateMarch. Check for registration forms,sponsorship materials and otherupdates on the conference eventwebpage, www.braininjurymn.org/EvntAnnualCon.cfm.

Roberta DePompei

HEADLINES WINTER 2005-06

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The Dragonfly Clan, lead byTeam Captain Tracy Winkel-Johnson, held their title as topfundraising team for the second yearin a row. The Dragonfly Clan raisedover $6,700. Winkel-Johnson wasalso the event’s top fundraisingindividual with $4,500 raised.

“My inspiration for fundraisingfor the Walk for Thought would haveto be my brother, Steve, who we lostto a brain injury. Participating in theWalk, really throwing myself into it,seems like a good way for me topositively honor my brother’smemory and keep his spirit alivewhile also doing something to helpothers,” said Winkel-Johnson.

Two teams raised over $2,500:Team Teddy and the StampedingTurtles. Team Nichole, TeamRegions, Craig’s Cracked Cranium,Team Neurons, Team Amy, TeamNowling, Miracle Lady, The MightyMains’l Marchers, TBI MetroServices and Team Dungarvin areteams that raised over $1,000.

Top fundraising individuals withover $1,000 a piece are Joanne

Walk for Thoughtfrom page 1

Bolles and Sue Winkel. Individualsthat raised over $500 include LisaNowling, Julie Hanf, Tammi Johnson,Jeff Gagnon, Michael Carter andTerri Traudt.

All proceeds from the walk willdirectly benefit the Brain InjuryAssociation of Minnesota’s multipleservices and programs that servepersons with brain injury.

Picture galleries from this year’swalk are available on the Associationwebsite.

Thanks to our participants,sponsors, volunteers, staff, WalkCommittee and board of directorsfor their support and commitment tobring help, hope and a voice to the94,000 Minnesotans who live with adisability due to brain injury. TheWalk would not have been assuccessful without everyone’sinvolvement. The steps we tookduring the Walk for Thought will helpthousands of Minnesotans affectedby brain injury achieve even greaterstrides of their own.

Watch the Association web site,www.braininjurymn.org, in thecoming months for details on nextyear’s walk.

Photo on left: Team Teddy gathered walkers of all agesphoto by Erin Mulcahy-Billig

photo by Sharon Rolenc

Top photo above: As the Team Captain of the Dragonfly Clan, Tracy Winkel-Johnsoncaptured both top fundraiser and top fundraising team titles this yearPhoto above: People gathered from all over greater Minnesota at the walk inBlackduck

Photo by Lisa Karsten

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Photo by Lisa KarstenBoard chair Russ Philstrom (center back) with Maxine Beck (left) and her daughterRhonna Mistic (right) and granddaughter Nichole Mistic (front) at the Blackduck walk.

Photo by Sharon RolencWalk for Thought participants utilized several methods of transportation to get aroundLake Phalen

HEADLINES WINTER 2005-06

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three or more of these limitations tobe considered priority one. Thereare four priority categories.Historically, categories two, threeand four have waiting lists, and formany years, most people incategories three and four have notbeen served.

According to Giles, the prioritytwo category was reopened forservice on November 21. “Becauseof the changes already made, nowwe were able to open priority two,and anyone that was on the waitinglist has been taken off. Priority twowill now be open for the foreseeablefuture,” she said.

Several changes are in place inthe hopes of improving services, aswell as opening up service to peoplein lower priority categories. One is alarger reliance on WorkForceCenters as a means to help peoplewho need less support, and a way toavoid duplication of services.

Minnesota WorkForce Centers(WFCs) provide tools, resourcesand services needed for job search,career planning and training needs.WFCs are a collaborative effortbetween DEED and local communityagencies. Their goal is to helppeople who are seeking employmentas well as businesses who areseeking employees.

Each center has a ResourceRoom that is operated similar to alibrary, offering tools like assistivetechnology, books, equipment,software/internet access, staffsupport and employment workshops.The environment requires consumersto be self-directed in order to accessservices.

Professionals in the brain injuryfield, however, are concerned aboutthe unique challenges that may facepersons with brain injury that try toaccess help through WFCs. “Aperson with brain injury who tries touse the workforce centerindependently, may get lost in themany steps required to get a job.With no contact person to help cuethem on the steps to take, and helpproblem solve along the way, theycan get frustrated, have difficultyfollowing through a process and getlost or give up. This system has thepotential to lose many of ourconsumers with no net to support orcatch them,” said Ardis Sandstrom,Associate Director for the BrainInjury Association of Minnesota.

Substantial Employment

Another standard for determiningeligibility for VR intensive services iswhether an individual’s plan will leadto “substantial employment.” Thereason for this came out of VR’sconcern that people were not

working up to their potential, or wereusing VR services as a means toaccess other public services likeMedical Assistance for EmployedPersons with Disabilities (MA-EPD).

“Once MA-EPD came out, wehad a lot of referrals for peoplemaking just $75 a month in the hopesof getting MA-EPD. And we startedsaying – that’s not what we’reabout,” said Giles. “We’re not goingto open an intensive case andprovide intensive services for folks ifthey are trying to minimize their ownpotential.”

Giles said that there is nominimum amount of hours thatdetermine “substantial employment.”Much of the eligibility is based on theindividual’s potential and is left up tothe determination of the VRcounselor.

“When you are working withpeople, there is no formula.Everybody is an individual. That’sthe beauty of what we do, weaddress the individual,” said Giles.

Performance Based Agreements

One of the most significantchanges in VR becomes effectiveJanuary 1. A new PerformanceBased Agreement replaces thetraditional fee based service that VRutilizes. Currently, the fee basedsystem pays an hourly fee tovocational rehabilitation providers.The new system will pay a flat fee forNon-supported Employment($1,750 total) and a flat fee forSupported Employment ($2,100).Fees are paid out at certainbenchmarks along the way.

“In the past we were paying forthe process, and the process couldgo on endlessly, and there reallywasn’t a lot of quality measurementsbuilt into the process,” said Giles.

The new structure means thatproviders do not get the bulk of theirfee (35 to 50 percent) paid until theconsumer is in stable employment forat least 90 days.

“Our main concern with the newsystem is that how is it going to affectclients, especially clients that have themost severe disabilities. Becausewith the performance based system,it may actually discourage someproviders from serving clients whohave the highest needs through VRbecause it’s a set fee system,” saidWade Majewski, Director of BrainInjury Services, TBI Metro Services.

As a larger provider, TBI MetroServices will likely absorb any initialfinancial losses, and Majewski saidthat their TBI clients should not beconcerned.

“I don’t think this will changehow we do business,” saidMajewski. “We’re taking a wait andsee approach. We’re also waiting tosee if there are any other changes

from the state before determining ifthere are any changes we need tomake with our system.”

Some VR providers underwentsignificant changes as a result of the2004 VR waiting list, and are bracedand ready for this next round ofchanges.

“We aggressively sought outother avenues of funding to continuebeing of service to the people that wewere working with. One of thethings that it did was renew our focuson working with area business andthe employers that we [currently]work with in terms of networking.So now when we have people comein, we are able to do more rapidplacement. It forced us to be moreeffective and efficient in the deliveryof service,” said Christian McCalla,vice president of FunctionalIndustries.

When asked whether they wouldbe more careful in the selection ofconsumers they help under thePerformance Based Agreement’s flatfee structure, McCalla said probablynot, and that the people with moresevere disabilities who take longer toplace will be balanced out by peoplethat are easier to place. “The idea is

Vocational Rehabilitationfrom page 1

that the law of averages will accountfor some of that variability.”

Ultimately, the success of VR’schanges will depend on how allparties work together – VRcounselors, providers, communityorganizations and consumers.

“The system is really predicatedon having good communicationamongst all of those entities that areinvolved in seeking employment withthe person and helping them to besuccessful in that employment,” saidMcCalla.

For persons with brain injurywho are struggling with newcommunication challenges after theirinjuries, the importance of self-advocacy will likely prove to be botha necessity and a barrier.

“During the first nine months of2005, the Association had 475persons identify barriers to vocationalneeds around access to vocationalrehabilitation, employment supportservices, inability to find jobplacement and retention, andaccommodation concerns. This is anissue that greatly impacts personswith brain injury and an issue that theAssociation takes very seriously,”said Sandstrom.

Not eligibleBy Sharon Rolenc

On an icy January in 2004, 19-year-old Rachel Talbert lost controlof her vehicle, and hit an electrical box. She was in a coma for threedays and experienced a brain injury as a result. Since her brain injury,Talbert experiences on-going headaches, chronic fatigue, a lowfrustration tolerance, short term memory and minor speech problems.“My memory is slowly getting better,” she said.

At the time of her crash, Talbert was employed as a housecleaner.The work was physically demanding, and due to problems after herbrain injury including extreme fatigue, Talbert was forced to cut herhours. “But they worked me back up to 36 hours a week because Ireally needed the money to survive,” said Talbert who lives on her ownin an apartment in greater Minnesota.

She was hoping to find work that was less physically demandingand fatiguing, less isolating, and more in contact with other people.She turned to Vocational Rehabilitation because she wanted to findwork that was more suitable for her to manage with a brain injury, andshe needed help and guidance to follow through with her employmentsearch. “Since my brain injury, I get frustrated really easy and I justquit trying.”

Talbert was told she was not eligible because she was alreadyworking. She said she feels caught between a “rock and a hardplace.”

“I’m a hard worker and I’m on time all of the time,” said Talbert.She has the skills necessary to keep a job, but needs structuredguidance on how to get into another profession – one better suited forthe challenges that she faces with her brain injury. She would also likea job that utilizes her people skills. “I’m really good with people. Iwas thinking it would be nice to be a dietary aide in a nursing home, sothat I can be around people.” Talbert’s also concerned that other low-skill jobs wouldn’t work well with the challenges she faces with a braininjury. “I have to stay away from cashier work or waitressing,” shesaid because the math is too difficult after her brain injury, and thestress that comes with such professions would be too much for her tomanage.

Talbert expressed frustration with the lack of vocational help shehas had after her brain injury. “I just need a little help. I want to lookforward to work and not be so tired all of the time.”

HEADLINESWINTER 2005-06

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Volunteer Spotlight: Mathew MenardVolunteer duties: Mat answers phones, does data entry, mailings,typing, transcribing and other administrative projects. He also types 50words per minute. If you call the office Wednesdays, Thursdays, orFridays, chances are Mat is the friendly voice who directs your call.

Birthplace: Anoka, Minn.

Age: 21

Length of Service: Volunteer since November 2004

Pets: Cat named Shasta. She’s black with a white stomach and feet

Hobbies: Baking (chocolate chip cookies are a favorite), movies(recently saw and recommend “War of the Worlds”), Bingo and watchingmovies at Vision Loss Resources, chatting online

Reason for volunteering: I enjoy helping others and love being aroundother people

Best vacation ever: When I went to a cabin up North by Duluth withmy mom and dad. It was quiet and relaxing and really nice to be awayfrom the city and all the noise.

What Mat wants you to know about him: I’m a friendly guy and fun tobe around. I enjoy talking to people, especially online.

What Mat wants you to know about the Brain Injury Associationof Minnesota: Everyone here is always friendly and willing to help.

Recent Achievement: Mat received the 2005 Award for Excellence in Youth Volunteerism from the Minnesota Association for Volunteer Administration. This award recognizes a young Minnesota volunteer (19-24 years old) who has distinguished accomplishments and shown extraordinary interest in the areaof volunteerism. Through his personal examples, Mat demonstrates the impact young people can have on the improvement of their community through anoutstanding commitment to volunteerism.

By Kimberly FerencikVolunteer Coordinator

2005 was another fantastic yearof volunteer support for the BrainInjury Association of Minnesota.Individuals gave more than 5,500hours of their time to help peopleaffected by brain injury and raiseawareness about brain injury.

The following people havewarmly contributed their time andtalent to support persons with braininjury and their families in 2005. Fortheir continued support, the BrainInjury Association of Minnesotasincerely thanks ALL of them:Anthony AghentaMohsina AhmedKathy AndersonSheldon AndersonSteven ArnoldSimone ArsenaultGal AusenSharyl Helgeson BallOtto BangHeather BarberKristi BeckJessalyn BecknellEmily BergesonElaine BergstromMawuli BlabuhRichard BloomAnnmarie BolattoAlex Bowden

Another fantastic year of volunteerism at the AssociationAmanda BowdenJay BowdenKeaton BowdenSpencer BowdenMark BoydBob BraunKen BrittonKaren BryanDavid BulfordAlexis BushNancy CarlsonSue CarrLaura CaseyDana Castonguay-HullRachel CherryAmy CoadErwin ConcepcionJane CorkerySara CromeySusan CrutchfieldBarbara CurrinAngela DavisBonnie DeBoeGene DeBoeAmanda DicksonJenny DreisEmme DrewsCharles DugganDiane DunnDarwin DyceJulie DysteJoAnn ErbesCarol EstradaCat FeehanCharles FinleyKatie Foss

Karen FreedRosemary FroehleEmily FuersteBarb FultonCarol FuryJeff GagnonCarsten GehringJudy GryniewskiJane HamptonIrma HauserDenise HerrmannSusan HowryKristi Hyink-HuttemierJenna JohnsonWillis JohnsonMonica JunkerSteven KaatzRobert KarolKim KangMelissa KellyJoann KenersonJanis KeyesTodd KimlingerElena KrasnokutskaBrad KuhlmanSimon LaiJim LandRobin LandySusan LarsenKimberly LarsonGwyn LederJennie Lee-BurnsSue LeporeLiz LippertBud LordJohn Lucia

Mathew Menard (left) received the 2005 Award for Excellence in Youth Volunteerism.Brad Donaldson, Director of Operations for the Association attended the ceremony.

photo by Steve Menard

Gail LundeenCollins LussierAnn MacheledtCarrie MacNabbWade MajewskiJacqueline MartinCraig MartinsonSusan MayerLaura McDanielsPatrick McGuiganRachel MeauxMary MeesterJerry MellumMat MenardLisa MeyerDebra MillerAnne MoessnerBen MoitaAlex MorawieckiAduato MouraoRicardo MouraoBrittany MrozekDianne NausAtina NelsonCynthia NeubeckerStanley NickellsKari OllendickChristian OlsonPam ParsonsMatt PattonAnnette PearsonRuss PhilstromLynn M. PierceAlan PorcielloSara PritzlAlice Prtine

Volunteerson page 16

Aleta ReesPeter RileySandra RobertsonJon RoeslerKeegan RolencHolly RoosBud RosenfieldAngela RutgersonLenia SalasBrian SammonMary SantowskiNatalie SchmitAmanda ScottDave ScottTerri ScottCindy SeebaRichard SeurerKate ShannonSingle Volunteers Twin CitiesSpeciose SinyigayaElizabeth SkinnerAdrienne SlaughterAnnette SobekJulia SochaKelly SochaEd SootsmanMike StrandDan StoresMike StrandQuincy StroeingJay StuartTBI MetroSerena ThompsonDouglas ToavsSusan Ellerbusch ToavsTerri Traudt

HEADLINES WINTER 2005-06

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Service and therapy dogsBy Lexi Bush

For many persons withdisabilities, the recommendation for aservice or therapy dog may seemhelpful, but often, confusion betweenthe two types of dogs can causemore problems than solutions for thenew owner.

Most commonly, individuals withdisabilities are encouraged by familymembers, occupational therapists ormedical professionals to get either aservice or therapy dog to assist themwith obstacles that plague theireveryday routines, said Sue Kliewer,the Graduate Follow-Up Director forHelping Paws of Minnesota.

But, because of the largedifference in responsibilities betweenthe two types of dogs, uncertaintycan arise from the owner about thereal purpose for the animal.

According to the Americans withDisabilities Act, service dogs “areanimals that are individually trained toperform tasks for people withdisabilities – such as guiding peoplewho are blind, alerting people whoare deaf, pulling wheelchairs, alertingand protecting a person who ishaving a seizure, or performing otherspecial tasks.”

Additionally, the ADA allowspeople with disabilities to bring theirservice dogs into nearly all placeswhere the general community isaccepted, such as in theaters,airplanes, restaurants, retail storesand hotels.

According to Kim Hyde, theDirector of Training for the Hearingand Service Dogs of Minnesota,owners of service dogs should notencounter any problems with publicaccess unless they are questionedabout why the dog is not wearing aharness or cape.

Oppositely, therapy dogs are notprotected under the Americans withDisabilities Act and do not completethe same training as service dogs.

Unlike service dogs, therapydogs carry out their duties by requestonly and have restricted access topublic places.

For example, therapy dogs areallowed to work in hospitals, nursinghomes, prisons or abuse shelters togive people affection, motivate thosewho are mobility impaired to tryphysical activity, or accelerate thememory in people who suffer fromAlzheimer’s, but only by invitation.

Because the two types of dogsserve different purposes, ownersoften become confused with howthey are able to use the dog in theireveryday lives.

For example, if a professionalinstructs a patient to get a dog to helpwith isolation or depression, and thepatient assumes the new animal is aservice dog, they will face problemswith public access and federalprotection for the animal, saidChristina Saby, Resource Facilitatorfor the Brain Injury Association ofMinnesota.

Although this problem is notextremely common, some disabledpeople attempt to train their therapydogs to become service dogs, but itis very difficult to have a disabilityand train at the same time, Kliewersaid.

Additionally, if the new dog is notallowed in the owner’s residence,they may be forced to give the dogaway and break a special bond, orrelocate to a new, animal-friendlyapartment and encounter financialproblems from the unexpected move.

“If someone has a pet dog andneeds a service dog, they will mostoften find another home for the pet,”Hyde stated. “[But] if the dogqualifies, we will assist them intraining and certifying their pet.”

Training for a therapy dogrequires the animal to pass acertification test that proves the dogis obedient, non-aggressive and

physically healthy, among otherthings.

Although problems and confusioncan arise about the real purpose ofthe animal, for most, the dog’scompany is well worth it in the end.

While reflecting on her servicedog in the article, “My UncannyAssistant,” Claudia L. Osborn stated,“Micah Matisse has fostered myindependence and enhanced thequality of my life. He is my dailyreminder of the wonderfulness ofunconditional love, of patience andperseverance. In many ways and atmany levels, this dear little friend andassistant has reshaped my lifeindelibly and made me much thericher for the experience.”

For additional information onservice and therapy animals, pleasevisit:

Hearing and Service Dogs ofMinnesota: http://www.hsdm.org

Helping Paws Service Dogs: http://www.helpingpaws.org

The Delta Society: http://www.deltasociety.org

Assistance Dogs International, Inc.:http://www.adionline.org

The ADA Homepage: http://www.usdoj.gov/crt/ada/adahom1.htm

HEADLINESWINTER 2005-06

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LEGISLATIVE CORNERKeeping up to date with public policy

By Jeff NachbarPublic Policy Director

2005 Legislative Home Visits a tremendous success

Citizen Advocate Sign-up FormYes! I’d like to become a Citizen Advocate and make a difference in the

lives of the 94,000 Minnesotans who live with brain injury.

Name:

Address:

City, State, Zip

Day Phone:

Night Phone:

Fax:

Email:

I am a:

Please return the form to Jeff Nachbar, Brain Injury Association ofMinnesota, 34 13th Ave NE, Suite B001, Minneapolis, MN 55413

For more info: 612-378-2742, jeffn@braininjurymn.org

❒ Person with brain injury ❒ Family member ❒ Professional

I’d be willing to:❒ Contact my legislator❒ Attend a brain injury event❒ Tell my story❒ Other:

From Duluth to Winona you told your storiesand legislators sat up and listened.

Each year, between Labor Dayand Thanksgiving, the Brain InjuryAssociation of MN turns its attentionto the grassroots. We gather ourmembers in local communities acrossthe state and look to you to tell uswhat is happening in your life andhow, by working together, we canimprove the quality of life for allpeople impacted by brain injury.Then, during the second half of thesemeetings, we invite statepolicymakers to hear your stories,comments and suggestions. Theselegislative forums, or home visits, arethe backbone of our policy work.

They make brain injury issues real forlegislators and set the stage for theupcoming legislative session and thepolicy changes we need.

In 2005, the Brain InjuryAssociation of MN held 15 of theseevents all across the state. FromDuluth to Winona you told yourstories and legislators sat up andlistened. People with brain injuriestalked about what their lives werelike, what happened and what it islike now. Family members and lovedones shared how brain injury hasaffected their lives. Professionalsdiscussed their experiences workingon behalf of people with brain injuryand the challenges they face workingin a system with diminishingresources. Everyone, including thelegislators, heard over and over againhow the issues of housing,transportation, employment andaccess to quality health care areimportant to our members. You alsotalked about the importance ofpreventing future brain injuries bypassing tougher seatbelt and helmetlaws. There is much work to bedone but we have an excellent start.

My heartfelt thanks go out tothose of you who took the time toattend. It was incredible to see thecourage you all displayed, night after

Now it’s time to turn our attention to the 2006 legislative session dueto start on March 1, 2006. There is still much work to do and wemust take advantage of the momentum that has been built up with ourlegislative forums. The Brain Injury Association of MN cannot do thisalone; we have to work together if we hope to be able to create thepolicy changes necessary to make things better.

For years, the Brain Injury Association of MN has worked to build upa Citizen Advocate Program as a way to keep people informed oncritical issues and to apply grassroots pressure on policymakers whenwe need their votes. In the next few months we’ll be reorganizing ourCitizen Advocate Program to make it easier for people to getinvolved. Whether you’re willing to make phone calls, write letters,send emails, attend hearings or come to events, we need your help.

Many of you are already signed up as citizen advocates. If you are,you should be hearing from us soon to talk about ways for you tobecome even more involved. If you’re not already signed up, pleaseconsider becoming a Citizen Advocate. We can show you how tomake a difference, keep you informed and then we can work togetherto create a brighter future. I look forward to continuing our worktogether.

night, as you came up front andtalked about your life. I’m convincedyour passion and commitment willmake a difference in our upcomingwork at the Capitol and I encourageyou to stay involved. Thanks also tothe hard working staff here at theAssociation that helped make thishappen.

If you couldn’t attend one of ourevents, or we didn’t hold one in yourcommunity and you are willing to tellyour story please contact me.

2005 Legislative ForumHighlights:

• 15 Events held in: Anoka,Brainerd, Buffalo, Burnsville,Cloquet, Coon Rapids, Duluth,Eagan, Edina, Faribault, Foley,South Minneapolis, Shakopee,St. Anthony, Winona.

• 26 Legislators attended:Senators - Belanger, Day,Jungbauer, Koering, Lourey,McGinn, Ranum, Solon, Wergin;

Representatives – Beard,Emmer, Erhardt, Erickson, Fritz,Goodwin, Hilty, Hornstein,Hortman, Larson, Pelowski,Peterson-Neil, Powell, Ruth,Samuelson, Wardlow, Wilken.

• 168 Total participants attended,at least one legislator attendedevery event.

• One legislator said they wouldnever again be able to vote onthese issues without thinkingabout the people who came tothe event.

• Every legislator talked about theimportance of people staying intouch with them, that it was theonly way they could know aboutissues affecting their constituents’lives.

• One legislator talked about theirown brain injury, something theyhad never before disclosed inpublic.

What’s Next:Citizen Advocate Program

HEADLINES WINTER 2005-06

page 14

SPONSORSAcknowledgement of Donations: August 16 - November 15, 2005

DONORS

MEMBERS

FOUNDATIONS

WEBSITESPONSORSchwebel, Goetz & Sieben

Mr. & Mrs. Douglas ColemanMs. Mary HarrissMr. David HolewinskiMs. Peggy KraemerMr. & Mrs. William MatsonMrs. Margaret NelsonMr. & Mrs. Russell PhilstromMs Catherine ShannonMr. & Mrs. Ken Waschke

Medtronic Foundation

Mayo Medical CenterProWorks Inc.Mr. Martin AllenMs. Claudia AndersonMs. Linda BeaucheneMs. Kristi Ferris, Opportunity

PartnersMs. Debbie FinchMs. Natalie FinchMr. Errol HigdonMs. Cathy JarosMs. Janet JonesMr. Butch Karcher, Karcher Foster

Services Inc.

ORGANIZATIONSCommunity Solutions FundUS BankUnited Fund

MEMBERS MEMORIALSIn Memory of Florence WinkelMr. Donald Carlson

In Memory of Gerald ProwMr. Arthur HamburgenMs. Anne Moessner

In Memory of John MackMs. Jane JohnstonMr. Daniel MareckMr. Chris Russ

In Memory of Randy HansonMs. Elaine Sauer

Mr. William LederMs. Valdean LueckDr. Kathleen McCannMs. Debbie MikeshMr. Mark OlsonMs. Melanie SchroederMr. Fred Soucie, Soucie, Buchman,

Wiederholt & Bolt, LTDMs. Mary SwisherDr. John TeferMr. Glenn TridgellMs. Jennifer TroyDr. Gale Valtinson, Bethesda

Rehabilitation HospitalDr. Nancy Wagner, Gillette

Children's Specialty Healthcare

• Family Involvement

• Prevention Services

• Emergency Services

• Inpatient Trauma Services Coordination

• Acute Inpatient Stabilization

• Brain Injury Rehabilitation

• Knapp Rahabilitation Center

• Mild to Moderate TBI Clinic

• Pediatric and Adult

• Community Reintegration Referrals/Follow-up

• Interdisciplinary Teams

• Survivors Group

• Statewide Physicians Referral Network

• Community Education

(612) 873-3950 www.hcmc.org

ComprehensiveBrain Injury

Care andRehabilitation

HEADLINESWINTER 2005-06

page 15

Sign me up for:

❑ Headlines Online, a freeelectronic newsletterpublished bi-weekly.

Complete form and send to:Brain Injury Association of Minnesota

34 13th Ave NE, Suite BOO1Minneapolis, MN 55413

In 1984, a small group of familiesand professionals banded together toform what is now the Brain InjuryAssociation of Minnesota. Theyfought and advocated for systemicchange so that persons with braininjury have supports in place thatallow their return to the community.

Over the years, we have assistedthousands of persons with braininjury and family members innavigating life after brain injury. Wehave also provided referrals,outreach and training forprofessionals in the brain injurycommunity. Our reach and scope ofservices have grown exponentiallyover the past two decades.However, our successes over theyears could not have been possiblewithout the on-going support fromthe brain injury community.

One of the most basic ways thatyou can demonstrate your support ofpersons with brain injury and yourcommitment to creating a betterfuture through brain injury prevention,research, education and advocacy isto become a member of the BrainInjury Association of Minnesota.

While most of our services arefree, and you don’t need to be amember to receive these services,your membership sends a clearmessage to your fellow communitymembers that you believe in theorganization’s mission and have astake in our continued success.

The Brain Injury Association ofMinnesota offers a variety of servicesincluding:• Resource Facilitation – two year

follow-up support for personswith brain injury

• Waiver Case ManagementServices (TBI, CADI andRelocation)

• Information about brain injuryrehabilitation and supportservices

• Answers to questions about alltypes of brain injury and commonconsequences

• Education and public awarenessactivities throughout the year

• Continuing education andprofessional developmentactivities for professionals whosupport persons with brain injury

• Outreach services forcommunities of color andunderserved populations

• Referrals to dozens of supportgroups statewide

In addition to demonstrating yoursupport of people with brain injury,your membership benefits include:subscription to the quarterlyHEADLINES newsletter and the bi-weekly Enews newsletter, discountson conferences and educationmaterials.

There are several membershiplevels, so that even those on fixedincomes can demonstrate theirsupport and belief in the Brain InjuryAssociation of Minnesota.

Just over twenty years ago,families had little in the way ofsupport for their loved ones whoselives were devastated by brain injury.Today, people are forging new pathsin life after brain injury thanks to thehelp and advocacy of the BrainInjury Association of Minnesota.

Make a difference in lives ofpersons with brain injury. Providehelp, hope and a voice to the 94,000Minnesotans who live with theconsequences of brain injury.Become a member today.

❑ Non-profit organization: $250❑ Corporation: $500❑ Individual Lifetime: $1,000❑ Other: $

Name:

Address:

City:

State, Zip Code:

Telephone:

Email:

❑ Individual: $35❑ Limited income: $5-15❑ Professional: $50

I am (please check one):

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❑ Credit Card: ❑ Visa ❑ Mastercard

Card Number:Expiration Date:Signature of Cardholder:

❑ A person with brain injury❑ Family member/friend❑ Professional

Demonstrate support ofpersons with brain injury

Join Today!

Brain injury support groups can help you find others with similarexperiences, useful information about brain injury and solutions toproblems. Sharing of similar experiences helps members feel lessalone and more ready to deal with day to day issues.

The Brain Injury Association of Minnesota makes referrals tosupport groups throughout the state, including for persons with braininjury, their families and friends and for young persons.

These groups are autonomous, self-determined peer groups andare independent of the Association.

For meeting times, location, and a contact person for a specificsupport group, or for information about how to start your own group,call the Brain Injury Association of Minnesota at 612-378-2742 or1-800-669-6442.

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HEADLINES WINTER 2005-06

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Mayo Clinic Physical Medicine and Rehabilitationprovides comprehensive rehabilitation and medical servicesfor people with traumatic brain injury and other types ofacquired brain disorders

Why Mayo Clinic?• Level 1 Trauma Center• Only Midwest NIDRR* designated Traumatic

Brain Injury Model System• Comprehensive outpatient and inpatient

evaluation and treatment programs• Accredited by Commission Accreditation of Rehabilitation

Facilities (CARF) and Joint Commission on Accreditationof Healthcare Organizations (JCAHO)

Mayo Clinic200 First Street SWRochester, MN 55905

For more information contact: Program Secretary 507-255-3116

*National Institute on Disability and Rehabilitation Research

Helpingpatients rebuildtheir lives

Christine TraversMary TellersTerri TraudtMalai TurnbullKevin TurnquistRobert Two BearsGale ValtinsonCy VangRobert Ver StraetenMandi WardBob WellsJoani WernerLorraine WhitePatty WhiteJerry WilliamsTanika WilliamsTimberly WilliamsDeb WilliamsonErin WilliamsonPat WinickEllen YangPatrice Aime YemmeneOur sincerest apologies to anyonewhose name we accidentallyomitted.

The many ways volunteers wereinvolved are too numerous to list, butthe following offers a good overview.

In 2005, volunteers:• mailed information to people recently

discharged from a Minnesotahospital with a brain injury

• helped children with recreationalactivities at the family retreat so

parents could have time to meetand discuss the challenges (andjoys!) of raising a child with abrain injury

• showed people the right way towear a bike helmet and gave awayfree helmets at the Mall of America

• talked to employees at businessesacross the state to raiseawareness of brain injury andmoney for Association services

• created and presented workshopsat our annual conference

• wrote updates about legislationaffecting people with brain injuries

• translated information aboutbrain injury into Spanish, Frenchand Russian

• created a search engine for theAssociation’s website library

• helped reach out and connect theBrain Injury Association ofMinnesota to organizationsserving communities of color

• served coffee and bagels towalkers at the 4th Annual Walkfor Thought

• worked on planning for thechange in leadership and theAssociation’s growth for the nextfive years

• contacted other service providersfor updated information soAssociation staff can make thebest possible referrals to personswith a brain injury

• researched the brain-injuringeffects of methamphetamine use

• updated Association mailing listsso professionals, people withbrain injury, family members,hospital staff and you receive themost up-to-date informationabout brain injury (including thisnewsletter!)

• the list goes on and onI’m looking forward to 2006 and

all of the fantastic ways volunteerswill make a difference.

Volunteersfom page 11

On behalf of all of the staff at theBrain Injury Association ofMinnesota, I want to give a BIGTHANKS to the more than 100people who gave of themselves thisyear. It is so great to have partnersin our mission to create a betterfuture through brain injury prevention,research, education and advocacy.

For more information aboutvolunteering, call 612-378-2742 orvisit our websitewww.braininjurymn.org/vo.cfm