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Public Policy of the Brain Injury Network
Policy approved by the Board 3-11-10
Community Reintegration (Reintegrative Services):
"Community Reintegration after Brain Injury" is a term used to describe the goal of bringing people with brain injury back to a restored function within the larger society. Community reintegration also refers to various interventions and strategies that are employed to achieve that goal. Community reintegration generally occurs past the acute and sub-acute medical care and rehabilitation phases. Psychologists and other trained professionals are ever seeking out the most optimal methods of “community reintegrative programming” to help people with brain injuries get back to the business of normal life.
Community reintegration strategies generally involve the survivor and his or her family and focus on day-to-day functional aspects. Community reintegration programming does not focus on the medical side, but on the life skills side. Consequently, community reintegration for people with brain injuries should focus on activities in the community or in the home environment as opposed to in the medical setting environment.
It is the position of the Brain Injury Network that any hospital model project programming for brain injuries include a community reintegrative component. For example, we recommend that all Level I and Level II trauma centers have, as a part of their “comprehensive services for brain injury” true community reintegrative services. These might include such features as help Relearning Tasks such as shopping or getting around town (transit and paratransit); Basic Cognitive Skills (money management, memory devices); Peer Support (meetings, help-line, drop-in center); In-Home Assistive Care (personal grooming and hygiene, house cleaning); Transitioning (back to school environments), and Vocational Training. Also helpful in this phase would be Service Coordination Information and Referral with community (city and county) departments and non-profits. The focus of this coordination is on link ups to disability benefit programs, disability resources, health and human services, homeless services, housing and legal assistance, low income programs, substance abuse services, (vocational) rehabilitation, and elementary, secondary and post-secondary education opportunities.
We do not necessarily expect hospitals to themselves provide community reintegrative services (in fact, they really are not “medical services” so much as “independent living” services). However, if hospitals claim that they are providing comprehensive services for people with brain injuries, this is an important aspect along the continuum of services which must be addressed and included. The ultimate success of the patient in resuming a more normal life often hinges on whether or not he or she receives these community reintegrative services.
Therefore, we would like to see hospitals offering brain injury acute, subacute and rehabilitation care arrange to coordinate with other providers in the local community so that a smooth, coordinated and continued delivery of optimal reintegrative services is provided to their patients who have brain injuries and require community reintegrative services past the medical interventive stage. Hospitals should not try to pass off clearly medical therapies as “community reintegrative services”. Also, hospital networks which have developed “TBI Model Project” networks should have “community reintegrative services” in conjunction with other service providers within their “best practice” model. These recommendations apply to anyone with a brain injury including civilians, military personnel (veterans), young adults, adults, and seniors.