TBI Docu-series Blog Pt.2 by Susanne Regan, Service Coordinator Supervisor Service Coordination Department

June 5, 2018 | FREE Blog

Welcome back and thank you for joining us again on our second TBI-Docu-series Blog!
Today, we will be exploring the world of Service Coordination and its tremendous impact upon the lives of hundreds of TBI survivors. The SC department at FREE was established in the year 2000, under the Department of Health Traumatic Brain Injury Waiver. At that time, we served approximately 10 individuals of varied disabilities. The SC’s provided the individuals with support and resources towards maintaining their independence within the community. The Service Coordinator’s role was to assist the individuals with food stamp recertification packets, Medicaid recertification packets and updating/maintaining their status on the Traumatic Brain Injury Waiver. Throughout the years, the department has grown within the number of individuals that we serve and the amount of Service Coordinators providing that support. At the end of 2016, the Service Coordination Department welcomed the first Nursing Home Transition Diversion Waiver participant. Today, we’re welcoming numerous interviews and applicants to join our NHTD waiver programming. The SC department works as a well-oiled machine towards assisting individuals within the establishment, development and achievement of their short and long-term goals. The department also works to increase the overall independence within the community. Our Service Coordination team is inclusive of three professionals; Elaine Stadier, Erica Davis and Nettie Gibbs. The team is led by the SC Manager Susanne Regan, who possesses 17 years’ experience within the TBI field, a Bachelor’s degree in Special Education and a Master’s Degree in Reading. At this current time, the team is assisting 47 individuals enrolled in the TBI or NHTD waiver, as well as assisting 8 individuals in the application process for the TBI or NHTD Waiver.
Throughout Sue’s 17 years of working as a TBI Service Coordinator, she has observed numerous individuals come and go, as well as face and overcome various obstacles. As their service coordinator, she assisted individuals towards the obtainment of their own apartments with housing assistance and subsidies, in addition to the maintenance and upkeep of their benefits and entitlements. Furthermore, she has witnessed individuals who have triumphed through numerous challenges and overcame deficits with the assistance of waiver services towards graduating from the TBI Waiver, as a whole. Sue stated that one of the proudest moments of her career was watching a young woman, who experienced significant cognitive and physical limitations accomplish the feat of becoming a Certified Nursing Assistant (CNA). This particular female had been on the TBI waiver for 13 years and once she began working steadily as a CNA, she went onward to find her soul mate and the pair established a life and a home together. This young woman achieved all of her successes with the assistance and lessons that she acquired from her Service Coordinator and other TBI Waiver providers. She graduated from the TBI Waiver in May 2015. This young lady continues to thrive on her own with the support of her family and friends. A second beautiful success story follows another former TBI graduate, who sustained her injury in a car accident and was approved for the TBI Waiver in July of 2012. This individual worked diligently with her Service Coordinator, her TBI Waiver providers and husband to overcome any physical and cognitive challenges that she was experiencing. In return, she was able to maintain a part time job and begin a family of her own. After 3 years of support, she graduated from the TBI Waiver. Sue shines with pride when discussing her various TBI clientele and the many accomplishments that she’s witnessed them achieve with SC services over the last two decades.
Elaine Stadier has been working in Service Coordination for approximately 2 years. Throughout her 2 years, she has learned to assist individuals in the maintenance of their benefits and entitlements, housing subsidies, TBI Waiver services and ensuring that they are living within a safe and protected environment. Within her role as a Service Coordinator, she has had the opportunity and responsibility to learn about each person’s past and present lives. In this way, all aspects of the person can be considered and factored in, to best establish a highly supportive team environment that can benefit the person as best as possible. Elaine has expressed that she has found it to be very important to communicate with all TBI Waiver providers. This communication allows the team to build and develop a holistic approach which encompasses the proper supports towards bridging any gaps and identifying any issues or concerns. All team members support and assist each individual’s unique needs and develop compatible strategies specific towards each individual’s strengths, personality and experience. One of Elaine’s fondest memories is with a young lady who sustained her TBI in a car accident. Elaine remembers a specific conversation that helped her understand the perspective of how your life changes after you sustain a head injury. This young lady emphasized “when you have a head injury, you begin a new life full of new opportunities.” Elaine has found that many of her individuals have been gaining more independence when they are engaging in a variety of opportunities that are supported and provided through the TBI or NHTD Waiver.
Nettie Gibbs has been working in the Service Coordination department for a little over a year. Nettie has found that it is important to establish a good working relationship with the individuals and their natural supports. She works hard to ensure that the natural supports are included in all aspects of each individual’s growth and development towards independence. In addition, Nettie has found that when working as a Service Coordinator, you may need to assist an individual in overcoming an unforeseen event in their lives. For instance, when Nettie first began, she was immediately faced with a challenge to assist a gentleman in overcoming the obstacle of being evicted. Nettie attended housing court hearings with the gentleman and assisted him in locating resources within the community that could potentially assist him in paying back past due rental fees. The gentleman, with Nettie’s due diligence and hard work, was able to remain in his home and work closely with his natural supports to pay his rent on time and remain debt free with the landlord.
Nettie has additionally found during her employment that it is important to learn and build a good rapport with all of the different providers serving the individuals in the NHTD and TBI Waiver. For instance, Nettie learned that there are a variety of Home and Community Support Services (HCSS) providers on Long Island. She has come to learn that certain providers have a better staffing pool to provide services in different locations on Long Island. For example, Nettie diligently worked with multiple HCSS providers before finding the right HCSS provider to serve her individual in Riverhead. The family and individual were pleased with the new HCSS provider and felt supported in the individual’s care.
Erica has been working in Service Coordination for over 7 months. She has come to the department having worked with a variety of disabilities and a wealth of knowledge about the TBI Waiver program. Erica has stated that the Service Coordination position is one of the most crucial pieces to the TBI Waiver. Participants rely on their Service Coordinator to not only link them to other TBI or NHTD Waiver services, but to assist with important aspects of their everyday lives. Most participants are unable or unaware of how to fill out important paperwork and rely heavily on their Service Coordinators for guidance and assistance. Without the Service Coordination position, many individuals may be at risk of losing their services. For instance, Erica assisted a young lady in obtaining a fair hearing to overturn the decision to lower her food stamp award. The young lady was able to obtain a higher amount of food stamps with Erica’s assistance and learn that it is very important to include housing verification form with recertifying her food stamp benefits.
Erica also has found that one of the most rewarding aspects of being a Service Coordinator is to witness the personal growth of each client. It is important to know that each client on your caseload is different and has their own strengths and weaknesses. What may work for one person may not necessarily work for another, as individuals with TBI’s are all extremely diverse. Knowing how to implement different strategies and tools for your individuals plays a big role in their success. Erica has found that watching her clients use these strategies and tools to their advantage and learn how to regain independence is extremely gratifying and makes the job what it is. For instance, Erica assisted a gentleman to complete his weekly shopping when his Independent Living Skills Trainer (ILST) was on vacation. This particular gentleman has a difficult time expressing his needs and wants. On this particular day, the gentleman wanted to purchase strawberries, but could not remember the word “strawberry.” The gentleman looked at Erica for assistance and she suggested reviewing his cart to see if there were any compatible items that could help him remember the word. The gentleman immediately remembered the word “strawberry” when he saw his blackberries and raspberries in the cart. The gentleman was able to ask the produce specialist for strawberries.
Tune in next time to further explore our Counseling Department services for clients with Traumatic Brain Injuries and our Nursing Home Transition Diversion Waiver participants. Our DOH services provide a cost-effective alternative to nursing home placement.
For more information, Click on  Traumatic Brain Injury Medicaid Waiver Program

Traumatic Brain Injury Medicaid Waiver Program (TBI)