Outcomes in a Sub Acute Brain Injury Rehabilitation Program

1
Outcomes in a Sub Acute Brain Injury
Rehabilitation Program

• George Fluharty, MA-CCC, SLP
• Thomas Fisher, PhD, Psychologist
• Nathan Glassman, PhD, Psychologist
• Cindy Sellon, MSW, Social Worker

2
SABIR

• Specialty brain injury program providing
  residential services for individuals who are slow
  to recover
• Minimum of 2 hours of interdisciplinary therapy
  at least 5 days/week
• For individuals Rancho Level 2 or 3
• Not ready for acute rehabilitation
• For individuals Rancho Level 4 or 5
• Completed acute rehabilitation not ready to go
  home

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SABIR (cont.)

• Provide continued rehabilitation for individuals
  slow to recover from brain injury
• These individuals are capable of significant
  functional recovery months to years after injury
• A SABIR program may further ameliorate disability
  and reduce long term care costs

4
Description

• Retrospective review of outcomes for clients
  admitted to a Subacute Brain Injury
  Rehabilitation Program (SABIR)
• Despite severity of injuries, independent living
  skills of clients improved
• 89 returned to community settings

5
Subjects

• 17-68 years of age
• 51 males (78) and 14 females (22) in study
  sample
• Median admission FIM score of 66
• Median discharge FIM score of 100
• Median gain 21
• Points to the value of rehabilitation efforts
  even for individuals functioning at low level
• 18 (28) eligible for State of WI BI Medicaid
  Waiver

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Acute Length of Stay (LOS)

• Average acute rehabilitation stay following brain
  injury is 21-28 days
• Clients continue to have significant functional
  deficits
• Difficult for families to provide care at home
• SABIR provided an alternative
• Continued rehabilitation and time

7
State of Wisconsin BI Medicaid Waiver

• Provides funding for services in the community
  for individuals with severe brain injury
• Personal care attendants, equipment, etc.
• Had to meet State definition of brain injury

8
Results

• 16 (88) of BI Medicaid Waiver and 42 (89)
  non-waiver individuals were successfully
  discharged to community settings
• All but 7 of the 65 subjects of this study
  returned to private residences or group homes.
• SABIR services result in good outcomes for
  individuals who are slow to recover after brain
  injury
• SABIR LOS also allowed for families to understand
  needs and prepare for discharge home of loved one.

9
Discussion

• Granger et al. found that each point of
  improvement in FIM score correlated with a 5
  minute reduction in physical care needed per day.
  
• The median gain in FIM score of 21 for the total
  SABIR group could translate into a reduction of
  105 minutes of care needed per day for each
  client.

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Discussion (cont.)

• Individuals who needed Brain Injury Waiver funds
  had significantly lower FIM scores and longer LOS
  at the SABIR program than those who were able to
  return to the community without the Waiver.

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Conclusion

• The findings of the study supported the
  hypothesis that SABIR services promoted positive
  outcomes for people who are slow to recover from
  Brain Injury (BI).