Teletherapy and Home and Community-Based Brain Injury Waivers: Through Pandemic and Beyond

Abstract

<h3>Research Objectives</h3> To investigate the perceived effectiveness, consumer satisfaction and provider perspective of Home and Community Based (HCBS) Brain Injury (BI) waiver services provided via teletherapy. <h3>Design</h3> Program Evaluation. <h3>Setting</h3> The Kansas Home and Community Based Brain Injury Waiver program combines state and federal funding to provide intensive rehabilitation in a natural setting. In some parts of Kansas, these specialized services are not readily available (DRC and KU RTC/IL, 2014). In response to the pandemic, waiver therapies were permitted to be provided via telephonic and tele-video delivery methods. BI waiver providers were able to deliver services to consumers in areas that were previously void of therapists. Perceived benefits of this approach include accessibility and convenience, time and cost efficiencies, and user autonomy (Ownsworth et al., 2020). <h3>Participants</h3> Two surveys containing 10 equivalent questions each, were distributed to two separate respondent groups. The first survey was distributed to 130 consumers on the BI waiver and the second to 121 therapists providing rehabilitative services to waiver participants (n=86 respondents, 30 consumers and 56 providers). <h3>Interventions</h3> Rehabilitative services include physical, occupational, speech, cognitive and behavioral therapies. Services are authorized on an hour per week basis for each needed discipline (i.e., 6 hours/per week of OT) by the respective Managed Care Organization. During sessions, rehabilitative professionals support consumers to achieve discipline specific therapy goals and person-centered goals created by the consumer. Goals addressed range from self-care and transfers to relationship development and employment. <h3>Main Outcome Measures</h3> Program Evaluation Criteria: • 75% of survey respondents agree or strongly agree teletherapy technology is reliable and easy to use. • 75% of survey respondents agree or strongly agree to being satisfied with services. • 75% of survey respondents identify teletherapy as an effective method of service delivery. <h3>Results</h3> The criteria were met or exceeded for satisfaction and effectiveness, but not for technology. <h3>Conclusions</h3> This program evaluation demonstrates the need for further analysis and improvement of teletherapy technology and access. <h3>Author(s) Disclosures</h3> Erica Bates is Employed by Minds Matter, LLC, a BI Waiver service provider.