Hunter Brain Injury Service 

Hunter Brain Injury Service (HBIS) is one of the units of Hunter Rehabilitation Disability Service, which also includes the Spinal Cord Injury Service, Hunter Prosthetics and Orthotic Service, Driver Assessment & Training Service, and the Hydrotherapy Pool and Gymnasium Services.
 

Hunter Brain Injury Service covers the local government areas
of Newcastle, Lake Macquarie, Port Stephens, Greater Taree, Great Lakes, Singleton, Scone, Gloucester, Maitland, Merriwa, Muswellbrook, Wyong and Gosford.  These areas have a combined population of approximately 918,000 people.  The primary target group is working aged people who have sustained a traumatic brain injury.  People with acquired brain injury are
offered a 12 week block of therapy and case management, with referral then to community services.
 

Three different streams of rehabilitation are provided by Hunter Brain Injury Service.   These are:
 

·        Transitional Living Unit – a residential program with accommodation for up to five clients.  It operates Monday to Friday with clients spending their weekends at home.  This is located at Bar Beach.

·        Outpatient Service – this stream allows clients to live at home whilst still attending the Brain Injury Service for therapy appointments.  This  service is also located at Bar Beach.

·        Outreach – this stream is involved with clients who are living in the community and not involved in the other streams but who still require some therapeutic input at home and/or linkages to local disability and mainstream services.  This includes exploring lifestyle and leisure options with clients in mainstream activities where possible.  Both Bar Beach and Taree offices provide an outreach service. 
 

Clients are able to move across the streams.  For example, an Outreach client may require a short TLU admission in order to assess his capacity to move out of home to independent living, or another client may come to TLU straight from hospital, then move to Outpatient and later Outreach services as his abilities and needs change.
 

From January to December 2005 there were 33 new adult admissions to the TLU and 140 new  adult admissions  to  community streams.
 

Hunter Brain Injury Service’s staff include the
Director of Disability Services (who also is responsible for the Spinal, Prosthetic, Driving and Hydrotherapy
and Gymnasium services), 1.0 FTE Team Leader; 
3.0 FTE Social Workers;  3.0 F.T. Occupational
Therapists; 2.0 FTE Physiotherapists;  1.2 FTE Psychologists;  1.0 FTE Neuropsychologist; 
1.4 FTE Speech Pathologists;  3.0 FTE Rehabilitation Assistants and 2.4 FTE Administration Assistants.   There is also 0.5 FTE Occupational Therapist based
at HBIS who provides the driver assessments for
people with brain injury as well as other services
across the Hunter area.  A weekly clinic by the
Medical Rehabilitation Specialist and a monthly clinic
by the Neuropsychiatry Service are also an integral
part of the service provided at HBIS.

SERVICES PROVIDED BY HUNTER BRAIN INJURY SERVICE

• The Hunter Brain Injury Service operates as a transdisciplinary team with close liaison between therapists and rehabilitation assistants, as well as other staff. 
   

• A case management model of client management is used with all allied health staff providing both assessment and therapy, as well as case management.  Clients are allocated according to priority and staff workload.
   

• Case management includes development of the rehabilitation plans with the client and/or insurer, liaison with medical staff, therapists and significant others, arranging transport, organising feedback meetings, oversight of day-to day issues in the TLU, liaison with return to work providers, co-ordination of appointments.
   

• HBIS does not provide long term case management and only case manages those clients who are actively involved in a rehabilitation program
   

• Specialist therapy by all Allied Health disciplines.
   

• Education and consultation to families, schools, service providers, carer’s groups, public and private hospitals. return to work providers etc.
   

• Short TLU admission for assessment of young people in nursing homes, hostels or boarding houses who have the potential to move to community accommodation
   

• Close ties are maintained with Hunter Brain Injury Respite Options, Headstart Community Access Programme and Hunter Brain Injury Group
   

ROLE OF THE SOCIAL WORKERS

• Initial assessments (along with other team members depending on allocation)
   

• Comprehensive psychosocial assessments which include support networks, lifestyle issues, finances, accommodation, work/education history, AOD assessment, mental health screen for depression,
  anxiety and stress disorders,
  sexuality issues, preinjury issues such
  as previous criminal justice involvement. 
   

• Counselling for significant others in relation to the brain injury and adjustment issues
   

• AOD counselling while clients are in the TLU, then referral on to AOD specific services. 
   

• Education to significant others and other services
   

• Community development activities
   

• Member of the Committee of Management of the Hunter Brain Injury Respite Options Service  (funded  
  by Dept of Disability Ageing & Home Care)

• Attend the Transition Meeting with children’s brain injury team
   

• In conjunction with other team members establish links with other relevant organisations e.g. indigenous medical services, Disability Advocacy Service, Probation and Parole Service, Victims of Crime organisations
   

• Applications for Guardianship and/or Financial Management
   

• Liaison with Government and non-Government services re income maintenance, financial matters,  legal issues, accommodation, family support, child protection, long term case management providers etc
   

• Advocacy
   

• Mediation
   

• Submission writing

CURRENT ISSUES FOR SOCIAL WORK IN THE HUNTER

·         Lack of supported accommodation for young people with a brain injury
 

·         There are a number of young people in nursing homes in the Hunter area and Social Workers have been linking these to the Young People in Nursing Home Project
 

·         Establishing closer links with the Indigenous Services
 

·         Tyranny of distance – experienced by most rural services in maintaining adequate therapy and other services  when people return to the rural areas.
 

·         Long-term case management –  some services have an aged care focus which has limited our clients’ access to long term case management
 

·         Respite – some respite services limited to the aged which limits access for families
 

·         Public Housing – early stage liaison and planning re how best to manage brain injury clients who are often located in disability complexes where most of the other residents are aged
 

RECENT PROJECTS

• Involvement in the research project for developing the family outcome assessment tool.
   

• Co-ordinating a major community awareness day in conjunction with Walk With a Rose
   

• Involvement in the TLP Outcomes Study
   

• Involvement in the BIRP Directorate TLU Evaluation project
   

• Utilising the resources from the Acquired Brain Injury Outreach Service (ABIOS) Queensland, to run groups for children whose parents have had an ABI
   

• In the process of developing an AOD resource for Brain Injury Services