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Community Skills Program® is a private, non-residential community reentry program, founded in 1981 for people with brain injuries. It is now in its 35th year of continuous operation. Based on request by referring persons, Community Skills Program also serves persons with other neurologic impairments and/or developmental disabilities such as autism, Asperger's, attention deficit disorder, etc.
As the name implies, community reentry programs assist individuals to reenter
the community. Many persons require extensive
treatment following a brain injury and receive emergency treatment, acute care,
and acute and post-acute rehabilitation. However, even after receiving extensive
treatment, many individuals with brain injuries still need additional services
to make a satisfactory transition from hospital- or facility-based services to
their own homes and communities. Other individuals may have received only
emergency treatment or minimal inpatient or outpatient treatment and then
experience problems when they try to perform their usual roles at home, school,
or work, or in the community at large. The services we provide are listed in our
brochure and under Services on this website; individuals may receive any or all of the services, depending on their
In the early to mid 1980s, when Community Skills Program® was growing, the terms community reentry, community reintegration, or community integration were frequently used to describe our type of program. Later, the term community-based was applied generically to various programs not on the grounds of a hospital or institution. In 1992, the Commission on Accreditation of Rehabilitation Facilities (CARF) categorized brain injury programs as medical or community integrated, and, in 1996, began using the term community integrative. The term community-based is now being used again by CARF. Our program fits the labels of community reentry, community-based, community integration, community reintegration, community integrated, and community integrative. We prefer the term community reentry because our focus is on the individual, who is reentering the community, not the program, which is integrated in the community. When individuals enter our program, they are making the transition to their homes and communities; being integrated in the community is the goal. We provide services to facilitate this process.
Depending on the individual’s circumstances, referral to Community Skills Program® may be appropriate following emergency or acute care, acute rehabilitation, concurrent with outpatient services or day treatment, or following outpatient services, day treatment, or transitional living/residential treatment. Our services are often requested while an individual is receiving outpatient or day services at a hospital or facility, to provide an opportunity for the individual to apply, in his/her real-life setting, the skills being addressed during facility-based treatment. This arrangement provides an excellent opportunity to make observations of one’s functional capacities in the community, and to share this information with the therapists in the facility. Our services have also been requested many years following an individual’s brain injury and rehabilitation treatment; that usually happens when a family member or rehabilitation case manager believes the individual may be able to engage in a more productive daily routine.
Why are the additional services necessary if quality treatment has been provided prior to the individual’s discharge to his/her home?
The nature of the disability is usually the reason. Following a traumatic brain injury, individuals frequently have difficulty transferring skills and knowledge from one setting to another, even despite a high level of motivation to do so. The transfer of learning simply cannot be assumed. Services in the individual’s own home and community environment help the individual to apply skills and knowledge acquired or re-acquired during earlier phases of the rehabilitation process. These services are often crucial to the individual’s ability to preserve his/her level of functional capacity and make additional progress. Failure to provide the services needed at this critical point in an individual’s rehabilitation may result in regression. To assure that the dollars already spent on rehabilitation were a good investment, services to help clients successfully manage this transitional period are strongly recommended.
The scope and duration of services depend on the individual’s needs as well as factors such as family and community resources and support. The goal is to provide the individual with services enabling him/her to meet the demands of his/her own environment (for example, using public transportation to get to work or to maintain a physical conditioning program at a local health club or YMCA).
That varies, depending on when we receive the funding authorization, where the individual lives, and if a staff member is available to provide services in that community. If a staff member is available, services can begin immediately upon receiving an authorization from the funding source. If not, recruitment of a staff member will be necessary. The match between the individual and staff member is very important; it may take time to find a good “match.” It is important that as much advance notice of referrals as possible is given, to prevent a delay in needed services.
At present we are serving 91 people: 32 in New Jersey and 59 in Pennsylvania.
The majority of the staff has a master’s degree in a rehabilitation or rehabilitation-related discipline. The staff members who have a bachelor’s degree are persons who have work experience, particularly in the field of brain injury rehabilitation, that has prepared them to provide treatment in a community-based program. All staff members receive clinical supervision from a licensed psychologist with a specialty in neuropsychology. The director, program coordinators, and client services liaisons provide supervision on an ongoing basis as well. As soon as they are eligible to do so, staff members apply to the American Academy for the Certification of Brain Injury Specialists (AACBIS). Community Skills Program supports this process (through training and funding); you will see the CBIS credential after staff members' names.
The staff of Community Skills Program® use a holistic, transdisciplinary approach, centered on the high-interest areas and personal goals of the individual. The reason for this is that, at this stage in the rehabilitation process, a major aim of treatment is the integration of skills and abilities; a holistic, transdisciplinary approach facilitates this process.
The term facilitator has often been used in a generic sense because the focus of the treatment is on facilitating the individual’s successful return to his/her home and community. Facilitators facilitate the transfer of knowledge and skills from one setting to another. They also facilitate the adjustment of the individual to his/her post-injury environment.
We do not officially use the term facilitators for our staff,
although we use the term generically and recognize that other persons use the
term in describing our staff. It is important to note that the educational
preparation and work experience of “facilitators” vary widely; some programs use
paraprofessionals as facilitators. We do not classify our staff as facilitators
since doing so might lead one to assume that they possess a lower level of
training and experience than is the case. We used the designation of “counselor”
for many years, but, to emphasize that we specialize in the rehabilitation of
individuals following neurologic impairments, we now use the job title of
Yes, and we expect that this may be the case more often in the future, given the trend toward referrals of individuals coming from acute care settings. If the individual requires supervision, it often makes good sense to supplement our services with home health services, especially if the individual does not have the stamina to participate in our therapeutic services for a full day; using a home health aide for part of the day is a cost-effective approach. We have worked successfully with home health agencies and have provided training to their staff to promote a focus on goal-directed outcomes rather than custodial care.
At the discretion of the person to be served, family members and significant others are involved in the pre-admission evaluation process and the development of the individualized program plan that guides the treatment. Then, once a month a team meeting is held with each client, almost always at the client’s home. The client’s family members/significant others, case manager, insurance representatives, and other involved professionals are invited to participate. Family members’ input and feedback is sought during these meetings, and is welcome at all other times. We believe family members and significant others play a vital role in treatment following brain injury. The way in which family members and significant others are involved should be at their choosing, however. Some persons want to be actively involved at every step in the rehabilitation process, while others may express the need for a respite.
Community resources that will be available long-term must be developed to provide support for the individual with a brain injury and his/her family. Community Skills Program has had long-standing relationships with the Brain Injury Alliance of New Jersey, Inc. (BIANJ) and the Brain Injury Association of Pennsylvania, Inc. (BIAPA). Staff members routinely refer their clients and family members to the BIANJ or BIAPA support groups, and encourage their participation in the associations' annual conferences.
We take our responsibility for case management very seriously. Internal case management is handled by the staff member providing one-to-one treatment, as well as by our program coordinators and/or client services liaisons. We work closely with the external case managers (e.g., rehabilitation nurses) whom we regard as valuable members of the treatment team.
Services in New Jersey and Pennsylvania are paid for through a variety of sources, and funding can be blended as well. Because most traumatic brain injuries occur in automobile accidents, auto insurance has been the primary source of insurance funding. Funding has also come from federal and state agencies, health insurance, workers’ compensation benefits, private pay, structured settlements, school districts, voluntary organizations (e.g., Catholic Social Services, the Catholic Archdiocese, and Rotary Club), and scholarships (e.g., Brian’s Run Fund).
As of January 1, 2016, the following insurance carriers are
currently funding treatment for individuals in Community Skills Program®:
Allstate Insurance Company
Bergen Risk Managers
Claims Resolution Corporation
Liberty Mutual Insurance Company
New Jersey Manufacturers Insurance Company
New Jersey Property-Liability Insurance Guaranty Association (PLIGA)
Procura Management Services
Risk Enterprise Management
St. Paul Travelers Insurance Company
Wounded Warrior Project
Community Skills Program®
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measure its outcomes?
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