When Many Voices Are Better Than One

By Lynn Brouwers, M.S., CRC, CBIST, Rainbow Rehabilitation Centers

Even though recognition of the impact of brain injury has improved over that past several decades, access to the right services – at the right time – has improved only marginally. Most persons with brain injury and their families face policy limits in insurance plans that provide only a limited post-acute rehabilitation benefit. In addition to the fatigue often experienced from months of sitting at the bedside, families are asked to advocate for services. They can’t do it alone. Julie Dixon writes an excellent article about the necessary advocacy role that clinicians and rehabilitation providers must include in their practice.

There are advocacy issues that can be addressed best by “many voices.” Texas brain injury service providers demonstrated the power of this approach when they addressed the need to include a post-acute residential benefit in health plans written for Texas residents. Michigan providers staved off a change in Michigan car insurance for decades, when other states such as Pennsylvania, New Jersey, New York, and Colorado lost lifetime rehabilitation and long-term benefits under their plans. Many states’ provider groups have advocated for excellence in brain injury-specific Medicaid waivers. A few states’ provider groups and consumer organizations have even sued their state or insurance companies to open access to needed services and community supports.

Achieving a group goal like those achieved above is possible! Here are some steps you can take:

• Show up. Form an ongoing committee that includes providers, consumer advocacy organizations, and consumers from across your state. Make your invitations fun; socialize with a purpose!
• Stand up. Volunteer to lead or participate. Set a goal as a group. Do you want to change health insurance policy by educating the policy makers? Do you want a more comprehensive Medicaid Waiver? Do you want to change a law or administrative rule that is determined by your state legislature? Do you want to help consumers use their insurance appeal processes or increase consumer communications to the insurance commissioner so the problem of access to a particular need is documented? Pick one and get focused.
• Make a Plan. Depending on what goal you pick, you’ll need to find an advocate in your insurance, government, or legislative body. State leaders often have a friend, family member, or neighbor who was injured who struggled with access to care. Ask for input as you put a plan together to raise awareness and ask for a change. Target the intended audience, put the plan in writing, and share with your group.
• Speak up. Meet with the intended audience as a group. You will get their attention.
• Celebrate. Set a time frame. When do you expect to achieve your goal? Celebrate your success as a group on that date. What did you learn? Perhaps you made gains toward the goal, but the job is not done. Revise the plan and keep working.
• Leave a legacy. Professionals want to do the right thing. By working together, we can all learn to be better advocates. Feel the power of our community. Enjoy strengthened friendships while socializing with a purpose.

About the Author

Lynn Brouwers joined Rainbow Rehabilitation Centers in 2008 as a director in the area of program development. Lynn has more than 30 years of leadership experience in medical rehabilitation with a specialty in programs for persons with traumatic brain injury and spinal cord injury. She has directed and managed CARF-accredited brain injury rehabilitation programs in acute rehabilitation, subacute rehabilitation, residential rehabilitation, vocational rehabilitation, and home and community-based services. Lynn is a Certified Rehabilitation Counselor and Certified Brain Injury Specialist Trainer with the Academy of Certified Brain Injury Specialists. She is a past president of the Michigan Brain Injury Provider Council, where she served for 26 years. She is also a former board member of the Brain Injury Association of Michigan and was appointed by the Governor to the Michigan TBI Services and Prevention Committee. In addition to her work at Rainbow Rehabilitation, she also works as a surveyor for CARF International. She holds a bachelor’s degree in psychology from Hope College and a master’s degree in Rehabilitation Services from the University of Wisconsin.