Coming into Focus A Needs Assessment and State Plan for Iowans with Brain Injury, November 1998

Coming Into Focus presents a needs assessment related to Iowans with brain injury, and a state action plan to improve Iowa���s ability to meet those needs. Support for this project came from a grant from the Office of Maternal and Child Health to the Iowa Department of Public Health, Iowa���s lead agency for brain injury. The report is a description of the needs of people with brain injuries in Iowa, the status of services to meet those needs and a plan for improving Iowa���s system of supports. Brain injury can result from a skull fracture or penetration of the brain, a disease process such as tumor or infection, or a closed head injury, such as shaken baby syndrome. Traumatic brain injury is a leading cause of death and disability in children and young adults (Fick, 1997). In the United States there are as many as 2 million brain injuries per year, with 300,000 severe enough to require hospitalization. Some 50,000 lives are lost every year to TBI. Eighty to 90 thousand people have moderate to acute brain injuries that result in disabling conditions which can last a lifetime. These conditions can include physical impairments, memory defects, limited concentration, communication deficits, emotional problems and deficits in social abilities. In addition to the personal pain and challenges to survivors and their families, the financial cost of brain injuries is enormous. With traumatic brain injuries, it is estimated that in 1995 Iowa hospitals charged some $38 million for acute care for injured persons. National estimates offer a lifetime cost of $4 million for one person with brain injury (Schootman and Harlan, 1997). With this estimate, new injuries in 1995 could eventually cost over $7 billion dollars. Dramatic improvements in medicine, and the development of emergency response systems, means that more people sustaining brain injuries are being saved. How can we insure that supports are available to this emerging population? We have called the report Coming into Focus, because, despite the prevalence and the personal and financial costs to society, brain injury is poorly understood. The Iowa Department of Public Health, the Iowa Advisory Council on Head Injuries State Plan Task Force, the Brain Injury Association of Iowa and the Iowa University Affiliated Program have worked together to begin answering this question. A great deal of good information already existed. This project brought this information together, gathered new information where it was needed, and carried out a process for identifying what needs to be done in Iowa, and what the priorities will be.

Iowa Maternal and Child Health Comprehensive Title V Assets and Needs Assessment, July 15, 2010

The Iowa Department of Public Health Bureau of Family Health and the Child Health Specialty Clinics embarked on a five-year needs assessment in March 2008 with a daylong strategic planning session involving key administrative and staff personnel from both agencies. As part of the strategic planning, the participants began preparation of a comprehensive assessment to identify the need in Iowa for: preventive and primary care services for pregnant women, mothers, and infants; preventive and primary care services for children; and services for children and youth with special health care needs.

Disability in Iowa: Public Health Needs Assessment

According to the Centers for Disease Control and Prevention (CDC), the number of adults reporting a disability is expected to increase, along with the need for appropriate medical and public health services. People with disabilities (PWD) face many barriers to good heath, including having overall poorer health, less access toadequate health care, limited access to health insurance, skipping mediacl care because of cost, and engaging in risky health behaviors including smoking and physical inactivity. The goals of the Iowa public health needs assessment were to assess the burden of disability in Iowa counties including health risk factors such as chronic conditions, determine access to preventive health care, and determine the effect of socioeconomic conditions. The state level assessment was based on th 2009-2012 American Community Survey (ACS) and publiccally available Behavioral Risk FactorSurveillance System (BRFSS) 2011 survey. The 2001-2010 combined BRFSS data was used for county level assessment. The needs assessment led us to conclude that adult Iowans with idsabilities face several challenges compared to non-disabled adults. They are more likely to suffer from debilitating chronic conditions and social disparities. Counties with the higher levels of poverty were more likely to have PWD with higher levels of disability related disparities.

Needs Assessment Study of the Iowa DOT Maintenance Facility Construction Needs, 1989

The purpose of this study is to provide recommendations relative to the location and construction needs for highway maintenance facilities within the state of Iowa. These recommendations were to be developed with consideration being given to the public's expectations and priorities for highway maintenance services. As a part of the study effort, a review was made of the methods used by other states to deliver highway maintenance services. To accomplish the study, Wilbur Smith Associates undertook a series of tasks. These efforts included gathering of data and information to characterize the various maintenance programs and the delivery of maintenance and operations services by the Department. We researched the delivery of highway maintenance services in other states. Interviews with Iowa DOT maintenance personnel were accomplished. A schedule of public hearings was developed and ten hearings were held. All the information was integrated and various analyses were made. From these analyses we drew conclusions and developed recommendations.

Hospital Health Care Access Assessment Program ��� Transition to Managed Care, December 2015

The Department on Human Services (DHS) carefully considered how to transition Medicaid services to managed care while creating stability for both members and providers.

2016 Title V Needs Assessment: Executive Summary, May 2015

Since early 2014, the Iowa Department of Public Health���s (IDPH) Bureau of Family Health (BFH) and the Oral Health Center (OHC), along with partners at the University of Iowa Division of Child and Community Health (UI-DCCH) collaborated to conduct the five-year Needs Assessment (NA) for the FFY2016 Title V Maternal and Child Health Block Grant.

2016 Title V Needs Assessment: Appendices, May 15, 2015

The Iowa Department of Public Health���s (IDPH) Bureau of Family Health (BFH) and the Oral Health Center (OHC), along with partners at the University of Iowa Division of Child and Community Health (UI-DCCH) collaborated to conduct the five-year Needs Assessment (NA) for the FFY2016 Title V Maternal and Child Health Block Grant.

2016 Title V Needs Assessment Report: Final Report, May 15, 2015

The Iowa Department of Public Health���s (IDPH) Bureau of Family Health (BFH) and the Oral Health Center (OHC), along with partners at the University of Iowa Division of Child and Community Health (UI-DCCH) collaborated to conduct the five-year Needs Assessment (NA) for the FFY2016 Title V Maternal and Child Health Block Grant.

Feasibility of Cooperative Development of Wetland Mitigation Projects, TR-526, 2006

The Iowa Department of Transportation (Iowa DOT) currently performs wetland mitigation on a project-by-project basis. At the same time, other agencies like the Iowa Department of Natural Resources and Natural Resource Conservation Service are performing wetland restoration projects, and counties and cities may be mitigating wetland losses as well. This project examined the feasibility of developing cooperative wetland mitigation projects in order to utilize state and local resources more efficiently to benefit both Iowa and local communities. The project accomplished the following objectives: (1) Identified and characterized cooperative wetland mitigation programs nationwide; (2) Developed a needs assessment through a survey of state, county, and large city agencies in Iowa to describe wetland mitigation programs and determine challenges with mitigation and program improvements, including long-term risks associated with maintenance and monitoring programs; (3) Surveyed state, county, and city agencies and organizations to identify resources available for developing cooperative mitigation projects and procedures; (4) Developed a conceptual framework for cooperative wetland mitigation.

2002 Iowa Youth Survey State of Iowa Results, April 2003

The 2002 Iowa Youth Survey (IYS) State of Iowa report was designed to help state-level planners identify youth development-related needs, develop relevant programs, and assess the outcomes of those programs. These data can help us better understand our youth and their needs. They can help us assess the strengths and weaknesses of our schools, families and communities from the young person���s perspective. In addition, the data in this report help the state obtain funds for a wide variety of programs. At every step in the process ��� from needs identification, to program development and implementation, to program assessment ��� the 2002 IYS data will provide a valuable resource. The state report can also help Iowa���s schools, area education agencies and counties assess their relative strengths and weaknesses. The grades 6, 8, and 11, as well as male and female percentages reported in each of these reports can be compared with the respective state report percentages. The higher the proportion of students in each of these columns that completed a usable IYS questionnaire, the more likely the comparisons with the state report percentages will be unbiased. Such comparisons should be considered exploratory, but for the most part are likely to prove useful.

A Transportation Safety Planning Tool for the City of Ames, August 2011

The historically-reactive approach to identifying safety problems and mitigating them involves selecting black spots or hot spots by ranking locations based on crash frequency and severity. The approach focuses mainly on the corridor level without taking the exposure rate (vehicle miles traveled) and socio-demographics information of the study area, which are very important in the transportation planning process, into consideration. A larger study analysis unit at the Transportation Analysis Zone (TAZ) level or the network planning level should be used to address the needs of development of the community in the future and incorporate safety into the long-range transportation planning process. In this study, existing planning tools (such as the PLANSAFE models presented in NCHRP Report 546) were evaluated for forecasting safety in small and medium-sized communities, particularly as related to changes in socio-demographics characteristics, traffic demand, road network, and countermeasures. The research also evaluated the applicability of the Empirical Bayes (EB) method to network-level analysis. In addition, application of the United States Road Assessment Program (usRAP) protocols at the local urban road network level was investigated. This research evaluated the applicability of these three methods for the City of Ames, Iowa. The outcome of this research is a systematic process and framework for considering road safety issues explicitly in the small and medium-sized community transportation planning process and for quantifying the safety impacts of new developments and policy programs. More specifically, quantitative safety may be incorporated into the planning process, through effective visualization and increased awareness of safety issues (usRAP), the identification of high-risk locations with potential for improvement, (usRAP maps and EB), countermeasures for high-risk locations (EB before and after study and PLANSAFE), and socio-economic and demographic induced changes at the planning-level (PLANSAFE).

Iowa Plan for Brain Injury, 2007-2010

Traumatic Brain Injury (TBI) impacts the lives of thousands of Iowans every year. TBI has been described as the ���Silent Epidemic��� because so often the scars are not visible to others. The affects of brain injury are cognitive, emotional, social, and can result in physical disability. In addition to the overwhelming challenges individuals with brain injury experience, families also face many difficulties in dealing with their loved one���s injury, and in navigating a service delivery system that can be confusing and frustrating. In 1998, the Iowa Department of Public Health (IDPH) conducted a comprehensive statewide needs assessment of brain injury in Iowa. This assessment led to the development of the first Iowa Plan for Brain Injury, ���Coming Into Focus.��� An updated state plan, the Iowa Plan for Brain Injuries 2002 ��� 2005, was developed, which reported on progress of the previous state plan, and outlined gaps in service delivery in Iowa. Four areas of focus were identified by the State Plan for Brain Injuries Task Force that included: 1) Expanding the Iowa Brain Injury Resource Network (IBIRN); 2) Promoting a Legislative and Policy Agenda, While Increasing Legislative Strength; 3) Enhancing Data Collection; and, 4) Increasing Funding. The IDPH utilized ���Coming Into Focus��� as the framework for an application to the federal TBI State Grant Program, which has resulted in more than $900,000 for plan implementation. Iowa continues to receive grant dollars through the TBI State Grant Program, which focuses on increasing capacity to serve Iowans with brain injury and their families. Highlighting the success of this grant project, in 2007 the IDPH received the federal TBI Program���s ���Impacting Systems Change��� Award. The Iowa Brain Injury Resource Network (IBIRN) is the product of nine years of TBI State Grant Program funding. The IBIRN was developed to ensure that Iowans got the information and support they needed after a loved one sustained a TBI. It consists of a hospital and service provider pre-discharge information and service linkage process, a resource facilitation program, a peer-to-peer volunteer support network, and a service provider training and technical assistance program. Currently over 90 public and private partners work with the IDPH and the Brain Injury Association of Iowa (BIA-IA) to administer the IBIRN system and ensure that families have a relevant and reliable location to turn for information and support. Further success was accomplished in 2006 when the Iowa legislature created the Brain Injury Services Program within the IDPH. This program consists of four components focusing on increasing access to services and improving the effectiveness of services available to individuals with TBI and their families, including: 1) HCBS Brain Injury Waiver-Eligible Component; 2) Cost Share Component; 3) Neuro-Resource Facilitation; and, 4) Enhanced Training. The Iowa legislature appropriated $2.4 million to the Brain Injury Services Program in state fiscal year (SFY) 2007, and increased that amount to $3.9 million in SFY 2008. The Cost Share Component models the HCBS Brain Injury Waiver menu of services but is available for Iowans who do not qualify functionally or financially for the Waiver. In addition, the Neuro-Resource Facilitation program links individuals with brain injury and their families to needed supports and services. The Iowa Plan for Brain Injury highlights the continued need for serving individuals with brain injury and their families. Additionally, the Plan outlines the paths of prevention and services, which will expand the current system and direct efforts into the future.

2005 Iowa Youth Survey State of Iowa Results, Revised December 2006

The 2005 Iowa Youth Survey (IYS) State of Iowa report was designed to help state-level planners identify youth development-related needs, develop relevant programs, and assess the outcomes of those programs. These data can help you better understand our youth and their needs. They can also help you assess the strengths and weaknesses of our schools, families, and communities from the young person���s perspective. In addition, the data in this report help the state obtain funds for a wide variety of programs. At every step of the process���from needs identification, to program development and implementation, to program assessment���the 2005 IYS data will prove to be a valuable resource. The state report can also help Iowa���s schools, area education agencies, and counties assess their relative strengths and weaknesses. The grades 6, 8, and 11, as well as male and female percentages reported in district-level, AEA-level, county-level, and other 2005 IYS reports can be compared with the respective state report percentages. The higher the proportion of students in each of these columns that completed usable IYS questionnaires, the more likely the comparisons with the state report percentages will be unbiased. Such comparisons should be considered exploratory, but for the most part are likely to be useful.

Medicaid Value Management Program SFY 2008 Report Executive Summary, 2007

In SFY 2007 the Medicaid Value Management program was developed under the direction of the Iowa Medicaid Director to establish a more comprehensive approach for improving the quality and value of medical services to Iowa Medicaid members. Medical services Unit provided the leadership for the program development and implementation.

Iowa State Plan for Brain Injury 2013-2018

Traumatic Brain Injury (TBI) impacts the lives of thousands of Iowans each year. The effects of brain injury (often called the "silent epidemic" because resulting injury is often not visible to others) are cognitive, emotional, and social but may also result in physical disability. This state plan, created by the Governor's Advisory Council on Brain Injuries, is intended to provide guidance for brain injury services and prevention activities in Iowa. This is the fourth Iowa State Plan for Brain Injury. In addition to a statewide needs assessment, development of this plan included recommendations made by the Mental Health and Disability Services Redesign Brain Injury Work-group. For the first time in the history of TBI surveillance in Iowa, the numbers and rates of TBI deaths are decreasing, however hospitalizations and emergency department visits resulting from TBI are steadily increasing. This trend is likely due to the decrease in motor vehicle accidents and improved hospitalization protocols. Looking to the future, the Advisory Council on Brain Injuries identified goals in each of four focus areas. These focus areas are: #1 Individual and family access; dedicated to the enhancement of the lives of individuals with brain injuries and their families. #2 Service and support availability; #3 Service system enhancements; continued funding growth and public awareness campaigns that draw attention to the impact of brain injury. #4 Brain injury prevention; working to prevent and reduce three of the most common causes of brain injury are falls, no helmet use, and motor vehicle crashes.