The Brain Injury Association and the Defense and Veterans Head Injury Program has published extensive information about choosing rehabilitation services. The information here is drawn from their publication.
Until recently, rehabilitation programs for people with brain injury have been largely provided in a "medical model." There is now a trend toward community and home-based rehabilitation models. As managed care continues to shorten the average length of stay in hospitals and rehab facilities, the importance of community services grows.
Fortunately, providers of services are offering more community-based options, though it may be necessary to negotiate with insurance companies, HMO's, and managed care companies to obtain the right types, intensity, and duration of services an injured person needs.
Some guiding principles for choosing rehab services are outlined below. In addition to those principles, a decision maker should be prepared to ask many questions about
- You know your needs best. Professionals help provide information for making informed choices, but you have to live with those choices.
- Be curious. Ask questions about the program, staff, philosophy, and methodology. Insist on explanations if you don't understand something.
- Learn from others. Talk with at least three people who participated in each program you are considering.
- Explore more than one program. There are hundreds of rehabilitation programs and services to choose from. The closest one, or the one with the most services, is not necessarily the one that will best meet your needs.
- Listen to your instincts. Make decisions when you are ready. If you feel pressured, report it to the program's corporate office, licensing agencies, and accrediting organizations.
- Get it in writing! Keep a log of whom you spoke to, the date, time, and a summary of your conversation. Keep copies of all correspondence. People you speak with should readily agree to be taped. Get any commitments for services in writing before you choose a program.
- Looks aren't everything. Don't judge the quality of services by nice looking facilities or marketing materials.
- The ultimate goal is to take charge. Programs should promote self-determination to the fullest extent possible, and maximize integration in the community.
- Know your financial situation. Find out how much the insurance carrier, managed care organization, or other health care payer will pay, for what services and under what conditions. Ask about the long-term implications of decisions you make today. Get regular (at least monthly) updates about where you stand financially with the payer and program. Find out about public or other private benefits you may be eligible for and apply promptly.
- Be involved. Participate in team meetings. Establish regular verbal and written contact with key people in the program. Voice your opinions, questions, and concerns promptly.
- The customer is always right. As a consumer of brain injury rehabilitation services, you are the customer. If you are not satisfied, work with the program and funding source to remedy the situation promptly.