Research Proposal

TRAUMATIC BRAIN INJURY: HANDBOOK FOR COUNSELORS AND

RESOURCE DIRECTORY FOR CALIFORNIA AGENCIES

A Project

Presented to the faculty of the Graduate and Professional Studies in Education

California State University, Sacramento

Submitted in partial satisfaction of the requirements for the degree of

MASTER OF SCIENCE

Counseling

(Vocational Rehabilitation)

Shanna Welch

SPRING 2014

Shanna Welch

TRAUMATIC BRAIN INJURY: HANDBOOK FOR COUNSELORS AND

RESOURCE DIRECTORY FOR CALIFORNIA AGENCIES

A Project

Shanna Welch

Approved by:

______, Committee Chair Guy Deaner, Ph.D.

Date

iii

Student: Shanna Welch

I certify that this student has met the requirements for format contained in the University format manual, and that this project is suitable for shelving in the Library and credit is to be awarded for the project.

, Department Chair Susan Heredia, Ph.D. Date

Graduate and Professional Studies in Education

Abstract

TRAUMATIC BRAIN INJURY: HANDBOOK FOR COUNSELORS AND

RESOURCE DIRECTORY FOR CALIFORNIA AGENCIES

Shanna Welch

Statement of the Problem

The purpose of this project was to develop a handbook for professionals who work with people who have a Traumatic Brain Injury (TBI) and their families as well as develop a comprehensive, California resource directory. The last time this sort of project was done was in 2004, so a newer and updated version was clearly needed. The handbook will serve to educate professionals regarding the unique conditions and challenges of clients who have TBI as well as methods to help that individual get to work. The community resource directory will serve as a repository of information for professionals while providing assistance to individuals with TBI and their families.

Sources of Data

Sources of data for the development of this project included a review of related literature in vocational rehabilitation counseling; traumatic and acquired brain injury literature; journal articles, books, and internet sites detailing research and studies related to TBI; and unpublished masters projects and theses. Information was updated and assessed for relevance from Kristen Kunz's 2004 thesis, Traumatic Brain Injury: A

Handbook and Comprehensive Sacramento Area Community Resource Directory. Also consulted were California and national organizations deemed relevant by this author to be listed in the directory. The Traumatic Brain Injury Resource Directory (TBIRD): A

Guide to Northern California Resources for Individuals with Brain Injury, 6th edition

(2006); the Brain Injury Association of California Resources (2014); and the Community

Services Directory, 57th edition (City of Sacramento, 2011) were reviewed.

Conclusions Reached

TBI is so complex that one specialty cannot fulfill the counseling needs for these clients. A handbook was developed to educate professionals regarding the unique conditions and challenges of clients who have a TBI, and a California resource directory was developed to serve as a repository of information for professionals and to provide assistance to individuals with TBI and their families.

, Committee Chair Guy Deaner, Ph.D.

Date

ACKNOWLEDGMENTS

Production of this handbook and directory was accomplished under the direction of Lynda Eaton of Mercy Hospital Outpatient Rehab Center and the Head Trauma

Support Project, Inc.; Eric J. Ratinoff and Taryn J. Smith of Kershaw, Cutter, & Ratinoff,

LLP; and Guy Deaner, advisor to Shanna Welch, and Professor at California State

University, Sacramento. Special thanks go to each of them for their encouragement, direction, and support. Special thanks also goes to Tami Welch, mother of Shanna

Welch, for all of the hours she spent helping type up resources for the directory and for checking the websites to ensure all the information was current and updated.

The printing and production of this directory is provided by Eric J. Ratinoff, Civil

Justice Attorney, and this assistance is very gratefully acknowledged.

vii

TABLE OF CONTENTS

Page

Acknowledgments...... vii

Chapter 1. INTRODUCTION ...... 1

Background of the Problem ...... 1

Statement of the Problem ...... 6

Definition of Terms...... 7

Limitations of the Project...... 13

Organization of the Project ...... 14

2. REVIEW OF THE LITERATURE ...... 15

Introduction ...... 15

Experiences of Care by Clients and Families ...... 16

Access to Services...... 17

Outcome Results from Longitudinal Studies ...... 25

Improvements in Services ...... 31

Factors Leading to Successful Vocational Outcomes ...... 34

Summary ...... 44

3. METHODOLOGY ...... 47

4. SUMMARY AND RECOMMENDATIONS...... 52

Summary ...... 52

viii

Recommendations ...... 53

Appendix A. Traumatic Brain Injury: A Handbook for Counselors ...... 56

Appendix B. Traumatic Brain Injury: A Comprehensive California Resource

Directory ...... 101

References ...... 244

ix 1

Chapter 1

INTRODUCTION

Background of the Problem

The author became acquainted with Traumatic Brain Injury (TBI) in 2011 when she started graduate school. The author had studied psychology in the past and was always fascinated by the brain and even more intrigued when hearing about TBI in her

“Medical Aspects” class. She studied TBI thoroughly including limitations and vocational outcomes, and to this day she continues to learn. The author volunteers with people with TBI at Mercy Outpatient Rehabilitation Center and helped plan the “Walk

For Brain Injury” in the past. This passion for those with brain injury is what started her interest in this project.

According to Kolakowsky-Hayner (2010), TBI is a global health problem and one of the leading causes of death and disability in the United States, especially among persons under the age of 50. On average, the greatest number of TBIs occur in persons between the ages of 16-35 (Kolakowsky-Hayner, 2010). In the United States, someone receives a TBI every 23 seconds. Over one and a half million injuries occur per year, with 290,000 severe enough for hospitalization, eight times the number of people diagnosed with breast cancer and 34 times the number of new cases of HIV and AIDS each year (Kolakowsky-Hayner, 2010). Persons with brain injury often experience many different lasting functional problems. Although some problems are resolved relatively early post-injury, deficits have been known to persist for nearly a decade or more

(Kolakowsky-Hayner, 2010). Due to such an extended recovery period, finding and maintaining employment are ongoing problems for persons with brain injury. Research suggests that returning to work after brain injury is limited to as little as one-third of the brain-injured population (Kolakowsky-Hayner, 2010). Brain injury is not something that should be ignored. Access to services and treatment for people with brain injury (BI) is very important to have but not always easy to come by.

A study by O’Callaghan, McAlister, and Wilson (2010) indicated very few participants reported receiving services in line with recommendations made in clinical care guidelines. All the adults with TBI reported accessing acute care. However, their access to care following this point dropped. Sixty-four percent of participants with TBI reported receiving inpatient rehabilitation services. Participation increased slightly to

70% receiving outpatient rehabilitation, but only 25% of the participants with TBI stated they were receiving therapy services at the time of the study and only 22% reported they received ongoing monitoring. Over half the participants with TBI reported neither receiving therapy nor ongoing monitoring at the time of the study (O’Callaghan et al.,

2010). In a different study, Leith, Phillips, and Sample’s (2004) objective was to learn what the individuals in four focus groups (with persons with TBI and their families) in

South Carolina perceived their service needs to be and where they experienced service gaps in the existing system of TBI services. Results of this qualitative study revealed an overwhelming consensus regarding the need for: (a) An early, continuous, and comprehensive service delivery system; (b) information and education; (c) formal and

3 informal advocacy; (d) resourcefulness in and empowerment of persons with TBI and their families; and (e) human connectedness and social belonging. Effective strategies were needed to link services into an ongoing continuum of TBI care, increase TBI- specific education and awareness, and foster social re-integration (Leith et al., 2004).

Shigaki, Hagglund, Clark, and Conforti (2002) focused on the ability of people with SCI, TBI, and strokes to access health care under a Medicaid fee-for-service reimbursement model in central Missouri. Results of this quantitative study were people with SCI reported the most frequent difficulty accessing services (87%), followed by persons with BI (79%), and stroke (65%). In a subgroup of respondents, 60% reported failure to receive at least one service; 81% reported that access difficulties affected health or daily routine. The researchers concluded that people with rehabilitation-related disabilities may experience greater barriers to needed services than the larger population of persons with disabilities (Shigaki et al., 2002). Regarding psychological services, 26% of respondents who needed counseling and mental health services had difficulty accessing them and 29% reported difficulty obtaining therapeutic services for cognitive problems (Shigaki et al., 2002).

The study by Hart et al. (2010) developed a measure of the type, amount, and location of post-placement interventions. Treatment was measured prospectively for six months after job placement for 65 people with moderate to severe TBI, treated at five

TBI Model System centers. The sample was well educated, with 65% having attended at least some college. The majority was not only employed at the time of injury but were

4 returning to pre-injury employers. People with TBI with more limited education and employment history may be at higher risk of chronic unemployment post injury and may also have difficulty accessing vocational services. Three-fourths of the sample group was still working at the placement job after six months but, longitudinally, only 27% were competitively employed at one year post-injury (Hart et al., 2010). Despite the stated importance of vocational re-entry after TBI and the high need for vocational help perceived by consumers, relatively few persons with TBI get help to find or maintain employment (Hart et al., 2010). Previous work examining treatment components of vocational rehabilitation within the Traumatic Brain Injury Model System (TBIMS) network found much variation among centers, from no services at all to comprehensive programs offering job readiness, job placement, and supported employment.

The quantitative study by Bounds, Schopp, Johnstone, Unger, and Goldman

(2003) evaluated the vocational outcomes of individuals who sought services from a state

Vocational Rehabilitation (VR) program. Given that all states provide VR services to persons with TBI who experience vocational difficulties, the sample of persons with TBI was determined to evaluate vocational outcomes for those with TBI, including gender differences in these outcomes (Bounds et al., 2003). The findings indicated that a higher percentage of men’s cases than women’s cases were rated as successful vocational closures. In this study, 23.6% of the men found employment through Department of

Vocational Rehabilitation (DVR), while only 4.4% of the women did. It was also found

5 that women (73.9%) were more likely than men (56.4%) to have their case closed before services were initiated (Bounds et al., 2003).

In another study, Horn, Yoels, and Bartolucci (2000) wanted to determine key characteristics or factors associated with vocational rehabilitation participation during the first year following discharge for persons with either traumatic brain injury (TBI), spinal cord injury (SCI), intra-articular fracture (IAF), or burn injury (BURNS). Results showed TBI patients lacking private insurance were 2.6 times more likely to participate in vocational rehabilitation, while older SCI and TBI patients were about twice as likely to participate in vocational rehabilitation (Horn et al., 2000). Those lacking valuable socioeconomic resources, such as private insurance (for TBI) and social support systems provided by marriage (for BURNS and IAF patients) were much more likely to be referred to vocational rehabilitation. This was true for older SCI and TBI patients as well. Lacking such resources, patients may be viewed by referral agents as less likely to benefit from inpatient or outpatient rehabilitation (Horn et al., 2000).

This synthesis of research shows people with TBI often have trouble receiving treatment in the short and long term, a problem that needs to be further addressed.

Although Mazurek et al. (2011) showed some improvements are starting in access to services, there needs to be more education for patients and health-care professionals as well as easier access. People with BI find it difficult to know how to get treatment and navigate the health-care system, as well as even navigating websites with information.

During the Sacramento TBI Network meeting in May 2012, professionals specializing in

BI stated a need for a handbook specifically for Vocational Rehabilitation Counselors to educate them on TBI so they could more accurately do their jobs and successfully place their consumers in the workforce. A need also exists for a place such as one website and/or a resource booklet with all the services available to them listed in one place, making the services easy to find. This online resource directory is needed in all of

California versus just Sacramento because not every county or town has the services needed by those with TBIs. If a client needs a specific surgery, for example, but the client’s town does not have a surgeon who does the procedure, nearby counties can be searched. The counselors of these individuals can utilize the directory, as well as those with TBI. With more education and an easier way to access treatment and services, greater steps can be taken toward getting people with TBI the treatment and placement they need and deserve.

Statement of the Problem

The idea for this project came from a TBI Network Meeting in the Sacramento area in May 2012, with about 30 or 40 professionals who specialize in BI. The needs for a BI handbook for vocational counselors as well as a statewide resource guide were expressed. The biggest problem was a lack of knowledge on the professionals’ parts as well as lack of easy access to resources. In addition, there was not any existing resource as comprehensive as this project. While searching the Internet, much time and digging were required to even find sources for those affected by BI, let alone find them all in one place.

The Brain Injury Association of California (BIACAL; 2013) is one of the better places to find information on TBI, yet it still lacks the amount of resources that such a large organization is expected to have. BIACL’s purpose is to provide information, resources, education, advocacy and support for those affected by brain injury. The mission is to “be the voice of brain injury, and to bring help, hope and healing to thousands of Californians living with brain injury, their families, and the professionals that serve them” (2014, para. 2). BIACAL’s goals and mission statement are very close to the goals of this project. However, even BIACAL, one of the leading organizations for

BI, lacks information for their consumers. The website has information about BI, including brain facts, California independent living centers, California regional centers, and sources for veterans. The organization even has a TBI resource directory. However,

BIACAL’s resource directory is only for Northern California. This Master’s project includes a resource directory for the entire state of California related to BI. Another problem is that the last time a resource directory was done by a California State

University, Sacramento (CSUS) graduate student was in 2004, and it was only for the

Sacramento area. A definite need exists for an updated handbook and resource guide.

Definition of Terms

Atraumatic Brain Injury

A category of brain injury receiving less attention in the literature is atraumatic

causes of brain injury. Examples include arterial-venous malformations (blood

vessels with weaknesses present at birth) and infections in the brain, both of

which can result in cerebrovascular accident (Brodwin, Tellez, & Brodwin, 2009).

Acquired Brain Injury (ABI)

Acquired brain injury (ABI) is another name for Traumatic Brain Injury (Brain

Injury Association of California, 2013).

Brain Injury (BI)

A brain injury (versus traumatic brain injury) is caused by something inside the

body, not outside the body. An example of internal causes of brain injury include

cerebrovascular accident (stroke), an infection, or aneurisms (Brodwin et al.,

2009).

Closed Head Injury

In a closed head injury, the scull is not penetrated. Damage usually occurs when

the brain experiences rapid acceleration and deceleration because of a blow to the

head, such as in a motor vehicle accident or fall. Next, the brain stem turns and

twists on its axis causing localized or widespread damage to the brain. The brain

then rebounds and hits the opposite side of the skull (the “contre coup”).

Consequently, in closed head injury, damage often occurs to diffuse areas of the

brain. Swelling and bleeding, problems that frequently occur with open-head

injuries, also cause injury to various areas of the brain (Brodwin et al., 2009).

Deficits

A disadvantage, impairment, or handicap (Deficits, 2013).

Department of Rehabilitation (DOR)

The California Department of Rehabilitation works in partnership with consumers

and other stakeholders to provide services and advocacy resulting in employment,

independent living, and equality for individuals with disabilities (California

Department of Rehabilitation, 2013).

Glascow Coma Scale

The Glasgow Coma Scale (GCS) is a tool medical professionals use to objectively

evaluate the degree to which a person is conscious or comatose. Also referred to

as the “Glasgow Coma Score,” it operates on a scale of “3” to “15,” in which

progressively higher scores indicate higher levels of consciousness. Immediately

after a head trauma, emergency doctors and nurses will use the GCS to assess a

patient’s condition. Others who use the GCS include intensive care staff, EMTs,

and chronic care professionals (Brainline.org, 2014).

Medicaid

A U.S. government program, financed by federal, state, and local funds, of

hospitalization and medical insurance for persons of all ages within certain

income limits (medicaid, 2013).

Medicare

A U.S. government program of hospitalization insurance and voluntary medical

insurance for persons ages 65 and over and for certain people with disabilities

under 65 (Medicare, 2013).

Neuropsychological Evaluation

Neuropsychological evaluation (NPE) is a testing method through which a

neuropsychologist can acquire data about a subject’s cognitive, motor, behavioral,

linguistic, and executive functioning. In the hands of a trained neuropsychologist,

these data can provide information leading to the diagnosis of a cognitive deficit

or to the confirmation of a diagnosis, as well as to the localization of organic

abnormalities in the central nervous system (CNS). The data can also guide

effective treatment methods for the rehabilitation of impaired patients. NPE

provides insight into the psychological functioning of an individual, a capacity for

which modern imaging techniques have only limited ability. However, these tests

must be interpreted by a trained, experienced neuropsychologist to be of any

benefit to the patient. These tests are often coupled with information from clinical

reports, physical examination, and, increasingly, premorbid and postmorbid self

and relative reports. Alone, each neuropsychological test has strengths and

weaknesses in its validity, reliability, sensitivity, and specificity. NPE is useful

for measuring many function categories, including the following: Intellectual

functioning, academic achievement, language processing, visual/special

procession, attention, concentration, verbal learning and memory, visual learning

and memory, executive functions, speed of processing, sensory-perceptual

functions, motor speed and strength, motivation/symptom validity, and

personality assessment (Medscape, 2013).

Open Head Injury

In an open head injury, verification of TBI is not difficult. The person’s brain

matter has been penetrated, such as by stabbing or gunshot. Skull fractures,

visible brain matter, and obvious bleeding indicate the trauma. Often, the patient

goes into a coma or a physician pharmacologically induces a coma immediately

following the trauma. The coma may last minutes, weeks, or months. This type

of head injury is more likely to damage a specific area of the brain. Additional

risks exist as well; some patients develop infections or need to have their lost

skull material replaced with artificial plates (Brodwin et al., 2009).

Rehabilitation Services Administration (RSA)

The Rehabilitation Services Administration (RSA) oversees grant programs that

help individuals with physical or mental disabilities to obtain employment and

live more independently through the provision of such supports as counseling,

medical, and psychological services; job training; and other individualized

services. RSA’s major Title I formula rand program provides funds to state

vocational rehabilitation (VR) agencies to provide employment-related services

for individuals with disabilities, giving priority to individuals significantly

disabled (California Department of Education [CDE], 2013).

Spinal Cord Injury (SCI)

SCI causes profound changes in virtually all physical systems and functional

abilities. When the spinal cord is damaged, communication is disrupted between

the brain and parts of the body innervated at or below the lesion. The lesion may

be complete (no nerve fibers functioning below the level of injury) or incomplete

(one or more nerve fibers is secure). The cord need not be completely severed to

result in a complete injury; the nerve cells may be destroyed as a result of

pressure, bruising, or loss of blood supply, and if they die they do not have the

ability to regenerate. The amount of functional loss depends upon the level of

injury and on the neurological completeness of the injury. The public views the

inability to walk as the primary consequence of SCI. Although this ability is

undeniably important, SCI also affects such areas as arm and hand strength and

dexterity, bowel and bladder control, sexual function, temperature regulation,

susceptibility to infections, and even the ability to breathe (Brodwin et al., 2009).

Stroke

Stroke is a medical emergency characterized by the rapid loss of brain function

due either to interruption of its blood supply (ischemic stroke) or bleeding into the

brain from rupture of a blood vessel (hemorrhagic stroke). Ischemic strokes

account for 80% and hemorrhagic strokes, 20%. Both forms result in reduction of

oxygen and nutrition to the brain, which leads to the symptoms of stroke and

possible brain damage (Brodwin et al., 2009).

Traumatic Brain Injury (TBI)

Traumatic brain injury involves sudden physical damage to the brain. TBIs are

caused by something outside the body. For example, TBIs may result from

vehicle collisions, falls, stabbings, gunshots, infections, tumors, and strokes.

Persons with TBI undergo such dramatic cognitive and personality changes that

they seem, both to themselves and to those closest to them, to be different people

than they were pre-injury (Brodwin et al., 2009).

Limitations of the Project

This project is for Vocational Rehabilitation Counselors who are supporting clients with TBI, as well as for the client and their families. The project may briefly touch on other injuries, as certain injuries and conditions can often go hand-in-hand with head trauma, but the focus is always on the TBI, so it excludes other traumas. Although the professional handbook can be applied in other areas, the handbook specifically targets use by Vocational Rehabilitation Counselors, thus limiting the scope of the user population. The resource guide in this project covers the entire state of California, but not any other geographical region (i.e., the entire United States of America), so the project is also limited by geography. Only those materials available up to May 2014 were used in this project, so it is also limited by time. The final limitation is author bias.

The author believes people with TBI can return to work. She also believes that access to resources is not as easy as it should be. Information the author thought to be most important and/or relevant to the problem and population was explored in the professional handbook as well as in the California resource guide.

Organization of the Project

Chapter 2 offers a review of literature specifically related to this project. A look at the dimensions of the problem is delineated as follows: Experiences of care by clients and families, access to services, follow-up studies, and future hopes and possibilities.

Chapter 3 outlines the methodology used by the author to define and describe how this resource guide and handbook appendixes were developed. Chapter 4 outlines the summary and recommendations reached by the author. Appendix A is the Handbook for

Vocational Rehabilitation Counselors and Appendix B is the Community Resource

Directory. An extensive reference list completes the project.

Chapter 2

REVIEW OF THE LITERATURE

Introduction

According to Kolakowsky-Hayner (2010), TBI is a global health problem and one of the leading causes of death and disability in the United States, especially among persons under the age of 50. On average, the greatest number of TBIs occurs in persons between the ages of 16 and 35. In the United States, someone receives a TBI every 23 seconds. Over one and a half million injuries occur per year, with 290,000 severe enough for hospitalization. That is eight times the number of people diagnosed with breast cancer and 34 times the number of new cases of HIV and AIDS each year (Kolakowsky-

Hayner, 2010). Unfortunately, people with TBI often have difficulty getting the help they need. Persons with BI often experience many functional problems, and although some are resolved relatively early post-injury, deficits have been known to persist for nearly a decade or more. Kolakowsky-Hayner (2010) went on to say that due to such an extended recovery period, finding and maintaining employment are ongoing problems for persons with BI. Research suggests returning to work after brain injury is limited to as little as one-third of the brain-injured population. Brain injury should not be ignored.

Access to services and treatment for people with BI is important but not always easy to come by. This synthesis of research focuses on access to treatment and services for people with TBI.

Experiences of Care by Clients and Families

O’Callaghan et al. (2010) investigated the continuation of care experienced by adults and their significant others following a moderate to severe TBI in Victoria,

Australia. Their study presented the experiences of 202 Victorians admitted for acute care following a moderate to severe TBI over a four-year period. The authors used mixed methods and the study had two separate research stages. The first stage involved the distribution of two statewide surveys; the first of these surveys targeted adults with moderate to severe TBI of working age, and the second targeted a significant other of the person with TBI. The second stage of the research involved 17 in-depth interviews between the first author, an adult with TBI, and the significant other. Results of this study indicated very few participants reported receiving services in line with recommendations made in clinical care guidelines. O’Callaghan et al. (2010) went on to say that all the adults with TBI reported accessing acute care. However, their access to care following this point dropped. Sixty-four percent of the participants with TBI reported receiving inpatient rehabilitation services. Participation increased slightly to

70% receiving outpatient rehabilitation. However, only 25% of the participants with TBI stated they were receiving therapy services at the time of the study and only 22% reported they received ongoing monitoring. Over half the participants with TBI reported neither receiving therapy nor ongoing monitoring at the time of the study.

In a different study, Leith et al. (2004) aimed to learn what individuals in four focus groups (with persons with TBI and their families) in South Carolina perceived their

17 service needs to be, and where they experienced service gaps in the existing system of

TBI services. Persons in the study had to be at least 15 years of age and either had or lived with someone who had incurred a TBI within the last five years. A total of 21 persons with TBI and their family members participated in the focus group sessions, ranging from mild to severe TBI. The results of the Leith et al. (2004) qualitative study revealed an overwhelming consensus regarding the need for: (a) An early, continuous, and comprehensive service delivery system; (b) information and education; (c) formal and informal advocacy; (d) resourcefulness in and empowerment of persons with TBI and their families; and (e) human connectedness and social belonging. Persons with TBI and families in South Carolina experienced the service system as unorganized, uneducated, unresponsive, and uncaring. Effective strategies were needed to link services into an ongoing continuum of TBI care, increase TBI-specific education and awareness, and foster social re-integration.

Access to Services

Shigaki et al. (2002) focused on the ability of people with SCI, TBI, and strokes to access health care under a Medicaid fee-for-service reimbursement model in central

Missouri. On the basis of previous research, the authors anticipated this group would experience substantial difficulties accessing healthcare services, including rehabilitation and psychological services. Participants included 138 individuals with SCI, BI, or stroke

(Shigaki et al., 2002). The authors sent out a survey consisting of 115 items. Participants were asked about their insurance coverage, hospital and emergency room use, self-

18 reported health status, history of medical conditions, usual source of health care, healthcare services they needed during the past 12 months, difficulties accessing needed services, and whether access difficulties affected their health (Shigaki et al., 2002).

According to the results of this quantitative study, people with SCI reported the most frequent difficulty accessing services (87%), followed by persons with BI (79%), and stroke (65%). In a subgroup of respondents, 60% reported failure to receive at least one service; 81% reported access difficulties affected health or daily routine. The researchers concluded people with rehabilitation-related disabilities may experience greater barriers to needed services than the larger population of persons with disabilities.

Shigaki et al. (2002) went on to say that dental services were the most difficult to access, with 82% of people who needed these services reporting having difficulty or being unable to obtain them. Other services reported as difficult to obtain included personal care attendant services (50%), medical supplies (47%), eyeglasses (3%), durable medical equipment (31%), physical therapy (30%), specialist provider care (27%), occupational therapy (20%), in-home nursing (20%), speech therapy (17%), care for minor health problems (14%), and prescribed medications (13%). Regarding psychological services,

26% of respondents who needed counseling and mental health services had difficulty accessing them, and 29% reported difficulty obtaining therapeutic services for cognitive problems.

Shigaki et al. (2002) also found that when respondents reported difficulty or inability to obtain needed healthcare services, follow-up occurred to help determine why

(Shigaki et al., 2002). For all respondents, the most frequently cited reason was the provider did not take Medicaid, and Medicaid did not cover the service. Other reasons varied somewhat but most frequently included that Medicaid did not approve enough hours, they had problems finding personal care attendants to help when needed, there was difficulty getting appointments and/or scheduling problems, they could not afford it, and there were transportation problems.

Sligar and Zeng (2008) evaluated website accessibility of state vocational rehabilitation (VR) agencies who communicate with potential consumers and the public on a variety of topics (including their mission, available services, eligibility requirements, office locations, and outcomes) through websites. These agencies must locate consumers to serve, employers to hire their consumers, and vendors to provide services. State VR agencies must provide accessible information for citizens, primarily persons with disabilities. To examine the accessibility of VR websites for persons with disabilities,

Sligar and Zeng (2008) used the automated tool “Bobby” to evaluate 80 home pages.

They found that all 80 agencies had a working website, though 34 (43%) provided no information about the site’s accessibility. Thirty-one provided other Web accessibility information such as a disclaimer or link to a more accessible page, and seven (9%) of the websites did not pass the Bobby evaluation.

The primary objective of a quantitative study by Kolakowsky-Hayner (2010) was to examine racial disparity within the state-federal vocational rehabilitation system, among clients with BI. The Rehabilitation Services Administration (RSA) collects data

20 annually on rehabilitation outcomes and services provided for every person who has applied for or received VR services, and this information is put into what is called the

RSA 911 database. The authors examined the use of the RSA 911 database.

Specifically, the analyses were conducted to evaluate possible ethnic and racial differences in the rate of acceptance for VR services and whether or not differences exist with regard to entry into the system. The current investigation by Kolakowsky-Hayner

(2010) used part of Aday and Anderson’s (1974) framework for the “Study of Access” to explain racial disparity among clients with BI within the vocational rehabilitation system, with the goal of allowing for healthcare planners and policymakers to make better decisions regarding progress and need. Based on this framework, the investigation focused on the characteristics of the population at-risk portion of the model, and it attended to the constructs of predisposition, enablement, and need.

To answer the research questions set forth in this investigation by Kolakowsky-

Hayner (2010), information regarding VR acceptance, reason for closure, and predisposing and enabling characteristic variables were collected for analysis in this design. The authors used an RSA database to obtain data. The design included statistical procedure, using SPSS. Then the data were analyzed using a single Exhaustive Chi- squared Automatic Interaction Detector (CHAID) analysis (Kolakowsky-Hayner, 2010).

Participants in the study included a national sample of 18,304 people, with a primary or secondary diagnosis of brain injury, who had applied for or received VR services through the federal/state VR program. Participants included clients from 77 rehabilitation

21 agencies throughout the Federal Rehabilitation System. There were 66.4% males and

33.6% females (Kolakowsky-Hayner, 2010). Racial and ethnic backgrounds included

15,101 Whites (82.5%), 2,607 Blacks (14.2%), 305 American Indians and Alaskan

Natives (1.7%), and 280 Asian and Pacific Islanders (1.5%), with only 7.8% of participants of Hispanic origin. The majority of the participants had never been married, most had completed high school, and few had received special education.

Kolakowsky-Hayner (2010) found that overall, the average age for persons with brain injury who were not accepted for rehabilitation services was greater than persons accepted for these services, which might show a possible age bias. The acceptance rate was about 85% for the overall sample. Acceptance rates were similar for males and females. White and Asian or Pacific Islander clients had higher acceptance rates than

Black and American Indian or Alaskan Native applicants. Persons of Hispanic origin had lower acceptance rates than non-Hispanic persons. Applicants who had received special education services had higher acceptance rates than those who had completed schooling through the regular education system, including those with less than a high school education, a high school education, and greater than a high school education

(Kolakowsky-Hayner, 2010). The study also found that applicants with BI who were widowed or never married had higher acceptance rates than those who were married, divorced, or separated. Acceptance rates for persons with and without medical insurance coverage at the time of application were similar, and applicants referred by private and

22 public educational institutions had higher acceptance rates than those referred by all other sources.

Because approximately 75% of persons who incur TBIs are male, the majority of the research today is focused on men. Given the limited research existing regarding vocational outcomes for women with TBI, the quantitative study by Bounds et al. (2003) evaluated the vocational outcomes of individuals who sought services from a state VR program. Given that all states provide VR services to persons with TBI who experience vocational difficulties, the sample of persons with TBI was determined to evaluate vocational outcomes for those with TBI, including gender differences in these outcomes.

Each participant in the study by Bounds et al. (2003) was administered a standard neuropsychological evaluation used as part of a statewide DOR protocol. This battery consisted of many different instruments, including the Wechsler Adult Intelligence and

Memory Scales, the Woodcock-Johnson Tests of Achievement, and a measure of grip strength. Information from DVR was obtained on each participant, including: (a) services provided by DVR, (b) work status variables at the same time as referral, (c) work status variables at the time the case was closed, and (d) the financial cost of the case to

DVR (Bounds et al., 2003). Participants were 78 individuals with TBI from Missouri who were provided services by the Missouri DVR. Participants were included in the study only if they qualified for DVR services based on either a primary or secondary diagnosis of TBI as well as completed DVR services and having a closed case. Generally consistent with national norms, 71% of the participants were male, and 29% were female.

Seventy-nine percent of the participants were Caucasian, 17% were African-American, and 4% were of other ethnicity. Bounds et al. (2003) obtained information from the

Missouri DVR, including services provided by the DVR, work status variables at the time of referral, work status variables at the time the case was closed, and the financial cost of the case to DVR.

Male and female participants did not differ in level of education, age, or time since injury, but women scored higher than men on measures of written language skills, and men scored higher on strength and fine motor speed tests (Bounds et al., 2003). The results were interesting in that they seemed to support stereotypical beliefs about vocational roles for men and women. Specifically, the findings indicated that a higher percentage of men’s cases than women’s cases were rated as successful vocational closures. In this study, Bounds et al. (2003) found that 23.6% of the men found employment through DVR, while only 4.4% of the women did. Also, women (73.9%) were more likely than men (56.4%) to have their case closed before services were initiated. These studies show age and racial disparity issues still exist while receiving services. Another issue studied is the quality of continuing care.

Pickelsimer et al. (2007) aimed to assess unmet needs of persons with TBI one year after hospital discharge, compare perceived needs with needs based on deficits

(unrecognized needs), determine major barriers to services, and evaluate the association of needs with satisfaction with life. Participants were 1830 individuals with TBI aged 15 years and older. Results showed that around 35% of participants reported at least one

24 unmet need, 51% had unrecognized needs, and 47% reported at least one barrier to receiving help. Receiving help significantly increased satisfaction with life. Pickelsimer et al. (2007) also found that participants reported wanting to return to work, looking for work, and needing help finding work. They also reported needing special equipment, needing improved job skills, and needing information about services.

The state of Colorado has operated a TBI surveillance system for over a decade.

The original purpose of the system was to conduct ongoing, systematic data collection to estimate the incidence of TBI in the state. However, researchers and prevention specialists have also used the system to identify risk factors and high-risk groups to target prevention efforts. The primary objective of Sample, Johns, Gabella, and Langlois

(2004) was to determine the feasibility of this surveillance system to link individuals to information and services in their communities. The study used qualitative research methods to gather information to evaluate the potential for linking persons from the

Colorado TBI Surveillance System to information about services in their home communities. Phone interviews were conducted with agency representatives, and the researchers conducted two focus groups with persons with TBI and family members, with a total of 29 participants in each focus group. Sample et al. (2004) found that participants saw many current problems with linking persons to services and with accessing care.

The participants supported using TBI surveillance data to link persons to information and services, offered suggestions, discussed confidentiality and consent issues, described possible cultural competence issues, and addressed cost feasibility (Sample et al., 2004).

Overall, persons with TBI and their family members overwhelmingly supported using the

Colorado TBI Surveillance System to link persons to services, and they found it helpful.

One major concern, however, was how to link persons not included in the surveillance data because their TBI had happened before the surveillance system was implemented or because their injury had not resulted in hospitalization.

Outcome Results from Longitudinal Studies

According to Thornhill et al. (2000), more than 150,000 patients with head injury are admitted to hospitals each year in the United Kingdom. The objective of their study was to determine the frequency of disability in young people and adults admitted to hospitals with a head injury and to estimate the annual incidence in the community. For a year, Thornhill et al. (2000) and research staff frequently visited each hospital to identify young people and adults (aged 14 years or more) admitted with head injury. Children were not studied because services for their care are separate and assessment of outcome is more difficult than with older subjects. The researchers successfully identified 99% of the relevant cases, which was 2,995 young people and adults admitted to hospitals with a head injury.

Data were extracted from case records to characterize the patient and the cause of severity of injury on arrival at the hospital. The researchers provided written information about their study to patients or relatives and obtained their consent for participation at the time of admission, or as soon as possible after discharge, and at further contact at three and six months. By using standard, structured questionnaires, Thornhill et al. (2000)

26 obtained information from the patients, relatives, or caregivers by telephone interview or postal questionnaire one year after the injury. This was supplemented by personal interviews when additional data were needed. The authors aimed to follow up with all patients with severe head injuries, and they successfully followed up with 549 of the 769 patients selected. The characteristics of those followed up were closely representative of the randomly selected group (Thornhill et al., 2000). Of the clients, fewer than half were seen in hospitals after discharge, and only 28% were reported as having received input from rehabilitation services. Only 15% of patients had contact with social work services.

The most common contact reported for disabled survivors was with their general practitioner (91%), but only 54% of such contacts were related to head injury.

Another study by Horn et al. (2000) aimed to determine key characteristics or factors associated with rehabilitation participation during the first year following discharge for persons with either TBI, SCI, IAF, or BURNS. The study consisted of

1,311 individuals drawn from a larger longitudinal study. To be included in the study, participants had to have sustained one or more of the four injuries being studied, had an acute care length of stay of three or more days, had been residing in and injured in

Alabama, had been discharged alive from an acute care hospital between predetermined days, had been at least 18 years of age or older when injured, and had been participating in scheduled follow-up interviews 12 months after discharge from the acute care setting

(Horn et al., 2000). Medical records and longitudinal survey (telephone questionnaire)

27 data were collected for persons in the four injury groups and analyzed using hierarchical logistic regression procedures for each domain of factors.

Horn et al. (2000) found that TBI patients lacking private insurance were 2.6 times more likely to participate in vocational rehabilitation, while older SCI and TBI patients were about twice as likely to participate in vocational rehabilitation. Those who lacked valuable socioeconomic resources, such as private insurance for TBI and social support systems provided by marriage for BURNS and IAF patients, were much more likely to be referred to vocational rehabilitation. This was true for older SCI and TBI patients as well. Horn et al. (2000) stated that lacking such resources, patients may be viewed by referral agents as less likely to benefit from inpatient or outpatient rehabilitation. Persons are usually more likely to need VR services when they have not been able to get full access to other services/treatment. In the study, a higher need for

VR was not necessarily a good thing.

The purpose of a study by Shigaki, Johnstone, and Schopp (2009) was to determine outcomes for persons with TBI in terms of employment status, income, and public assistance received at two years after injury. Participants were individuals enrolled in the TBI Model Systems National Data Centre (TBIMS) program at the

University of Missouri. Eighty individuals initially enrolled in the study had two-year follow-up TBIMS data. For the current sample, vehicular accidents were the leading cause of TBI (61%), followed by falls (20%), acts of violence (6%), pedestrian accidents

(4%), being hit by falling objects (2%), and other vehicle accidents (2%). Regarding

28 injury severity, 23 participants had GCS data from the time of admission to the ER. At baseline, 18% of the 49 participants reporting financial data received some type of public support (Shigaki et al., 2009). At two years post-injury, data were available for 29 of the original 49 participants. Of these, 38% reported receiving some type of public financial support. Preliminary examination of differences suggests, however, that more males than females were employed at baseline (71% vs. 55%), and total private income for men was approximately twice the amount reported by women. Shigaki et al. (2009) also found that 18% of both males and females reported receiving public assistance at baseline. At two-year follow-up, only 35% of men reported being employed, suggesting a steep decline in employment. In contrast, employment among women at the two-year mark remained fairly stable (50%).

Shigaki et al. (2009) examined earned income as another indicator of successful employment. At baseline, 78% of the respondents reported having earned income.

Additionally, 4% reported obtaining financial assistance from family, and 4% reported income from other private sources. At two-year follow-up, data were available for 29 of the original subjects. Forty-one percent reported having earned income. Fourteen percent reported financial assistance from family, and 7% reported income from other private sources (Shigaki et al., 2009). The authors also found that at the time of injury,

68% of participants were employed while at two-year follow-up, only 38% of participants reported being employed. At two-year follow-up, individuals with TBI reported higher levels of employment and earned income than was previously reported

29 for one-year post-injury but continued to experience declines relative to pre-injury baseline. Unemployment was 12% at baseline, whereas unemployment was 25% at two years post-injury.

The purpose of a study by Gary et al. (2010) was to examine racial and ethnic differences in employment outcomes 10 years after TBI. The study found after considering age at injury, pre-injury employment status, and cause of injury, the odds of being competitively employed versus not being competitively employed at 10 years post- injury were 2.4 times greater for whites as compared to minorities (Gary et al., 2010).

The minority sample in the authors’ study, on average, appeared to be surrounded by difficult circumstances, including limited education, limited social support, low employment, and violence at time of injury. The TBI further undermined their potential for employment. The authors also found employment outcome for the minority group was worse than that for the white group, even though the injuries sustained by the minority group were actually less severe, on average, than for the white group (Gary et al., 2010). These findings are particularly disconcerting.

Gary et al. (2010) suggested the following recommendations to help rehabilitation professionals target specific needs of minorities with TBI and address employment disparities found. The first recommendation was rehabilitation professionals working with clients following TBI need to be fully aware of inequities in employment outcomes among minorities and whites as an important first step in addressing disparities (Gary et al., 2010). The second recommendation is to increase recruitment of minorities into

30 rehabilitation fields. Recruitment strategies for minority students by allied health programs should focus on early exposure to rehabilitation professions and effective outreach through summer enrichment programs, pre-matriculation, establishment of social networks, and collaboration with historically black colleges and universities and minority organizations. The third recommendation is that rehabilitation professionals should incorporate culturally appropriate strategies into treatment to ensure successful employment outcomes after injury. It appears standard approaches to vocational rehabilitation are unlikely to be as successful with minority populations (Gary et al.,

2010). Faith-based institutions, for example, have been an important network and healthcare resource for African Americans. Hispanic culture places a huge emphasis on the inclusion of family, extended family, and friends within their communities in their care and recovery (Gary et al., 2010). Rehabilitation professionals must be willing to include these support networks for job-seeking opportunities, survival skills, job placement, and maintenance.

Attention needs to be given to social support for the injured person, to hopefully generate positive social encounters. Initiating work activity with volunteer positions may also be helpful in this population to develop necessary work skills that may not have existed prior to the trauma (Gary et al., 2010). Skills such as timeliness, responsibility, and appropriately interacting with supervisors and coworkers could be developed. Any population with limited work skills prior to brain injury will have difficulty benefiting from typical vocational rehabilitation interventions. The fourth and final

31 recommendation by Gary et al. (2010) was that rehabilitation professionals should provide assistance and guidance to minorities with TBI and employers once they are placed in employment, both in early and later phases. VR counselors and other specialists should be involved in their clients’ progress once placed in the VR system.

However after a certain amount of time (e.g., 90 days after job placement), the case will be considered successful and closed as rehabilitated (Gary et al., 2010). Although minorities with TBI can successfully return to employment, many have problems with maintaining a job once employed one to four years post-injury. Thus, rehabilitation professions should place extra efforts in developing long-term follow-up systems for minority clients with TBI initially placed in employment and after their case has been successfully closed (Gary et al., 2010).

Improvements in Services

The aim of Mazurek et al. (2011) was to examine potential geographic differences among individuals with TBI and SCI in demographics, rehabilitation services/costs, and outcomes at one-year follow-up. According to the U.S. Census Bureau (as cited in

Mazurek et al., 2011), roughly 20% of the population lives in rural areas. Furthermore, rural residents of all ages have a higher rate of disability than do urban residents. Access to health care and rehabilitation services is more difficult for rural residents with disabilities than for their urban counterparts and, therefore, it is important to more fully examine potential geographic differences among individuals with significant disabilities.

A total of 152 participants with TBI from the Missouri Model Spinal Cord Injury

System were enrolled at initial acute or rehabilitation hospitalization and followed by

Mazurek et al. (2011) for one year. Measures included demographics, rehabilitative services/costs, functional independence measure, residency at discharge, and substance use. Data from each participant were collected and entered into a database and participants were enrolled within one year of injury. The battery included a wide range of health and functional measures collected at baseline and then at regular follow-up intervals. The current study examined data collected at the time of injury through one- year follow-up. The centers used in the study provided access to a large rural catchment area, offering a unique opportunity for geographic comparisons (Mazurek et al., 2011).

Few differences in demographics or rehabilitation services were found when comparing rural and urban groups, and there were no differences in one-year outcomes measured.

The results suggest that, contrary to expectations, individuals with severe disabilities in rural areas had not necessarily experienced worse outcomes than those in urban areas, indicating potential improvements in access to services in rural areas (Mazurek et al.,

2011). Although a large majority of the current research showed access to treatment and services continues to be difficult and unequal, it is encouraging to see some improvements are being made, offering us hope for the future.

Ruff (2005) discussed advances achieved over the past two decades in understanding mild traumatic brain injury (MTBI). Research during the 1980s was focused more on severe TBI but during the 1990s, MTBI received quite a bit more

33 recognition. A significant advance in the diagnosis of MTBI was achieved when the

American Congress of Rehabilitation Medicine (ACRM) established diagnostic criteria for MTBI. The ACRM moved beyond the previous notion that MTBI should only be diagnosed if the patient had sustained definite loss of consciousness (LOC). Ruff (2005) also discussed that prior to this, most neurologists diagnosed a concussion only if LOC was observed. The ACRM definition, supported by ongoing research, led to the acceptance that LOC is not essential for diagnosing an MTBI and that posttraumatic amnesia (PTA) or neurological symptoms are sufficient to render a diagnosis.

The diagnostic criteria for MTBI established by the ACRM include any period of loss of consciousness for up to 30 minutes (which must result from external forces to the brain and not from drug-related or psychological reaction), any loss of memory for events immediately before and after the accident for as much as 24 hours, any alteration of mental state at the time of accident (dazed, disoriented, or confused), and focal neurological deficit(s) that may or may not be transient (Ruff, 2005). One year after the

ACRM definition was published, the fourth edition of Diagnostic and Statistical Manual of Mental Health (DSM-IV) included for the first time a set of criteria proposed for studying concussions further. It introduced three levels of severity within the MTBI spectrum. One level corresponds with the ACRM definition, one with the DSM-IV definition, and the third level bridges the two (Ruff, 2005). Advances in understandings such as these show that over the past two decades, knowledge has increased in understanding MTBI and the level of treatment people with MTBI need.

In another study, Scherer (2005) discussed how planning assistive technologies and other supports for individuals with cognitive disabilities requires comprehensive and individualized assessment of current goals, past experiences with the use of technologies, and the person’s predisposition to the use of alternative or additional supports. In this study, prior research identified the critical needs for an assessment process that would identify what influences the successful use of assistive technology and other supports for people with cognitive disabilities (Scherer, 2005). Results found that components of successful support result from a good match of device and support features, user goals and preferences, and environmental resources. As the number of assistive technology options increase, individualized interventions for people with cognitive disabilities will be easier to accomplish. Ruff (2005) also points out that the key to successful and optimal use of these products will be an appropriate and comprehensive assessment of consumer needs and preferences and the identification of additional accommodations and supports. Technologies forced on consumers that do not fit with their preferences or ways of doing things have a decreased probability of use. Moreover, technologies that minimize interactions with others or set up barriers to social activities go unused. The question today is no longer whether or not to incorporate technology into rehabilitation, but how best to do it.

Factors Leading to Successful Vocational Outcomes

Previous research on vocational rehabilitation after TBI suggested coaching and other services provided following job placement are particularly important for successful

35 work re-entry for people with TBI. Hart et al. (2010) developed a measure of the type, amount, and location of post-placement interventions. Treatment was measured prospectively for six months after job placement for 65 people with moderate to severe

TBI, treated at five TBI Model System (TBIMS) Centers. The sample was well educated, with 65% having attended at least some college. The majority was not only employed at the time of injury, but they were returning to pre-injury employers. People with TBI with more limited education and employment history may be at higher risk of chronic unemployment post injury, but may also have difficulty accessing vocational services (Hart et al., 2010).

Despite the stated importance of vocational re-entry after TBI and the high need for vocational help perceived by consumers, relatively few persons with TBI get help to find or maintain employment. Hart et al. (2010) stated that services provided after job placement are considered particularly crucial for people with TBI. This study measured the treatment components considered important by job coaches and other staff involved in vocational treatment of TBI, such as the development of cognitive compensatory strategies and counseling on emotional issues. A surprising degree of variation in the amount and types of interventions provided to study participants was found, and in the locations where treatments were delivered. Hart et al. (2010) also found the centers providing less intensive treatment (and less treatment at the workplace) also tended to serve less impaired clients much closer in time to the injury, and mostly returned them to pre-existing jobs rather than engaging in job development. Within centers, participants

36 who demonstrated worse cognitive speed prior to job placement tended to receive more treatment overall, and more treatment in both cognitive and emotional/interpersonal domains. For the average client, one center provided significantly more treatment days than two other centers. These findings suggested substantial differences and inconsistencies among the five TBIMS centers in the amount, types, and locations of services provided after job placement. Three-fourths of the sample group was still working at the placement job after six months but, longitudinally, only 27% were competitively employed at one year post-injury (Hart et al., 2010).

In a study by Wrona (2010), administrative records from the Washington State

Department of Labor and Industries (DLI) data were used to describe medical rehabilitation services and return to work (RTW) referrals for cases over five years. The data represented official records for disability determination and referral for VR services.

In the State of Washington, the DLI is the single payer of workers’ compensation benefits and has responsibility for the Washington State Industrial Insurance Fund. This state fund was created as a part of the legislation providing workers’ compensation benefits through employers in the state (Wrona, 2010). Medical impairment ratings by body part and function are used in the determination of permanent disability benefits. A single instance of TBI can include several bodily injuries, some of which may be permanent and others, temporary. All these considerations are involved in the final determination of disability benefits. Four mutually exclusive disability levels were used in reporting results in the Wrona (2010) study – no disability, temporary disability, permanent

37 disability, and fatal. Disabilities, whether permanent or temporary, are apparent within a week in 93% of cases. In this study, the median referral time was three months. There are three distinct rehabilitation trajectories – inpatient only, 26.5%; outpatient only,

54.6%; both, 13.9% of referred cases. Surgical procedures were performed during 81% of admissions. Only 48% of nonfatal TBI injuries included a medical rehabilitation phase. Medical rehabilitation included occupational, physical, speech, recreational, and functional evaluations. It was also found that most hospital stays for medical therapy ended with routine discharges.

Referrals for vocational services occurred using both RTW and VR systems in

32% of referred cases, a very low number. Given the importance of medical rehabilitation for all cases in model treatment programs, it is puzzling that only 48% of the treatment cohort received such services. Employment rate after referral for VR by workers’ compensation agencies was 65%. Wrona (2010) suggested that this high level of successful rehabilitation in workers’ compensation may be, in part, because RTW services like work hardening, work conditioning, and supported employment can be included in vocational interventions as long as they are instrumental in achieving the goal of the proposed intervention.

The purpose of a study by Soeker (2012) was to describe the methodology used to develop the Model of Occupational Self Efficacy, an occupational therapy practice model to facilitate returning to work after a BI. Occupational Self Efficacy is a process facilitated by the occupational therapist, encouraging building inner strength in the

38 individual with the TBI. This process enables individuals with TBI to develop a strong personal belief they can cope with various barriers or obstacles in their lives. They realize their autonomy by initiating tasks independently and in turn improve their self- esteem and self-confidence (Soeker, 2012). The process ultimately enables the individual with the BI to become a capable person through actively participating in tasks, which enhances his or her sense of accomplishment and competence in occupational roles.

Soeker (2012) used the International Classification of Functioning, Disability and

Health (ICF) as a framework for post-acute traumatically brain-injured patients. The most prevalent problems affecting individuals with BI in the components of Body

Functions, and Activities and Participation were identified. Problems regarding body function included deficits with temperament and personality functions, thought functions, sensations associated with hearing, vestibular functions, and making decisions (insight and initiation). Problems related to activities and participation restrictions included limitations in undertaking remunerative employment, driving, looking after one’s health, and participating in recreation and leisure activities.

Soeker (2012) also found that successful participation in the occupational role such as the worker role will improve his or her self-efficacy beliefs and ultimate health status. The brain-injured individual’s medical condition and impairments should therefore be assessed and treated to facilitate participation in purposeful occupations.

Four themes emerged during the study reflecting the experiences of people returning to work after a BI: (a) a sense of loss of former self, (b) uncertainty about the future, (c)

39 road to acceptance and believing in yourself, and (d) participation in occupation enabling growth. The themes contributed to the central concept called Occupational Self Efficacy that resulted in the development of the occupational therapy practice model (Soeker,

2012). This model was designed to be utilized in hospitals, rehabilitation agencies, work, and home environments. The model is applicable to clients who suffered a TBI classified as mild or moderate according to the GCS and can be generalized.

The authors found that multidisciplinary rehabilitation, work screening, transparency with employer, gradual return to work, assessment of the clients work skills, client involvement in rehabilitation, work assessment, ergonomic accessibility and entrepreneurship, assessment of the client’s multiple work skills, individual and family group support as a component of returning to work intervention, fostering self- determination, respectful interaction, and government support for the enhancement of one’s worker skills helped enable persons with TBI to return to work. Barriers of returning to work included delays in administration procedures and the disability grant process, poor networking between health professional and employer, and employer disrespect of employee’s rights to be accommodated in the workplace (Soeker, 2012).

Soeker, Rensburg, and Travill (2011) conducted a different study and pointed out most brain injuries occur at the time when people are aiming for vocational goals and acquiring the skills and values needed to achieve success. Poor return-to-work rates have been reported, specifically for patients with severe TBI. This study investigated a comprehensive neuro-rehabilitation programme (holistic cognitive program), which

40 consists of a post-acute intensive and interdisciplinary six-week rehabilitation program.

The holistic cognitive rehabilitation program is a typical program enabling individuals with BI to gain employment. Its three phases are holistic intervention focusing on general strategies to aid daily living, occupational trials in vocational placement, and support for the maintenance of employment. Supported employment programs provide assistance with job coaches, transportation, assistive technology, specialized job training, and tailored supervision (Soeker et al., 2011). The authors investigated these rehabilitation programs to determine if they enable clients to return to work.

Soeker et al. (2011) identified financial challenges and travel for services are of concern. Easy access to treatment facilities and open communication between health officials, employers, and individuals with BI positively contributed to the participants’ return to work. Assessments in the occupational therapy department assisted participants in determining whether they had the cognitive, physical, and psychological capacity needed to return to their previous or alternative job. Most of the participants in this study highlighted that the expense of treatment facilities limited their ability to access treatment. Soeker et al. (2011) also found that regarding VR programs, the participants believed these programs should not only focus on the assessment of the client’s work ability but also include the use of ergonomics when designing RTW programs. An emphasis on improving the client’s entrepreneurship skills was also made, as this would enable clients to create their own employment opportunities if they could not find a job.

Participants thought a support group would be extremely helpful when designing a rehabilitation program.

In a study by Matheson (2010), 62 adults with BI were referred for a work capacity evaluation. Developing a clear understanding of work-relevant functional limitations in the cognitive, emotional, and executive functions is made difficult by the common misperception that the intelligence quotient (IQ) is a good representation of intelligence. Past research has found IQ scores to be unrelated to the size of brain lesions and is considered an unreliable indicator of neuropathic determination. Thus, if one takes

IQ as an indicator of brain injury, the effects of the brain damage may be missed. A more recent term for impairment of the brain’s ability to integrate and synthesize information and experience resulting in functional limitations evidenced as behavioral disturbances is

“dysexecutive syndrome” (Matheson, 2010).

This study showed both executive dysfunction and IQ are related to severity of

TBI, but executive dysfunction and IQ are not related to each other. Both can be affected by BI, but the effects are relatively independent. Matheson (2010) also identified four components of executive dysfunction found among persons with work disability due to

TBI. The neuropsychological opinion in terms of the person’s ability to shift and refocus attention and transition to other activities, plan and organize tasks, organize material for tasks, and monitor task performance would certainly be helpful to rehabilitation professionals. Adding an instrument such as the Behavior Rating Inventory of Executive

Functioning (BRIEF) to a standard neuropsychological test battery would position the

42 neuropsychologist to provide improved direction to rehabilitation colleagues. The authors also found that going beyond highly structured neuropsychological tests or self- reports to assess work disability is important.

Van Velzen et al. (2011) described factors experienced by adults with moderate- to-severe acquired brain injury (ABI) as either limiting or facilitating during the process of RTW to further improve the VR process. Their sample participants included people with moderate to severe ABI admitted to and discharged from inpatient rehabilitation.

The groups were found at a Dutch Rehabilitation Center and there was a distinction between the three groups of people with ABI: (a) people with nontraumatic ABI who experience mainly physical problems, (b) people with nontraumatic ABI who experience mainly cognitive problems, and (c) people with traumatic ABI who could have experienced both physical and cognitive problems (Van Velzen et al., 2011).

From the interviews, it became clear that most participants experienced problems during their process of RTW. Only one subject reported hardly any problems. The factors mentioned were both internal (e.g., impairments of the upper or lower extremities) and external to the participants (e.g.,, lack of knowledge and support from employers, colleagues, and specialists) (Van Velzen et al., 2011). The most commonly mentioned limiting factor was tiredness. Participants stated they were not working or were working fewer hours and they needed a longer time to recover than before their injury because of tiredness. In turn, tiredness should be taken into account during the process of RTW.

Cantor et al. (2008) aimed to examine the relationships between post-TBI fatigue

(PTBIF) and comorbid conditions, participation in activities, quality of life, and demographic and injury variables. The participants consisted of 223 individuals with mild to severe TBI and 85 non-injured individuals in the control group. The authors found that fatigue was more severe and prevalent in individuals with TBI and more severe among women. PTBIF has significant impact on well-being and quality of life and cannot be accounted for by comorbid conditions alone, suggesting it is related to brain injury itself. It appears to be unrelated to demographic and injury variables other than gender. PTBIF does not limit the quantity and frequency of participation.

Van Velzen et al. (2011) found that another commonly mentioned limiting factor was the incomplete and slow recovery of the results of ABI. In most people the results of the ABI will always influence their working capacity. Not all participants were able to mention more than one facilitating factor. However, one factor was mentioned by all participants: the will to return to work. All participants stated they really wanted to return to work. Even those who were not able to return to work almost three years post- injury were still hoping to return to work in the future. However, Van Velzen et al.

(2011) also found those who experienced a quick and more complete recovery did return to work. Those for whom the recovery took a long time were less successful in returning to work. Finally, the knowledge and support of the employer, colleagues, occupational physician, and occupational specialist played an important role for most participants.

Those participants who returned to work more often reported the will of employer and

44 colleagues to cooperate and help during and after the process of RTW as facilitating.

Those who reported a lack of assistance from employer and colleagues were less likely to return to work. It can be important to inform and coach employers and colleagues during the process of vocational rehabilitation to make the process as successful as possible

(Van Velzen et al., 2011). All of the different aspects of ABI and recovery should be kept in mind during the process of vocational rehabilitation to make the outcome as successful as possible.

Summary

In summary, the literature reviewed confirms that due to an extended recovery period, finding and maintaining employment is an ongoing problem for persons with brain injury (BI). Access to services and treatment for people with BI is very important to have, but not always easy to come by. It has been found that clients and their families experience a lack of long-term inpatient and outpatient rehabilitation, as well as trouble accessing health care services. It has been found that acceptance rates into rehabilitation programs were higher for White and Pacific Islander clients, those who have received special education services, those who were widowed or never married, and for those referred by private and public educational institutions. Results showed that traumatic brain injury (TBI) patients lacking private insurance were 2.6 times more likely to participate in vocational rehabilitation, while older spinal cord injury (SCI) and TBI patients were about twice as likely to participate in vocational rehabilitation. Those who

45 lack valuable socio-economic resources and social support systems also had a higher chance of receiving these services.

Although gaining access to services is still difficult for those with TBI, there have been some improvements as well. It has been found that individuals with severe disabilities in rural areas had not necessarily experienced worse outcomes than those in urban areas, indicating potential improvements in access to services in rural areas. A significant advance in the diagnosis and understanding of TBI has also been achieved over the past two decades, and technology will play a huge part in the future. As the number of assistive technology options increase, individualized interventions for people with cognitive disabilities will be easier to accomplish. The question today is no longer whether or not to incorporate technology into rehabilitation, but how best to do it.

Research has shown which factors best lead to successful vocational outcomes and which ones do not. The International Classification of Functioning, Disability and

Health (ICF) has been used as a framework for post-acute traumatically brain-injured patients. The most prevalent problems that affected individuals with brain injury were found in body functions, and activities and participation. The brain-injured individual’s medical condition and impairments should, therefore, be assessed and treated to facilitate their participation in purposeful occupations. It was found that multidisciplinary rehabilitation, work screening, transparency with employer, gradual return to work, assessment of the client’s work skills, client involvement in rehabilitation, work assessment, ergonomic accessibility and entrepreneurship, individual and family group

46 support as a component of returning to work intervention, fostering self-determination, respectful interaction, and government support for the enhancement of one’s worker skills helped enable persons with TBI to return to work. Barriers of returning to work included delays in administration procedures and the disability grant process, poor networking between health professional and employer, and employers disrespecting employee rights to be accommodated in the workplace. The most common limiting factor was tiredness. Participants stated they were not working or were working fewer hours and they needed a longer time to recover than before their injury because of the tiredness. Tiredness should therefore be taken into account during the process of return to work. This literature review discussed experiences of care by clients and their families, access to services, outcome results from longitudinal studies, improvements in services, and factors that lead to successful vocational outcomes.

Chapter 3

METHODOLOGY

While volunteering at the Mercy Outpatient Rehabilitation Center (MORC) (also known by the Department of Rehabilitation as ‘Mercy TBI’), the author had the opportunity to work with speech therapists, neuropsychologists, physical therapists, and occupational therapists. The neuro-rehabilitation team also met regularly with

Department of Rehabilitation (DOR) counselors, Alta California Regional Center

(ACRC) service coordinators, and other professionals in the rehabilitation field, and it was there that the initial motivation for the project occurred. The author was able to learn their approach of RTW for job seekers with TBI. During a TBI Network meeting in

February 2012, a need was expressed for a BI resource directory for the whole state of

California. Rehabilitation counselors as well as other professionals are expected to know a great deal of information, yet are provided with few resources to help in this area (L.

Eaton, B. Westre, & E. Ratinoff, personal communication, February 16, 2012). They also said that clients do not always have an easy time accessing the services they need.

After hearing this conversation, it became clear to the author that the BI community/rehabilitation counselors need more resources and more information on TBI.

Furthermore, because it was stated counselors do not have enough time to attend trainings, the author would have to find a convenient way to bring this information to them.

In July 2012, the author began research for relevant materials for her project.

What she found was a great deal of written training, PowerPoint presentations, lectures, printed manuals, peer-reviewed journal articles, thesis projects, and handouts related to rehabilitation, BI, and RTW. The author realized the information collected as individual materials would benefit rehabilitation counselors and clients; however, she wondered how much more this information would help counselors if all the information was compiled in one place, such as a directory and electronic resource website.

In an attempt to find out if such a resource existed, the author spoke to Lynda

Eaton, the Client Services Liaison at the Mercy Traumatic Brain Injury Program. Ms.

Eaton explained there was not one place to find a multitude of BI resources of which she was aware, but such a resource, especially one that would save time and provide additional resources to what she already had, would definitely be utilized. The author also researched for such a resource. She did not come across one in her Internet search.

The closest the author saw was a resource directory done by the Brain Injury Association of California; the resources were mainly in Northern California, and the directory was not as comprehensive as the author of this project intended for her directory. She checked the Brain Injury Association of California website which carries only TBI information and resources for Northern California, showing the author a need for such a project.

In August 2012, while preparing for the literature review section of this project, the author researched peer-reviewed journals, library resources, EBSCO host, ERIC databases and a variety of Internet resources. Terms used to locate resources included

49 traumatic brain injury, employment, access to resources, vocational rehabilitation counseling, counselors, brain injury, stroke, treatment, job placement, and Department of

Rehabilitation. In addition, the author maintained structure of her project by utilizing the

Vocational Rehabilitation Counseling Masters Project Handbook. In addition to journals, some information was gathered through websites. Studies collected and examined varied in perspectives. Not only did they report on the lack of access to BI resources but they also reviewed the methods rehabilitation counselors have used to help individuals with TBI get back into the workforce. By completing the literature review, the author became knowledgeable and aware of the need for a handbook and electronic resource website of TBI information.

In January 2013, the author met with DOR counselors in several different offices or by telephone and inquired about what they felt was most needed while working with people with TBI. The author observed the underlying theme in their responses as the lack of accessibility to available resources and the wish to know more about TBI related to what is needed to help the individual return to work. There is an obvious lack of knowledge on the professional’s part and lack of resource accessibility. The author decided a handbook for counselors would also be useful so rehabilitation professionals will know everything they need to know about BI to help the person get back to work.

The author started working on the handbook by researching general information about

BI. She came across “Understanding Brain Injury: A Guide for the Family” by the Mayo

Clinic (2008). This manual explains the causes and types of brain injury, lists the

50 behavioral changes most common among people who sustain brain injuries, and offers simple techniques to use to help them deal with possible changes. The author found this very useful. She also searched the web and found a guide to starting a brain injury support group. The author also utilized information from textbooks, the Brain Injury

Association of California, and the Job Accommodation Network (2013) to compile a useful handbook for rehabilitation counselors.

Starting in April 2013, and continuing until the completion of this project, the author began researching and compiling web sources for the research directory. The web sources gained for the directory were collected through a variety of search engines. The search engines most commonly used included google.com (www.google.com) and

Google Scholar (www.scholar.google.com). Bing (www.bing.com), Info.com

(www.info.com), and others were used to maintain a variety of search results. The author searched to find the web sources that would be utilized in the directory, searching for resources by county. The author found this task challenging due to the fact that many sites and web sources view were not sufficient for what the author intended for this project. On many occasions, the web source was missing information so the author had to call the agencies to find out more. However, using the created criteria, the author was able to ensure the web’s sources used were current, consistent to rehabilitation literature, accessible, comprehensive, and, most importantly, useful for individuals with TBI and professionals who will be utilizing the website.

Throughout the entirety of the project, the author periodically met with Taryn

Smith and Eric Ratinoff. Mr. Ratinoff is a brain injury lawyer who first expressed the need for the California TBI resource directory and who is helping fund this project. The author met with Ms. Smith and Mr. Ratinoff periodically to update them on the progress of the project and discuss what other resources could be added to the directory.

Chapter 4

SUMMARY AND RECOMMENDATIONS

Summary

The purpose of this project was to develop a handbook for counselors and a resource directory (with resources throughout California) for individuals with BI, their family, and professionals who work with BI. Appendix A is the handbook for rehabilitation counselors and Appendix B is the resource directory of brain injury resources in California. Primary sources of information for Chapters 1 and 2 were obtained through Educational Resources Information Center (ERIC), a social service and rehabilitation database located on the CSUS library’s website. This author also explored

Internet resources for statistics and data. The author also went to the CSUS library to examine journal articles, such as articles from The Journal of Head Trauma

Rehabilitation.

After the author confirmed no other comprehensive California resource directory or handbook for counselors currently being utilized, she began the process of locating relevant materials and resources. Most materials were located through in-depth Internet search. The author searched by county and used key words such as traumatic brain injury, resources, and county. As resources from other counties came up, the author made sure to save those as well. Many resources were not relevant to the author’s search, so it took a long time to find adequate services. Information from some agencies was collected through conversations by phone and by pulling resources in smaller, pre-

53 existing directories. With all the data and resources collected, this author began assembling the materials and resources for both the handbook and resource directory.

The handbook is intended to provide rehabilitation counselors and other professionals the information they need to have more knowledge on BI and the methods that help get a person with TBI back to work. The resource directory mainly is intended for professionals helping people with BI, but it can be utilized by clients or anyone else looking for resources for BI. This includes family members, doctors, counselors, and caregivers. Rehabilitation counselors can utilize the resource directory to find services to benefit them and/or the clients with whom they work. The author intends to eventually add all the resources from the directory onto an electronic web site to ensure greater accessibility. It is this author’s belief that the combination of the handbook, resource directory, and electronic resource web site will be used as a tool to educate, network, gain skills, and present current up-to-date information to individuals with BI and those helping them.

Recommendations

It is recommended this Master’s Project be utilized as resources to assist counselors throughout their daily professional practice and to help clients (individuals with BI) find the services they need. This resource directory will save counselors and other rehabilitation professional’s time because everything they need will be in one place, and they will be able to avoid the hassle of web searching. Counselors will be able to use the handbook to gain knowledge of skills and strategies needed in their daily work and

54 professional practice. In addition, the handbook and directory have the potential to provide training to counselors and other professionals.

As previously mentioned, at the completion of the project, the directory and handbook will be put onto a website. Because the rehabilitation literature is constantly changing, it is recommended the website be maintained and updated on a regular and ongoing basis. The effectiveness and utility of this resource for counselors are unknown, as the handbook and directory have yet to be distributed amongst rehabilitation professionals. Another recommendation is that an evaluation of the handbook and resource directory be conducted by rehabilitation counselors to learn more about its effectiveness and any improvements that can be made. The recommendation for the use of this resource is, that once distributed to the community, it be presented to rehabilitation counselors at their quarterly meetings. The hope is these resources will provide a stepping stone toward more counselor awareness and knowledge of individuals with BI, and how to provide them with the resources and help they need to get back to work. On a larger scale, the researcher plans to distribute this resource to agencies such as the

Department of Rehabilitation, PRIDE Industries, and to Mercy’s brain injury program so that all professionals, clients, and family members will have the opportunity to gain access to a resource to increase continual awareness of TBI. Lastly, assistive aids for the person with TBI might also be further explored in the future, as these areas are very important to the reintegration of individuals with TBI into the community at large, and will get better as technology continues to advance.

APPENDICES

APPENDIX A

Traumatic Brain Injury: A Handbook

for Counselors

TABLE OF CONTENTS

INTRODUCTION ...... 58

Part I: What is a Brain Injury? ...... 59 -- Structure and Function of the Human Brain ...... 59 -- Types and Causes of Brain Injury ...... 59 -- Process of Brain Injury Recovery ...... 61

Part II: Changes after a Brain Injury ...... 63 -- Behavior, Memory and Thinking Problems After Brain Injury ...... 63 -- Communication Changes after Brain Injury ...... 67 -- Perceptual Changes after Brain Injury ...... 69 -- Emotional Changes after Brain Injury...... 71 -- Impact of Fatigue after Brain Injury...... 73 -- Seizures after Brain Injury ...... 73 -- Driving after Brain Injury ...... 74

Part III: Life after a Brain Injury ...... 76 -- Going Home ...... 76 -- Relationships ...... 76 -- Sexuality ...... 76 -- Returning to School ...... 77 -- Recreation and Leisure ...... 78 -- Use of Alcohol and Drugs ...... 78 -- Activity Restrictions ...... 79

Part IV: Returning to Work after a Brain Injury ...... 80 -- Factors Affecting Return to Work ...... 80 -- Functional Limitations ...... 80 -- Rehabilitation Outcomes ...... 84 -- Factors Affecting Outcome ...... 84 -- Vocational Rehabilitation and Placement ...... 85 -- Ticket to Work ...... 86 -- Accommodations ...... 87 -- A Partnership Approach ...... 91

Part V: How to Start a Brain Injury Support Group ...... 92 -- What is a Support Group? ...... 92 -- Support Group Contact Log ...... 94 -- The First Meeting ...... 96 -- How to Keep a Group Going ...... 96 -- Basic Guidelines for Support Groups ...... 97 -- Brain Injury Support Group Questionnaire ...... 99 -- Future of the Group ...... 100

INTRODUCTION

Thousands of people with brain injury enter the workforce each year. Returning to work is a goal that drives most survivors of brain injury through the long and difficult rehabilitation process. However, when they finally achieve this goal they often have difficulty adjusting to workplace expectations. Brain injury is a life-altering event affecting virtually every area of a person’s life, including work; yet merely simple adjustments in the work environment can help the person with a brain injury be successful on the job.

The purpose of this handbook is to help rehabilitation counselors become more familiar with traumatic brain injury (TBI) so they can successfully help people with brain injury return to work. This handbook covers causes and types of brain injury, types of common changes among people who sustain brain injuries, and offers simple techniques to help them deal with the possible changes. Also, the handbook discusses how to start a brain injury support group. The handbook concludes with accommodations for an employee with a brain injury. The effort put forth by rehabilitation counselors can make a tremendous difference to clients with brain injuries and their success in the workforce.

The information in this handbook was drawn from a variety of sources. The Traumatic Brain Injury Survivors Network Development Project (www.tbisn.org), Mayo Clinic’s “Understanding Brain Injury: A Guide for the Family”, the book Medical, Psychosocial, and Vocational Aspects of Disability (Brodwin, Tellez, & Brodwin, 2009), the Brain Injury Association of California, and the Job Accommodation Network (JAN; 2014) all contributed to the information provided in this handbook.

Part I: What is a Brain Injury?

Structure and Function of the Human Brain

The human brain is composed of billions of nerve cells, arranged in patterns working together to control thought, emotion, behavior, movement, and sensation. Knowing something about the brain’s structure and function is useful for a better understanding. The brain is divided into two halves looking nearly the same but differing in many functions. These halves are called the cerebral hemispheres and consist of right and left hemispheres. The hemispheres are further divided into four separate areas called lobes.

For most people, the left half of the brain controls verbal functions, including language, thought, and memory involving words. The right half controls nonverbal functions, including the recognition of differences in visual patterns and designs, reading maps, and enjoying music. The right hemisphere also is involved in expressing and understanding emotions.

Although each half of the brain has distinct functions, the two parts work closely together in a special way to control body activity. The left side of the brain controls the right side of the body, and the right side of the brain may cause movement problems or weakness on the left side of the body. Specific parts of the brain control specific functions. The effect of a brain injury is partially determined by the injury’s location.

Types and Causes of Brain Injury

What causes a traumatic brain injury?

When an outside force strikes the head, damage to the brain and skull protecting the brain may result. The outside force could be a blow to the head caused by an automobile accident or fall. The initial response to this trauma may vary. The injured person may feel slightly dazed or may lose consciousness for several minutes, hours, or even days. The strength of the outside force is important in determining how serious the injury is to the skull and brain.

Direction of the outside force is also important in determining the extent of brain injury. When the head is struck from the front, back, or sides, the brain is quickly thrust forward and then again backward against the inside of the skull, causing localized brain damage in the area of the initial impact, on the opposite side of the skull, or in both places. Bleeding may occur on both sides. This type of injury is called a coup-contrecoup injury. Localized brain injury also can be caused by a fracture of the skull, or when an object enters the head and damages brain tissue in its path. When the head is struck at an angle and rotates, nerve cells in many areas of the brain can be stretched simultaneously, leading to much more widespread damage. This is known as diffuse axonal injury, which can occur without fracture or penetration of the skull. TBI can result in a combination of both localized and diffuse damage to the brain.

What are other causes of brain injury?

Not all brain injuries are a result of outside forces; therefore, not all brain injuries are TBIs. A change in flow of blood within the brain can cause brain damage. A blocked or burst blood vessel or lack of oxygen to the brain can damage brain cells. Swelling of brain tissue after such an occurrence can result in further damage. Strokes, aneurysms, and tumors are examples of other causes of brain injury.

Other causes of brain injury may include:

Acquired brain injury – Refers to medical conditions occurring in the brain (usually following birth), changing its function. Such conditions include stroke, TBI, brain hemorrhage, tumor, anoxia, and other non-degenerative diseases of the brain.

Aneurysm – Ballooning of a weakened wall of a vein, artery, or the heart

Anoxia – Lack of oxygen to brain tissue, damaging cells

Concussion – Temporary disturbance of brain function resulting from fall or blow jarring the brain within the skull, also called mild TBI

Contusion – Injury on the brain’s surface, similar to a bruise

Edema – Swelling caused by more-than-normal fluid in brain tissue. With pressure buildup, edema can also result in brain cell damage and blood flow interruption

Encephalitis – Potentially life-threatening infection or inflammation of the brain

Hematoma – Pooled blood inside the brain tissue or on its surface. With pressure buildup, hematomas can result in brain cell damage and blood flow interruption

Hemorrhage – Profuse bleeding (internal or external) caused by damage to a blood vessel

Meningitis – Infection and inflammation of central nervous system affecting membranes and cerebrospinal fluid surrounding brain and spinal cord

Skull fracture – Break in the skull (bone that covers brain)

Stroke – Interruption of blood flow to part of the brain caused by an artery blockage, hemorrhage, or aneurysm. Decreased blood flow results in little or no oxygen reaching brain cells

Tumor – Abnormal growth or tissue appearing normal, but with no function. The tumor may be malignant (cancerous) or benign (non-cancerous)

Process of Brain Injury Recovery

Recovery may be measured in weeks, months, and years and slows with the passage of time. The effects of brain injury often are long-lasting and recovery may be incomplete. Although some people with severe brain injuries experience only mild long-term difficulties, others may require care or special services for the rest of their lives.

In the first few weeks after a brain injury, swelling, bleeding, or changes in brain chemistry often affect the function of healthy brain tissue. The injured person’s eyes may remain closed and the person might not show signs of awareness. As swelling decreases and blood flow and brain chemistry improve, brain function usually improves. With time, the person’s eyes may open, sleep-wake cycles may begin, and the injured person may follow commands, respond to family members, and speak. A period of confusion and disorientation often follows, during which the person’s ability to pay attention and learn stops and agitation, nervousness, restlessness, or frustration may appear. Sleeping patterns may be disrupted. Overreaction to stimulation and physical aggression may result. This stage can be disturbing for family because the person behaves uncharacteristically.

Inconsistent behavior is also common. Some days are better than others. A person may begin to follow a command (lift your leg, squeeze my finger) and then not demonstrate this behavior again for a time. This stage of recovery may last days or even weeks. However, once demonstrated, a behavior usually reappears. In this stage of recovery, try not to become anxious about inconsistent signs of progress. Ups and downs are normal. Family and friends can help by creating a calm, quiet environment (for example, limiting the number of people in the person’s room, turning off the television, and dimming the lights). In addition, ask questions of the clinical nurse specialist and others on the healthcare team responsible for keeping you accurately informed. You are encouraged to ask questions to stay abreast of your loved one’s progress.

What happens in the brain during the later stages of recovery is not clear, but some parts of the recovery process are slowly beginning to be understood. Recovery from brain injury does not mean replacement of destroyed brain tissue. There is no known way for the brain to create new cells. However, many things can occur to help restore surviving brain tissue to its best possible function. Although the total number of brain cells does not change, it is thought that surviving brain tissue has the capacity to gradually learn how to carry on some of the functions of destroyed cells.

Depending on the nature of the brain injury, some people only need regular follow-up appointments with a healthcare provider. Others receive therapy, tests, and monitoring on an outpatient basis. Still others begin treatment in an intensive care unit (ICU) or a general hospital unit and may be transferred later to a rehabilitation unit. After they leave the hospital, therapy as an outpatient may continue. During the early weeks after injury, treatment focuses on stabilizing the person’s physical condition, preventing complications such as pneumonia and blood clots, and addressing medical issues such as removing blood or other fluid buildup to reduce swelling and pressure in the brain.

When the healthcare team determines the person with brain injury is ready, the rehabilitation process can begin. Rehabilitation encourages the body’s natural healing process through: -- Stimulation and enhancing physical and thinking abilities -- Teaching new techniques to compensate for lost physical, thinking (cognitive) and behavioral skills

As cognitive and physical abilities progress, the focus shifts to improving attention span and mobility; coping with memory and thinking problems; and increasing strengthening, balance, and range of motion exercises. Community outings to practice skills learned in the hospital may be included. How much and what rehabilitation therapy the person with brain injury receives depend on factors such as level of awareness, other injuries such as fractures, the need for rest, and the ability to participate in therapy.

Key Points:

-- Recovery from a brain injury is a process that takes time -- Various treatment options and coping strategies can help life gradually feel “normal” again -- Most adults with brain injury progress through common recovery stages -- Length and outcome of each stage cannot be predicted -- During recovery, a person may shift back and forth between stages -- Inconsistency is common -- A broad range of therapy, testing, and other treatment options are available to help people after brain injury -- Treatment for brain injury is tailored to meet individual needs -- Members of the healthcare team determine when the rehabilitation process will begin

Part II: Changes after a Brain Injury

Behavior, Memory and Thinking Problems After Brain Injury

Brain injury can disturb: -- Alertness and concentration -- Self-awareness -- Perception -- Memory and learning -- Reasoning, planning, and problem-solving -- Speech and language -- Motor control -- Emotions

The following information will help familiarize the counselor with behavior, memory, and thinking problems a person with brain injury may experience. Also included are specific techniques a counselor can use to help the client participate more effectively and comfortably in the work environment. Consistent and frequent repetition of the specific techniques listed will increase the chance of success for the client. Also, the following describes the signs/symptoms of clients and how the rehabilitation counselor can help with those symptoms.

Confusion

Signs: -- Confuses times/tasks in schedule of activities -- Confuses past and present events -- Confabulates (makes up convincing stories to fill memory gaps; not intentional lying)

What to do: -- Encourage use of a notebook to log events and encourage the client to refer to the notebook for details of daily events -- Gently remind client of correct details of past and present events -- Confirm accurate information with other people -- Arrange for consistency in routine tasks (such as using a calendar and notebook) -- Limit changes in daily routine -- Provide detailed explanations of even the most basic changes in policies or procedures

Difficulty Remembering

Signs: -- Unable to remember tasks from day to day -- Unable to remember new information

What to do: -- Establish structured routine of daily tasks

-- Encourage consistent use of memory aids such as calculators and notebooks to plan, record, and check off tasks as completed -- Encourage person to write down new information in memory notebook -- When client finds a job, encourage co-workers also to write down any information they may need to provide the person -- Encourage review and rehearsal of memory notebook information frequently throughout the day -- Provide opportunities for repeated practice of new information -- Try to pair new information with things the client can recall -- Provide spoken cues as needed for recall and, if necessary, help fill in memory gaps

Attention Problems

Signs: -- Short attention span -- Distractibility -- Difficulty attending to one or more things at one time

What to do: -- Have client focus on one task at a time -- Be sure you have client’s attention before beginning discussion or task -- Decrease distractions when working with person (turn off noises). -- Praise any improvement in length of attention to activity -- Gently refocus person’s attention to details of activity as needed -- Keep abrupt changes to minimum -- Ask client to repeat information just heard to be sure the conversation was followed

Difficulty with Decision Making – Poor Judgment

Signs: -- Hesitation with decisions -- Inappropriate and potentially harmful decisions -- Difficulty reasoning -- Ineffective problem solving

What to do: -- Encourage client to “stop and think.” Many people with brain injury benefit from a note or a stop sign on the front of their notebook reminding them to “stop and think.” -- Help client explore various options to problems -- Have client write down possible options in his or her notebook -- Discuss advantages/disadvantages of each option -- Role play to prepare discussion for various situations

Difficulty with Initiation

Signs: -- Has trouble getting started -- Appears disinterested or unmotivated

What to do: -- Help client develop structured daily routine -- Provide specific choices for daily tasks. “Would you like to do A or B?” -- Simplify tasks, breaking them down into simple steps; have client complete one step at a time -- Encourage use of a notebook or calendar and set specific deadlines for tasks to be completed -- Praise individual when getting started without assistance -- Establish time frame in which the client is expected to accomplish tasks

Difficulty Carrying Out a Plan of Action

Signs: -- Lack of follow-through with task -- Difficulty in planning sequence of tasks -- Appears disorganized

What to do: -- Begin with small, realistic projects -- Include client in planning the activity -- Provide clear and detailed explanation of activity before starting -- Break down new or complex tasks into several easier steps -- Have client write down sequence of steps for the task -- Ask client to repeat the task to ensure understanding -- Encourage client to refer to his or her plan, and check off each step and task as completed -- Repeat and explain sequence of activities as needed. -- Allow extra time for client to complete tasks

Difficulty with Self-Control – Impulsivity or Lack of Inhibition

Signs: -- Acts or speaks without all the information or without considering consequences -- Impulsiveness or poor judgment -- Inappropriate comments to or about others -- Gets stuck on one idea

What to do: -- Limit client’s options -- Suggest alternatives for behavior -- Explain reasons for tasks -- Be fair in expectations -- Respond immediately to inappropriate ideas but maintain discussion’s original focus

-- Encourage client to slow down and think through tasks and responses -- Provide verbal and nonverbal feedback in supportive way for reassurance -- If undesired behavior occurs, discuss consequences privately in calm and confident manner -- Praise and reward desired behavior

Impaired Self-Awareness

Signs: -- Lack of awareness of deficits and limitations -- Inaccurate self-image/self-perception

What to do: -- Anticipate lack of insight -- Prompt accurate self-statements -- Use feedback generously in a positive way. -- Give realistic feedback as you observe client behavior

Difficulty with Social Situations

Signs: -- Acting or speaking without all the information or without considering consequences -- Difficulty taking turns -- Socially inappropriate behavior or comments -- Not always sensitive to social boundaries

What to do: -- Provide clear expectations for desirable behavior -- Treat client appropriately for his or her age -- Plan and rehearse social interactions for the client to be familiar, predictable, and consistent -- Establish verbal and nonverbal cues to signal client to “stop and think” -- Encourage client to slow down and think through responses -- Prompt client to consider consequences of his or her behavior -- Provide positive feedback for appropriate behavior -- Encourage a break in activity when frustration is evident -- Respond immediately to inappropriate ideas but maintain discussion’s original focus -- If undesired behavior occurs, address behavior and consequences privately in calm and confident manner. Be objective, explaining the behavior, not the client, is inappropriate -- Reassure and be fair in your expectations

Difficulty Controlling Emotions

Signs: -- Mood swings ranging from anxious to sad to angry -- Inappropriate laughing or crying -- Lower tolerance for frustrating situations

What to do: -- Expect the unexpected -- Remain model of calm assurance and confidence if emotional outburst occurs -- Provide feedback in a gentle supportive manner after individual regains control -- Avoid comparing past with present behaviors -- Gently redirect behavior to different topic or activity -- Use humor in positive and supportive manner -- Recognize the client may use negative comments or refusal as means of control -- Understand brain injury often prevents individual from feeling guilt or empathy -- Recognize your own emotional reactions to person with brain injury

Communication Changes after a Brain Injury

A brain injury can affect the way the client communicates. Difficulties with communication can be caused by many different factors, including changes in behavior and thinking skills, problem solving, judgment, reasoning, awareness, memory loss, and self-awareness. Language ability and speech may also be affected by brain injury. Through language, a client receives and expresses ideas. Language is linked to cognition (thinking ability) and involves understanding, talking, reading, and writing. Clients with brain injury may have changes in one or many of these areas, affecting the way they communicate. The severity and combination of problems vary from one person to the next.

Initiating Conversation

Signs: -- Does not respond to another person’s conversation, questions, or comments -- Does not start, or is slow to start conversations, ask questions, or make comments -- Leaves long pauses -- Has difficulty explaining what he or she means

What to do: - Encourage individual to participate. “What do you think about that?” -- Ask open-ended questions. “Tell me about .” -- Give client time to organize thoughts. The client may need extra time to respond to any request or question -- Give individual your full attention, allowing time for him or her to complete the thought -- Rephrase what the client said, such as “Do you mean ?”

Following Conversation

Signs: -- Has difficulty paying attention to what is said -- Misinterprets what is said

What to do: -- Get client’s attention before speaking -- Be clear and concise -- Reduce distractions -- Emphasize important information -- Offer to repeat what was said -- Ask him or her to look at you when speaking -- Invite client to ask questions if he or she does not understand

Taking Turns in Conversation

Signs: -- Talks non-stop, does not give listener turn to speak -- Does not appear to adjust communication style or behavior to the situation

What to do: -- Politely interrupt and ask client for chance to speak -- Ask client to please keep it brief or tell client you would like to say something

Dealing with Topics

Signs: -- Has hard time selecting topics for conversation -- Has hard time keeping up when topics change -- Introduces new topic abruptly -- Does not always stay on topic

What to do: -- Ask about client’s interests and opinions -- Clarify new topics as they arise -- Ask how his or her comment relates to topic. “Do you mean ?” -- Tell person you are confused or “getting lost” in conversation

Intelligibility

Signs: -- Slurred speech --Speaks too loudly or softly, making it hard to understand message -- Speaks too rapidly

What to do: -- Tell client you did not understand common nonverbal cues -- Establish and use consistent gestures or cues, such as cupping your hand to your ear as a reminder to speak

Nonverbal Communication

Signs: -- Does not seem to understand common nonverbal cues -- Stands too close or too far from conversational partner(s) -- Uncomfortable number/type of physical contacts -- Body language does not seem to match what is said -- Facial expressions do not seem to match what is said -- Distracting, repetitive, or excessive body movements -- Poor eye contact -- Stares at others during conversation

What to do: -- Ask the client to maintain comfortable distance -- Politely ask individual to modify physical contacts and explain physical contacts make you feel uncomfortable -- Tell client you are confused by difference in body language and spoken message -- Ask client what he or she is feeling -- Politely ask individual to stop distracting movements

Perceptual Changes after Brain Injury

Perception is the brain’s ability to gather and make sense of information. Perceptual changes may cause people with brain injury not to realize what they feel, see or hear, even though their senses of touch, sight, and hearing are fine. Perceptual changes may impair the ability to judge distance, size, position, and speed of movement. Perceptual changes following brain injury can be temporary or permanent. The following information is intended to help identify perceptual changes and how to adapt to them.

Unilateral Neglect

Signs: -- Bumps into objects on affected side -- Turns head toward unaffected side -- Ignores food on side of plate on affected side -- Fails to dress affected side of body -- Forgets to bathe or attend to other hygiene tasks on affected side -- Applies makeup only to one side of the face -- Jabs eye on affected side when putting on glasses

What to do: -- Ask visitors to stand on affected side to encourage person to look toward affected side -- Position bright objects on affected side, performing this “visual cueing” only when person is alert and not tired

Visual Field Cut

Signs: -- Suddenly notices objects -- Bumps into object on affected side -- Turns head to unaffected side -- Cannot see food on side of plate on affected side -- Loses track of last location on page where the person was reading or writing -- When reading, cuts words in half and cannot be understood

What to do: -- Remind client to look around environment, especially on affected side -- Position bright objects or favorite things to affected side and ask client to turn head until objects are spotted

Apraxia

Signs: -- Uses objects incorrectly, using toothbrush, for example, to comb hair or fork to eat soup -- Fails to follow spoken directions due to inability to understand or do what is asked, not giving “thumbs up” sign, for example, when asked -- Puts clothes on backward, upside-down, or inside-out

What to do: -- Stop client from continuing task the wrong way -- Show client what to do by demonstrating position or movement

Spatial Relations

Signs: -- Mistakes chair location when sitting down -- Has difficulty finding items in cluttered room -- Has trouble using fork or spoon to pick up food from plate -- Misjudges distance, as in missing cup when pouring coffee -- Misjudges space between steps when going up or down stairs -- Reaches too far or not far enough for objects -- Stands too close or too far away from others in social situations

What to do: -- Limit clutter: keep home drawers organized and neat -- Keep items used often in same location -- Provide cues with words or pictures -- Remind that handrails should be used when available -- Encourage using both hands to feel objects -- Provide gentile reminders, such as asking person to move when standing too close or too far away

Emotional Changes after Brain Injury

A brain injury can affect brain areas controlling emotions. Common emotional problems for a person with brain injury and suggested ways to help are as follows.

Difficulty Controlling Emotions

Signs: -- Mood swings ranging from anxious to sad to angry -- Inappropriate laughing or crying -- Lower tolerance for frustrating situations

What to do: -- Expect the unexpected -- Remain model of calm assurance and confidence if emotional outburst occurs -- Take client to a quiet room or area for time to calm down and regain control -- Provide feedback gently and supportively after person regains control -- Avoid comparing past with present behaviors -- Gently redirect behavior to different topic or activity -- Recognize the client may use negative comments or refusal as means of control -- Understand brain injury often prevents individual from feeling guilt or empathy -- Recognize your emotional reactions to the client with brain injury

Intermittent Distress (comes and goes)

Signs: -- Unhappiness and irritability -- Cries easily -- Responds angrily for no apparent reason

What to do: -- Acknowledge feelings -- Give client chance to talk about feelings -- Listen and express desire to understand those feelings -- Encourage behaviors that helped cope with stress in the past

Grief

Signs: -- Tearfulness -- Restless sleep -- Change in appetite

What to do: -- Remind client grief is healthy and normal response -- Explain coming to terms with loss of some abilities may take time

-- Offer whatever support you can provide -- Seek guidance from member of health-care team

Depression

Feelings of sadness, frustration, and loss are common after a brain injury. Such feelings often appear during the later stages of recovery, when confusion decreases and self-awareness improves. If these feelings become overwhelming or interfere with recovery, the client may be suffering from depression. It is important for counselors to understand these feelings. Depression can arise as the person struggles to adjust to temporary or lasting disability caused by a brain injury. Depression also may occur if the injury affected areas of the brain controlling emotions. Being depressed is not a sign of weakness and is not anyone’s fault. Depression is an illness; one cannot get over depression simply by wishing it away, using more willpower, or “toughing up.” Depression after brain injury may result from biochemical and structural changes in the brain. Fortunately, medication and other therapies can help most people who have depression.

These are symptoms of depression: -- Persistent sadness -- Irritability, moodiness -- Anxiety -- Loss of interest or pleasure in life -- Neglect of personal responsibilities or personal care -- Changes in eating habits or sleeping patterns -- Fatigue, loss of energy, lack of motivation -- Extreme mood changes -- Feeling helpless, worthless, or hopeless -- Physical symptoms such as headaches or chronic pain that do not improve -- Withdrawal from others -- Thoughts of death or suicide

Self-esteem

Self-esteem is a person’s assessment of self-worth and is often adversely affected by brain injury. A problem may be more significant if the person with brain injury has had a mild to moderate injury or a severe injury with good self-awareness. The more aware the person with brain injury is, the more likely are changes in self-esteem.

What to do: -- Focus on positives -- Allow client to express feelings -- When necessary, redirect conversation to positive or neutral thoughts -- Express concern and desire to understand client’s feelings -- Point out the client’s successes, even partial successes -- Encourage as much independence as possible -- Do not criticize -- Give caring, realistic feedback

-- Help client plan ahead to maximize opportunities for success -- Choose activities and tasks the client can successfully complete

Impact of Fatigue after Brain Injury

How does fatigue impact employment?

An often-overlooked element of recovery from brain injury is fatigue, which may result from brain injury itself and other injuries associated with brain injury. Because activities that once were performed with little or no effort may now require great amounts of energy, a person with brain injury may experience an overwhelming sense of tiredness. This fatigue may directly impact work performance by making physical functioning, attention, concentration, memory, and communication more difficult.

When a person with brain injury returns to work, knowing how much he or she should do and for how long is difficult. Many individuals return to work with little understanding of how their brain injury will affect work performance. They may try to return too quickly and take on too much responsibility too soon. When this happens, despite dedicated effort, the client’s attempt may prove unsuccessful. To provide the greatest chance for success, many employees return to their former positions with medical restrictions, given to reduce fatigue and improve chances for a successful return to work. Restrictions may include a temporary reduction in working hours and workload. Often restrictions are accompanied by guidelines for gradually increasing work hours and responsibilities.

In time, a client’s stamina and energy level likely will improve and work hours and responsibilities may be increased. However, during this transitional time, employers and employees often become frustrated with the gradual pace and shift in responsibility. It is important to remember this is just one step in the recovery process for a person with brain injury. A supportive work environment with open communication between employee and supervisor will go a long way to promote healthy performance gains and reduce employment setbacks.

Seizures after Brain Injury

Post-traumatic epilepsy (seizures) is a medical condition that may occur after brain injury. Seizures can be caused by a sudden, excessive, disorderly electrical discharge of brain cell activity. The risk of ongoing seizures is related to the severity and characteristics of the injury. The risk seems to be greatest in the first two years after brain injury and then gradually declines. Up to 10% of people with TBI have ongoing seizures. The two types of seizures that may occur after brain injury are generalized (grand mal, tonic/clonic) and partial (partial complex and simple partial) seizures.

Generalized Seizures

Grand mal, tonic/clonic seizures usually involve involuntary jerking or shaking of most or all four limbs, unresponsiveness, and loss of bladder control. Most seizures are self-limited and last only a few minutes. The person may cry out, stiffen and fall, have jerking movements, turn flushed or blue, and have difficulty breathing. Try to remain calm and take the following steps: 1. Make sure the person is in a safe area and put something soft under the head if the person has fallen 2. Loosen tight clothing such as necktie or belt and remove glasses 3. Clear away any hazardous objects nearby 4. Place person on his or her side keeping chin away from chest to allow drainage of saliva from mouth 5. Do not force fingers or any object into person’s mouth 6. Do not restrain the person as you cannot stop the seizure

After the seizure, the person usually will be temporarily confused and drowsy. Do not offer any food, drink or medication until the person is fully awake. Someone should stay with the person until he or she has fully recovered. Check for a medical identification tag on a bracelet or necklace. Until a set seizure-free interval has been maintained (usually six months to one year), driving privileges are restricted by state law. During this time, extreme caution should be taken if the employee will be working around heavy or dangerous equipment.

Partial Seizures

Partial complex seizures may involve loss of awareness, inappropriate verbal response, purposeless movement, starting or repetitive chewing, swallowing, or lip-smacking motions. Simple partial seizures are an involuntary jerking or shaking of one part of the body without loss of consciousness. These may spread to other body parts and become generalized. Follow the same procedures as above to handle this situation.

Medical assistance generally is not necessary when partial seizures occur except when one seizure follows another in a continuous series or when a partial seizure develops into a generalized seizure and the person is not recovering.

Driving after Brain Injury

A person with a brain injury may have physical, thinking, perceptual, or vision impairments, or seizures making driving unsafe. Driving laws vary from state to state. In some cases, the person with brain injury may be required to pass written and behind-the-wheel driving examinations before resuming driving. The privilege of driving may be restricted or revoked temporarily, or in some cases even permanently. Talk with your loved one’s health-care provider if you have questions about his or her driving ability.

People with brain injury are responsible for their decision to drive and for any consequences that may result. In addition, the same problems that make driving unsafe can also make other

75 activities unsafe for individuals with brain injury. An example of another potentially unsafe activity is operating power equipment.

Part III: Life after a Brain Injury

Illness or injury to a client affects the whole family and those helping them, including rehabilitation counselors. If the illness is chronic, family roles, routines, and responsibilities may be interrupted or changed. Take a few minutes to identify how the roles in the client’s family have changed. What new responsibilities has he or she added to their daily routine? How have the changes affected the client’s life? It is important for counselors to consider changes in the client’s life and how that will affect him or her. Family support and relationships play a huge role in the client’s life after a brain injury.

Going Home

The process of rehabilitation begins in the hospital and continues at home. Outpatient therapy usually lasts considerably longer than inpatient therapy. Members of the health-care team will develop rehabilitation goals optimizing abilities of the person with brain injury. Having realistic goals and expectations of you as a professional and the client with a brain injury is important throughout the recovery process. Be available to help the client and family with adjustments to life at home after a brain injury.

Relationships

The family of the client with a brain injury may need to provide, in addition to physical care, companionship and emotional support for their loved one. Caregivers also may have many other responsibilities, including employment outside the home and caring for the home and children. Being a caregiver can be overwhelming, and suddenly being cared for can be hard for the client. Rehabilitation counselors should be available as support during this transition.

Appropriate community-based social support can help lessen stress and loneliness for both caregivers and client. Many community-based social support groups and centers for independent living can help make connections with other people with similar concerns and needs, and rehabilitation counselors can make referrals to these groups.

Sexuality

After a brain injury, the ability to appropriately express learned behaviors may be lost. The adult with brain injury may not understand when it is appropriate to kiss, hug, and touch other people.

Talking about feelings with a member of the rehabilitation team or someone he or she trusts may help the client. Although discussing sexual matters at first may feel uncomfortable, rehabilitation team members are expected to counsel the client on these feelings. The goals of rehabilitation for the person with brain injury include independence, self-reliance, and healthy personal relationships. The ability to develop and maintain social relationships is one of the most important measures of successful rehabilitation. Therefore, recognizing and discussing concerns about love and sex are important. Rehabilitation counselors are one of many resources for support in addressing sexual issues and concerns.

Returning to School

For children and teenagers, returning to school is important for social and educational growth. At school, in addition to learning, young people find friends and peer support and develop social skills. School also provides a place to monitor children’s intellectual and social growth. Sometimes the effects of a brain injury are not initially apparent in young children but become more noticeable later when thinking and social demands increase at school. School systems have special programs to help students with disabilities return to school. Most schools have trained special educators. However, not all special educators are familiar with the needs of people with brain injury.

In some states, a brain injury educational consultant is available through the Office of Special Education. This consultant will help special educators in local schools to assess and provide services to students with brain injuries. If someone who specializes in education after brain injury is not available through the school system, members of the rehabilitation team often consult with schools and help local educators develop an educational plan to meet the injured student’s academic needs.

For those returning to high school and college, developing specific accommodations can help the person with brain injury be successful in school. In most colleges, an office for students with disabilities assists in assuring that teachers provide such accommodations.

Some common accommodations to assist learning are:

-- Extra time for tests to compensate for slowed thinking or information processing --Tests given privately in distraction-free environment to accommodate difficulties with attention, concentration, and increased distractibility --Placement in classrooms with less noise and distractions --Tape-recording lectures to compensate for attention, concentration and memory problems --Access to teachers’ or peers’ class notes to compensate for difficulty in dividing attention between listening to lecture and taking notes --Assignments provided in writing to compensate for memory and concentration problems --Providing a place to rest or take breaks to compensate for fatigue and increasing frustration --Tutoring with peer or professional

In many cases, parents and family members become advocates who assure that the student with brain injury receives the necessary services to successfully return to school. Parents and family members also serve as go-betweens to make sure rehabilitation professionals and school personnel meet to develop a plan for successful return to school. Members of the brain rehabilitation team are prepared to assist parents and families in these efforts and to acquaint them with resources available through the school system and state government.

Recreation and Leisure

Participation in meaningful leisure experiences is essential to the recovery of the person with a brain injury. Most people naturally select activities they enjoy and help them meet some basic needs.

People with brain injuries may face barriers to experiencing this kind of fulfillment, including:

-- Attitude (some people may not realize the importance of leisure activities) -- Physical disability (they may no longer be able to enjoy the activities they once did) -- Lack of cognitive skills (skills needed to participate in some activities such as attention, concentration, initiation, planning, and problem solving may be impaired) -- Interruption of social and /or language skills -- Lack of knowledge (some may not know how to engage in certain leisure activities or how to adapt them so they can participate)

Rehabilitation counselors and families can help by:

-- Helping the person identify leisure interests -- Assisting with structuring time and daily schedules so leisure balances with necessary tasks and activities -- Planning ahead for recreation to keep life interesting -- Investigating community resources (city parks/recreation departments, libraries, churches, and other avenues for leisure options)

Through leisure, basic human needs are met, including:

-- Feeling good about themselves -- Being part of a group -- Experiencing success -- Laughing and having fun (reducing stress) -- Developing useful skills -- Developing friendships -- Strengthening social relationships

Use of Alcohol and Drugs

A brain injury can affect how people think and manage emotions. If a person with brain injury drinks excessive alcohol, or uses illicit drugs or prescription drugs in excess, the substances can further interfere with thought processes and result in serious damage to cells and nerves in the brain. Consequently, the effects of brain injury worsen. Counselors and family members play an important role in helping the person with a brain injury comply with physician recommendations about using alcohol and drugs.

To provide support, the client’s support team must:

-- Help motivate the person to lead an alcohol-free and drug-free lifestyle -- Rehearse ways to avoid or react differently to such situations so that future abuse can be prevented

Alcohol and drugs can trigger seizures and disturb:

-- Alertness and concentration -- Self-awareness -- Perception -- Memory and learning -- Reasoning, planning, and problem-solving -- Judgment -- Speech and language -- Motor control -- Emotions -- Social interactions or social behavior -- Motivation

Rehabilitation professionals strongly recommend that a person with brain injury avoid drugs or medications if recommended by a physician, including alcohol and cigarettes. A rehabilitation psychologist, social worker, or chemical dependency specialist can help assess whether a drug or alcohol problem exists.

Activity Restrictions

For safety, the health-care team may recommend activity restrictions. Avoiding additional brain injury is especially important. When to return to certain activities will depend on the health-care provider’s recommendations and factors such as the person’s balance, strength, reaction time, and judgment. The health-care provider may recommend the person not participate for a time in contact sports such as football or hockey or other activities that risk another brain injury, such as driving, using power equipment, climbing, rollerblading, downhill skiing, snowmobiling, or riding a bicycle or horse.

For safety, be sure the person:

-- Follows activity restrictions specified by the healthcare provider -- Is encouraged to wear a helmet if participating in sports or activities for which a helmet is available

Part IV: Returning to Work after Brain Injury

Can a person return to work after a brain injury? The answer depends on the person and the extent of the injury. A brain injury can cause many changes in behavior, emotions, communication, and thinking skills. Keeping a job may be difficult, even the same job held prior to the injury. Regardless of whether the person with a brain injury returns to work, discovering how best to use talents will make life more rewarding. Paid employment or volunteer or leisure activities may be options. Work plays a major role in most people’s lives. Work provides a sense of achievement, recognition, responsibility, financial independence, social interaction, and structure. Those who return to work after brain injury are generally healthier and have a higher self-esteem than those who do not.

Factors Affecting Return to Work

Returning to work after a brain injury depends on:

-- Availability of jobs -- Health -- Desire to work -- Physical abilities -- Ability to adjust to changes -- Social and behavioral abilities such as control of behaviors and getting along with co-workers -- Thinking and problem-solving abilities -- Self-awareness of deficits and limitations -- Vocational interests and capabilities -- Willingness to receive further training -- Willingness of employer to adapt the job or workplace to the injured person

Some state agencies can help people with disabilities reach their vocational goals, with a major role played by the rehabilitation counselor. The agencies’ services may include physical and vocational evaluations, training, help with assistive devices, transportation, and finding jobs. The client works with the rehabilitation team to determine what employment is the best fit for him or her. Returning to work after a brain injury can be challenging and rewarding. Interests, aptitudes, and financial options must be considered. The rehabilitation team will make every effort to help the injured person regain or develop the job skills needed.

Functional Limitations

The brain is such a crucial organ performing a wide variety of necessary functions, and injury to the brain causes a host of deficits. No one survivor is likely to exhibit all the functional limitations described below. Severity of injury and location of injury vary, as do resulting cognitive deficits. Even the number of locations of injury and severity at those locations are not necessarily determinative of functional outcome. Impairment of life processes related to deficits also depends on the client’s personal lifestyle and career demands. The description of deficits

81 below is helpful in understanding potential consequences of TBI; each client must be assessed for the particular injuries and resulting deficits.

Physical – Balance difficulties, fatigue, pain, hemiparesis, uneven gait, ataxia, apraxia, decreased motor speed, seizure disorders, sensory deficits

Cognitive – Impairments in attention/concentration, memory, visual or auditory perceptual processing, verbal reasoning, critical thinking/logic, language, awareness

Psychosocial – Personality changes, emotional lability, flat affect, depression, substance abuse, frustration intolerance, impulsivity/dis-inhibition, lack of initiative

Physical

Traumatic events such as automotive accidents and falls may result in physical impairments such as immobility caused by bone fractures), unrelated to the brain. There also may be physical consequences resulting directly from the brain injury, as described below:

Balance: Many people have difficulty with balance and coordination immediately following injury. In some, dizziness and unsteadiness are permanent conditions. Special retraining programs exist for these problems. Fatigue: For several reasons, extreme mental and physical fatigue is common after TBI, as are sleep disorders. It has been found that over half of patients with mild to severe TBI reported insomnia symptoms. Tasks formerly easy may become far more mentally challenging and, consequently, physically exhausting. Four hours of concentrated activity, for example, may necessitate several hours of rest. Some persons are poor at judging their physical limitations and struggle to gradually ease into school and work patterns without taking on too many responsibilities. Pain: Individuals with TBI frequently report headaches and may have sensitivity to pain. Those with concussions often have neck and back pain and require ergonomically correct workstations to reduce pain. Hemiparesis: As each side of the body is controlled by the opposite side of the brain, injury to the motor strip of one hemisphere affects movements on the opposite side of the body. For example, the left side of the body may be paralyzed because the right hemisphere was injured. Although a leg or arm may not itself be injured, the brain may not be able to control that leg or arm properly, resulting in dysfunctions of movement. Other Disorders of Movement: Any permanent impairment of movement caused by the inability of the brain to control the extremities. The individual experiences impaired gait, ataxia (jerky movements), apraxia (uncontrolled movements), muscle spasticity, tremors, and impaired small motor control. Decreased Motor Speed: Many people feel as though they are moving in slow motion. Their brain signals travel at a slower pace; all tasks take longer. These individuals appear to have a few seconds’ delay between when they decide to move and carry out the planned action. Seizure Activity (Traumatic Epilepsy): Following TBI, recurrent seizures are possible (17% of all cases). Most of those who experience seizures have their first seizure within 24 hours of injury. Usually, seizures are controllable with anti-convulsive medication. For the rare individual,

82 however, continuing seizures may provide the greatest obstacle to rehabilitation and, in some cases, cognitive skills progressively decline after each seizure.

Cognitive

Repeated mild TBIs occurring over an extended period (i.e., months and even years) can result in cumulative neurological and cognitive deficits, while repeated mild TBIs occurring within a short period (i.e., hours, days or weeks) can be catastrophic or fetal. People with TBI are likely to need assistance to perform activities of daily living. TBI can cause epilepsy and increases the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other disorders affecting the brain. Cognitive deficits are divided into some common classification that draws exclusively upon a single, distinct skill. Almost every activity involves two or more of the cognitive skills described below:

Attention/Concentration and Arousal: Some persons with TBI find it difficult to focus attention and maintain attention on a task. Persons may have difficulty becoming sufficiently aroused (i.e., alert) to focus on a specific activity, and may have a shortened attention span for activities that should capture their concentration. Some may be unable to shift mental tasks (alternation attention) or follow multi-step directions. Many tasks involve divided attention, such as driving, requiring a person to concentrate on steering while also obeying speed limits, monitoring other drivers, and perhaps navigating a new route, all while listening to the radio and having a conversation. Not surprisingly, driving is often impossible after TBI. Memory: Television shows and movies about persons with TBI usually depict memory loss as the chief cognitive deficit of TBI. These media depictions are misleading both in their narrow focus on memory loss and their dramatizing the type of memory loss that occurs. While memory loss among persons with TBI is common, the type of loss depicted in the media (where the person awakens from a coma and needs to be informed about events that have occurred) is uncommon. Retrospective amnesia (long-term memory loss), the inability to remember all that happened before the injury, seldom occurs. Far more common is anterograde amnesia (short-term memory loss). For example, many persons cannot remember new information, such as what they had for breakfast that same morning. Individuals may have prospective amnesia (inability to remember future plans). Some persons cannot keep track of their appointments, remember where to write the appointments, and remember to look at the planning guide with regular frequency. Intensive training may be necessary to establish what will become vital organizational habits. Perception/Visual Processing: Some persons have problems with spatial orientation. They get lost in a parking lot, going home or to work, or even in their own home environment. These individuals can lose the ability to deal with smaller-scale spatial relations as well. For example, they may find themselves unable to figure out which container is an appropriate size for storing leftovers or may have difficulty wrapping gifts. They struggle with visual field cuts, in which a large portion of their visual field is missing. Consequently, persons with TBI have to learn techniques to take in whole fields of information. Sensory Deficits: Other sensory deficits include visual processing difficulties (e.g., neglect of one side of the visual field), photosensitivity (sensitivity to light), loss of hearing, and loss of the senses of smell or taste. Verbal Reasoning: Many persons have problems understanding conversations. They cannot identify the main idea of written or spoken communication, distinguish relevant from irrelevant

83 details, detect similarities and differences, or understand analogies. They struggle to organize ideas, important papers, and their lives. Many have difficulty paying bills, even if sufficient funds are available, because of organizational or comprehension difficulties. Critical Thinking/Logic: One individual with TBI might declare an inability to return to work despite having received a medical clearance. Another may attempt to return to work without recognizing the presence of severe cognitive deficits. Judgment and the ability to process information accurately with consistency and speed can be impaired. Inability to make decisions is an additional area of impairment. Language: It is common for persons with TBI to have communicative disturbances (aphasia), which can take several forms. Individuals may have difficulty expressing thoughts (expressive aphasia), such as having word-finding problems. One might say, “that thing you write with” to communicate the word “pen.” Other speech problems stem from physical impairments including unclear speech when the person has decreased control of the muscles in lips, tongue, and jaw or because he or she has developed poor breathing patterns. The individual may produce excess saliva that gets in the way of clear speech. Dysarthria, where motor function interferes with correct formation of sounds, produces slurred speech, extremely difficult to understand. In addition, some persons have problems understanding others (receptive aphasia). They have difficulty understanding expressions or signs other people use or find they are unable to understand meanings of words. For example, some cannot discern humor or anger from a person’s tone of voice. Unawareness: Anosognosia is failure to recognize one’s own impairment. Three factors have been found to underlie lack of awareness of deficit following TBI: (a) diminished awareness of deficits secondary to impaired cognition, especially memory and reasoning deficits; (b) psychological reaction and denial of deficits; and (c) a relatively “pure” inability to recognize areas of impaired functioning as a direct consequence of brain injury. Self-awareness is most impaired for activities that have a significant cognitive and socioeconomic component, and is least impaired for basic activities of daily living. Self-awareness improves significantly during the first year after injury.

Psychosocial

Various psychological, behavioral, and emotional changes are common following TBI. The most frequent Axis I diagnoses are major depression and select anxiety disorders. Rates of resolution are similar for individuals regardless of their previous psychiatric histories. Major depression and substance abuse disorders are more likely to be a result of TBI than anxiety disorders. These conditions and others of a psychosocial nature are discussed below.

Personality Changes: TBI frequently exacerbates negative pre-injury personality characteristics. Someone with a short temper now has angry emotional outbursts. One adult daughter said of her father after his TBI, “He’s Dad, just more Dad.” A man who was formerly self-confident is now annoyingly arrogant and critical of others. Conversely, family members often report that the shy have become outgoing, and vice versa. A common complaint of family members after TBI is that the survivor has become intensely egocentric. It may become impossible for a conversation to occur without the survivor turning it into a conversation about self.

Emotional Lability: Heightened emotional responses or reactions are common. Some feel unable to control mood swings from moment to moment. They laugh or cry for no apparent reason and at inappropriate times. Flat Affect: Some survivors show complete lack of emotions. For example, they report a sense of puzzlement they neither feel elation at happy times nor anxiety in stressful times. The individual may have a rational awareness that emotion is warranted in a given situation yet be incapable of feeling or expressing emotions. Depression: Major depression is present in about 40% of individuals who were hospitalized for TBI. TBI may be accompanied by loss of defining personality traits, career, status, income, relationships, or feelings of competency. It is understandable that depression is a risk for any person aware of all these losses. Persons with TBI have a high divorce rate, lose many of their friends, and suffer family estrangements. They discover that, after the initial burst of rapid rehabilitation gains following their awakening from coma, progress levels off. Some deficits are temporary while others are permanent. Consequences of TBI have emotional costs not only for the person injured but also for families. Persistent and high levels of emotional distress, including depression and anxiety, have been documented in family members as well as the client. Decreased Frustration Tolerance: After TBI, persons may become frustrated more easily than before their injuries. They may realize particular tasks on which they are working seem elementary. They could competently perform the activities before injury, yet post-injury they are unable to perform them or with their former ease. They may have to depend on substantial compensatory strategies to do many activities they once performed readily. Under either circumstance, they behave inappropriately or aggressively. Some struggle with increased irritability and impatience, have reduced tolerance to stress, and are inflexible. Impulsivity/Disinhibition: We all have many thoughts each day we do not express, or urges on which we do not act. The frontal lobes within the brain keep us from acting on these ideas. Without this check system, people with TBI may ask inappropriate personal questions of coworkers, make inappropriate sexual advances, touch others inappropriately, act in an unsuitable aggressive manner, or make prejudicial and racist remarks. Lack of Initiative: Some individuals with brain injury lack initiative, even if they once possessed it. This effect, like impulsivity/disinhibition, is common with frontal lobe injuries. Such persons may be content to watch television all day and respond to most stimuli with apathy. Other Emotional Responses: Sometimes TBI survivors experience sexual difficulties, denial of disability, anxiety, agitation, anger, isolation, and dependence. They may be unable or unwilling to assume responsibility for their actions

Rehabilitation Outcomes

It is difficult to know when an individual has reached maximum recovery and improvement. Many physicians believe the outer limits for continued functional improvement are between six months and one to two years following TBI. Nonetheless, cognitive retraining has produced successes as long as 20 years post-injury. Findings indicate outcomes over the first five years following discharge from inpatient rehabilitation programs are dynamic, with most improvements seen during the first two years.

Factors Affecting Outcome

A variety of factors affect outcome. Severity of injury is the strongest predictor of recovery. Professionals working with TBI survivors measure severity of injury using several methods. First, TBI experts use length of coma to predict outcomes. According to studies, the longer the coma, the worse the outcome. Second, duration of post-traumatic amnesia is used to predict outcomes. The longer it takes to start remembering daily events, the more negative the outcome. Unfortunately, some people never regain ability to remember daily events.

Age correlates positively with outcomes. Among adults, the older a person is at time of injury, the worse the outcome. Consequences of TBI worsen with age and severity of brain injury. Researchers have determined that a higher pre-injury educational level correlates with better outcomes. Most persons with TBI have difficulty learning new information but a good portion of pre-injury knowledge and skills can be left intact. Persons well educated before injury frequently need to learn new ways to organize and access their previous knowledge and cognitive skills. A final predictor of good outcome is pre-injury work history. Those with poor work histories before their injuries are likely to have even greater problems post-injury.

Vocational Rehabilitation and Placement

Outcomes after TBI vary widely. Some with TBI recover fully and return to their former routines. Others are able to learn compensatory strategies and to perform modified versions of their former routines; others retrain for new occupations. Still others require structured work settings or find volunteer positions. Unfortunately, some return home to nonproductive lives.

For some with severe brain injuries, it seems clear a reasonable rehabilitation long-term goal is supported employment or volunteer work designed to increase life activity. Others with TBI are able to return to some form of work. Supported employment programs have been addressed, and promoting the effective use of compensatory strategies at the job site for individuals with TBI (through supported employment programs) has been shown to be effective. This approach has three main components: (a) assessment of residual skills, (b) identification of potentially effective compensatory strategies through situational assessment, and (c) incorporation of compensatory strategies into on-the-job training. Self-awareness is essential for succeeding in employment. Characteristics of supported employment able to promote a successful return to work include: community placement and integration, competitive hiring and wages, zero exclusion policy, holistic assessment, emphasis on choice and job matching, intervention after placement, co- worker and employer education, long-term follow along, job completion guarantee, and intensive ongoing analysis of program outcomes.

A number of projects over the last 20 years have shown that supported employment services can make a dramatic difference for people with TBI to get and keep jobs. However, funding for supported employment services is often not available, because many people in the U.S. do not understand TBI. People fail to appreciate that TBI weakens people's skills and that, for the price of relatively inexpensive supported employment services, people with TBI can be given the boost they need to get work and contribute to society in ways that more than offset the cost of these

86 services.

Because the disability is not visible and often misunderstood, the employer and the TBI survivor must cooperate to work out appropriate accommodations. The employee may need written instructions from the employer or may need to be assigned only one or a few tasks at a time. The employer must know the employee’s strengths and limitations. For example, a mechanic may still be able to diagnose what is wrong with an automotive engine by listening to it and observing its functioning, even though the person can no longer reassemble the engine after diagnosing and fixing the problem part. An attorney might be able to assist with legal strategizing, but unable to remember what steps were taken or which forms were filed with the court. Persons who process information slowly take longer to perform assigned tasks. Some employers can work around this deficit but not if impulsivity makes accuracy poor. In turn, persons with TBI need to be trained to work more slowly when accuracy is essential.

Individuals whose TBI has caused them to lose their inhibitions often struggle to return to work successfully. Most jobs require working with others. Impulsive sexual remarks, racial slurs, and low frustration tolerance are not the characteristics of those who succeed in most employment contexts. While employers can usually work around many memory and other cognitive problems, they are rarely willing to deal with obnoxious behavior. Job coaching helps in these situations. Some persons with TBI require this type of support permanently to retain employment.

State Vocational Rehabilitation Services

Each state has an agency to help people with disabilities find work. These state Vocational Rehabilitation (VR) services have different names in different states. All are funded in part by the federal and state governments. People disabled by TBI are entitled to apply for VR. In California, the California Department of Rehabilitation and the VA’s Vocational Rehabilitation and Employment (VR&E) are the most common VRs used by individuals with brain injury. The first obstacle clients must overcome in accessing state VR services is that the individuals must have severe enough disabilities to require services. State VR agencies are required to serve people with the most severe disabilities first. VR agencies may have order of selection criteria to make sure they serve those with the most need. If a question about severity of disability interferes with accessing VR services, evaluations by a rehabilitation specialist and neuropsychologist are usually helpful in proving impairments resulting from BI are severe and extensive enough to meet criteria for admission to VR services. Once they are qualified for services, VR counselors with experience working with people with BI best serve people this population. Experienced counselors know and use a number of special procedures critical for success in VR with people with BI. The person with brain injury, their significant others, or other advocates will need to help the VR counselor understand the special needs of people with brain injury.

Ticket to Work

The Ticket to Work and Self-Sufficiency Program is an employment program for people with disabilities interested in going to work. The Ticket program is part of the Ticket to Work and Work Incentives Improvement Act of 1999, legislation designed to remove many of the barriers that previously influenced people’s decisions about going to work because of concerns over

87 losing healthcare coverage. The Ticket to Work goal is to increase opportunities and choices for Social Security disability beneficiaries to obtain employment, vocational rehabilitation (VR), and other support services for employment. Under this program, the Social Security Administration (SSA) provides disability beneficiaries with a Ticket for use to obtain employment services from organizations called Employment Networks (ENs). The Ticket represents fees to an EN for services. The Ticket program is flexible and voluntary. SSA beneficiaries are not mandated to participate. In most cases, ENs can choose which services they want to provide, and to whom. Beneficiaries receiving Tickets can contact one or more ENs to discuss services. Once an agreement between beneficiary and EN is reached, the two work together to develop a plan to help the beneficiary reach his or her employment goal. The beneficiary can assign the Ticket to whatever agency he or she chooses.

Each state has a Benefits Planning, Assistance, and Outreach (BPAO) program that helps Social Security beneficiaries with disabilities make informed choices about work. The BPAO programs provide work incentives planning and assistance. Another offshoot of the Ticket program is a new service, called Ticket to Hire, developed with the Department of Labor to help employers locate and recruit skilled employment candidates with disabilities. Ticket to Hire is a free national referral service for employers to recruit workers from the Ticket to Work program.

Accommodations

Employers are required by the Americans with Disabilities Act (ADA) to provide reasonable accommodations to help any employee with a disability achieve vocational success. A job accommodation is an adjustment or modification of a job, job site, or manner of performing a job. The accommodation may help a person with disabilities to better perform essential job functions, increase productivity, or be independent in completing tasks. This can be a simple and inexpensive process. One such accommodation for a worker with a brain injury could be providing the person with a notebook to write down important information to compensate for memory deficits. The Job Accommodation Network (JAN) discusses accommodations and ADA compliances for brain injuries. The following is information provided by JAN:

Are TBI disabilities under the ADA?

The ADA does not list medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. Therefore, some people with TBIs will have a disability under the ADA and some will not. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment.

Are employees (or applicants) with TBIs required to disclose their disability to their employers?

No. Employees need only disclose their disability if/when they need an accommodation to perform the essential functions of the job. Applicants never have to disclose a disability on a job application or in the job interview unless they need an accommodation to assist them in the application or interview process.

Can an employer ask an employee with TBI to submit to a medical examination?

Yes, if the need for the medical examination is job-related and consistent with business necessity. Pre-job offer medical examinations or inquiries are illegal under the ADA. People with brain injuries (or any disability) do not have to submit to a medical exam or answer any medical questions until after they have been conditionally offered a job.

Accommodating Employees with TBIs

People with TBIs may develop some of the limitations discussed below, but seldom develop all. The degree of limitation will vary among individuals. Be aware not all people with TBIs will need accommodations to perform their jobs and many others may only need a few. The following is only a sample of possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider: 1. What limitations is the employee with a TBI experiencing? 2. How do these limitations affect the employee and the employee’s job performance? 3. What specific job tasks are problematic as a result of these limitations? 4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations? 5. Has the employee with a TBI been consulted regarding possible accommodations? 6. Once accommodations are in place, would it be useful to meet with the employee with a TBI to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed? 7. Do supervisory personnel and employees need training regarding TBIs?

Physical Limitations:

• Install ramps, handrails, and provide handicap parking spaces • Install lever-style door handles • Clear travel pathways of unnecessary equipment and furniture

Visual Problems:

• Provide written information in large print • Change fluorescent lights to high-intensity white lights • Increase natural lighting • Provide a glare guard for computer monitors • Consult a vision specialist particularly with someone who has lost part of or all vision

Maintaining Stamina During the Workday:

• Permit flexible scheduling; allow longer or more frequent work breaks • Provide additional time to learn new responsibilities • Provide self-paced workload

• Provide backup coverage for when the employee needs to take breaks • Allow for time off for counseling • Allow for use of supportive employment and job coaches • Allow employee to work from home during part of the day • Provide for job-sharing opportunities • Allow part-time work schedules

Maintaining Concentration:

• Reduce distractions in work area • Provide space enclosures or private office • Allow for use of white noise or environmental sound machines • Allow employee to play soothing music using cassette player and headset • Increase natural lighting or provide full spectrum lighting • Reduce clutter in employee’s work environment • Plan for uninterrupted work time • Divide large assignments into smaller tasks and steps • Restructure job to include only essential functions

Difficulty Staying Organized and Meeting Deadlines:

• Make daily TO-DO lists and check items off as they are completed • Use several calendars to mark meetings and deadlines • Remind employee of important deadlines via memos or e-mail or weekly supervision • Use watch or pager with timer capability • Use electronic organizers • Divide large assignments into smaller tasks and steps • Assign a mentor to assist employee in determining goals and provide daily guidance • Schedule weekly meetings with supervisor, manager, or mentor to determine if goals are being met

Memory Deficits:

• Allow employee to tape-record meetings • Provide typewritten minutes of each meeting • Use notebooks, calendars, or sticky notes to record information for easy retrieval • Provide written as well as verbal instructions • Allow additional training time • Provide written checklists and use color-coding to help identify items • Post instructions close to frequently used equipment

Problem-Solving Deficits:

• Provide picture diagrams of problem-solving techniques, e.g., flow charts • Restructure the job to include only essential functions • Assign a supervisor, manager, or mentor when employee has questions

Working Effectively with Supervisors:

• Provide positive praise and reinforcement • Provide written job instructions • Write clear expectations of responsibilities and consequences of not meeting them • Allow for open communication with managers and supervisors • Establish written long-term and short-term goals • Develop strategies to deal with problems before they arise • Provide written work agreements • Develop a procedure to evaluate effectiveness of accommodation

Difficulty Handling Stress and Emotions:

• Provide praise and positive reinforcement • Refer to counseling and employee assistance programs • Allow telephone calls during work hours to doctors and others for needed support • Provide sensitivity training to coworkers • Allow the employee to take a break as part of a stress management plan

Attendance Issues:

• Provide flexible leave for health problems • Provide a self-paced workload and flexible hours • Allow employee to work from home • Provide part-time work schedule

Issues of Change:

• Recognize that a change in office environment or of supervisors may be difficult for a person with a brain injury • Maintain open channels of communication between the employee and new and old supervisor to ensure an effective transition • Provide weekly or monthly meetings with employee to discuss workplace issues and production levels

Numerous products can be used to accommodate people with limitations. JAN's Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar is designed to let users explore various accommodation options. Many product vendor lists are accessible through this system and, upon request, JAN provides the lists and many more that are unavailable on the Web site. Contact JAN directly with any specific accommodation situations, or are looking for products, need vendor information, or seek a referral.

A Partnership Approach

Problems of thinking and behavior can emerge as a result of brain injury. It is important to recognize and understand the source of these problems is the injury to specific parts of the brain. After experiencing brain injury, a person may feel a loss of control in many aspects of life. This person may feel inferior or unequal in work situations. When working with a person with a brain injury, it is important to emphasize a partnership approach to negotiating thinking and behavior problems. This means acting as partners in the decision-making process by working together to determine how to solve a problem. The rehabilitation counselor and the client can work together as partners by following these tips:

1. Prepare plan of action -- The counselor should involve the person with brain injury in planning -- Define responsibilities in writing -- Use compensation tools such as calendars and notebooks through the planning phase

2. Keep it simple -- Break the task into small steps. Clarify the responsibilities of both counselor and client, and what is expected from each to complete tasks -- Keep the environment free of distractions. In an office setting, counselor and client should meet in a quiet room with phones turned off and free of interruptions

3. Use problem-solving format -- Recognize there is a problem -- Define the problem -- Decide on possible solutions to the problem -- Weigh advantages and disadvantages of each possible solution -- Pick solution based on most effective methods for brain injury -- Try solution -- Evaluate success of the solution -- Try another solution if the first is not working

4. Maintain open communication -- Discuss performance and job expectations -- Evaluate performance and provide gentle, realistic comments about behavior -- Identify successes and address areas of concern or problems directly without delay

Part V: How to Start a Brain Injury Support Group

The Traumatic Brain Injury Survivors Network Development Project. Project STAR at Charlotte Institute of Rehabilitation, Tacoma Brain Injury Support Group and People First of Washington (www.tbisn.org) developed a guide to start a local brain injury support group. The mission of the Traumatic Brain Injury Survivors Network Development Project is to create groups for those with TBIs. They are to credit for the following information on how to start a TBI support group.

What is a Support Group?

A support group offers the opportunity to share information and support one another in an environment of empathy and understanding. Often the best solutions can be found from others in like situations. Difficulties and emotions can be discussed freely without judgment and new friendships can be forged. After an illness or injury, getting on with life is often not as simple as one would imagine, especially if that injury or illness leaves the individual with lifelong impairments. This is especially true with brain injury. Both the individual and family often struggle to adjust to the life changes resulting from the brain injury. Getting information and services can often be a maze of confusing and conflicting situations, which can lead to frustration. Rehabilitation counselors can start a support group for their clients, to provide a much needed service to the client with brain injury (www.tbisn.org).

It is not uncommon for friends to disengage and extended family to become less involved in day- to-day activities. The family and individual with the injury can become more and more isolated. As social contacts dwindle, so does the opportunity to interact with others. Few outlets exist for dealing with the emotional aspects of lifestyle changes created by the illness or injury. Questions often remain unanswered, and the feeling of being alone in the situation intensifies. Individuals often want education or would like to educate others about brain injury. Rehabilitation counselors most often hold support groups at their place of work. Support group members can work together to educate the community on brain injury issues (www.tbisn.org).

Does our community need a support group? If so, how do I start one?

The first step in forming a support group is to determine the need. A need is present when two or more persons would benefit from sharing information and empathy. Almost everyone knows or knows of someone who has sustained a brain injury. Ask friends and relatives if they know of persons who may be interested. See if any clients would benefit from a support group. Once you have compiled a list of people who may be interested in the support group, contact the persons you have learned about or ask that they contact you. If even one other person expresses interest, you have established a need.

With the need established, and the first few participants lined up, you are well on your way to becoming an active support group and it is time to start putting the elements in place to make the group a reality. It is important to remember that support groups vary from one to another. Each group will form its own unique characteristics as it takes shape, so encourage others to offer ideas and perspectives (www.tbisn.org).

Finding a location for the support group meetings: Where do we look?

Finding a location for the group to meet is the next step in forming the support group. While estimating what participation level your group will reach is impossible, it is best to assume that participation will grow. Finding a location that will accommodate growth is important. Usually, finding a facility or organization that will offer free meeting space is not difficult. Wheelchair accessibility and being easy to locate are also important factors to consider. If the group is facilitated by a rehabilitation counselor, Department of Rehabilitation or Veterans Affairs offices are good locations for support groups (www.tbisn.org).

How do we let people know about the support group?

One of the most important steps in the process of starting a group is to identify ways to get the information to those who may be interested. Following are some suggestions to help advertise your support group. Contact other counselors and staff in the rehabilitation field to see if they know people who would benefit from the support group, and have the counselor refer them. The facilitator needs to decide if he or she wants the group to consist of only clients or have it open to the public. If the counselor wants the group open to the public, professionals in the intent area should be notified to start a support group. Professionals can include physicians, therapists, nursing agencies, health and human service providers, and organizations. You can contact these professionals by writing a letter and stating the intent to establish the support group, the purpose of the group, and location of meetings, if that has been determined. Ask that they refer any patients who may benefit from the group. Again, be sure to include complete contact information (www.tbisn.org).

Organization is important at this stage. Create a list from all of the contacts you receive so when the first meeting is scheduled you can contact those who expressed interest. Start a mailing and phone contact list you can add to as you receive calls from those who are interested. The following page presents a sample contact log. When a person who is interested in the group contacts you, ask questions to help you understand any specific needs of the caller, such as what meeting times would be best, special interest information and their needs. Make sure the contact information is complete so you can contact them (www.tbisn.org).

Get your groups involved in the community. Do such things as food drives; helping the elderly several times a year, and cleaning a park. Get other community groups to network with yours. Try to have a web presence, as a lot of people find things through the web. An online social network is a great way for people to connect. Be creative. One of the most important things to have a fulfilling life is to be involved in meaningful activities, which is the most important benefit the group facilitator offers in helping clients and their families build their life back or maintain their life. Facilitators also help the client in finding a new job (www.tbisn.org).

Support Group Contact Log

Name: Home phone: ______Cell phone: ______Address: Preferred meeting schedule: ______Day: ______Time: ______City/State: ______Zip: ______Interest: Email: ______I would like to help organize the group: Special interest: Other information: ______

The First Meeting

How should it be conducted?

The first meeting should be informational, allowing for introductions of the individuals who attend and exploring participants’ needs. Note that a support group will be defined by the dynamics of the individual members. As the organizer or facilitator, you will need to take notes and listen carefully to ideas and issues discussed. This will help you steer future meetings toward fulfilling those needs. Allow the group to develop naturally to meet the needs of the participants. As primary organizer, be prepared to lead and facilitate the meeting (www.tbisn.org).

How to Keep a Group Going

The following tips are helpful when organizing the group: --As people arrive, ask them to sign the sign-in sheet and introduce fist-time visitors to group members. This will encourage conversation. --Nametags should be used so that you will be able to address each person by name when talking or making introductions. Nametags also encourage group members to become acquainted and create a sense of belonging, essential in a support group. --Have any handouts or materials prepared in advance of the meeting. They can be placed on each seat in advance so early arrivals can review them. Note that you are drawing together strangers and each person has a different comfort zone. Some will socialize immediately while others will sit quietly and look through any available materials. --Open the meeting by introducing yourself to the group, presenting a brief personal overview. It is appropriate and necessary that you share openly and honestly whatever life situations led you to start the group. This may serve as an icebreaker and make those in the group more comfortable in sharing their stories. Group participants need to feel comfortable sharing their information with each other. Ask that the information shared within the group be treated as private and confidential. Some individuals will feel more comfortable sharing information if they understand it will not be discussed outside the meeting. --Ask each participant to briefly share his/her story with the group if they wish. Do not pressure those who seem reluctant to share information, as they must be allowed to participate within their own comfort zone. --Ten to 15 minutes before the scheduled end time, start bringing the meeting to a close. Thank the group for sharing, give your contact information to each person, and make sure everyone has placed their contact information on the sign-in sheet. Give the group the date, time, and location for the next meeting if one has been planned and remind them that the information on the sign-in sheet will be used to notify people of the next meeting. --Be prepared for some to become emotional. This may be the first opportunity some have had to share their experiences after brain injury. Allow time for composure if individuals become emotional and tearful. Available tissues are recommended. Each person should be given a chance to speak. Allow others to empathize with the emotional participant and then guide the meeting back to the agenda. After the first meeting it is not necessary for each group member to share his/her story.

--After those attending have shared their stories, start to develop group goals and establish what the people who are present hope to gain from attending the group. This can be determined by a combination of questionnaire and discussion. Many issues are similar, while some may have unusual and specific needs. It is important to include all issues, even those applicable only to one person. Inclusion makes a support group successful.

Basic Guidelines for Support Groups

Members provide each other with various types of help, usually nonprofessional and nonmaterial. The help may take the form of providing and evaluating relevant information, relating personal experiences, listening to and accepting others’ experiences, providing understanding, and establishing social networks.

1. Confidentiality - Everything shared in the group is confidential, not to leave the room. The group needs to develop this trust

2. Don't Give Advice - Group is to share feelings and experiences but not unsolicited advice except in problem-solving exercise

3. Responsibility - All members share responsibility to make the group work; it is their group and will always go the direction that each individual group decides

4. Acceptance - Group accepts members as they are and avoids making judgments

5. One Speaker at a Time - Groups are most beneficial when all participants have the opportunity to share and discuss individual issues or concerns. Members must be mindful of limited time and give each person enough time to speak without interruptions

6. Giving Attention - Members will give supportive attention to the person who is speaking and avoid side conversations, unless the group is divided into smaller groups. Everyone must get a voice and the group must respect each others’ opinions whether they agree with them or not

7. Avoid Interruptions – If interruption is necessary, return conversation to the person who was speaking

8. Sharing - Sharing is encouraged, but not required. If someone says, “pass,” you move on, no questions asked.

9. Questions - Group members have the right to ask questions and to refuse to answer

10. Try to be in the Present - Members try to be aware of their own feelings and talk about what is present rather than what life was like in the past

11. Discussion - Group does not discuss group members who are not present; exceptions would be an emergency or a party for that person

12. Begin and End on Time - Meeting will begin and end on time, leaving time for socialization at the end

13. Create Socialization Opportunities – Be creative and find out what your group wants to do and do it; have fun in your communities

14. Community Involvement – Creating opportunities for survivors to give back to their community is important

15. Advocacy – Each year your group chooses issues that are important and formally address them with letters, emails, phone calls, and face-to-face with lawmakers

16. Educational Component - Based on what your group has voted on, seek paid and unpaid professionals to bring them the specific information

17. Requirements to be an Officer – Must be a survivor of a brain injury. People without brain injury can be on the board but cannot hold an officer position. Officers have veto power on any vote. The officers must vote, and the vote is decided by the majority

Support groups can provide benefits and the following key results:

Emotional healing comes when people interact with other people Sharing similar experiences helps members feel less alone and more ready to deal with day-to-day issues Encouragement comes from learning about how others conquered situations similar to theirs Contribution helps support group members feel meaningful Education results from exposure to information and personal experiences in a group. Socialization occurs when connections with people are made and confidence in social skills develops when appropriate interaction occurs in support groups. Self-expression, as emotions are experienced and released, creates greater understanding of oneself Confidence-building results as members take responsibility for the work of the group and see progress with plans they made Safety, in the environment of a confidential, supportive, nonjudgmental group, allows for honest disclosure and sharing common difficulties Sense of growth occurs as long-term members see new participants and reminisce about where they began and how far they came in their personal journey

Brain Injury Support Group Questionnaire

Name: (optional) ______Phone number: ______Address: ______City/State: ______Zip:_ __ u feel are the most frustrating things that you are currently dealing with? ______2. Do you feel services for individuals with brain injury are adequate?

______3. Are you and your family getting the services you need?

______4. What do you hope to gain from participating in a support group? ______5. What type of speakers or other information would most benefit you? ______6. Do you feel that the time and location of the meeting is convenient?

______7. Would you be interested in helping lead the group or helping with future meetings and events?

______Comments: ______

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Future of the Group

If you put the basics of this guide into action, you now have a functioning support group within your community. As your efforts reach others and your group grows, it is important to remember the principal reason for the support group. A support group offers the opportunity to share information and support one another in an environment of empathy and understanding. The best solutions to problems can often be found from others in like situations. Difficulties and emotions can be discussed freely without judgment and new friendships can be forged (www.tbisn.org).

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APPENDIX B

Traumatic Brain Injury: A Comprehensive

California Resource Directory

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TABLE OF CONTENTS

INTRODUCTION ...... 104

County Name Page

Alameda County ...... 105 Alpine County ...... 113 Amador County ...... 113 Butte County ...... 113 Calaveras County ...... 115 Colusa County ...... 115 Contra Costa County ...... 116 Del Norte County ...... 120 El Dorado County ...... 121 Fresno County ...... 122 Glenn County ...... 125 Humboldt County ...... 126 Imperial County ...... 128 Inyo County ...... 129 Kern County ...... 129 Kings County ...... 131 Lake County ...... 131 Lassen County ...... 132 Los Angeles County ...... 133 Madera County ...... 144 Marin County ...... 144 Mariposa County ...... 147 Mendocino County...... 147 Merced County ...... 149 Modoc County ...... 150 Mono County ...... 151 Monterey County ...... 151 Napa County ...... 153 Nevada County ...... 155 Orange County ...... 156 Placer County ...... 161 Plumas County ...... 163 Riverside County ...... 165 Sacramento County ...... 167 San Benito County ...... 172

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San Bernardino County ...... 173 San Diego County ...... 176 San Francisco County ...... 180 San Joaquin County ...... 185 San Luis Obispo County ...... 186 San Mateo County ...... 188 Santa Barbara County ...... 191 Santa Clara County ...... 194 Santa Cruz County ...... 204 Shasta County ...... 206 Sierra County ...... 208 Siskiyou County ...... 209 Solano County ...... 210 Sonoma County ...... 213 Stanislaus County ...... 215 Sutter County ...... 216 Tehama County ...... 217 Trinity County ...... 218 Tulare County ...... 219 Tuolumne County ...... 220 Ventura County ...... 221 Yolo County ...... 224 Yuba County ...... 225 Additional Resources ...... 226

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INTRODUCTION

The author chose to do a traumatic brain injury (TBI) resource directory for the entire state of California because a directory has yet to be done that covers this much area. The author chose to separate resources by county so the reader can first look for services in the area in which they live. Then if what they need is not in their county, readers can look at nearby counties to find the resources they need. This is done in the hope that individuals with TBI get the help they need to live independent and fulfilling lives.

Resources from this directory, as well as other useful information about TBI, will be available on a website after the completion of this project. The website will be continuously updated with more resources in order for counselors and those with TBI to have up to date information at all times. To access this website, please visit www.braininjurysupportcenter.com.

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Alameda

Access Ability Medical Equipment and Supplies 5627 Stoneridge Drive, Suite 324 Pleasanton, CA 94588 Phone: (925) 225-1121 Access Ability Medical Equipment and Supplies offers a full-service facility with various kinds of adaptive equipment for use by people with disabilities including scooter lifts and carriers, hand controls, vehicle platform lifts, and other driving aids.

Access Options, Inc. 41545 Albrae Street Fremont, CA 95438 Phone: (408) 734-5438 http://www.accessoptions.com Access Options is dedicated to increasing mobility for persons with disabilities by improving access in several areas. They provide a wide range of services to eliminate architectural and transportation barriers.

AC Transit 1600 Franklin Street Oakland, CA 94612 Phone: (510) 891-4706 http://www.actransit.org AC Transit provides wheelchair accessible bus services throughout Alameda. East Bay Paratransit provides services for people with disabilities who are unable to use the regular bus services throughout Alameda County. Dial 511and then say “AC Transit” to speak with a person about route information including time points, destinations, or trip planning.

Alta Bates Summit Medical Center – Brain Injury Life Skills Support Group 2001 Dwight Way Berkeley, CA 94704 Phone: (510) 204-4411 http://www.altabatessummit.org/community/braininjury.html The Brain Injury Life Skills Program provides post-acute services for individuals with brain injury (and their caregivers) to make adjustments in their interpersonal relationships, job performance, and academic achievement. The program is comprised of three groups – two for brain injury and one for caregivers and family.

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Bay Area Outreach & Recreation 3075 Adeline Street, Suite 155 Berkeley, CA 94703 Phone: (510) 849-4663 http://www.borp.org Bay Area Outreach & Recreation (BORP) is a non-profit organization working to improve the health, independence, and social integration of people with physical disabilities through sports, fitness, and recreation programs. Programs include adaptive cycling, adventures and outings, adult wheelchair basketball, a fitness studio, power soccer, veterans’ outreach, and youth sports.

Bay Area Rapid Transit (BART) P.O. Box 12688 Oakland, CA 94604 http://www.bart.gov Bay Area Rapid Transit (BART) provides transportation services for the general public throughout the San Francisco Bay Area. BART trains run through Alameda County, Contra Costa County, San Francisco County, and San Mateo County. BART also offers a rider’s guide with information on access for people with disabilities.

Berkeley Commission on Disability 1901 Hearst Avenue Berkeley, CA 94704 Phone: (510) 981-6346 http://www.cityofberkeley.info/ContentDisplay.aspx?id=11374 The Berkeley Commission on Disability’s goal is to actively promote the total integration and participation of persons with disabilities into all areas of economic, political, and community life. Membership shall be made up primarily of persons who have disabilities. Meetings are held at the North Berkeley Senior Center.

Berkeley Paratransit Services 1901 Hearst Avenue Berkeley, CA 94704 Phone: (510) 981-7269 http://www.ci.berkeley.ca.us/ContentDisplay.aspx?id=3992 Berkeley Paratransit Services assists persons with disabilities and those 70 years of age or over by providing four programs that enhance their access to different transportation services. The four programs are Taxi Scrip Program, Wheelchair-Van Program, East Bay Paratransit Tickets, and Medical Return Trip Improvement Program.

Center for Accessible Technology 3075 Adeline Street, Suite 220 Berkeley, CA 94703 Phone: (510) 841-3224 http://www.CFORAT.org The Center for Accessible Technology (CforAT) provides access to computers and technology for people with disabilities. They do this so children with disabilities can succeed in school, so

107 adults with disabilities can find (and keep) jobs, and so all people with disabilities can use the Internet and email and benefit from the digital revolution. CforAT also provides business- consulting services to corporations, libraries, and government entities. They provide assistance on creating accessible websites and have users with disabilities test products and services.

Center for Independent Living (Berkeley) 3075 Adeline Street, Suite 100 Berkeley, CA 94703 Phone: (510) 841-4776 http://www.cilberkeley.org/index.html The Center for Independent Living (CIL) provides services, support, and advocacy to enhance the rights and abilities of people with disabilities to actively participate in their communities and to live self-determined lives. Programs at CIL include the four core services of Independent Living Centers identified by CIL consumers as important to their increasing independence: Peer Counseling, Systems Change, Independent Living Skills Training, and Information and Referral. Additional services include Assistive Technology consultation and training, employment services, and youth services. Please call for information on the CIL location in Oakland.

Chabot College – Disabled Student Resource Center 25555 Hesperian Boulevard Hayward, CA 94545 Phone: (510) 723-6725 http://www.chabotcollege.edu/dsrc/ The Disabled Student Resource Center (DSRC) at Chabot College serves the needs of students with a variety of disabilities including physical, communicative, psychological, and/or learning disabilities. The counseling staff provides academic, career, personal, and crisis counseling and assists students with successful transition to and beyond college. They provide academic assessment, Student Educational Plans, and referrals for diagnostic evaluations (which help meet Department of Rehabilitation requirements). The DSPS staff also assists with academic accommodations based on individual student needs (such as additional testing time for students with disabilities), community resources (such as special transportation services), and has a High Tech Center that includes adaptive computer equipment.

Ciddio-Morris Associates, Inc. 1611 Telegraph Avenue, Suite 808 Oakland, CA 94612 Phone: (510) 208-7100 http://www.ciddiomorris.com Ciddio-Morris Associates is a leading provider of vocationally related services. They strive to provide the most efficient and effective services to their customers, being aware of costs. Services include expert witness services, return to work services (disability management services), essential function job analyses, vocational assessment, planning and counseling for persons with barriers to employment, career counseling, assessment, outplacement services, and job placement assistance.

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College of Alameda – Programs and Services for Students with Disabilities 555 Ralph Appezzato Memorial Parkway Avenue Alameda, CA 94501 Phone: (510) 748-2326 http://alameda.peralta.edu/dsps Programs and Services for Students with Disabilities (DSPS) offers academic advising, counseling, diagnostic testing, access to assistive technology, and other academic accommodations. It is important to meet with a DSPS counselor each semester to review progress and arrange for classroom accommodations.

Community Resources for Independent Living (Fremont) 39155 Liberty Street, Suite A100 Fremont, CA 94538 Phone: (510) 794-5735 http://crilhayward.org/ Community Resources for Independent Living (CRIL) is a disability resource organization that advocates and provides resources for people with disabilities to improve lives and make communities fully accessible. CRIL offers independent living services at no charge to persons with disabilities living in Alameda County. To become a CRIL consumer, an individual must have a disability or functional limitation and be able to benefit from independent-living services. CRIL is also a resource for disability awareness education and training, advocacy, and technical advice. Please call for information on CRIL locations in Hayward and Livermore.

Department of Rehabilitation (Greater East Bay District) 1485 Civic Court, Suite 1100 Concord, CA 94520 Phone: (925) 602-3953 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Please call for DOR locations in Berkeley, Fremont, and Oakland.

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life's challenges, achieve personal goals, and gain greater independence for everyday living.

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Eden Medical Center Stroke & Brain Injury Rehabilitation 20103 Lake Chabot Rd. Castro Valley, CA Phone: (510) 889-5064 http://www.edenmedicalcenter.org/pmr.html Through an array of inpatient and outpatient services, Eden Medical Center assists patients in achieving the highest level of rehabilitation possible. Eden Medical Center’s Rehabilitation Services is committed to restoring function to patients with problems ranging from simple mobility issues to complex cognitive concerns. Eden Hospital holds a Stroke Support Group the fourth Tuesday of the month at 7pm. It is held in the Castro Valley Room. If interested in the support group, contact Sylvia Dawson CCC, (510) 880-5064 ext. 525.

Frank D. Penney Personal Injury Lawyer 1300 Clay Street, Suite 600 Oakland, CA 94612 Phone: (510) 962-4610 http://www.oakland-personal-injury.com/oakland-lawyer.aspx The Law Offices of Frank D. Penney were established with one vision in mind: Providing justice for personal injury victims and their loved ones. This firm has over a decade’s worth of experience in personal injury law and aims to improve the lives of clients.

Head Injury Law 180 Grand Avenue, Suite 935 Oakland, CA 94612 Phone: (510) 272-0657 http://www.headinjurylaw.com Harvey Hyman refers clients to the right lawyer: a lawyer who devotes his or her legal career to helping survivors of TBI win justice and fair compensation in court against the wrongdoer who injured them. He refers clients at no charge and makes sure they are matched with the perfect lawyer for their case.

Laney College – Disabled Students Programs & Services 900 Fallon Street Oakland, CA 94607 Phone: (510) 464-3428 http://www.laney.edu/wp/dsps/ Disabled Students Programs & Services (DSPS) determines and provides required academic accommodations for students with disabilities. Use of services is voluntary and is offered to assist students with disabilities who are attending Laney College. New students please call the Disability Resource Center (DRC) to make an intake appointment.

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Las Positas College – Disability Resource Center (DRC) 3000 Campus Hill Drive Livermore, CA 94550 Phone: (925) 424-1550 http://www.lospositascollege.edu/DSPS Las Positas College is committed to excellence and accessibility for all students. The DRC offers academic and personal support for students with physical, communication, learning, and psychological disabilities. Their goal is to encourage students to become independent and assertive participants in their own educational process. Accessibility in classes, facilities, and all services is their ultimate objective.

Livermore Amador Valley Transit Authority (WHEELS) 1362 Rutan Court, Suite 100 Livermore, CA 94551 Phone: (925) 455-7500 (General Information) (925) 455-7510 (Paratransit Dial-A-Ride) http://www.wheelsbus.com WHEELS provides accessible transportation services to the general public and to people with disabilities for the communities of Dublin, Livermore, and Pleasanton.

Merritt College – Disabled Services Program 12500 Campus Drive Oakland, CA 94619 Phone: (510) 436-2429 http://www.merritt.edu/wp/dsp The Disabled Services Program aims to provide equal access services that will empower students with disabilities to be successful at Merritt College. They provide accommodations based on the functional limitations of the disability in the academic setting while empowering students with disability self-management and self-advocacy. They create a level playing field in the classroom so students have the opportunity to demonstrate their abilities and not focus on the disability.

Mobility Systems 1010 Carleton Street Berkeley, CA 94710 Phone: (510) 540-0295 http://www.mobilitysystems.com Mobility Systems provides van conversions, installation of hand controls, van lifts, a chair topper for wheelchairs to be stored on top of a vehicle, scooter lifts, ramps for easy access to and from vehicles, and wheelchair restraints.

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Ohlone College – Disabled Students Program & Services 43600 Mission Boulevard Fremont, CA 94539 Phone: (510) 979-7401 http://www.ohlone.edu/org.dsps/ The Ohlone College Disabled Students Programs & Services (DSPS) are designed to open the doors to educational and occupational opportunities for students with disabilities. Their primary purpose is to provide an opportunity for all individuals to maximize their educational experience. Ohlone College encourages students with disabilities to participate (within the limits of their disabilities) in the same activities and courses as other students. Services are provided to meet the unique needs of students and help them achieve a successful college career.

Pacific Brain & Spine Medical Group, Inc. 20055 Lake Chabot Road, Suite 110 Castro Valley, CA 94546 Phone: (510) 886-3138 http://www.pacbrain.com/ Pacific Brain and Spine (PacBrain) is a Neurosurgery practice in Northern California with over 28 years of total experience in treating diseases of the brain, spine, and central nervous system. They are committed to achieving the best possible outcome for patients by providing personal attention and compassionate care coupled with skilled diagnosis and advanced treatment using the latest technologies. Please call for information on the PacBrain location in Oakland.

Services for Brain Injury 1440 Broadway, Suite 280 Oakland, CA 94612 Phone: (408) 434-2277 http://www.sbicares.org Services for Brain Injury (SBI) is the only organization of its kind in the Bay Area providing comprehensive rehabilitation (all under one roof) for people with traumatic brain injuries (TBI) or acquired brain injuries (ABI). SBI’s services range from post-acute programs, personal and social readjustment, vocational immersion and job placement, and supported employment including a job coach at the work site. At the heart of all SBI’s programming is an emphasis on comprehensive cognitive rehabilitation provided through a unique continuum of services. SBI’s Rehabilitation Program is designed for people with brain injuries to relearn skills lost due to injury or illness; reintegrate from hospital to home to community; and provide support, respite, and resources for families and friends. It is part of a unique continuum of programming individualized for the person with a brain injury to account for his/her social needs and recovery goals. SBI’s vocational services address barriers facing people with brain injuries as they work toward increased independence and gainful employment.

Stroke Support Group: Support Group for Individuals with Stroke 2500 Mowry Avenue, Suite 224 Fremont, CA 94538 Contact Doug at (510) 745-6525 for more information. The Stroke Support Group is for individuals with brain injury and their caregivers who meet

112 regularly to support each other by discussing common problems affecting them in their everyday lives.

The East Bay Brain Injury Support Group 5366 College Avenue Oakland, CA 94611 Contact Dr. Pamela Paradowski at (510) 433-9955 for more information. http://www.braininjuryconnection.org The East Bay Brain Injury Support Group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

Through the Looking Glass 3075 Adeline Street, Suite 120 Berkeley, CA 94703 Phone: (510) 848-1112 http://www.lookingglass.org Through the Looking Glass (TLG) is a nationally recognized center for research, training, and services for families in which a child, parent, or grandparent has a disability. They aim to create, demonstrate, and encourage early intervention services for families with a parent or child who has a disability and integrate expertise derived from personal experience and disability culture.

Veterans Administration Medical Center 3801 Miranda Avenue Palo Alto, CA 94304 Phone: (650) 493-5000 ext. 62201 http://www.paloalto.va.gov/ The Veterans Administration (VA) Brain Injury Rehabilitation Unit (BIRU) provides comprehensive screening, evaluation, and treatment for veterans with traumatic brain injury. Their Polytrauma Support Clinic Team provides and coordinates interdisciplinary rehabilitation services for veterans. Any veteran entitled to benefits (discharged from military service under other than dishonorable conditions) and medically stable is eligible for admission into the Polytrauma System of Care. The patient must have sustained multiple physical, cognitive, and/or emotional injuries secondary to trauma.

**For more brain injury resources near Alameda County, please see Contra Costa County, San Francisco County, San Joaquin County, San Mateo County, Santa Clara County, and Stanislaus County.**

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Alpine

Brain Injury Lawyers in Alpine County http://lawyers.findlaw.com/lawyer/practicestatecounty/brain-injury/california/alpine This lawyer directory is the largest online directory of attorneys. Browse more than one million listings covering everything from criminal defense to personal injury to estate planning. Detailed law firm profiles have information like the firm’s area of law, office location, office hours, and payment options. Attorney profiles include the biography, education and training, and client recommendations of an attorney to help employers decide who to hire. Use the contact form on the profiles to connect with an Alpine County attorney.

**For more brain injury resources near Alpine County, please see Amador County, Calaveras County, El Dorado County, Mono County, and Tuolumne County.**

Amador

Amador County Behavioral Health 10877 Conductor Boulevard, Suite 300 Sutter Creek, CA 95685 Phone: (209) 223-6412 http://www.bestmentalhealthfacilities.com Amador County Behavioral Health provides details on treatment centers and facilities so individuals can get needed testing and help from psychiatrists, counselors, and therapists.

**For more brain injury resources near Amador County, please see Alpine County, Calaveras County, El Dorado County, Sacramento County, and San Joaquin County.**

Butte

Butte College – Disabled Students Programs & Services 3536 Butte Campus Drive Oroville, CA 95965 Phone: (530) 895-2455 http://www.butte.edu The Disabled Students Programs & Services (DSPS) provides required academic accommodations for students with disabilities. DSPS provides support services, specialized instruction, and educational accommodations to students with disabilities so they can participate as fully in college as their non-disabled peers. The accommodations provided to a student depend on an individual student's disability and how that disability affects their access to the education process.

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Department of Rehabilitation (Chico Branch) 470 Rio Lindo Avenue, Suite 4 Chico, CA 95926 Phone: (530) 895-5507 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Enloe Hospital Head Injury Support Project W. 5th Avenue & The Esplande Chico, CA 95926 Phone: (530) 345-5799 Enloe Hospital’s support group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

Independent Living Services of Northern California 1161 East Avenue Chico, CA 95926 Phone: (530) 893-8527 http://ilsnc.org/index.html Independent Living Services of Northern California (ILSNC) is a nonprofit organization helping community members with disabilities achieve and/or maintain their optimal level of self-reliance and independence. ILSNC provides support services (e.g., information, housing assistance, and provider referrals) and eliminates barriers to increase opportunities for participation in the community. ILSNC also works to ensure provision of needed services, identified by persons with disabilities and other community members, while supporting consumers’ rights to live independently.

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Passages Caregiver Resource Center 2491 Carmichael Drive, Suite 400 Chico, CA 95928 Phone: (530) 898-5925 http://www.passagescenter.org/caregivers/ Passages Caregiver Resource Center offers services for family caregivers who provide care to adults with a brain/neurological impairment. The staff provides information, support, assistance, and community connections to help local caregivers.

**For more brain injury resources near Butte County, please see Colusa County, Glenn County, Plumas County, Sierra County, Sutter County, Tehama County, and Yuba County.**

Calaveras

**Sorry, there are no brain injury resources in Calaveras County. For brain injury resources near Calaveras County, please see Alpine County, Amador County, San Joaquin County, Stanislaus County, and Tuolumne County.**

Colusa

Foundation Resources for Equality and Employment for the Disabled 154 Hughes Road, Suite 1 Grass Valley, CA 95945 Phone: (530) 272-1732 http://www.freed.org Foundation Resources for Equality and Employment for the Disabled’s (FREED) mission is to eliminate barriers for people with disabilities through programs that promote independent living and effect systems change while honoring dignity and self-determination. FREED has a number of programs focusing on the issues that arise with aging and disabilities. They work with clients to figure out what they need and get connected. FREED provides services to residents of five county areas comprised of Nevada, Sierra, Yuba, Sutter, and Colusa Counties.

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**For more brain injury resources near Colusa County, please see Butte County, Glenn County, Lake County, Sutter County, and Yolo County.**

Contra Costa

Brain Tumor Support Group 3276 McNutt Avenue Walnut Creek, CA 94596 Contact Judy Blazin at (925) 933-0107 for more information. The Brain Tumor Support Group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

County Connection 2477 Arnold Industrial Way Concord, CA 94520 Phone: (925) 676-1976 http://www.cccta.org/wb County Connection provides fixed-route and paratransit bus service throughout the communities of Concord, Pleasant Hill, Martinez, Walnut Creek, Clayton, Lafayette, Orinda, Moraga, Danville, and San Ramon as well as unincorporated communities in Central Contra Costa County.

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Contra Costa College – Disabled Students Programs & Services 2600 Mission Bell Drive San Pablo, CA 94806 Phone: (510) 235-7800 Ext 220 http://www.contracosta.edu/studentservices/DSPS/Shared%20Documents/default.aspx The mission of Disabled Students Programs & Services (DSPS) at Contra Costa College is to provide support services, specialized instruction, and educational accommodations to students with disabilities so they can participate as fully and benefit as equitably from the college experience as their non-disabled peers.

Diablo Valley College – Disability Support Services 321 Golf Cart Road Pleasant Hill, CA 94523 Phone: (925) 685-1230 ext. 2364 http://www.dvc.edu/org/departments/dss/ Disability Support Services (DSS) is designed to ensure students with disabilities have equal access to all the educational offerings at Diablo Valley College. They facilitate equal opportunity through the provision of appropriate support services, curriculum, instruction, and adaptive technology.

Head Injury Support Group 7777 Norris Canyon San Ramon, CA 94583 Contact JoAnn Swift at (925) 443-4366 for more information. The Head Injury Support Group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

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Independent Living Resources 3200 Clayton Road Concord, CA 94519 Phone: (925) 363-7293 http://www.ilr.org Independent Living Resources (ILR) promotes the philosophy of independent living by creating opportunities, encouraging choices, advancing equal access, and furthering the level of independence for all people with disabilities. Please call for ILR locations in Antioch and Concord.

John Muir Health Neurosciences Institute 1601 Ygnacio Valley Road Walnut Creek, CA 94598 Phone: (925) 941-5050 http://www.johnmuirhealth.com/index.php/neurosciences1.html John Muir Health is a leader in the diagnosis and treatment of brain and spine disorders. John Muir Health's multidisciplinary approach serves the medical, surgical, and rehabilitation needs of patients with neurological diseases and injuries. The neurosciences staff includes neurologists, neurosurgeons, neuroradiologists, rehabilitation medicine physicians, neuropsychologists, nurses, and allied health professionals who are dedicated to a program of care meeting the specific needs of each individual patient. John Muir offers advanced techniques and technology to diagnose and treat neurological disorders of the brain and spine. The comprehensive programs available include treatment for cerebrovascular diseases (e.g., stroke, aneurysms), brain and spinal cord tumors, dementia (e.g., Alzheimer’s disease), spine diseases, and neurological disorders. A typical outpatient program may include assistance with activities of daily living, speech therapy, activities to improve control and muscle balance, an exercise program, gait and balance retraining, activities to improve cognitive impairments, education regarding the disease and disease process, and goal setting involving both the client and family members. Please call for John Muir Health Outpatient Centers in Brentwood, Walnut Creek, Concord, and Pleasant Hill.

Los Medanos College – Disabled Students Programs & Services 2700 East Leland Road Pittsburg, CA 94565 Phone: (925) 439-2181 Ext. 3133 http://www.losmedanos.edu/dsps/default.asp Los Medanos College’s Disabled Students Programs & Services (DSPS) provides specialized classes and support services to students with disabilities to allow them to fully participate in and benefit from courses at the college. Classes include reading, writing, spelling, arithmetic, and computer skills. Services and accommodations include but are not limited to priority registration, alternative testing, adaptive computer technology, sign language interpreters, textbooks recorded onto an audio file, and braille.

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Mt. Diablo Memory Center – Sport Concussion Program 1940 Tice Valley Boulevard, Suite C Walnut Creek, CA 94595 Phone: (925) 988-0569 http://www.sportconcussion.com/ The Sport Concussion Program provides pre-injury baseline testing and post-injury care as well as management to hundreds of athletes in the Bay Area. The mission of this program is to provide comprehensive concussion injury management through education, neuropsychological evaluation, academic support, and return-to-play consultation. Through proper treatment and management of concussion injuries, this program aims to significantly reduce recovery time, minimize risk for post-injury complications, and return the athlete to play when they are ready.

New Lift Support Group 981 N. Broadway Walnut Creek, CA 94596 Phone: (925) 947-4466 The New Lift Support Group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

Stroke Support Group of Contra Costa Phone: (925) 689-2464 Contact: Ernette at [email protected] The Stroke Support Group of Contra Costa is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

Pacific Brain & Spine Medical Group, Inc. 1320 El Capitan, Suite 300 Danville, CA 94526 Phone: (925) 884-2360 http://www.pacbrain.com/index.html Pacific Brain and Spine is a Neurosurgery practice in Northern California with over 28 years of total experience treating diseases of the brain, spine, and central nervous system. They are committed to achieving the best possible outcome for our patients by providing personal attention and compassionate care coupled with skilled diagnosis and advanced treatment using the latest technologies.

**For more brain injury resources near Contra Costa County, please see Alameda County, Sacramento County, San Joaquin County, and Solano County.**

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Del Norte

Department of Rehabilitation (Crescent City Branch) 286 M Street Crescent City, CA 95531 Phone: (701) 464-8347 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Redwood Caregiver Resource Center 141 Stony Circle, Suite 200 Santa Rosa, CA 95401 Phone: (707) 542-0282 http://www.redwoodcrc.org The Redwood Caregiver Resource Center (CRC) provides services to family caregivers throughout the Redwood Empire, including the counties of Del Norte, Humboldt, Mendocino, Lake, Sonoma, Napa, and Solano. Redwood CRC is part of a statewide system of 11 nonprofit Caregiver Resource Centers (CRCs) offering support and assistance to caregivers of adults with brain impairments through education, research, services, and advocacy.

**For more brain injury resources near Del Norte County, please see Humboldt County and Siskiyou County.**

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El Dorado

Department of Rehabilitation (Placerville Branch) 1166 Broadway, Suite S Placerville, CA 95667 Phone: (530) 626-0900 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Department of Rehabilitation (South Lake Tahoe Branch) 2489 Lake Tahoe Boulevard, Suite 4 South Lake Tahoe, CA 96150 Phone: (530) 541-3226 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

El Dorado Center (Folsom Lake College) – Disabled Students Programs & Services 6699 Campus Drive Placerville, CA 95667 Phone: (530) 642-5644 http://www.flc.losrios.edu/student-services/student-aid/dsps Folsom Lake College welcomes diverse students, including those with a variety of disabilities. Services are provided to students with physical, psychological, and learning disabilities through the Folsom Lake College’s Disabled Students Programs & Services (DSPS). The Program’s philosophy is to assist students with disabilities in becoming successful and independent learners who achieve their full potential and become actively engaged in the campus community.

Lake Tahoe Community College – Disability Resource Center One College Drive South Lake Tahoe, CA 96150 Phone: (530) 541-4660 http://ltcc.edu/web/current-students/disability-resource-center Lake Tahoe Community College (LTCC) provides individualized support services for students with disabilities. Individualized support services include academic advisement, assessment for learning disabilities, disability-related counseling, equipment loan, interpreters, learning aids, liaison with campus faculty and staff, linkage with university disability programs, note-taking assistance, referrals to on-campus and community agencies, registration assistance, test-taking accommodations, and tutorial services.

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Placerville Mobility Support Group 512 Main Street. Placerville, CA 95667 Contact Lynn Murray at (530) 295-7260 for more information The goal of this support group is to foster improved physical, mental, and emotional health for those who have mobility impairments. The group meets at the Main Street Round Table Pizza.

PRIDE Industries (Placerville Branch) 681 Main Street, Suite 114 Placerville, CA 95667 Phone: (530) 621-0469 http://www.prideindustries.com/ PRIDE provides the support, training and opportunity necessary to help people with disabilities overcome obstacles and find meaningful employment. PRIDE aims to be the premiere employer of people with disabilities, the vendor of choice in the markets they serve, and the recognized leader in meeting the needs of individuals in overcoming barriers to employment.

**For more brain injury resources near El Dorado County, please see Alpine County, Amador County, Placer County, and Sacramento County.**

Fresno

Brain Injury Support Group for Survivors & Families 2823 Fresno Street Fresno, CA 93710 Contact Jeff DiMarco at (559) 779-6919 for more information. The Brain Injury Support Group for Survivors & Families is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

Center for Independent Living – Fresno 3475 W. Shaw, Suite 101 Fresno, CA 93721 Phone: (559) 276-6777 http://www.cil-fresno.org/ The Center for Independent Living (Fresno) is a consumer based organization that empowers people with disabilities to make informed choices and be in control of their lives through a flexible range of services and opportunities.

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Department of Rehabilitation (San Joaquin Valley Branch) 2550 Mariposa Mall, Room 2000 Fresno, CA 93721 Phone: (559) 445-6011 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Driving Specialties Ltd. 2563 N. Fordhan Avenue Fresno, CA 93727 Phone: (559) 291-2563 http://www.drivingspecialties.com Serving the San Joaquin Valley, Driving Specialties Ltd. helps people with mobility limitations and their families and friends realize the freedom and independence of accessible transportation. They sell and maintain a complete range of products including full sized and minivan conversions, raised roofs and raised doors, hand controls, electronic gas and brake systems, and wheelchair and scooter lifts. They also offer a wide range of steering, braking, and secondary- control systems.

Fresno Area Express 3590 North Blackstone Fresno, CA 93706 Phone: (559) 621-7433 http://www.fresno.gov/DiscoverFresno/PublicTransportation/default.htm Fresno Area Express (FAX) offers 16 fixed-route bus lines and Handy Ride Paratransit Service (559-443-5650) is available for use by people with disabilities. FAX is operated by the city of Fresno as a public service to all citizens and visitors of Fresno.

Fresno City College – Disabled Students Program & Services 1101 E. University Avenue Fresno, CA 93741 Phone: (559) 442-8237 http://www.fresnocitycollege.com/index.aspx?page=2404 Disabled Students Program & Services (DSPS) provides instruction and services to students with disabilities to increase access to college programs. Students with acquired brain injuries, learning disabilities, hearing impairments, visual impairments, psychological disabilities, mobility disabilities, and chronic health conditions may qualify for services. Services include specialized instruction, adaptive equipment, job placement, mobility assistance, interpreting, note taking, textbooks on tape, testing accommodations, educational counseling and planning, priority registration, and specialized tutoring.

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Fresno County Rural Transit Agency 2035 Tulare Street, Suite 201 Fresno, CA 93706 Phone: (559) 233-6789 http://www.ruraltransit.org The Fresno County Rural Transit Agency (FCRTA) provides transportation services within rural incorporated areas of Fresno County to the general public, the elderly, and people with disabilities. Passenger fares are subsidized to allow reasonable costs and encourage frequent trips. Fares for service within a community are $0.35 per one-way trip for the elderly, the disabled, and children.

Stroke Support Group 2823 Fresno Street Fresno, CA 93710 Contact Sheila at (559)-459-6255 for more information. The Stroke Support Group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives. It meets the third Tuesday of every month 6:00pm-7:30pm.

Reedley College – Disabled Students Programs & Services 995 North Reed Avenue Reedley, CA 93654 Phone: (559) 638-3641 http://www.reedleycollege.edu/index.aspx?page=260 Disabled Students Programs & Services (DSPS) provides specialized services and accommodations for students with disabilities so they can reach their maximum potential while achieving their educational goals. Staff specialists interact with all areas of the campus to eliminate physical, academic, and attitudinal barriers. DSPS takes a personal interest in meeting the special needs of students with disabilities.

Resources for Independence, Central Valley 3008 North Fresno Street Fresno, CA 93703 Phone: (559) 221-2330 http://www.ricv.org/ Resources for Independence, Central Valley (RICV) encourages people with disabilities to be in control of their lives and live more independently through a diverse range of choices and opportunities. RICV educates the community on accessibility issues to ensure a proper support system for the individual.

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West Hills Community College – Disabled Students Programs & Services 300 Cherry Lane Coalinga, CA 93210 Phone: (559) 925-3346 http://www.westhillscollege.com/coalinga/students/student_programs/dsps/index.asp West Hills College has given special attention to removing physical barriers on campus and providing support services to students with disabilities. Disabled Students Program & Services (DSPS) provides special assistance to students with disabilities through individualized help and counseling. DSPS is committed to providing students with support enabling them to reach their academic goals.

**For more brain injury resources near Fresno County, please see Kings County, Madera County, Merced County, San Benito County, and Tulare County.**

Glenn

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

Independent Living Services of Northern California 1161 East Avenue Chico, CA 95926 Phone: (530) 893-8527 http://www.ilsnc.org/index.html Independent Living Services of Northern California (ILSNC) is a nonprofit organization helping community members with disabilities achieve and/or maintain their optimal level of self-reliance and independence. ILSNC provides support services (e.g., information, housing assistance, and provider referrals) and eliminates barriers to increase opportunities for participation in the community. ILSNC also works to ensure provision of needed services, identified by persons with disabilities and other community members, while supporting consumers’ rights to live independently.

126 adults with a brain/neurological impairment. The staff provides information, support, assistance, and community connections to help local caregivers.

**For more brain injury resources near Glenn County, please see Butte County, Colusa County, Lake County, Mendocino County, and Tehama County.**

Humboldt

College of the Redwoods – Disabled Students Services 7351 Tompkins Hill Road Eureka, CA 95501 http://www.redwoods.edu/District/dsps/index.asp College of the Redwoods puts student success first by providing outstanding developmental, career technical, and transfer education. The College continually assesses student learning and institutional performance to improve upon the programs and services offered.

Department of Rehabilitation (Eureka Branch) 1330 Bayshore Way, Suite 1001 Eureka, CA 95501 Phone: (707) 445-6300 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

Eureka Day Support Group 2740 Timber Ridge Lane Eureka, CA 95501 Phone: (707) 443-4875 Sponsored by the Humboldt Coalition for TBI, this support group is for individuals with brain injury and their caregivers who meet regularly (at the Timber Ridge Assisted Living Center) to support each other by discussing common problems affecting them in their everyday lives.

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Making Headway Center for Brain Injury Recovery 305 O Street Eureka, CA 95540 Phone: (707) 442-7668 http://www.mhwcenter.org Making Headway offers specialized programs to people who have brain injuries. Their programs create opportunities for self-determination and self-sufficiency through outreach, education, and prevention. Daily life-skills classes and counseling help people adjust to changes in their lives and relationships. Making Headway Center for Brain Injury Recovery offers the following services: information and referral, service coordination, supported living, community reintegration, vocational support, education, outreach, psychotherapy, support groups, and therapeutic recreational activities.

Tri-County Independent Living, Inc. 2822 Harris Street Eureka, CA 95503 Phone: (707) 455-8404 http://www.tilinet.org/ Tri-County Independent Living, Inc. (TILI) is a consumer controlled, community-based organization designed and operated within a local community by and for people with disabilities. They offer a wide variety of services to members of the community – free of charge. They offer independent-living skills training, housing assistance, peer support, and personal assistant services.

**For more brain injury resources near Humboldt County, please see Del Norte County, Mendocino County, Siskiyou County, and Trinity County.**

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Imperial

Access to Independence 400 Mary Avenue, Suite D Calexico, CA 92231 Phone: (760) 768-2044 http://www.accesstoindependence.org/ Access to Independence is a Center for Independent Living (CIL) that provides services to people with disabilities to maximize their independence and integrate them into their communities. Their advocacy programs typically take the form of information, education, and referral (working with their consumers to teach independent-living skills, assessing which resources will be of further assistance, and giving consumers the tools they need to move forward as their own advocate).

Department of Rehabilitation (El Centro Branch) 1214 State Street El Centro, CA 92243 Phone: (760) 353-1350 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Imperial Valley College – Disabled Students Programs & Services 380 E. Aten Road Imperial, CA 92251 Phone: (760) 355-6313 http://www.imperial.edu/students/dsps Disabled Student Programs & Services is designed to provide supportive services to students with disabilities, including those with brain injuries. The program provides priority registration, counseling, class scheduling, mobility assistance, interpreting, alternate text production, adaptive physical education, special parking, and health and wellness assessments.

Southern Caregiver Resource Center 3675 Ruffin Road, Suite 230 San Diego, CA 92123 Phone: (858) 268-4432 http://www.caregivercenter.org Southern Caregiver Resource Center (SCRC) is a nonprofit organization that provides free support services for family caregivers caring for adults with chronic and/or disabling conditions. They provide referrals, consultations, resources, counseling, and respite services to caregivers of adults with brain injuries. Call for an updated list of support groups in your area.

**For more brain injury resources near Imperial County, please see Riverside County and San Diego County.**

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Inyo

Inland Caregiver Resource Center 1420 East Cooley Drive, Suite 100 Colton, CA 92324 Phone: (909) 514-1404 http://www.inlandcaregivers.com Inland Caregiver Resource Center (ICRC) is part of a statewide system of Caregiver Resource Centers with grant support from the California Department of Mental Health. Inland Caregiver Resource Center is a good place to start if you are looking for help in taking care of a loved one with a brain impairing condition such as Alzheimer’s disease, stroke, Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), or traumatic brain injury. They provide counseling, education, training, family consultation, care planning, and referrals when needed.

**For more brain injury resources near Inyo County, please see Fresno County, Kern County, Mono County, San Bernardino County, and Tulare County.**

Kern

Bakersfield Community College – Disabled Student Programs & Services 1801 Panorama Drive Bakersfield, CA 93305 Phone: (661) 395-4011 http://www.bakersfieldcollege.edu/student/dsps/ The purpose of Disabled Student Programs & Services is to ensure access to the college and its programs and to provide accommodations and support services for students with disabilities. The program provides services for students with physical disabilities (including temporary disabilities), psychological disabilities, learning disabilities, speech and language disorders, students who are blind or have visual impairments, students who are deaf or hard of hearing, and students with health limitations. The special services include counseling, registration assistance, learning disabilities assessment, tutoring, mobility assistance, sign language interpreter and reader services, special classes, alternative testing arrangements, and note-taking assistance. Special equipment includes tape recorders, materials in alternate formats (braille, large print, tape), and assistive computer technology.

Centre for Neuro Skills (Bakersfield) 2658 Mt. Vernon Avenue Bakersfield, CA 93306 Phone: (800) 922-4994 http://www.neuroskills.com The Centre for Neuro Skills (CNS) has post-acute medical treatment, therapeutic rehabilitation, and disease management services with specially trained staff for individuals recovering from

130 acquired brain injury. Their cost-effective, patient-centered programs maximize treatment effect, learning generalization, and stability of recovery in real-world settings. The goal is to facilitate skill acquisition and help each patient resume a normal rhythm of living. The Brain Injury Programs and Services include post-acute inpatient rehabilitation, neurobehavioral rehabilitation, outpatient and day treatment, assisted living, multicultural programs, family education, community reintegration, and home evaluations.

Cerro Coso Community College – Disabled Student Program & Services 3000 College Heights Boulevard Ridgecrest, CA 93555 Phone: (760) 384-6250 http://www.cerrocoso.edu/specialservices/programs/dsps.htm The Disabled Student Program & Services (DSPS) provides access and support to students with disabilities. They function as a resource to Cerro Coso Community College faculty in offering students equity and excellence in education, maximizing each student’s educational potential while helping him or her develop and maintain independence.

Department of Rehabilitation (Bakersfield Branch) 4925 Commerce Drive, Suite 150 Bakersfield, CA 93309 Phone: (661) 395-2525 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Department of Rehabilitation (Ridgecrest Branch) 1400 N. Norma Street, Suite 105 Ridgecrest, CA 93555 Phone: (760) 446-2523 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Independent Living Center of Kern County 5251 Office Park Drive Bakersfield, CA 93309 Phone: (661) 325-1063 or (800) 529-9541 http://www.ilcofkerncounty.org/ The mission of the Independent Living Center of Kern County (ILCKC) is to empower people with disabilities to grow creatively, professionally, and personally as well as educate the community about disability related issues. It is the vision of ILCKC to promote positive change in society, leading to the integration and acceptance of persons with disabilities within the community.

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Taft College – Disabled Students Program & Services 29 Emmons Park Drive Taft, CA 93268 Phone: (661) 763-7769 http://www.taftcollege.edu.tcwp/dsps/ The Disabled Students Program & Services (DSPS) provides support services, specialized instruction, and educational accommodations to students with disabilities so they can participate as fully and benefit as equitably from the college experience as their non-disabled peers. An educational contract is developed for each student that links goals, curriculum program, and academic accommodations to his/her specific disability-related educational limitation.

**For more brain injury resources near Kern County, please see Inyo County, Kings County, Los Angeles County, San Luis Obispo County, Santa Barbara County, Tulare County, and Ventura County.**

Kings

**Sorry, there are no brain injury resources in Kings County. For brain injury resources near Kings County, please see Fresno County, Kern County, San Luis Obispo County, and Tulare County.**

Lake

Department of Rehabilitation (Lakeport Branch) 55 1st Street Lakeport, CA 95453 Phone: (707) 263-3797 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

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Lake Transit Authority Phone: (707) 263-3334 http://www.laketransit.org Lake Transit Authority (LTA) provides public transit services throughout Lake County and operates connecting routes to intercity and regional bus services in Napa and Mendocino counties.

**For more brain injury resources near Lake County, please see Colusa County, Glenn County, Mendocino County, Napa County, Sonoma County, and Yolo County.**

Lassen

Department of Rehabilitation (Susanville Branch) 170 B Russell Avenue Susanville, CA 96130 Phone: (530) 257-6073 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

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Independent Living Services of Northern California 1161 East Avenue Chico, CA 95926 Phone: (530) 893-8527 http://www.ilsnc.org/index.html Independent Living Services of Northern California (ILSNC) is a nonprofit organization helping community members with disabilities to achieve and/or maintain their optimal level of self- reliance and independence. ILSNC provides support services (e.g., information, housing assistance, and provider referrals) and eliminates barriers to increase opportunities for participation in the community. ILSNC also works to ensure provision of needed services, identified by persons with disabilities and other community members, while supporting consumers’ rights to live independently.

Lassen Community College – Disabled Student Programs & Services P.O. Box 3000/Highway 139 Susanville, CA 96130 Phone: (530) 251-8895 http://www.lassencollege.edu/admissions/student-services/dsps Disabled Student Programs & Services assists students who have any qualifying type of disabling condition. Services are available for students who have mobility, visual, hearing, speech, brain injury, and psychological disabilities. The services assist students in obtaining their educational, vocational, and employment goals. They have three special programs to serve students: High Tech Center, Learning Disabilities Lab, and Adaptive Physical Education.

Passages Caregiver Resource Center 2491 Carmichael Drive, Suite 400 Chico, CA 95928 Phone: (530) 898-5925 http://www.passagescenter.org/caregivers/ Passages Caregiver Resource Center offers services for family caregivers who provide care to adults with brain and neurological impairment. The staff provides information, support, assistance, and community connections to help local caregivers.

**For more brain injury resources near Lassen County, please see Modoc County, Plumas County, Shasta County, and Tehama County.**

Los Angeles

Antelope Valley College – Office for Students with Disabilities 3041 West Avenue K Lancaster, CA 93536 Phone: (661) 722-6360 http://www.avc.edu/studentservices/ssd/#.UyFR3DkTHzI The Office for Students with Disabilities (OSD) program provides support services, specialized

134 instruction, and educational accommodations to students with disabilities so they can participate as fully and benefit as equitably from the college experience as their non-disabled peers. A Student Educational Contract (SEC) is developed for each student, linking students’ goals, curriculum program, and academic accommodations to his/her specific disability related educational limitation. The OSD encourages students to be as independent and self-reliant as possible. They work closely with each student to assess their needs and provide accommodations directly addressing a student’s functional limitations (as a result of their disability).

Betty Clooney Center for Persons with Traumatic Brain Injury 4439 1/2 E. Village Road Long Beach, CA 90808 Phone: (562) 938-9005 http://www.bcftbi.org/ The Betty Clooney Center (BCC) serves the needs of persons with traumatic brain injury (TBI). The center addresses the needs of survivors with cognitive disabilities caused by traumatic brain injury, strokes, aneurisms, brain tumors, brain cancer, and brain damage from trauma. The BCC offers TBI case management, vocational rehabilitation, information and referral, supported living, and TBI support groups.

Casa Colina Centers for Rehabilitation – Transitional Living Center 255 East Bonita Avenue Pomona, CA 91767 Phone: (909) 596-7733 http://www.casacolina.org Casa Colina is a CARF-accredited brain injury residential program. They provide individuals the opportunity to maximize medical recovery and rehabilitation potential efficiently in an environment recognizing their uniqueness, dignity, and self-esteem. The center offers inpatient care, outpatient care, transitional care, and long-term residential care. They also have programs for patients diagnosed with brain injury, stroke, spinal cord injury, and orthopedic injury.

Centre for Neuro Skills (Los Angeles) 16542 Ventura Boulevard, Suite 500 Encino, CA 91436 http://www.neuroskills.com The Centre for Neuro Skills (CNS) has post-acute medical treatment, therapeutic rehabilitation, and disease management services with specially trained staff for individuals recovering from acquired brain injury. Their cost-effective, patient-centered programs maximize treatment effect, learning generalization, and stability of recovery in real-world settings. The goal is to facilitate skill acquisition and help each patient resume a normal rhythm of living. The Brain Injury Programs and Services include post-acute inpatient rehabilitation, neurobehavioral rehabilitation, outpatient and day treatment, assisted living, multicultural programs, family education, community reintegration, and home evaluations.

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Cerritos College – Disabled Student Programs & Services 11110 Alondra Boulevard Norwalk, CA 90650 Phone: (562) 860-2451 http://www.cms.cerritos.edu/dsps/ Students with limitations due to a disability may receive support services and instruction from Disabled Student Programs & Services (DSPS). The mission of DSPS is to assess, address, and provide reasonable accommodative service and referrals to students with disabilities, enabling them to equally access and fully participate to the best of their abilities in curricular activities at Cerritos College.

Citizens Advisory Commission on Disabilities Phone: (562) 570-6803 http://www.longbeach.gov/hr/ada/cacod.asp The purpose of Citizens Advisory Commission on Disabilities (CACOD) is to advise the Mayor and City Council of Long Beach on the concerns and issues affecting people with disabilities in the community. CACOD serves anyone with a disability that substantially limits functioning in one or more major life activities or any person who has a record of such impairment. A life activity is defined as any mental or physical function or activity that creates a substantial barrier to such things as employment, housing, transportation, recreation, or health services.

Citrus College – Disabled Student Programs & Services 1000 West Foothill Boulevard Glendora, CA 91741 Phone: (626) 914-8675 http://www.citruscollege.edu/stdntsrv/dsps/Pages/default.aspx Citrus College is committed to providing students with disabilities an accessible educational environment allowing each student the opportunity to reach his/her academic goals and participate in a full range of campus programs and activities. They provide support services to compensate disability-related educational limitations. Such support services are essential components of the educational program because they help disabled students realize their educational potential in mainstreamed academic programs.

College of the Canyons – Disabled Students Programs & Services 26455 Rockwell Canyon Rd. Santa Clarita, CA 91355 Phone: (661) 259-7800 http://www.canyons.edu/Offices/DSPS/Pages/default.aspx Disabled Students Programs & Services (DSPS) assists students with disabilities meet their educational needs. They offer priority registration, tutors in certain subjects, assistive computer technology, counseling, test-taking accommodations, deaf/hearing impaired interpreters, and alternate media.

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Communities Actively Living Independent and Free 634 South Spring Street, 2nd Floor Los Angeles, CA 90014 Phone: (213) 627-0477 http://www.califilc.webs.com/ The mission of Communities Actively Living Independent and Free (CALIF) is to achieve greater input, participation and control over policies and services especially those for people with disabilities. They address discrimination wherever it exists, encourage meaningful participation of persons with disabilities in mainstream activities that enhance the positive image and experience of disability, and provide the disability community with the following core services: housing advocacy, individual and benefits advocacy, personal assistance services advocacy, information and referral, peer counseling, independent-living skills training, and assistive technology.

Department of Rehabilitation (Greater Los Angeles District Office) 3333 Wilshire Boulevard, Suite 200 Los Angeles, CA 90010 Phone: (213) 736-3904 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Call for DOR locations in City of Commerce, Culver City, East Los Angeles, and Norwalk.

Department of Rehabilitation (Los Angeles County South Bay District Office) 4300 Long Beach Boulevard, Suite 200 Long Beach, CA 90807 Phone: (562) 422-8325 http://www.rehab.cahwnet.gov/ The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Call for DOR locations in Long Beach, Bell, Inglewood, Lawndale, Compton, and Gardena.

Department of Rehabilitation (Orange/San Gabriel District Office) 222 S. Harbor Boulevard, Suite 300 Anaheim, CA 92805 Phone: (714) 991-0800 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Call for DOR locations in El Monte and West Covina.

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Department of Rehabilitation (Van Nuys/Foothill District Office) 5900 Sepulveda Boulevard, Suite 240 Van Nuys, CA 91411 Phone: (818) 901-5024 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Please call for DOR locations in Glendale, Santa Clarita, and Canoga Park. Call for DOR locations in Lancaster, Santa Clarita, Canoga Park, Glendale, and Pasadena.

Disabled Resources Center, Inc. 2750 East Spring Street, Suite 100 Long Beach, CA 90806 Phone: (562) 427-1000 http://www.drcinc.org/ Disabled Resources Center, Inc. (DRC) aims to empower people with disabilities to live independently in the community and make their own decisions about their lives. The DRC provides assistive technology, benefits advocacy, employment services, group orientations, housing funding, independent living, personal assistance, and workshops.

East Los Angeles College – Disabled Student Program & Services 1301 Avenida Cesar Chavez Monterey Park, CA 91754 Phone: (323) 265-8650 http://www.elac.edu/studentservices/dsps/index.htm Disabled Student Program & Services (DSPS) provides educational support for eligible students with disabilities in the achievement of their academic and vocational goals. Assistance such as note takers, disabled parking, special tutoring, audio CD and E-Text for the blind, mobility aids, and equipment loans are available for students with disabilities. In addition, special-learning skills classes and computers are available to enhance DSPS students’ classroom success.

El Camino College – Special Resource Center 16007 Crenshaw Boulevard Torrance, CA 90506 Phone: (310) 660-3295 http://www.elcamino.edu/academics/src/ El Camino College established a special program to assist students with disabilities in their pursuit of a postsecondary education. The purpose of the program is to assist students with disabilities in performing on an equal basis with non-disabled students in an integrated campus setting. Upon completion of one or more Educational Development courses and/or Special Resource Center (SRC) services, a student will be able to show competency to apply requisite student skills in the integrated campus community.

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Glendale College – Disabled Student Programs & Services 1500 North Verdugo Road Glendale, CA 91208 Phone: (818) 240-1000 Ext. 5905 http://www.glendale.edu Disabled Student Programs & Services (DSPS) mission is to ensure students with disabilities are all given equal opportunity to earn a quality education at Glendale Community College. Services and accommodations include academic and personal counseling, disability assessment, adapted computer technology and instruction, academic support and instruction, alternate media, adapted physical education, interpreter and note-taking services, information and assistance to faculty, mobility assistance, and collaboration with the Department of Rehabilitation.

Independent Living Center of Southern California (Lancaster Branch) 1505 West Avenue J, Suite 102 Lancaster, CA 93534 Phone: (661) 942-9726 http://www.ilcsc.org/ The Independent Living Center of Southern California (ILCSC) is dedicated to providing services that offer the opportunity to seek an individual course towards independence while educating the community. ILCSC services include emergency services, housing assistance, advocacy, information and referral, peer support, assistive technology, benefits assistance, vocational training, independent-living skills, job placement/coaching, transition, transportation, and horticulture classes. Call for the ILCSC location in Van Nuys.

LA Dot Transit Services 201 North Los Angeles Street, Suite 18B Los Angeles, CA 90012 Phone: (323) 808-2273 http://www.ladottransit.com LA Dot Transit Services (LADOT) is a leader in the planning, design, construction, and operations of transportation systems in the City of Los Angeles and partners with sister agencies to improve transportation service and infrastructure in the city and the region. The LADOT site provides real-time arrival information for the Downtown DASH and selected Community DASH routes. To see a listing of routes, click one of the links to visit the live map or live arrival times from your desktop computer.

Long Beach Memorial Medical Center – Stroke Receiving Center 2801 Atlantic Avenue Long Beach, CA 90806 Phone: (561) 933-8832 http://www.memorialcare.org Long Beach Memorial is a dedicated Stroke Receiving Center for Los Angeles County providing patients with advanced treatment options and a highly trained stroke team, making fast response times and positive outcomes a reality. The MemorialCare Stroke Center is certified as a Primary Stroke Center by the Joint Commission, which seeks to improve the safety and quality of care provided to the public. The Joint Commission certifies that approved programs like the

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MemorialCare Stroke Center at Long Beach Memorial follow national standards and guidelines to improve outcomes for patients.

Los Angeles City College – Office of Special Services 855 North Vermont Avenue Los Angeles, CA 90029 Phone: (323) 953-4000 Ext. 2270 http://www.lacitycollege.edu/services/oss/index.html The Office of Special Services’ (OSS) mission is to facilitate equal access for students with disabilities, allowing full participation in educational programs, services, and campus activities through appropriate and reasonable accommodations. They provide support services such as note-taking assistance, interpretive services, test-taking assistance, alternative media, and more.

Los Angeles County Metropolitan Transportation Authority – LA Metro Phone: (213) 922-2000 http://www.metro.net Los Angeles County Metropolitan Transportation Authority (Metro) is unique among the nation’s transportation agencies. It serves as a transportation planner, coordinator, designer, builder, and operator for one of the country’s largest, most populous counties. Metro aims to provide a safe, clean, and reliable transportation system to the general public and people with disabilities.

Los Angeles Harbor College – Disabled Students Programs & Services 1111 Figueroa Place Wilmington, CA 90744 Phone: (310) 233-4000 http://www.lahc.edu Students with disabilities are encouraged to visit the Disabled Students Program & Services (DSPS) office. Services include assisting with Department of Rehabilitation, classroom accommodations for students with physical challenges, diagnostic assessment for learning disabilities eligibility, learning strategies/study-skills classes, liaison with recordings for the blind and dyslexic (books on tape), program planning and counseling, registration assistance, special accommodations for those with profound hearing loss/ visual impairments, special parking permits, as well as test proctoring and related accommodations.

Los Angeles Mission College – Disabled Students Programs & Services 13356 Eldridge Avenue Sylmar, CA 91342 Phone: (818) 364-7734 http://www.lamission.edu/dsps Disabled Students Programs & Services (DSPS) at Los Angeles Mission College is a support system enabling students to fully participate in the college's regular programs and activities. They provide a variety of services from academic and vocational support to assistance with Financial Aid. All services are individualized according to specific needs. They do not replace regular programs but, rather, accommodate students’ special requirements. The program is dedicated to meeting the educational, occupational, and personal needs of disabled individuals.

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Los Angeles Pierce College – Special Services 6201 Winnetka Avenue Woodland Hills, CA 91371 Phone: (818) 719-6430 http://www.piercecollege.edu/offices/special_services/ Special Services at Los Angeles Pierce College is a support system enabling students with disabilities to fully participate in the college’s regular programs and activities. They provide a variety of services from academic and vocational support to assistance with Financial Aid. All services are individualized according to specific needs. They do not replace regular programs but, rather, accommodate students’ special requirements. The program is dedicated to meeting the educational, occupational, and personal needs of disabled individuals.

Los Angeles Southwest College – Disabled Students Program & Services 1600 West Imperial Highway Los Angeles, CA 90047 Phone: (323) 241-5279 http://www.lasc.edu/dsps/index.html Disabled Students Programs & Services (DSPS) at Los Angeles Southwest College is a support system enabling students to fully participate in the college’s regular programs and activities. They provide a variety of services from academic and vocational support to assistance with Financial Aid. All services are individualized according to specific needs. They do not replace regular programs but, rather, accommodate students’ special requirements. The program is dedicated to meeting the educational, occupational, and personal needs of disabled individuals.

Los Angeles Valley College – Services for Students with Disabilities 5800 Fulton Avenue Van Nuys, CA 91401 Phone: (818) 947-2681 http://www.lavc.edu/ssd Services for Students with Disabilities (SSD) provides support services, specialized instruction, and educational accommodations to students with disabilities so they can participate as fully and benefit as equitably from the college experience as their non-disabled peers. A Student Educational Contract (SEC) is developed for each student, linking that student’s goals, curriculum program, and academic accommodations to his/her specific disability-related educational limitation.

Long Beach City College – Disabled Students Programs & Services 4901 East Carson Street Long Beach, CA 90808 Phone: (562) 938-4558 http://www.dsps.lbcc.edu Disabled Students Programs & Services (DSPS) at Long Beach City College is a support system enabling students to fully participate in the college’s regular programs and activities. They provide a variety of services from academic and vocational support to assistance with Financial Aid. All services are individualized according to specific needs. They do not replace regular

141 programs but, rather, accommodate students’ special requirements. The program is dedicated to meeting the educational, occupational, and personal needs of disabled individuals.

Mt. San Antonio College – Disabled Students Programs & Services 1100 North Grand Avenue Walnut, CA 91789 Phone: (909) 274-4290 http://www.mtsac.edu/dsps The mission of the Disabled Student Programs & Services (DSPS) is equal access. They expect students will enjoy full and equal access to any facility, class, program, service, or activity on campus. Students’ primary mission in attending college should be to receive a good education. With that in mind, DSPS is there to assist students pursuing their education at Mt. San Antonio College.

Northridge Hospital Medical Center, Center for Rehabilitation Medicine – Acute Brain Injury Program 18300 Roscoe Boulevard Northridge, CA 91328 Phone: (818) 885-8500 http://www.northridgehospital.org/Medical_Services/Rehabilitation_Medicine_Center_for/index. htm The Center for Rehabilitation Medicine (CRM) is a full-service rehabilitation program suited to treat patients who have suffered catastrophic or debilitating injury or illness. Since Northridge Hospital is a designated Adult & Pediatric Trauma Center, they often treat rehabilitation patients from the point of injury. CRM helps patients regain abilities and control of their lives. They offer treatment for all major disabling conditions including spinal cord injury, brain injury, stroke, multiple traumas, amputation, neurological disorders, arthritis, and orthopedic problems. Special programs for spinal cord injury, brain injury, stroke, and multiple traumas are offered by the center. The goal of the rehabilitation program is to deliver exceptional patient care to maximize each individual’s skills and independence.

Pasadena City College – Disabled Student Programs & Services 1570 East Colorado Boulevard Pasadena, CA 91106 Phone: (626) 585-7127 http://www.pasadena.edu/studentservices/dsps/ Disabled Students Programs & Services (DSPS) at Pasadena City College is a support system enabling students to fully participate in the college’s regular programs and activities. They provide a variety of services from academic and vocational support to assistance with Financial Aid. All services are individualized according to specific needs. They do not replace regular programs but, rather, accommodate students’ special requirements. The program is dedicated to meeting the educational, occupational, and personal needs of disabled individuals.

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Rancho Los Amigos National Rehabilitation Center 7601 East Imperial Highway Downey, CA 90242 Phone: (562) 401-7111 http://www.rancho.org/ Rancho Los Amigos National Rehabilitation Center provides care after traumatic illness or injury. They are a life support whether during recovery, rehabilitation, or reintegration back to living and loving life. The center offers rehabilitation for stroke, brain injury, spinal injury, pediatrics, orthopedic injury, and amputees.

Rio Hondo College – Disabled Students Programs & Services 3600 Workman Mill Road Whittier, CA 90601 Phone: (562) 908-3420 http://www.riohondo.edu/dsps/index.htm Disabled Students Programs & Services (DSPS) at Rio Hondo College is a support system enabling students to fully participate in the college’s regular programs and activities. They provide a variety of services from academic and vocational support to assistance with Financial Aid. All services are individualized according to specific needs. They do not replace regular programs but, rather, accommodate students’ special requirements. The program is dedicated to meeting the educational, occupational, and personal needs of disabled individuals.

Santa Monica College – Disability Resources 1900 Pico Boulevard Santa Monica, CA 90405 Phone: (310) 434-4000 http://www.smc.edu/StudentServices/DisabilityResources/Pages/default.asp Santa Monica College makes every effort to make its campus fully accessible to students with disabilities. The Center for Students with Disabilities offers guidance and counseling on admissions requirements and procedures as well as a number of special programs to help students with their academic, vocational, and career planning goals. In addition, the center offers accommodations such as tutoring, specialized equipment, and test proctoring for eligible students.

Services Center for Independent Living (Claremont Branch) 107 Spring Street Claremont, CA 91711 Phone: (909) 621-6722 http://www.scil-ilc.org/ Services Center for Independent Living (SCIL) works with people with disabilities in Los Angeles County. Services include self-advocacy training, assistive technology, housing information, independent-living skills training, peer counseling, personal care assistance, and information and referrals for a variety of timely topics. Call for the SCIL location in West Covina.

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Southern California Rehabilitation Services 7830 Quill Drive, Suite D Downey, CA 90242 Phone: (562) 862-6531 http://www.scrs-ilc.org The mission of Southern California Rehabilitation Services (SCRS) is to empower persons with disabilities to achieve their personalized goals through community education and individualized services that provide the knowledge, skills, and confidence building to maximize their quality of life. Such goals may be accomplished by providing individuals with information, referrals, direct supportive services, and/or specialized training so they may realize their full potential.

Sports Concussion Institute 5230 Pacific Concourse Drive, Suite 300 Los Angeles, CA 90045 Phone: (310) 643-9595 http://www.concussiontreatment.com/ In the case of a known or suspected concussion or an acquired brain injury, patients at the Sports Concussion Institute are assessed and treated by licensed neuropsychologists, board certified physicians, and certified athletic trainers. These individuals have extensive experience in the field of traumatic brain injury and concussion diagnosis, management, and community education. Depending on the nature of the injury and the client’s evaluation needs, the assessment may take anything from one hour (involving an interview and neurocognitive screen) to multiple hours spanning several days (more typical in cases when the injury was more severe or experienced further back in time, which requires longer-term treatment, accommodations, or rehabilitation). Regardless of the type of injury, their primary goal is to return the athlete back to play, school, work, and life as quickly and safely as possible.

Westside Center for Independent Living 12901 Venice Boulevard Los Angeles, CA 90066 Phone: (310) 390-3611 http://www.wcil.org/ The Westside Center for Independent Living (WCIL) is dedicated to assisting persons with disabilities and seniors in achieving and maintaining independent lives. Such goals are accomplished with support services and training programs provided by their peers. Independent Living promotes self-determination, community living, full participation in community life, and access to the same opportunities and resources available to people without disabilities. WCIL’s consumers are a diverse group of people of all ages and from all ethnic, cultural, and socioeconomic backgrounds. They work together with persons living with any type of disability including, but not limited to, the following: developmental, hearing, learning, mobility, physical, psychiatric, substance abuse, traumatic brain injury, and visual disabilities.

**For more brain injury resources near Los Angeles County, please see Kern County, Orange County, San Bernardino County, and Ventura County.**

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Madera

**Sorry, there are no brain injury resources in Madera County. For brain injury resources near Madera County, please see Fresno County, Mariposa County, Merced County, and Mono County.**

Marin

Brain Injury Network of the Bay Area 1132 Magnolia Avenue Larkspur, CA 94939 http://www.binba.org/ The Brain Injury Network of the Bay Area (BINBA) primarily serves traumatic brain injury survivors; today, over 30% of those served are stroke survivors and their families. BINBA is unique as its focus is on providing a coordinated network approach to post-acute brain injury rehabilitation. Post-acute rehabilitation is very important and BINBA provides long-term, affordable rehabilitation services.

College of Marin – Disabled Students Programs & Services 885 College Avenue Kentfield, CA 94904 Phone: (415) 485-9621 http://www.marin.edu/DSPS/index.html The philosophy of Disabled Student Programs & Services (DSPS) is to ensure an accessible and welcoming environment for individuals with disabilities. DSPS at College of Marin provides equal access to education to students with a wide range of permanent and temporary disabilities including learning disabilities; chronic health conditions; psychological disabilities; acquired brain injuries; and mobility, vision, and hearing impairments.

Department of Rehabilitation (Novato Branch) 75 Rowland Way, Suite 370 Novato, CA 94945 Phone: (415) 893-7702 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

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Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

Head Injury Support Group 1144 Magnolia Avenue Larkspur, CA 94939 Contact: Margaret Tilden (415) 461-6771 The Head Injury Support Group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

James C. Wilson, Ph.D. 712 D Street, Suite N San Rafael, CA 94901 Phone: (415) 485-1939 Email: [email protected] James C. Wilson is a psychotherapist. Psychotherapists are trained in neuropsychology and offer neuropsychological assessment, which can be very helpful in both demonstrating that brain damage occurred (and that the person has deficits from the TBI) and in evaluating cognitive strengths and weaknesses so plans can be made for compensation.

Kentfield Rehabilitation Hospital 1125 Sir Francis Drake Boulevard Kentfield, CA 94904 Phone: (415) 456-9680 http://www.kentfieldrehab.com Kentfield Hospital’s Brain Injury Program is renowned throughout California and beyond. Dr. Doherty is a board certified Physical Medicine and Rehabilitation Doctor (Physiatrist) who specializes in the care and management of traumatic and non-trauma related brain injuries. Additionally, the Spinal Cord Injury Program provides exceptional medical care for patients with traumatic and non-traumatic spinal cord injuries. The multidisciplinary-team approaches of Kentfield’s rehabilitation programs provide the depth of expertise needed to achieve superior outcomes.

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Marin Center for Independent Living 710 Fourth Street San Rafael, CA 94901 Phone: (415) 459-6245 http://www.marincil.org/ The mission of Marin Center for Independent Living is to assist persons with all types of disabilities to achieve their maximum level of sustainable independence as contributing, responsible, and equal participants in society. They offer a wide array of services to improve the client’s independence.

Marin County Support Group 710 Fourth Street San Rafael, CA 94903 Contact Larry at (415) 459-6245 for more information. The Marin County Support Group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

Marin Brain Injury Network of the Bay Area 1132 Magnolia Avenue Larkspur, CA 94939 Phone: (415) 461-6771 http://www.mbin.org The Marin Brain Injury Network of the Bay Area is a community re-entry program for adults with acquired brain injury. Services and programs include structured therapeutic day treatment, acquired brain injury survivor education and support group, caregiver support group, individualized therapeutic computer programs, neuropsychological assessments, psychotherapy, art therapy, occupational therapy, resource referral service, a concussion information website, and community presentations.

West Coast Post-Trauma Retreat 4460-16 Redwood Highway, Suite 362 San Rafael, CA 94903 Phone: (415) 721-9789 http://www.wcpr2001.org/index.html The West Coast Post-Trauma Retreat (WCPR) program is for first responders whose lives have been impacted by their work experience. It is a residential treatment facility and provides an educational experience designed to help current and retired first responders recognize the signs and symptoms of work-related stress, including post-traumatic stress disorder, in themselves and in others.

**For more brain injury resources near Marin County, please see Contra Costa County, Napa County, San Francisco County, and Sonoma County.**

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Mariposa

Mari-Go, Mariposa County Transit Phone: (209) 966-5315 http://www.ca-mariposacounty.civicplus.com/index.aspx?NID=422 Mari-Go, Mariposa County Transit is a general public Dial-A-Ride, curb-to-curb service with designated route areas. Vehicle operation hours are Monday through Friday, 8:30am to 4:00pm, except on holidays. Riders must call in advance to schedule rides. All buses are equipped with a lift and tie-down straps for people who use wheelchairs.

**For brain injury resources near Mariposa County, please see Madera County, Merced County, Mono County, and Tuolumne County.**

Mendocino

Community Resources for Independence (Mendocino Lake Branch) 1040 North State Street, Suite E Ukiah, CA 95482 Phone: (707) 463-8875 Community Resources for Independence (CRI) was established to advance the rights of persons with disabilities for equal justice, access, opportunity, and participation in the community.

Department of Rehabilitation (Ukiah Branch) 625 Kings Court, Suite A Ukiah, CA 95482 Phone: (707) 463-4791 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Disability Services and Legal Center 1000 Hensley Creek Road Ukiah, CA 95482 Phone: (707) 468-3000 http://www.disabilityserviceandlegal.org/ Disability Services and Legal Center (DSLC) is a resource center (one of California’s 28 Centers for Independent Living) promoting Independent Living through education, community partnerships, and advocacy.

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Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

Lake Transit Phone: (707) 263-3334 http://www.laketransit.org Lake Transit Authority (LTA) provides public transit services throughout Lake County and operates connecting routes to intercity and regional bus services in Napa and Mendocino counties.

Mendocino College – Disability Resource Center P.O. Box 3000 Ukiah, CA 95482 Phone: (707) 468-3031 http://www.mendocino.edu/tc/pg/2112/disability_resource_center.html The Disability Resource Center (DRC) offers counseling and instructional support services to disabled Mendocino College students. Some of the disabilities they work with are hearing loss, vision loss, learning disabilities, depression, psychological problems, mobility impairments, and brain injury. DRC encourages student autonomy, independence, responsibility, and equal educational opportunity.

**For more brain injury resources near Mendocino County, please see Glenn County, Humboldt County, Lake County, Sonoma County, Tehama County, and Trinity County.**

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Merced

Department of Rehabilitation (Merced Branch) 464 E. Yosemite Avenue, Suite A Merced, CA 95340 Phone: (290) 726-6529 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Merced College – Disabled Students Programs & Services 3600 M Street Merced, CA 95348 Phone: (209) 384-6155 http://www.mccd.edu/dss The Disabled Student Programs & Services’ (DSPS) purpose is to reduce the impact of a disability on the individual’s ability to fully participate in their chosen educational process. DSPS at Merced College makes a wide array of educational opportunities available to its students. The goal of DSPS is to optimize learning based on the potential of the individual, not to therapeutically remedy the disability. All disabled students are part of the college’s mainstream programs and services. While DSPS staff provides a supportive and individualized approach to the provision of services, students are encouraged to be independent and are expected to be responsible.

Merced County Transit 715 Martin Luther King Jr. Way Merced, CA 95340 Phone: (209) 384-3111 http://www.web.co.merced.ca.us/pubwrks/transport Merced County Transit provides transportation services for the general public and people with disabilities. It operates Dial-A-Ride service for the elderly, people with disabilities, and also to the general public when there is no bus route near their home.

Merced Transit Authority, “The Bus” 369 W. 18th Street Merced, CA 95340 Phone: Paratransit (209) 384-3111 The Merced Transit Authority provides transportation services for the general public and people with disabilities throughout Merced County. The website provides bus routes and schedules for the general public as well as those with disabilities.

**For more brain injury resources near Merced County, please see Fresno County, Madera County, Mariposa County, San Benito County, Santa Clara County, Stanislaus County, and Tuolumne County.**

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Modoc

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

Independent Living Services of Northern California 1161 East Avenue Chico, CA 95926 Phone: (530) 893-8527 http://www.ilsnc.org/index.html Independent Living Services of Northern California (ILSNC) is a nonprofit organization helping community members with disabilities to achieve and/or maintain their optimal level of self- reliance and independence. ILSNC provides support services (e.g., information, housing assistance, and provider referrals) and eliminates barriers to increase opportunities for participation in the community. ILSNC also works to ensure provision of needed services, identified by persons with disabilities and other community members, while supporting consumers’ rights to live independently.

Modoc Employment Center One Stop Office 221 North Main Street Alturas, CA 96101 Phone: (530) 233-5730 http://www.rehab.cahwnet.gov/ The Modoc Employment Center One Stop Office works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Passages Caregiver Resource Center 2491 Carmichael Drive, Suite 400 Chico, CA 95928 Phone: (530) 898-5925 http://www.passagescenter.org/caregivers/ Passages Caregiver Resource Center offers services for family caregivers who provide care to adults with brain and neurological impairment. The staff provides information, support, assistance, and community connections to help local caregivers.

**For more brain injury resources near Modoc County, please see Lassen County, Shasta County, and Siskiyou County.**

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Mono

Inland Caregiver Resource Center 1420 East Cooley Drive, Suite 100 Colton, CA 92324 Phone: (909) 514-1404 http://www.inlandcaregivers.com Inland Caregiver Resource Center (ICRC) is a non-profit corporation and is part of a statewide system of Caregiver Resource Centers with grant support from the California Department of Mental Health. Inland Caregiver Resource Center is a good place to start if you are looking for help in taking care of a frail, dependent older adult or a loved one with a brain impairing condition such as Alzheimer’s disease, stroke, Parkinson’s disease, Huntington’s disease, multiple sclerosis (MS), or traumatic brain injury. They provide counseling, education, training, family consultation, care planning, and referrals when needed.

**For more brain injury resources near Mono County, please see Alpine County, Inyo County, Fresno County, Madera County, Mariposa County, and Tuolumne County.**

Monterey

Central Coast Center for Independent Living 318 Cayuga Street, Suite 208 Salinas, CA 93901 Phone: (831) 757-2968 http://www.cccil.org/ Central Coast Center for Independent Living (CCCIL) promotes the independence of people with disabilities by supporting their equal and full participation in life. CCCIL provides advocacy; education; and support to people with disabilities, their families, and the community. CCCIL provides the following services to persons with disabilities who live in the counties of Santa Cruz, Monterey, and San Benito: information and referral, individual and systems change advocacy, benefits counseling, housing assistance, personal assistance services, peer support, independent-living skills training, and assistive technology.

Department of Rehabilitation (Salinas Branch) 928 E. Blanco Road, Suite 280 Salinas, CA 93901 Phone: (831) 769-8066 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

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Hartnell College – Department of Supportive Programs & Services 411 Central Avenue Salinas, CA 93901 Phone: (831) 755-6760 http://www.hartnell.edu/students/dsps Hartnell College offers supportive services and instruction for students with disabilities through the Department of Supportive Programs & Services (DSPS). To facilitate student success in academics and personal development, they provide services, instruction, and accommodations such as academic, career and personal counseling, assessment for learning disabilities, classroom accommodations, educational planning, note takers, and American Sign Language interpreters.

Monterey County Brain Injury Peer Support Group Harden Foundation 1636 Ercia Street, Salinas, CA 93901 Contact Irene Garcia at (831) 757-2968 ext.12 for more information. The Monterey County Brain Injury Peer Support Group meets the second and fourth Thursday of every month 3:30pm-5:00pm.

Monterey Peninsula College – Supportive Services Program 980 Fremont Street Monterey, CA 93940 Phone: (831) 646-4070 http://www.mpc.edu/studentservices/dsps/Pages/default.aspx The overall goal of the Supportive Services Program (SSP) is independence and maximum integration of students with disabilities. Services and/or instruction should lead to successful participation in the general college curriculum, vocational preparation, and enhanced potential for achieving personal/social goals. Services or instruction are provided in the most integrated setting possible and are directly related to the functional limitations of the student’s disability.

Monterey-Salinas Transit One Ryan Ranch Road Monterey, CA 93940 Phone: (831) 899-255 http://www.mst.org Monterey-Salinas Transit (MST) provides bus service to the greater Monterey and Salinas areas. Their goal is to provide residents and visitors with high-quality transit service. MST offers an Americans with Disabilities Act (ADA) Program to provide people with disabilities (who are unable to ride regular bus services) with curbside-to-curbside service. Reservations must be made by 5pm the day before the ride is needed and can be made up to two weeks prior to the day the ride is needed.

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Transportation Agency for Monterey County 55-B Plaza Circle Salinas, CA 93901 Phone: (831) 775-0903 http://www.tamcmonterey.org The Transportation Agency for Monterey County (TAMC) aims to develop and maintain a multimodal transportation system that enhances mobility, safety, access, and activities in Monterey County. TAMC offers an Elderly and Disabled Transportation Program to assist those individuals with their transportation needs.

**For more brain injury resources near Monterey County, please see Fresno County, Kern County, Kings County, San Benito County, San Luis Obispo, Santa Clara County, and Santa Cruz County.**

Napa

Community Resources for Independence: Napa Branch 1040 Main Street, Suite 208 Napa, CA 94559 Phone: (707) 258-0270 Community Resources for Independence’s (CRI) purpose is to assist in making a better life possible for those disabilities and to create opportunities for people with disabilities to live independently. CRI provides an array of services to best meet individual needs and maximize choice.

Department of Rehabilitation (Napa Branch) 1250 Main Street, Suite 200 Napa, CA 94559 Phone: (707) 253-4924 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Disability Services & Legal Center 1040 Main Street, Suite 208 Napa, CA 94559 Phone: (707) 528-2745 http://www.disabilityserviceandlegal.org/ Disability Services & Legal Center (DSLC) operates as a non-profit organization dedicated to enhancing lives and advancing the rights of people with disabilities in Sonoma, Napa, Lake, and Mendocino counties in California. Most of their services are free, but legal fees are contingent upon winning the case. DSLC also offers Americans with Disabilities Act (ADA) consulting to

154 businesses and organizations. Services are available by appointment or at Monday orientation. Call for more information.

Napa Valley College – Disabled Students Programs & Services 2277 Napa Vallejo Hwy Napa, CA 94558 Phone: (707) 253-3080 http://www.napavalley.edu/studentservices/dsps/Pages/default.aspx The mission of Disabled Students Programs & Services (DSPS) is to provide assistance and support to students with verified disabilities so they can succeed in Napa Valley College’s many programs and services. DSPS serves all people with disabilities and have specialized knowledge in learning disabilities, mobility disabilities, acquired brain injury, deaf and hard of hearing, and visual disabilities.

**For more brain injury resources near Napa County, please see Colusa County, Lake County, Marin County, Solano County, Sonoma County, and Yolo County.**

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Nevada

Department of Rehabilitation (Grass Valley Branch) 380 Sierra College Drive, Suite 220 Grass Valley, CA 95945 Phone: (530) 477-2600 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Dignity Health Sierra Nevada Memorial Hospital 155 Glasson Way, Building 3, Suite 220 Grass Valley, CA 95945 Phone: (530) 274-6170 http://www.snmh.org/Medical_Services/Rehabilitation/index.htm Sierra Nevada Memorial Hospital (SNMH) offers a wide range of outpatient rehabilitation services in the community. Services include neurological rehabilitation (speech, occupational, and physical therapy), fall prevention, balance and gait retraining, hand therapy, cognitive retraining, vestibular rehabilitation, community access, swallow retraining, and balance and strengthening classes.

Foundation Resources for Equality and Employment for the Disabled 154 Hughes Road, Suite 1 Grass Valley, CA 95945 Phone: (530) 272-1732 http://www.freed.org The mission of Foundation Resources for Equality and Employment for the Disabled (FREED) is to eliminate barriers for people with disabilities through programs that promote independent living and effect systems change while honoring dignity and self-determination. FREED has a number of programs focusing on issues that arise with aging and disabilities. FREED works with clients to figure out what they need and helps them get connected.

PRIDE Industries (Grass Valley Branch) 12451 Loma Rica Drive Grass Valley, CA 95945 Phone: (530) 477-1832 http://www.prideindustries.com/ PRIDE provides the support, training, and opportunity necessary to help people with disabilities overcome obstacles and find meaningful employment. PRIDE aims to be the premiere employer of people with disabilities, the vendor of choice in the markets they serve, and the recognized leader in meeting the needs of individuals in overcoming barriers to employment.

**For more brain injury resources near Nevada County, please see Placer County, Sacramento County, Sierra County, Sutter County, and Yuba County.**

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Orange

Coastline Community College – Acquired Brain Injury Program 11460 Warner Avenue Fountain Valley, CA 92708 Phone: (714) 546-7600 http://www.coastline.edu/students-with-disabilities/acquired-brain-injury/ Coastline’s Acquired Brain Injury (ABI) Program is a demanding one-year educational program designed to provide structured cognitive retraining for adults who have sustained a brain injury due to traumatic (such as a motor vehicle accident or fall) or non-traumatic (such as a non-age- related stroke, brain tumor, or infection) injuries. Coastline’s ABI Program has developed a unique curriculum to address these special needs. The ABI Program emphasizes cognitive retraining, socialization, and career development to promote individual responsibility and independence. Students in the program learn strategies to compensate for deficits in verbal skills, memory, figural skills, critical thinking, attention, and organization. With a strong focus on emotional adjustment to brain injury and appropriate psycho-social skills, the program teaches students to apply these skills to practical, real-life home and work environments. Coastline’s ABI Program also offers neuro-educational assessment, counseling for students and families, and planning for the future.

Cypress College – Disabled Students Program & Services 9200 Valley View Street Cypress, CA 90630 Phone: (714) 484-7104 http://www.cypresscollege.edu/services/dsps The Cypress College Disabled Students Program & Services (DSPS) provides services to eligible students that are individualized to meet each student’s needs. DSPS students are eligible to use the High Tech Computer Lab; be enrolled in special classes; receive priority registration; receive academic, vocational, and personal counseling; and receive assistance in connecting with other programs and resources.

Dayle McIntosh Disability Resource Center (Garden Grove) 13272 Garden Grove Boulevard Garden Grove, CA 92843 Phone: (714) 621-3300 http://www.daylemc.org/ The Dayle McIntosh Disability Resource Center (DMC) is an Independent Living Center. DMC provides people with disabilities knowledge, support, skills, and tools to live richer, fuller, and more independent lives. They aim to advance the empowerment, equality, integration, and full participation of people with disabilities in the community. Call for information on DMC locations in Laguna Hills.

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Department of Rehabilitation (Laguna Hills Branch) 24012 Calle De La Plata, Suite 220 Laguna Hills CA 92653 Phone: (949) 598-7942 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Department of Rehabilitation (Santa Ana Branch) 2002 East McFadden Avenue, Suite 100 Santa Ana, CA 92705 Phone: (714) 662-6030 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Easter Seals Disability Services: Southern California 1570 E. 17th Street Santa Ana, CA 92705 Phone: (714) 834-1111 http://www.easterseals.com/southerncal/ Easter Seals provides exceptional services, education, outreach, and advocacy so people with disabilities can live, learn, work, and play in their communities. Easter Seals offers services for autism, children, adults, seniors, military and veterans, employment and training, medical rehabilitation, and for recreation.

Fullerton College – Disability Support Services 321 East Chapman Avenue Fullerton, CA 92832 Phone: (714) 992-7270 http://www.dsp.fullcoll.edu/ Disability Support Services (DSS) at Fullerton College integrates students with disabilities into the mainstream of Fullerton College’s programs and services. DSS is committed to providing support services and/or educational accommodations to qualified students with disabilities, ensuring access and equal opportunity so students with disabilities may pursue their educational goals.

Golden West College – Disabled Students Programs & Services 15744 Goldenwest Street Huntington Beach, CA 92647 Phone: (714) 895-8721 http://www.goldenwestcollege.edu/ace

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The mission of Disabled Students Programs & Services (DSPS) is to ensure all students with disabilities have equal access to educational opportunities at Golden West College so they can participate freely and actively in all facets of campus life.

High Hopes Head Injury Program 2953 Edinger Avenue Tustin, CA 92780 Phone: (949) 733-0044 http://www.highhopes.ws/ The High Hopes Head Injury Program is dedicated to the rehabilitation and retraining of those who have been devastated by traumatic head injuries. High Hopes offers scholarship assistance for many students who would otherwise be unable to afford their programs. High Hopes has difficult financial problems as it is the lowest costing program of its kind in the nation. In addition, High Hopes offers scholarship assistance for many students who would otherwise unable to afford a program. As the cost of providing the program is not covered by student tuition income, High Hopes is only able to offer such assistance through fund raising by direct donations and events like the annual Eric Marienthal and Friends Benefit Concert.

Irvine Valley College – Disabled Students Programs & Services 5500 Irvine Center Drive Irvine, CA 92720 Phone: (949) 451-5243 http://www.ivc.edu/student/dsps/Pages/default.aspx Irvine Valley College’s Disabled Students Programs & Services (DSPS) embraces the philosophy of total integration of programs and students with disabilities into the community college system. The program was created with the goal that all educational courses and services would focus on promoting student integration. The college has successfully integrated all special instructional courses into curriculum.

Mission Hospital Regional Medical Center – Brain Injury Center 27700 Medical Center Road Mission Viejo, CA 92691 Phone: (949) 364-1400 http://www.mission4health.com/Our-Services/Brain-Injury-Center.aspx The Mission Hospital Brain Injury Center treats all types of head injuries, including concussion and traumatically injured neurologic patients. The Center works with a team of physicians; nurses; and physical, occupational, and speech therapists to create treatment and re-entry plans.

Orange Caregiver Resource Center 130 W. Bastanchury Road Fullerton, CA 92835 Phone: (714) 446-5030 http://www.caregiveroc.org The Caregiver Resource Center (CRC) is for families coping with the physical, emotional, and financial responsibilities of caregiving. By providing families with individualized supportive services, CRC stands apart as the only Orange County agency focusing specifically on the needs

159 of caregivers who are coping with a loved one’s chronic illness. Services include family consultation, assessment, care planning, counseling, referrals for resources, psycho-educational seminars, respite planning, and community education.

Orange Coast College – Special Programs and Services 2701 Fairview Road Costa Mesa, CA 92628 Phone: (714) 432-5807 http://www.orangecoastcollege.edu/student_services/special_services/Pages/default.aspx Special Programs and Services (SPS) provide support services for students with disabilities. Students with physical, learning, and psychological disabilities choose Orange Coast College for its accessible campus and the many services available through SPS. SPS offers programs and services so students with disabilities can equally access educational activities while at college.

Orange County Transportation Authority 550 S. Main Street Orange, CA 92863 Phone: (714) 560-6282 http://www.octa.net Orange County Transit Authority (OCTA) is Orange County’s primary transportation agency. OCTA was formed by consolidating seven separate transportation agencies including bus, rail, freeways, express lanes, bikes, and ride sharing. OCTA’s vision is to create an integrated and balanced transportation system supporting the diverse travel needs and reflecting the character of Orange County.

Saddleback College – Special Services Program 28000 Marguerite Parkway Mission Viejo, CA 92692 Phone: (949) 582-4566 http://www.saddleback.edu/dsps The Special Services Program provides support services, specialized instruction, and authorizes educational accommodations for students with disabilities so they can fully participate and equitably benefit in their college experience. A Student Educational Contract (SEC) is developed with each student. The SEC links students’ goals, curriculum, programs, and academic accommodations. Services may include accommodated testing, assessment of learning disabilities, specialized counseling, interpreter services for students who are deaf, alternate media, access to adapted computers and software, priority registration, and specialized instruction.

Santa Ana College – Disabled Student Programs & Services 1530 W. 17th Street Santa Ana, CA 92706 Phone: (714) 564-6000 http://www.sac.edu/studentservices/dsps The mission of Disabled Student Programs & Services (DSPS) is to provide equal access to educational opportunities for students with disabilities. Through the utilization of specialized

160 instructional programs and disability related services, DSPS encourages independence and assists students in attaining their educational, personal, and vocational goals.

Santiago Canyon College – Disabled Students Program & Services 8045 E. Chapman Avenue Orange, CA 92869 Phone: (714) 628-4860 http://www.sccollege.edu/StudentServices/DSPS Disabled Students Program & Services (DSPS) provides instructional support services and academic accommodations to students with verifiable disabilities attending college. Program services are designed to ensure students have an equal opportunity to participate and succeed in college programs, services, and activities. Available services include priority registration, registration assistance, academic advisement, test-taking accommodations, learning disabilities assessment, assistive technology, note-taking assistance, and sign language interpreters.

Sports Concussion Institute 2400 E. Katella Avenue, Suite 450 Anaheim, CA 92806 Phone: (657) 224-9681 http://www.concussiontreatment.com/ In the case of a known or suspected concussion or an acquired brain injury, patients at the Sports Concussion Institute are assessed and treated by licensed neuropsychologists, board certified physicians, and certified athletic trainers. These individuals have extensive experience in the field of traumatic brain injury and concussion diagnosis, management, and community education. Depending on the nature of the injury and the client’s evaluation needs, the assessment may take anything from one hour (involving an interview and neurocognitive screen) to multiple hours spanning several days (more typical in cases when the injury was more severe or experienced further back in time and requires longer-term treatment, accommodations, or rehabilitation). Regardless of the type of injury, their primary goal is to return the athlete back to play, school, work, and life as quickly and safely as possible.

St. Joseph Health Mission Hospital 27700 Medical Center Road Mission Viejo, CA 92691 Phone: (949) 364-1400 http://www.stjhs.org The Mission Hospital Brain Injury Center has the capabilities and training to treat a full spectrum of head injuries, including traumatically injured neurologic patients. The Traumatic Brain Injury Program was one of the first in the nation to use brain oxygen monitors to better gauge and amend treatments. By advancing their practices and adopting state-of-the-art techniques, the Center boasts a 70% positive outcome in the most severe traumatic brain injuries. Mission’s TBI program treats concussions just as seriously as severe brain injuries. The signs and symptoms of a concussion can be subtle but the effects can result in lifetime disabilities if not treated properly, so they want to ensure the person gets the best treatment possible.

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St. Jude’s Brain Injury Network 130 W. Bastanchury Road Fullerton, CA 92835 Phone: (714) 446-5626 http://www.tbioc.org The purpose of the St. Jude Brain Injury Network is to demonstrate the effectiveness of a service approach assisting persons with a traumatic brain injury to attain access into gainful employment, community reintegration programs, and affordable housing.

St. Jude’s Continuing Rehabilitation Center – Stroke Program 2767 East Imperial Highway Brea, CA 92821 Phone: (714) 578-8720 http://www.stjudemedicalcenter.org/Our-Services/Stroke.aspx St. Jude Medical Center Inpatient Rehabilitation Program is widely regarded as one of the best in the country, and it is accredited by the Joint Commission and the Commission on Accreditation of Rehabilitation Facilities (CARF). Strokes can happen at any age and the ways to treat them are as unique as the people affected. St. Jude has comprehensive programs to meet the specific needs of individuals who have experienced a stroke.

Winways Post-Acute Rehabilitation for Brain Injury 7732 East Santiago Canyon Road Orange, CA 92869 Phone: (714) 771-5276 http://www.winwaysrehab.com/winways/ Winways at Orange County offers personalized programs to meet the needs of individuals with traumatic brain injury, stroke, aneurysm, post-concussive syndrome, or other neurological disorders.

**For more brain injury resources near Orange County, please see Los Angeles County, Riverside County, San Bernardino County, and San Diego County.**

Placer

Department of Rehabilitation (Auburn Branch) 11641 Blocker Drive, Suite 125 Auburn, CA 95603 Phone: (530) 823-4040 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

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Department of Rehabilitation (Roseville Branch) 151 N. Sunrise Avenue, Suite 601 Roseville, CA 95661 Phone: (916) 774-4400 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Placer County Transit (PCT) Phone: (530) 885-BUSS http://www.placer.ca.gov/Departments/Works/Transit/PCT PCT provides a safe and direct means of transportation service for western Placer County residents. They are committed to providing comprehensive and reliable transit service and want passengers to enjoy a comfortable and pleasant ride aboard their buses.

Placer Independent Resources Services, Inc. 11768 Atwood Road., Suite 29 Auburn, CA 95603 Phone: (530) 885-6100 http://www.pirs.org/ Placer Independent Resource Services, Inc. (PIRS) is a non-profit independent living center. Their mission is to advocate, empower, educate, and provide services for people with disabilities that enable them to control their alternatives for independent living.

PRIDE Industries (Auburn Branch) 13080 Earhart Avenue Auburn, CA 95603 Phone: (530) 888-0331 http://www.prideindustries.com/ PRIDE provides the support, training, and opportunity necessary to help people with disabilities overcome obstacles and find meaningful employment. PRIDE aims to be the premiere employer of people with disabilities, the vendor of choice in the markets they serve, and the recognized leader in meeting the needs of individuals in overcoming barriers to employment.

PRIDE Industries (Roseville Headquarters) 10030 Foothills Boulevard Roseville, CA 95747 Phone: (916) 788-2100 http://www.prideindustries.com/ PRIDE provides the support, training, and opportunity necessary to help people with disabilities overcome obstacles and find meaningful employment. PRIDE aims to be the premiere employer of people with disabilities, the vendor of choice in the markets they serve, and the recognized leader in meeting the needs of individuals in overcoming barriers to employment.

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Sierra College – Disabled Student Programs & Services 5000 Rocklin Road Rocklin, CA 95677 Phone: (916) 781-0598 http://www.sierracollege.edu/student-services/specialized-programs/disabled-students/index.php Sierra College’s Disabled Student Programs & Services (DSPS) assists students with disabilities in performing on an equal basis with students without disabilities in an integrated campus setting. Services and accommodations for students include priority registration, disability counseling, academic counseling, test-taking accommodations, vocational counseling, class accommodations, and assistive technology. Sutter Rehabilitation Institute – Traumatic Brain Injury Program 6 Medical Plaza Roseville, CA 95747 Phone: (916) 878-2588 http://www.sutterroseville.org/rehab/programs/brain/ Sutter’s brain injury specialty unit is designed to meet the special behavioral and physical needs of patients who have suffered traumatic and non-traumatic brain injuries. There are 10 private rooms designed to meet the unique needs of brain injury patients. The unit is self-contained with a gym, dining/recreation area, and speech therapy in the unit. Patients can progress to the larger general populated areas as they are able to tolerate more and more stimulation.

Sutter Rehabilitation Institute Brain Injury Support Group 6 Medical Plaza Roseville, CA 95747 Phone: (916) 878-2573 The Sutter Rehabilitation Institute Brain Injury Support Group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

**For more brain injury resources near Placer County, please see El Dorado County, Nevada County, Sacramento County, Sutter County, and Yuba County.**

Plumas

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

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Feather River College – Disabled Students Program & Services 570 Golden Eagle Avenue Quincy, CA 95971 Phone: (530) 283-0202 http://www.frc.edu/studentservices/ The mission of Disabled Students Programs & Services (DSPS) is to provide equal access to educational opportunities for students with disabilities. Through the utilization of specialized instructional programs and disability related services, DSPS encourages and fosters independence and assists students in attaining their educational, personal, and vocational goals.

Independent Living Services of Northern California 1161 East Avenue Chico, CA 95926 Phone: (530) 893-8527 http://www.ilsnc.org/index.html Independent Living Services of Northern California (ILSNC) helps community members with disabilities achieve and/or maintain their optimal level of self-reliance and independence. ILSNC provides support services (e.g., information, housing assistance, and provider referrals) and eliminates barriers to increase opportunities for participation in the community. ILSNC also works to ensure provision of needed services, identified by persons with disabilities and other community members, while supporting consumers’ rights to live independently.

Passages Caregiver Resource Center 2491 Carmichael Drive, Suite 400 Chico, CA 95928 Phone: (530) 898-5925 http://www.passagescenter.org/caregivers/ Passages Caregiver Resource Center offers services for family caregivers who provide care to adults with brain and neurological impairment. The staff provides information, support, assistance, and community connections to help local caregivers.

Plumas Transit Systems 711 East Main Street Quincy, CA 95971 Phone: (530) 283-2538 http://www.plumastransit.com/default.html Plumas County Transit is dedicated to ensuring accessible transportation. Route deviation services are provided to people with disabilities who are unable to travel to and from fixed-route bus stops. Such services are offered throughout their entire fixed-route service area. All vehicles are equipped with hydraulic lifts and are designed to accommodate wheelchair users.

**For more brain injury resources near Plumas County, please see Butte County, Lassen County, Sierra County, Shasta County, Tehama County, and Yuba County.**

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Riverside

College of the Desert – Disabled Students Program & Services 43-500 Monterey Avenue Palm Desert, CA 92260 Phone: (760) 773-2534 http://www.collegeofthedesert.edu/students/dsps/Pages/default.aspx Disabled Students Programs & Services (DSPS) at College of the Desert is committed to providing students with disabilities equal access to a community college education. Through the utilization of specialized instructional programs and disability related services, DSPS encourages and fosters independence and assists students in attaining their educational and vocational goals.

Community Access Center 1310 Oak Valley Parkway Beaumont, CA 92223 Phone: (951) 769-8539 http://www.ilcac.org/ The mission of Community Access Center (CAC) is to empower persons with disabilities to control their own lives; create an accessible community; and advocate for achieving complete social, economic, and political integration. They implement this vision by providing information, supportive services, and independent-living skills training. The primary purpose of CAC is to empower consumers with disabilities by providing services and information to support them in making choices that will positively affect their independence. CAC also has locations in Palm Desert, Riverside, and Indio. Please call for more information.

Department of Rehabilitation (Inland Empire District Office) 3130 Chicago Avenue Riverside, CA 92507 Phone: (951) 782-6650 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Call for DOR locations in Blythe, Palm Desert, and Temecula.

166 sclerosis (MS), or traumatic brain injury. They provide counseling, education, training, family consultation, care planning, and referrals when needed.

Mt. San Jacinto College – Disabled Students Programs & Services 1499 North State Street San Jacinto, CA 92583 Phone: (909) 487-6752 Ext. 1440 http://www.msjc.edu/dsps Disabled Students Programs & Services (DSPS) assists students with disabilities gain maximum access to college curriculum and programs while attaining their academic, vocational, and personal goals. Students may be referred to DSPS by instructors, counselors, community agencies, high schools, a parent, or by self-referral. They are eligible for appropriate and reasonable accommodations and support services upon completion of an application, verification of the disability, and an intake interview.

Palo Verde College – Disabled Student Programs & Services 1 College Drive Blythe, CA 92225 Phone: (760) 922-6168 http://www.paloverde.edu/current-students/dsps.aspx Disabled Student Programs & Services (DSPS) is designed to assist students with disabilities. Services are offered to help students circumvent their functional limitations and become active, productive members of the college community. The program emphasizes independence and self- reliance while providing the support necessary for individuals to achieve their goals.

Riverside City College- Disabled Student Programs & Services 4800 Magnolia Avenue Riverside, CA 92506 Phone: (951) 222-8060 http://www.rcc.edu/services/disablestudents/Pages/_dsps_home.aspx Riverside City College’s Disabled Student Programs & Services (DSPS) provides support services and accommodations. Their office provides support for students with brain injuries; students with psychological, medical, mobility, and learning disabilities; and students who are deaf/hard of hearing. DSPS also wants to ensure that veterans who are coping with injuries (psychological, physical, sensory, or cognitive) are aware of the resources available to minimize their stress and facilitate their timely attainment of educational and career goals.

Stroke Recovery Center 2800 East Alejo Road Palm Springs, CA 92262 Phone: (760) 323-7676 http://www.strokerecoverycenter.org The mission of the Stroke Recovery Center (SRC) is to provide comprehensive therapeutic experiences to improve the health and functional deficits of stroke and traumatic brain injury (TBI) patients by educating and inspiring each person to continue the journey of physical

167 recovery. The rehabilitation program allows stroke and TBI survivors to participate in individualized and group therapies in a safe and supportive environment.

**For more brain injury resources near Riverside County, please see Imperial County, Orange County, San Bernardino County, and San Diego County.**

Sacramento

Access Leisure & Paralympic Sport Sacramento Club 915 I Street, Fifth Floor Sacramento, CA 95814 Phone: (916) 808-3809 http://www.accessleisuresac.org/ Access Leisure is a program of the City of Sacramento Department of Parks and Recreation. Access Leisure provides sports, residential camping, and outdoor education as well as social and fitness programs for children, teens, and adults with disabilities. The Paralympic Sport Sacramento Club program is a formal partner with the United States Olympic Committee’s Paralympic Division.

American River College – Disabled Students Programs & Services 4700 College Oak Drive Sacramento, CA 95841 Phone: (916) 484-8382 http://www.arc.losrios.edu/Support_Services/DSPS.htm The goal of Disabled Students Programs & Services (DSPS) is to promote equal access to programs and facilities at American River College, thereby ensuring students with disabilities experience the opportunity to fully participate in campus activities. The philosophy of DSPS is to encourage maximum independence and empowerment through a successful educational experience.

American River College Traumatic and Acquired Brain Injury Support Group (TABIS) 4700 College Oak Drive Sacramento, CA 95841 Phone: (916) 484-8382 Barbara Westre is a dedicated Disabled Students Programs & Services (DSPS) Counselor who developed a support group addressesing the needs and supporting the methods of students who have traumatic and acquired brain injury. The group often has guest speakers and offers a good place to learn of community resources for TBI. Call for more information on the support group.

Bond Driving School – Adaptive Training 3333 Balmoral Drive Sacramento, CA 95821 Phone: (916) 485-5779 http://www.bonddrivingschool.com

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Bond Driving School offers specialized adaptive driving instruction using the vehicle owned by the person with the disability. The school specializes in hand control evaluations and training. They assess clients’ mobility and include a detailed report to help him or her obtain the hand control devices tailored specifically for their needs. It is Bond Driving School’s aspiration to help people with disabilities regain independence by guiding the individual every step of the way from evaluation to the installation to the training on the newly equipped vehicle.

Cosumnes River College – Disability Support Programs & Services 8401 Center Parkway Sacramento, CA 95823 Phone: (916) 691-7275 http://www.crc.losrios.edu/Student_Services/DSPS.htm Disability Support Programs & Services (DSPS) provides equal educational opportunities for students with disabilities. Students are encouraged to lead active and independent lives by participating in all college programs. Counseling, support services, and academic accommodations are provided to students who are eligible for the program.

Department of Rehabilitation (Northern Sierra District Office) 721 Capital Mall Sacramento, CA 95814 Phone: (916) 558-5300 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Call for more DOR locations in Sacramento and Fair Oaks.

Disabled Sports USA of Northern California 6060 Sunrise Vista Drive, Suite 2540 Citrus Heights, CA 95610 Phone: (916) 722-6447 http://www.dsusafw.org Disabled Sports USA Far West leads the way in adaptive sports and recreation for people with disabilities. Disabled Sports has continued its rehabilitation orientation and remains dedicated to the belief that sports are a vital part of the process in which disabled individuals gain self- confidence, mobility, and greater independence. Their programs promote education, socialization, and employment; they instill in participants the knowledge that it's not their disabilities but their abilities that count.

Easter Seals Superior California 3205 Hurley Way Sacramento, CA 95864 Phone: (916) 485-6711 http://www.myeasterseals.org Easter Seals Superior California is dedicated to empowering people with disabilities by offering a wide range of services and leadership opportunities designed to encourage maximum

169 independence. Adults with disabilities looking for meaningful employment find training and career opportunities through Easter Seals job training and employment services. Easter Seals staff’s focus is to teach individuals vocational skills and appropriate work behaviors. Instruction, training, and supervision are provided in small groups and on a one-to-one basis.

Easter Seals Minimal Brain Injury Support Group 3205 Hurley Way Sacramento, CA 95864 Phone: (916) 568-6660 The Easter Seals Minimal Brain Injury Support Group is hosted by Easter Seals and is for individuals with brain injury who meet regularly to support each other by discussing common problems affecting them in their everyday lives. Please call for more information.

Folsom Lake College – Disabled Students Programs & Services 10 College Parkway Folsom, CA 95630 Phone: (916) 608-6500 http://www.flc.losrios.edu/student-services/student-aid/dsps Folsom Lake College (FLC) welcomes diverse students, including those with a variety of disabilities. Services are provided to students with physical, psychological, and learning disabilities through the FLC’s Disabled Students Programs & Services (DSPS). The program’s philosophy is to assist students with disabilities in becoming successful and independent learners who achieve their full potential and become actively engaged in the campus community.

Head Trauma Support Project 2500 Marconi Ave. Sacramento, CA 95821 Phone: (916) 568-6660 http://www.headtraumasacramento.org The Head Trauma Support Project (HTSP) is dedicated to providing resources for survivors of brain injury, their family and friends, caregivers, and medical and rehabilitation professionals. HTSP’s goal is to promote better understanding and provide treatment and quality of life for those with traumatic brain injuries. HTSP’s Survivor Group meets weekly and offers support for those recovering from brain injuries through camaraderie, social interaction, and special activities. HTSP also sponsors a weekly Family-Caregiver Support Group addressing the special challenges of caring for a loved one with TBI.

Kershaw, Cutter & Ratinoff, LLP – Traumatic Brain Injury Lawyer and Resource Center 401 Watt Avenue Sacramento, CA 95864 Phone: (916) 448-9800 http://www.kcrlegal.com/brain-injury-resource-center.aspx Kershaw, Cutter, & Ratinoff (KCR) Northern California Brain Injury Lawyers represent injured people and businesses throughout the nation and are passionate about getting great results for their clients. Their lawyers are known for victories in cases involving serious personal injuries, automobile and motorcycle accidents, insurance bad faith, brain and spinal cord injuries,

170 dangerous drugs, defective mobile devices, wage and hour claims, class action lawsuits, consumer fraud, product liability, false claims, medical malpractice, elder abuse, asbestos injuries, and complex litigation. Eric J. Ratinoff is a partner in the firm who has a passion for those with brain injuries. In 2013, he was elected to the Board of Directors of the California Brain Injury Association (BIACAL). The Traumatic Brain Injury Resource Center has a multitude of information and resources on TBI and other types of brain injuries.

Mercy General Hospital Acute Rehabilitation Program – Neurological Institute of Northern California 4001 J Street Sacramento, CA 95819 https://www.hospitals.dignityhealth.org/sacramento/Pages/services/neurology/Neuro- Rehabilitation.aspx Mercy General Hospital’s Acute Neurological Rehabilitation Program provides intensive rehabilitation services to help patients develop the skills needed to return to a life of independence. The neurological rehabilitation team works with patients to set goals and develop an individual treatment program to help them learn self-advocacy, responsibility, and self- management. Mercy’s Neurological Rehabilitation program is one of only four California demonstration projects for rehabilitative treatment of traumatic brain injury. About 60% of the patients served on the unit have sustained either an acquired or traumatic brain injury.

Mercy Outpatient Rehabilitation Center – Return to Work Program 7777 Greenback Lane, Suite 110 Citrus Heights, CA 95610 Phone: (916) 453-7944 https://www.hospitals.dignityhealth.org/sacramento/Pages/services/rehabilitation/Outpatient- Rehabilitation-Center.aspx Mercy strives to provide rehabilitative care in an environment that encourages recovery, independence, and a positive sense of wellbeing. Their rehabilitation team works with patients to set goals and develop an individualized treatment programs to help them learn self-advocacy, responsibility, and self-management. The Mercy Outpatient Rehabilitation Center (MORC) has a specialized Traumatic Brain Injury Program and a neuro team who have extensive experience working with TBI. MORC works hand in hand with the California Department of Rehabilitation to assess individuals with brain injury to see how they are currently functioning and assess their readiness to return to work.

PRIDE Industries (Sacramento Branch) 1281 National Drive Sacramento, CA 95834 Phone: (916) 649-9499 http://www.prideindustries.com/ PRIDE provides the support, training, and opportunity necessary to help people with disabilities overcome obstacles and find meaningful employment. PRIDE aims to be the premiere employer of people with disabilities, the vendor of choice in the markets they serve, and the recognized leader in meeting the needs of individuals in overcoming barriers to employment. Call for more PRIDE locations in Sacramento, North Highlands, and Fair Oaks.

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Regional Transit- Sacramento 1225 R Street Sacramento, CA 95814 Phone: (916) 321-2877 http://www.sacrt.com Sacramento Regional Transit (SacRT) is a bus and light rail service in Sacramento County. SacRT connects to other bus systems in Folsom and Placer County and is for the general public and for people with disabilities.

Resources for Independent Living 420 I Street, Suite 3 Sacramento, CA 95814 Phone: (916) 446-3074 http://www.ril-sacramento.org/ Resources for Independent Living (RIL) aims to promote the socioeconomic independence of persons with disabilities by providing independent living services and advocacy. Services include information, referrals, advocacy, independent living skills, assistive technology, peer counseling, personal assistance services, and housing.

Sacramento Area Brain Tumor Support Group 4860 Y Street Sacramento, CA 95814 Contact: Karen Smith (916) 734-6511 The Brain Tumor Support Group offers emotional support and educational programs to patients with brain tumors, their families, and their friends. The group meets the first Thursday of the month at 6:30pm.

Sacramento City College – Disabled Resource Center 3835 Freeport Blvd. Sacramento, CA 95822 Phone: (916) 558-2087 http://www.web.scc.losrios.edu/disabilitiescenter/ The Disability Resource Center (DRC) of Sacramento City College (SCC) provides educational opportunities and access to students with disabilities who intend to take classes at SCC. A variety of services are available at the DRC that give students with disabilities the opportunity to fully participate in all aspects of college programs and activities through appropriate and reasonable accommodations.

Sacramento Regional Transit District P.O. Box 2110 Sacramento, CA 95812 Phone: (916) 321-2849 http://www.sacrt.com The Sacramento Regional Transit District (RT) operates 67 bus routes in the Sacramento area. RT’s entire bus and light rail system is accessible to people with disabilities, and RT also

172 provides a door-to-door transportation service for Sacramento area residents who are unable to use fixed-route service. RT provides this service through a contract with Paratransit, Inc.

Sacramento Van Conversions & Mobility 5821 Florin Perkins Road Sacramento, CA 95828 Phone: (916) 381-8267 http://www.sacvans.com Sacramento Van Conversions provides transportation and mobility alternatives for people with disabilities. They provide mobility vans and mobility services of the highest quality standards while adhering to the safest industry transportation standards. Trained technicians can help consumers find the right product to suit their mobility needs. They sell new and used wheelchair accessible vans, power chairs, scooters, and lifts; they also offer repairs and service.

South County Transit 1117 Camellia Way Galt, CA 95632 Phone: (209) 745-3052 http://www.sctlink.com South County Transit provides Dial-A-Ride and fixed-route services to Galt and unincorporated areas of South Sacramento County for people with disabilities and the general public.

Statewide Independent Living Centers (SILC) 1600 K Street, Suite 100 Sacramento, CA 95814 Phone: (916) 445-5627 Centers for Independent Living (CILs) provide services to maximize the independence of individuals with disabilities and the accessibility of the communities in which they live. CILs provide several core services including advocacy, independent-living skills training, information and referral, and peer counseling.

**For more brain injury resources near Sacramento County, please see Amador County, Contra Costa County, El Dorado County, Placer County, San Joaquin County, Solano County, Sutter County, and Yolo County.**

San Benito

Central Coast Center for Independent Living 1111 San Felipe Road, Suite 107 Hollister, CA 95023 Phone: (831) 636-5196 http://www.cccil.org/ Central Coast Center for Independent Living (CCCIL) promotes the independence of people with disabilities by supporting their equal and full participation in life. CCCIL provides advocacy;

173 education; and support to people with disabilities, their families, and the community. They provide the following services: information and referral, individual and systems change advocacy, benefits counseling, housing assistance, personal assistance services, peer support, independent-living skills training, and assistive technology.

Del Mar Caregiver Resource Center 40 Central Avenue Salinas, CA 93901 Phone: (831) 424-4359 http://www.delmarcaregiver.org The Del Mar Caregiver Resource Center helps family caregivers care for their loved ones and themselves. They offer services for family caregivers of adults living with a brain impairment such as Alzheimer’s disease, stroke, dementia, Huntington’s disease, Parkinson’s disease, multiple sclerosis, mild cognitive impairment, brain tumors, brain injury, and other conditions that may cause memory loss or confusion. They offer services for care planning, counseling and support groups, workshops and training, legal and financial consultation, and respite care.

**For more brain injury resources near San Benito County, please see Fresno County, Merced County, Monterey County, and Santa Clara County.**

San Bernardino

Barstow College – Office of Student Support 2700 Barstow Road Barstow, CA 92311 Phone: (760) 252-2411 ext. 7225 http://www.barstow.edu/StudentServices/DSPS/ The ACCESS program for students with disabilities strives to remove barriers that may prevent a student from succeeding in a classroom or college environment. They provide reasonable accommodations geared toward an individual’s disability without changing the fundamental elements of the course. The program works with all people with disabilities including those with brain injuries.

Chaffey College – Disability Programs and Services 5885 Haven Avenue Rancho Cucamonga, CA 91701 Phone: (909) 652-6379 http://www.chaffey.edu/DPS/index.shtml Chaffey College Disability Programs and Services (DPS) provides individuals with disabilities the opportunity to acquire the necessary knowledge and skills for increased self-actualization and independence; this allows students an equal opportunity to the same quality education as any other student. Such skills may also be used to gain a college degree or for vocational development leading to employment.

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Crafton Hills College – Disabled Student Services 11711 Sand Canyon Road Yucaipa, CA 92399 Phone: (909) 389-3325 http://www.craftonhills.edu/Current_Students/Disabled_Student_Services Disabled Student Programs & Services (DSPS) provides support services, specialized equipment, and educational accommodations to students with disabilities so they can fully participate and benefit from the college experience. To qualify for support services, one must be enrolled at Crafton, have a disability, and must have the ability to benefit from support.

Head Injury & Trauma Spinal Support Group (HITSS) 11406 Loma Linda Drive, Room 129A Loma Linda, CA 92354 Phone: (800) 986-4487 http://www.teampossabilities.org PossAbilities is a free community outreach program developed by the Loma Linda University Medical Center East Campus. Its goal is to offer individuals with disabilities a sense of community. They also provide activities and practical help to integrate them back into life, once again giving them the opportunity to be valuable members of our communities.

Inland Caregiver Resource Center 1420 East Cooley Drive, Suite 100 Colton, CA 92324 Phone: (909) 514-1404 http://www.inlandcaregivers.com Inland Caregiver Resource Center (ICRC) is a non-profit corporation and is part of a statewide system of Caregiver Resource Centers with grant support from the California Department of Mental Health. ICRC is a good place to start if you are looking for help in taking care of a loved one with a brain impairing condition such as Alzheimer’s disease, stroke, Parkinson’s disease, Huntington’s disease, multiple sclerosis (MS), or traumatic brain injury. They provide counseling, education, training, family consultation, care planning, and referrals when needed.

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Rolling Start, Inc. (San Bernardino Branch) 570 West Fourth Street San Bernardino, CA 92401 Phone: (909) 884-2129 http://www.RollingStart.org Rolling Start, Inc. (RSI), a resource center for independent living, provides the general public with some information that will lead to a clearer understanding of a Center for Independent Living (CIL). Services include information and referral, independent living skills, advocacy, peer advising, housing, personal assistants, assistive technology, and transition services. Call for information on the Victorville RSI location.

San Bernardino Valley College – Disabled Students Programs & Services 701 South Mt. Vernon Avenue San Bernardino, CA 92410 Phone: (909) 384-4443 http://www.valleycollege.edu/student-services/specialized-counseling-services/disability-services Disabled Students Programs & Services (DSPS) is committed to providing students with disabilities an accessible educational environment allowing each student the opportunity to reach his/her academic goals and participate in campus programs and activities. DSPS provides support services to accommodate for disability-related educational limitations. Such support services are essential components of the educational program because they help disabled students realize their educational potential in mainstream academic programs.

Victor Valley College – Disabled Students Programs & Services 18422 Bear Valley Road Victorville, CA 92392 Phone: (760) 245-4271 http://www.vvc.edu/offices/disabled_student_program_services/ Victor Valley College Disabled Students Programs & Services (DSPS) gives individuals with disabilities the opportunity to acquire the necessary knowledge and skills for increased self- actualization and independence. Such skills may also be used to gain a college degree or for vocational development leading to employment. DSPS has been designed to respond to the individual needs of students with disabilities eligible for services, allowing students equal opportunity to the same quality education as any other student.

**For more brain injury resources near San Bernardino County, please see Inyo County, Kern County, Los Angeles County, Orange County, and Riverside County.**

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San Diego

Access to Independence (San Diego Branch) 8885 Rio San Diego Drive, Suite 131 San Diego, CA 92108 Phone: (619) 293-3500 http://www.accesstoindependence.org/ At Access to Independence (a2i), advocacy programs take the form of information, education, and referral. They work with consumers to teach independent-living skills, assess which resources will be of further assistance, and give consumers the tools they need to move forward as their own advocate. Employment services work with each client to assess employment qualifications and begin the job-development process. Clients are given opportunities to assess their employment needs, create and perfect resumes, work on job applications, and practice interview skills. Call for information on the a2i location in Vista, CA.

Alpine Physical Therapy & Wellness Center (Alpine) 2549 Alpine Boulevard Alpine, CA 91901 Phone: (619) 445-3168 http://www.aptwc.com Alpine Physical Therapy & Wellness (APTW) is dedicated to providing the best physical therapy, medical services coordination, and health for their clients. There is treatment for orthopedic/sports injuries, post-surgical conditions including total joint replacement, stroke, brain injury, spinal cord injury, balance disorders, geriatric exercise guidance, manual therapy and joint mobilization techniques, work related and cumulative trauma injuries, back injuries, and wellness programs. Call for information on the APTW location in Julian, CA.

Cuyamaca College – Disabled Students Programs & Services 900 Rancho San Diego Parkway El Cajon, CA 92019 Phone: (619) 660-4239 http://www.cuyamaca.edu/dsps/ Disabled Students Programs & Services (DSPS) assists students with disabilities by determining and providing appropriate academic accommodations related to their disabilities so they can achieve their educational goals. DSPS facilitates inclusive and sustainable learning environments and increases success for students with disabilities through innovative support services.

Department of Rehabilitation (San Diego District Office) 7575 Metropolitan Drive, Suite 107 San Diego, CA 92108 Phone: (619) 767-2100 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living,

177 and equality for individuals with disabilities. Call for DOR locations in La Mesa, San Marcos, and Chula Vista.

Grossmont College – Disabled Student Programs & Services 8800 Grossmont College Drive El Cajon, CA 92020 Phone: (619) 644-7000 http://www.grossmont.edu/dsps/ Disabled Student Programs & Services (DSPS) at Grossmont College was established to accommodate the academic needs of students with disabilities. DSPS offers eligible students access to a variety of specialized support services and assistive equipment. Such services are intended to accommodate students with disabilities in regular college programs and activities.

Learning Services: Specialists in Brain Injury Care 2335 Bear Valley Parkway Escondido, CA 92027 http://www.learningservices.com/ Learning Services understands the serious challenges facing people who have sustained a brain injury; they help families navigate the complicated process of treatment, recovery, and rehabilitation. The acquired brain injury (ABI) rehabilitation programs take place within a residential environment, designed to deliver comprehensive therapy in a real-world setting. Specific programs include post-acute neuro-rehabilitation, neurobehavioral rehabilitation, day treatment, and supported living. Such programs provide therapeutic environments and functional-based treatment designed to meet the individual needs of residents.

Mira Costa College – Disabled Students Programs & Services 1 Bernard Drive Oceanside, CA 92056 Phone: (760) 795-6658 http://www.miracosta.edu/studentservices/dsps/ Disabled Students Programs & Services (DSPS) assists students with disabilities by providing appropriate academic accommodations related to their disabilities so they can achieve their educational goals. DSPS facilitates inclusive and sustainable learning environments and increases opportunities for access and success for students with disabilities through innovative support services.

Palomar College – Disability Resource Center 1140 West Mission Road San Marcos, CA 92069 Phone: (760) 744-1150 ext. 2375 http://www.palomar.edu/drc The Disability Resource Center (DRC) is a department within the division of Student Services. DRC staff is available to facilitate services for students with various documented disabilities, and it offers a variety of services and equipment for student use. The goal of DRC is to create an environment encouraging students to function effectively, enabling students to participate in regular college curriculum.

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San Diego Brain Injury Foundation P.O. Box 84601 San Diego, CA 92138 Phone: (619) 294-6541 http://www.sdbif.org The San Diego Brain Injury Foundation (SDBIF) was founded as a resource for people with brain injuries in San Diego County to provide information, support, education, and community awareness. The mission of SDBIF is to improve the quality of life for brain injury survivors and their families living in San Diego County.

San Diego City College – Disability Support Programs & Services 1313 Park Boulevard San Diego, CA 92101 Phone: (619) 388-3513 http://www.sdcity.edu/CollegeServices/StudentSupportResources/DSPSDisabilitySupportProgra msandServices.aspx Disability Support Programs & Services (DSPS) provides services and courses to support students with disabilities in the achievement of their academic and vocational goals. The instructional component promotes equal participation in mainstream academic programs through preparatory and skill maintenance courses and offers courses for personal growth.

San Diego Mesa College – Disability Support Programs & Services 7250 Mesa College Drive San Diego, CA 92111 Phone: (619) 388-2780 http://www.sdmesa.edu/students/services/dsps/ The Disability Support Programs & Services (DSPS) at Mesa College aims to accommodate the academic needs of students with disabilities. DSPS offers eligible students access to a variety of specialized support services and assistive equipment intended to assist college students with disabilities in successfully participating in regular college programs and activities.

San Diego Miramar College – Disability Support Programs & Services 10440 Black Mountain Road San Diego, CA 92126 Phone: (619) 388-7800 http://www.sdmiramar.edu/students/dsps Disability Support Programs & Services (DSPS) at Miramar College offers a variety of services for students with disabilities including those with learning disabilities; impairments in vision, hearing, and mobility; psychiatric conditions; acquired brain injuries; and other medical disabilities. A Student Education Plan is developed for each student based on their academic and vocational goals, strengths, and limitations.

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San Diego Metropolitan Transit System Phone: (619) 557-4555 http://www.sdmts.com/ The Metropolitan Transit System (MTS) provides bus and rail services directly or by contract with private operators. MTS coordinates all its services and determines the routing, stops, frequencies, and hours of operation. There are 93 fixed bus routes and Americans with Disabilities Act (ADA) complementary paratransit service (MTS Access). Fixed-route bus services include local, urban, express, premium express, and rural routes.

Southwestern College – Disability Support Services 900 Otay Lakes Road Chula Vista, CA 91910 Phone: (619) 482-6512 http://www.swccd.edu/index.aspx?page=336 The mission of Disability Support Services (DSS) is to develop an inclusive, accessible, and sustainable educational environment at Southwestern College that promotes student success through innovative accommodations; programs; trainings; and partnerships with students, educators, and the community. Accommodations and services include academic advising, counseling, registration assistance, test proctoring, sign language interpreting, personal- development classes, academic accommodations, and use of the High Tech Center.

Southern Caregiver Resource Center 3675 Ruffin Road, Suite 230 San Diego, CA 92123 Phone: (858) 268-4432 http://www.caregivercenter.org The Southern Caregiver Resource Center (SCRC) provides free support services for family caregivers caring for adults with chronic and/or disabling conditions. They provide referrals, consultations, resources, counseling, and respite services to caregivers of adults with brain injuries. Call for an updated list of support groups in your area.

Veterans Administration San Diego Health Care 3350 La Jolla Village Drive San Diego, CA 92161 Phone: (858) 552-8585 http://www.sandiego.va.gov/services/Traumatic_Brain_Injury.asp The Veterans Administration (VA) San Diego Healthcare System provides comprehensive screening, evaluation, and treatment for Veterans with Traumatic Brain Injury. Their Polytrauma Support Clinic Team provides and coordinates interdisciplinary rehabilitation services for Veterans. Any Veteran entitled to benefits (discharged from military service under other than dishonorable conditions) and medically stable is eligible for admission into the Polytrauma System of Care. The patient must have sustained multiple physical, cognitive, and/or emotional injuries secondary to trauma.

**For more brain injury resources near San Diego County, please see Imperial County, Orange County, and Riverside County.**

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San Francisco

Abramson Smith Waldsmith LLP – Brain Injury & Spinal Cord Injury Lawyer 44 Montgomery Street, Suite 3340 San Francisco, CA 94104 Phone: (415) 421-7995 http://www.aswllp.com/CM/Custom/TOCTraumaticBrainInjuryOverview.asp The brain injury attorneys at Abramson Smith Waldsmith, LLP work closely with clients and their families to ensure their medical condition has been thoroughly assessed and they are receiving appropriate care. This law firm goes the extra mile to ensure clients receive full and fair compensation. They are known for their use of cutting-edge technology to demonstrate the injury and explain how it has affected their clients.

Bracamontes & Vlasak: A Professional Law Coorporation – Brain Injury Accident Lawyers 220 Montgomery Street, Suite 870 San Francisco, CA 94104 Phone: (415) 906-3146 http://www.bvlawsf.com/Personal-Injury/Brain-Injuries.shtml Bracamontes & Vlasak (BV Law) has success in aggressively litigating pediatric brain injury, anoxic brain injury, and neurotoxic brain injury cases. Whether a person or company is responsible for the brain damage or traumatic brain injury suffered is something that needs to be determined on a case-by-case basis. Initial consultations are free. The vast majority of cases are taken on a contingency fee basis, meaning they do not get paid unless the client recovers.

Brainstorm 207 Skyline Boulevard San Francisco, CA 94132 Phone: (415) 213-8558 http://www.prrcsf.org/index.php/services-and-support/traumatic-aquired-brain-injury/brainstorm Brainstorm is a unique, social recreation and community integration program serving adults who have an acquired or traumatic brain injury. A diverse selection of classes are provided to assist participants in the process of developing or relearning valuable skills needed to function as independently as possible in the community.

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California Pacific Regional Rehabilitation Center Castro Street & Duboce Street San Francisco, CA 94114 Phone: (415) 600-5393 http://www.cpmc.org/services/rehabcenter/ As part of Sutter Health, Regional Rehabilitation services at California Pacific Medical Center (CPMC) features some of the top-rated rehabilitation physicians in the San Francisco Bay Area and Northern California. They provide personalized patient care using the most advanced acute rehabilitation and outpatient rehabilitation therapy available. Services include rehabilitation for brain injury, stroke, spinal cord injury, congenital deformity, amputation, major multiple traumas, hip fractures, burns, neurological disorders, arthritis, pulmonary, transplant, cardiac, oncology, and general medicine.

CalTrain 1250 San Carlos Avenue P.O. Box 3006 San Carlos, CA 94070 Phone: (800) 660-4287 http://www.caltrain.com CalTrain provides train service between San Francisco and Gilroy and has routes in San Francisco County, San Mateo County, and Santa Clara County. CalTrain is a proof-of-purchase system. Passengers must have a valid ticket before boarding the train and must show their ticket to a conductor or fare inspector upon request. Tickets are not sold on the train.

Centre for Neuro Skills – San Francisco 2200 Powell Street, Suite 120 Emeryville, CA 94608 http://www.neuroskills.com The Centre for Neuro Skills (CNS) has post-acute medical treatment, therapeutic rehabilitation, and disease management services with specially trained staff for individuals recovering from acquired brain injury. Their cost-effective, patient-centered programs maximize treatment effect, learning generalization, and stability of recovery in real-world settings. The goal is to facilitate skill acquisition and help each patient resume a normal rhythm of living. The brain injury programs and services include post-acute inpatient rehabilitation, neurobehavioral rehabilitation, outpatient and day treatment, assisted living, multicultural programs, family education, community reintegration, and home evaluations.

Choulos Choulos & Wyle – San Francisco Brain Injury Attorney 425 California Street San Francisco, CA 94104 Phone: (415) 951-6231 http://www.ccwlawyers.com/Serious-Injuries/Brain-Injury.shtml Choulos Choulos & Wyle have extensive experience in the area of catastrophic personal injuries, including brain injuries. Their California brain injury lawyers also have extensive experience handling cases involving brain injuries to infants and children. Traumatic brain injuries dramatically affect the lives of brain-injured people and their families. In many cases, these

182 injuries leave individuals permanently disabled or in need of months and sometimes years of rehabilitation and therapy. Their TBI attorneys want to make sure injured clients (and their families) have the resources they need to deal with these drastic changes. They handle brain injury cases in the San Francisco Bay Area and throughout California including San Francisco, Oakland, Sacramento, San Jose, and other communities.

City College of San Francisco – Disabled Students Programs and Services 50 Phelen Avenue, Room 323 San Francisco, CA 94112 Phone: (415) 452-5481 http://www.ccsf.edu/NEW/en/student-services/student-counseling/dsps/about.html The City College of San Francisco (CCSF) Disabled Students Programs and Services (DSPS) is a partnership between students and DSPS staff. The staff consists of faculty members, counselors, disability specialists, technology and media specialists, instructional assistants, interpreters, and office staff. Counselors help students identify their academic and career goals and develop appropriate accommodations for them to succeed.

Concussion and Brain Injury Program 1500 Owens Street San Francisco, CA 94158 Phone: (415) 353-1915 http://www.ucsfhealth.org The Bay Area Concussion and Brain Injury Program at UCSF is the region’s premier center for evaluating and treating head injuries in athletes. Their team includes experts from specialties such as sports medicine, physical medicine and rehabilitation, neuropsychology, neuroradiology, neurology, and neurosurgery. With this combined expertise, the program can evaluate, diagnose, and manage virtually any sports concussion and help athletes safely recover and return to sports.

Department of Rehabilitation (San Francisco District Office) 301 Howard Street, Suite 700 San Francisco, CA 94105 Phone: (415) 904-7100 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

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Family Member Support Group (Parents and Caregivers) 207 Skyline Boulevard San Francisco, CA 94132 Phone: (415) 213-8558 The Family Member Support Group is meant for the parents and caregivers of those with chronic and/or disabling conditions since it is important for caregivers to have someone to talk to who is going through similar situations. Contact Terry Twitchell for more information.

Golden Gate Bridge, Highway & Transportation District 1011 Andersen Drive San Rafael, CA 94901 http://www.goldengate.org Golden Gate Bridge, Highway and Transportation District provide transportation to the general public and to people with disabilities through the Golden Gate Transit and Golden Gate Ferry public transit systems. All transportation services are accessible to people with disabilities.

Independent Living Resource Center of San Francisco 649 Mission Street, 3rd Floor San Francisco, CA 94105 Phone: (415) 543-6222 http://www.ilrcsf.org/ Independent Living Resource Center of San Francisco (ILRC-SF) is a group of professionals and volunteers who are passionate about supporting and empowering people with disabilities to lead meaningful, independent lives and to actively participate in their communities. They work collaboratively with individuals to help them determine what services and programs are right for them. They provide information and referrals related to assistive technology, housing, employment, eligibility for benefits, and free peer counseling.

Muni (San Francisco Railway) 949 Presidio Avenue #150A San Francisco, CA 94115 Phone: (415) 923-6142 http://www.sfmta.com/ Muni provides transportation services around the San Francisco area to the general public and to people with disabilities. Almost all bus lines are accessible to wheelchairs, and there are paratransit services for people with disabilities who are unable to use bus and light rail services.

Ron Ruff, Ph.D. – S.F. Neuropsychological Services 909 Hyde Street, Suite 620 San Francisco, CA 94109 Phone: (415) 771-7833 http://www.ronruff.com Dr. Ruff is a clinical neuropsychologist and rehabilitation psychologist who specializes in working with patients who have sustained traumatic brain injury (TBI). The focus of his research and clinical work in neuropsychology has been assessing and treating the cognitive and psychological changes that occur with neurological illness. He has developed and published

184 several tests addressing specific functions often compromised in patients with TBI. The therapeutic model includes evaluating not only the patient’s cognitive strengths and weaknesses but also their emotional status. He also integrates the caregivers’ and community’s role into the patient’s rehabilitation. Dr. Ruff built a support network for his patients and their families by founding the San Diego Brain Injury Foundation, which remains a successful organization.

San Francisco General Hospital BASIC Support Group 1001 Potrero Avenue San Francisco, CA 94110 Phone: (415) 437-3035 http://www.bcftbi.org/tbi-resources/support-groups-details.asp?5 The San Francisco General Hospital and Trauma Center (SFGH) is recognized as one of the nation’s top hospitals with inpatient, outpatient, emergency, diagnostic, and psychiatric services for adults and children. They host a TBI support group called BASIC for individuals with brain injury and their caregivers so they have people to turn to who have similar experiences.

San Francisco Traumatic Brain Injury Network 207 Skyline Boulevard San Francisco, CA 94132 Phone: (415) 213-8558 http://www.prrcsf.org/index.php/services-and-support/traumatic-aquired-brain-injury/traumatic- brain-injury-network The San Francisco Traumatic Brain Injury Network (SF TBI) is a collaborative project between the Pomeroy Recreation and Rehabilitation Center, the Department of Rehabilitation, and St. Mary’s Medical Center. SF TBI’s primary goal is to empower adults with a TBI to utilize existing programs to return to the community and achieve optimal independence.

Scarlett Law Group 536 Pacific Avenue San Francisco, CA 94133 Phone: (415) 352-6264 http://www.scarlettlawgroup.com Randall H. Scarlett is a board member and executive committee member of the Brain Injury Association of California. He is also a past chair and current board member of the Traumatic Brain Injury Litigation Section of the American Association for Justice. He has dedicated much of his professional and personal time to the services of those sustaining TBI.

**For more brain injury resources near San Francisco County, please see Marin County and San Mateo County.**

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San Joaquin

Altamont Corridor Express (ACE) 949 East Channel Street Stockton, CA 95202 Phone: (209) 944-6220 http://www.acerail.com Altamont Corridor Express (ACE) provides weekday commuter train service between the San Joaquin Valley and the Santa Clara Valley. For individuals with disabilities, trains are wheelchair accessible.

Department of Rehabilitation (Stockton Branch) 1507 East March Lane, Suite A Stockton, CA 95210 Phone: (209) 473-5900 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Disability Resource Agency for Independent Living (DRAIL) 501 West Weber Avenue, Suite 200-A Stockton, CA 95203 Phone: (209) 477-6342 http://www.drail.org/ Disability Resource Agency for Independent Living (DRAIL) works to ensure a life of possibility is a reality for the members in their community living with a disability. They want to enable clients to live independently, and they do so by supporting clients with technology and helping clients get connected to resources and services improving quality of life.

San Joaquin Delta College – Disabled Support Programs & Services 5151 Pacific Avenue Stockton, CA 95207 Phone: (209) 954-5330 http://www.deltacollege.edu/dept/dsps/index.html Disabled Support Programs & Services (DSPS) empowers students with disabilities to achieve their goals and become contributing members of society by eliminating barriers and facilitating services for students to become accountable, self-reliant, responsible, and capable. The primary purpose of DSPS is to provide access and support to students in academic programs. Staff assists students with academic accommodations and services authorized by DSPS counselors.

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San Joaquin General Hospital Rehabilitation Center 500 West Hospital Road French Camp, CA 95231 Phone: (209) 468-6280 http://www.sjphysicalmedicine.com The Rehabilitation Center at San Joaquin General Hospital provides comprehensive inpatient rehabilitation for patients. Individualized intensive rehabilitation therapy programs provide patients the opportunity for maximum achievable recovery and independence.

San Joaquin Regional Transit District 1533 East Lindsay Street Stockton, CA 95205 Phone: (209) 943-1111 http://www.sj-smart.com San Joaquin Regional Transit District (SJRTD) provides transportation services to the general public and people with disabilities. They offer bus routes between cities and commuter service for those traveling long distances. SJRTD also operates Dial-A-Ride paratransit services for use by people with disabilities who are unable to use regular services.

**For more brain injury resources near San Joaquin County, please see Amador County, Calaveras County, Contra Costa County, Sacramento County, Santa Clara County, and Stanislaus County.**

San Luis Obispo

Cuesta College – Disabled Student Programs & Services Highway 1 San Luis Obispo, CA 93403 Phone: (805) 546-3148 http://www.cuesta.edu/student/servs_classes/dsps/ Disabled Student Programs & Services (DSPS) at Cuesta College aims for the full participation of students with disabilities in all aspects of their education. DSPS advocates and facilitates equal educational opportunities through appropriate support services, instruction, policies, and funding allocations. DSPS works to eliminate discrimination against students with disabilities and to promote their independence, growth, productivity, and equality. Their goal is to provide academic accommodations and other services to assist students in achieving their academic goals.

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Department of Rehabilitation (San Luis Obispo Branch) 3220 S. Higuera Street, Suite 102 San Luis Obispo, CA 93401 Phone: (805) 549-3361 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Independent Living Resource Center, Inc. 7425 El Camino Real, Suite R Atascadero, CA 92422 Phone: (805) 462-1162 http://www.ilrc-trico.org/ All services at the Independent Living Resource Center (ILRC) are a combined effort of the consumers and the staff. They work to provide information about the array of choices available and assist consumers in following the path they want. Importantly, the ILRC strives to ensure all disabled veterans have access to the best and most up to date support services available. Through the ILRC Veterans Outreach Program, a vast array of community-based services and support exists to serve those who have served their country. Disabilities including post-traumatic stress disorder, traumatic brain injury, and many others can come about as a result of military service. ILRC aims to help these disabled veterans.

Sierra Vista Regional Medical Center 1010 Murray Avenue San Luis Obispo, CA 93405 Phone: (805) 546-7600 http://www.sierravistaregional.com The Rehabilitation Services Department of Sierra Vista Hospital provides a comprehensive multidisciplinary team approach designed to help inpatients reach their full potential. Their team of physical therapists, occupational therapists, and speech language pathologists work together with the patient, family, and medical team to meet realistic and meaningful goals of recovery. Goals are specific to each individual. Therapy can range from brief consultation for minor injuries to long-term intervention for more severe disabilities.

**For more brain injury resources near San Luis Obispo County, please see Kern County, Kings County, Monterey County, and Santa Barbara County.**

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San Mateo

Canada College – Disability Resource Center 4200 Farm Hill Boulevard Redwood City, CA 94061 Phone: (650) 306-3259 http://www.canadacollege.edu/disabilityresourcecenter/index.php Canada College provides students with disabilities academic support and reasonable accommodations through the Disability Resource Center (DRC). Services are provided to students with a wide range of disabilities and are determined on the basis of supporting medical, psychological, or learning disability documentation.

Center for Independence of Individuals with Disabilities 1515 South El Camino Real, Suite 400 San Mateo, CA 94402 Phone: (650) 645-1780 http://www.CIDSanMateo.org/ Center for Independence of Individuals with Disabilities (CIID) provides support services, community awareness, and advocacy to promote full and equal community integration for people with disabilities in San Mateo County. Programs include assistive technology, work-incentive planning assistance, counseling and peer support, home modification services, independent-living planning and support, information and referral, advocacy, and Americans with Disabilities Act (ADA) consulting and training.

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College of San Mateo – Disabled Students Programs & Services 1700 W. Hillsdale Boulevard San Mateo, CA 94402 Phone: (650) 574-6438 http://www.collegeofsanmateo.edu/dsps Disabled Students Programs & Services (DSPS) provides support services and accommodations to students with disabilities. Accommodations and services include academic advising, counseling, registration assistance, test proctoring, sign language interpreting, personal- development classes, academic accommodations, and use of the High Tech Center.

Community Gatepath 1764 Marco Polo Way Burlingame, CA 94010 Phone: (650) 697-8924 http://www.communitygatepath.org Community Gatepath has been “Turning Disabilities into Possibilities” by helping children and adults with disabilities achieve personal goals and live full and productive lives in school, the community, home, and the workplace. Gatepath places individuals in jobs and supports even more through their job-coaching services. Their success is a result of strong community partnerships with local and national businesses as well as community-based organizations. Community Gatepath also offers the STEPAHEAD Support Group for Families and Caregivers; this support group is for individuals with brain injury and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives.

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

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Mills-Peninsula Health Center 100 South San Mateo Drive San Mateo, CA 94401 Phone: (650) 696-4300 http://www.mills-peninsula.org Mills-Peninsula Stroke Center offers a wide range of inpatient and outpatient rehabilitative programs and services to help patients improve their quality of life by reducing pain and restoring function. Mills-Peninsula was first in San Mateo County to earn accreditation as a Primary Stroke Center by The Joint Commission. Staff includes a trained stroke treatment team that provides prompt diagnosis and treatment, including the most advanced medications to dissolve clots. Experienced neurologists and other clinical experts lead the team. Mills-Peninsula provides risk assessment as well as acute care high priority emergency services.

Pacifica Post-Acute Rehab 385 Esplanade Avenue Pacifica, CA 94044 Phone: (650) 993-5576 http://www.pacificarehab.com Pacifica Post-Acute Rehab is a skilled nursing facility. Their rehabilitation team is committed to providing outstanding results and excellent quality of care. Patients are empowered through individualized programs to reach goals of increased independence. Patients’ families are also encouraged to participate in therapy sessions. They offer physical therapy, occupational therapy, and speech therapy for people with illness or injuries.

San Mateo County Transit District 1250 San Carlos Avenue P.O. Box 3006 San Carlos, CA 94070 Phone: (800) 660-4287 http://www.samtrans.org San Mateo County Transit District (SamTrans) provides bus services throughout San Mateo County and into parts of San Francisco and Palo Alto. It is accessible to the general public and to people who use a wheelchair. SamTrans also operates Redi-Wheels and Redi-Coast paratransit transportation for those people with disabilities who cannot use the regular bus service.

Skyline College – Disability Resource Center 3300 College Drive San Bruno, CA 94066 Phone: (650) 738-4280 http://www.skylinecollege.edu/disabilityresoures/ Skyline College’s Disability Resource Center (DRC) offers services to students with disabilities. Services include but are not limited to ASL interpreting, registration assistance, extended time on placement tests, adaptive physical education classes, Assistive Technology classes, note taking, equipment loans, textbooks and tests/exams in alternate formats, and referral services.

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Veterans Administration Medical Center 3801 Miranda Avenue Palo Alto, CA 94304 Phone: (650) 493-5000 ext. 62201 http://www.paloalto.va.gov/ The Veterans Administration (VA) Brain Injury Rehabilitation Unit (BIRU) provides comprehensive screening, evaluation, and treatment for veterans with traumatic brain injury. Their Polytrauma Support Clinic Team provides and coordinates interdisciplinary rehabilitation services for Veterans. Any veteran entitled to benefits (discharged from military service under other than dishonorable conditions) and medically stable is eligible for admission into the Polytrauma System of Care. The patient must have sustained multiple physical, cognitive, and/or emotional injuries secondary to trauma.

**For more brain injury resources near San Mateo County, please see Alameda County, San Francisco County, Santa Clara County, and Santa Cruz County.**

Santa Barbara

Allan Hancock College – Learning Assistance Program 800 South College Drive Santa Maria, CA 93454 Phone: (805) 922-6966 ext. 3380 http://www.hancockcollege.edu/lap/index.php The Learning Assistance Program (LAP) at Allan Hancock College is committed to providing equal opportunity and access to students with disabilities through reasonable accommodations, instruction, assessment, counseling, and advocacy. Their purpose is to support students by providing a variety of direct support services, specialized instruction, and advocacy.

Coast Caregiver Resource Center (CCRC) 5350 Hollister Avenue, Suite C Santa Barbara, CA 93111 http://ventura.networkofcare.org/mh/services/agency.aspx?pid=CoastCaregiverResourceCenterC CRC_211_2_0 Coast Caregiver Resource Center (CCRC) assists families and caregivers in caring for their brain injured adults at home. Information, referrals, support groups, and counseling are available as well as a comprehensive library on brain impairments. Legal consultation and in-home and out- of-home respite care available to families caring for an adult whose brain impairment occurred after the age of 18 and is not receiving Medi-Cal.

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Department of Rehabilitation (Santa Barbara District) 509 East Montecito Street, Suite 101 Santa Barbara, CA 93101 Phone: (805) 560-8130 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Call for more information on the Santa Maria DOR.

Independent Living Resource Center, Inc. (Santa Maria) 327 East Plaza Drive, Suite 3A Santa Maria, CA 93454 Phone: (805) 925-0015 http://www.ilrc-trico.org/ All services at the Independent Living Resource Center (ILRC) are a combined effort of the consumers and the staff. They work to provide information about the array of choices available and assist consumers in following the path they want. Importantly, the ILRC strives to ensure all disabled veterans have access to the best and most up to date support services available. Through the ILRC Veterans Outreach Program, a vast array of community-based services and support exists to serve those who have served their country. Disabilities served include post-traumatic stress disorder, traumatic brain injury, and many others. Please call for information on the ILRC location in Santa Barbara, CA.

Insight Neuropsychology 3063 Orleans Lane Oxnard, CA 93036 Phone: (805) 988-6197 http://www.insightneuropsychology.com/ Insight Neuropsychology specializes in personalized neuropsychological assessment and treatment services to assist clients in promoting their cognitive health. Insight’s goal is to help clients learn about how their brains are functioning since insight is the first step in learning how to improve mental functions. Insight provides comprehensive evaluations of brain injury including mild traumatic brain injury and concussions. They also evaluate memory loss, cognitive impairment, dementia, stroke, Parkinson’s disease, and attention deficit hyperactivity disorder (ADHD).

Jodi House: Brain Injury Support Center 625 State Street Santa Barbara, CA 93101 Phone: (805) 563-2882 http://www.jodihouse.org Jodi House empowers people with brain injuries and their families to reconnect, rebuild, and move forward together within the community. The day program works with members to encourage their physical, cognitive, and behavioral rehabilitation. Classes such as Tai Chi, yoga, and dance help promote physical balance and strength while classes such as brain work out, memory, and communication skills promote cognitive function and memory improvement.

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Through one-on-one help and support groups, Jodi House is able to aid clients in their emotional recovery.

Law Offices of Robert S. Patterson 33 West Mission Street Santa Barbara, CA 93101 Phone: (888) 479-4589 http://www.robertpattersonlaw.com Robert Patterson is a Head and Brain Injury Attorney who understands how devastating and life changing traumatic brain and head injuries can be. That is why, when these injuries are caused by the negligence of someone else, he works hard to secure full compensation for his clients. The lawyer provides clients with the research, case preparation, and trial skills of a large firm along with the compassion and individual attention of a small firm.

Santa Barbara City College – Disabled Student Programs & Services 721 Cliff Drive Santa Barbara, CA 93109 Phone: (805) 965-0581 ext. 2364 http://www.sbcc.edu/dsps/index.php Disabled Student Programs & Services (DSPS) provides educational support services and reasonable accommodations for students with disabilities who are enrolled in courses at SBCC. Services include but are not limited to American Sign Language (ASL) interpretation, registration assistance, extended time on placement tests, lockers, adaptive physical education classes, assistive technology classes, note taking, equipment loans, textbooks and tests/exams in alternate formats, and referral services.

Solutions at Santa Barbara 1135 North Patterson Avenue Santa Barbara, CA 93111 Phone: (805) 683-1995 http://solutionsatsantabarbara.com/ Solutions at Santa Barbara offers highly personalized, comprehensive post-acute rehabilitation programs to meet the needs of individuals with traumatic brain injury, stroke, aneurysm, post- concussive syndrome, or other neurological disorders.

**For more brain injury resources near Santa Barbara County, please see Kern County, San Luis Obispo County, and Ventura County.**

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Santa Clara

Abilities United 525 East Charleston Road Palo Alto, CA 94306 Phone: (650) 494-0550 http://www.abilitiesunited.org Abilities United (formerly Community Association for Rehabilitation) supports children and adults with disabilities, their families, and the community while creating a culture in which all members of society are included and appreciated for their distinctive contributions. Abilities United provides a lifetime of services to individuals with developmental and physical disabilities. Although they primarily serve people with developmental disabilities and their families, people with other types of disabilities can benefit from services as well.

Able People Foundation 552A Valley Way Milpitas, CA 95035 Phone: (408) 263-8000 http://www.ableproject.org/ Able People Foundation addresses the growing need of low-income seniors and individuals with disabilities, especially those with physical limitations. They help people locate mobility and assistive devices.

Alfred Scopp, Ph.D. 515 South Drive, Suite 15 Mountain View, CA 94040 Phone: (650) 961-9430 http://www.healthgrades.com/provider/alfred-scopp-3h4f3 Alfred Scopp is a psychotherapist. Psychotherapists are trained in neuropsychology and offer neuropsychological assessment, which can be very helpful both in demonstrating that brain damage occurred (and that the person has deficits from the TBI), and evaluate cognitive strengths and weaknesses so compensation strategies can be determined.

Almaden Health & Rehabilitation Center 2065 Los Gatos-Almaden Road San Jose, CA 95124 Phone: (408) 377-9275 http://www.marinerhealthcare.com Almaden Health & Rehabilitation Center is committed to providing compassionate and comprehensive care for the clients served. Throughout their network of 21 skilled nursing facilities located in California, they provide 24-hour care ranging from short-term rehabilitation therapy to quality long-term restorative nursing care.

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Back on Track to Success – Rehabilitation Research Center 751 South Bascom Avenue San Jose, CA 95128 Phone: (408) 885-2397 http://www.tbi-sci.org/call.html Back on Track to Success is a community-based mentoring program at Santa Clara Valley Medical Center focused on helping teens and young adults with disabilities get a job or go to college. It is a one-on-one mentoring program where mentors are trained to connect participants with the appropriate community resources and support they need to be successful.

Bay Area Transit http://www.bayareatransit.net/ San Francisco International Airport (SFO) is a largest airport in the Bay Area. Airport shuttles are located on the upper level (Departures), on the outer curb, in the loading island. Outside of this time frame, the shuttles are still there but you are on your own. If you have chartered the van, you will be directed to terminal courtyard. All courtyards are located on the lower level (Arrivals) along with taxis and scheduled buses.

Bracamontes & Vlasak: A Professional Law Corporation – Brain Injury Accident Lawyers 1400 Coleman Avenue, Suite F13 Santa Clara, CA 95050 Phone: (415) 906-3146 http://www.bvlawsf.com/Personal-Injury/Brain-Injuries.shtml Bracamontes & Vlasak (BV Law) has success in aggressively litigating brain injury, anoxic brain injury, and neurotoxic brain injury cases. Their website teaches the client about brain injury and the importance of having a good lawyer.

De Anza College – Disability Support Programs & Services 21250 Stevens Creek Boulevard Cupertino, CA 95014 Phone: (408) 864-8407 http://www.deanza.edu/dsps/ The Disability Support Programs & Services (DSPS) includes four campus programs offering a comprehensive array of accommodations, special classes, and support services. They aim to

196 ensure access to the college’s curriculum, facilities, and programs to promote student success in realized individual and vocational goals.

Department of Rehabilitation (San Jose District Office) 100 Paseo de San Antonio, Room 324 San Jose, CA 95113 Phone: (408) 277-1355 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities. Call for more DOR locations in San Jose and Gilroy.

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area provides innovative therapy, training, education, and support services to individuals from birth through young adulthood living with disabilities. Easter Seals Bay Area helps individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

Evergreen Valley College – Disabilities Support Program 3095 Yerba Buena Road San Jose, CA 95135 Phone: (408) 270-6447 http://www.evc.edu/current-students/support-programs The Disabilities Support Program (DSP) provides support services and instructional programs for students with disabilities attending Evergreen Valley College. The program promotes student independence and works to make campus classes, facilities, and services accessible to students with disabilities.

Foothill College – Reach Program 4000 Middlefield Road Palo Alto, CA 94303 Phone: (650) 949-6960 http://www.foothill.edu/drc/reach.php The Foothill College Community Education REACH Program (located at the Middlefield Campus) is designed to provide the essential link between outpatient rehabilitation and full community reintegration for adults recovering from stroke and acquired brain injuries. With the assistance of the coordinator, students participate in individual goal setting. Classes are tailored to allow each student to reach their maximum physical, emotional, and social potential and to achieve the highest level of independence.

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Gavilan College – Disability Resource Center 5055 Santa Teresa Boulevard Gilroy, CA 95020 Phone: (408) 848-4800 http://www.gavilan.edu/drc/ Gavilan College’s Disability Resource Center cultivates learning and personal growth in students of all backgrounds and abilities through innovative practices in both traditional and emerging learning environments. Transfer pathways, career and technical education, developmental education, and support services prepare students for success in a dynamic and multicultural world.

Gentiva – Rehab Without Walls 4030 Moorpark Avenue, Suite 251 San Jose, CA 95117 Phone: (408) 556-0420 http://www.gentiva.com Gentiva’s Rehab Without Walls post-acute rehabilitation provides home health and hospice services to those they serve. Clinical services include skilled nursing; physical, occupational, and speech therapy; cardiac and pulmonary care; neurorehabilitation; wound care; pain management; medication management; patient education to promote self-management; and treatment for balance problems that can lead to fall risks

Gilroy Healthcare and Rehabilitation Center 8170 Murray Avenue Gilroy, CA 95020 Phone: (408) 842-9311 http://www.gilroyhealthcare.com Gilroy Healthcare and Rehabilitation Center (GHC) is Gilroy’s premiere skilled nursing and rehabilitation facility. With 132 beds, GHC provides therapy, rehab, and nursing for residents all over the Bay Area.

Housing for Independent People 481 Valley Way Milpitas, CA 95035 Phone: (408) 941-1850 http://www.housingscc.org Housing for Independent People (HIP) is a collaborative provider of housing for people with special needs. HIP serves very low-income people with developmental disabilities, brain injuries, psychiatric disabilities, people with HIV/AIDS, and the elderly.

Janoff Law Group – San Jose Brain Injury Lawyer 111West Saint John Street, Suite 1040 San Jose, CA 95113 Phone: (408) 286-2300 http://www.janofflaw.com/Personal-Injury/Catastrophic-Injuries/Brain-Injuries.shtml With traumatic brain injury (TBI), it is necessary to map out a clear road to recovery, involving

198 doctors and other providers familiar with the latest medical insights into brain injury care. Janoff Law Group takes a special interest in catastrophic injuries because the need for compensation is so much greater. Attorney Jeffrey Janoff seeks maximum compensation to pay for clients’ long- term medical expenses and to compensate for the inability to earn again. They also include the clients’ families’ pain and suffering in legal claims.

Learning Services: Specialists in Brain Injury Care 10855 DeBruin Way Gilroy, CA 95020 http://www.learningservices.com/ Learning Services understands the serious challenges facing people who have sustained a brain injury and they help families navigate the complicated process of treatment, recovery, and rehabilitation. The acquired brain injury (ABI) rehabilitation programs take place within a residential environment, designed to deliver comprehensive therapy in a real-world setting. Specific programs include post-acute neuro-rehabilitation, neurobehavioral rehabilitation, day treatment, and supported living. Such programs provide therapeutic environments and functional based treatment designed to meet the individual needs of residents.

Los Altos Sub-Acute and Rehabilitation Center 809 Fremont Avenue Los Altos, CA 94024 Phone: (650) 941-5255 http://www.losaltossubacute.com Los Altos Sub-Acute & Rehabilitation Center (LASRC) is dedicated to providing quality health to those in need. Their purpose is to provide patients with positive rehabilitative therapy and exceptional nursing care. They also aim to help individuals achieve their highest possible functioning level and to assist them in returning home whenever practical. LASRC uses the latest technology and techniques to ensure all residents reach their highest functional potential.

Mild Traumatic Brain Injury Support Group 3369 Union Avenue San Jose, CA 95124 Contact: Robert Medel (408) 885-2397 The Mild Traumatic Brain Injury Support Group is for individuals with brain injuries and their caregivers who meet regularly to support each other by discussing common problems affecting them in their everyday lives. It meets the second and fourth Tuesday of every month from 6:30pm-8:00pm at the Camden Community Center.

Mission College – Disability Support Programs & Services 3000 Mission College Blvd. Santa Clara, CA 95054 Phone: (408) 855-5085 http://www.missioncollege.edu/depts/dsps/index.html The goal of Disability Support Programs & Services (DSPS) is to support college students with disabilities in entering campus life, its programs, and its activities. They emphasize educational achievement as well as retention and success in both higher education and career goals.

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Reasonable accommodations are provided to minimize the effects of disabilities and maximize potential success within Mission College courses. DSPS does testing to determine what level of class is appropriate, and they offer some basic classes for people just recovering from TBI.

Mountain View Healthcare Center 2530 Solace Place Mountain View, CA 94040 Phone: (650) 961-6161 http://www.mvhealthcare.com Mountain View Healthcare Center (MVHC) is a premier skilled nursing and rehabilitation facility in the Bay Area. MVHC emphasizes the team approach to comprehensive treatment, enabling staff to give residents the best quality care available. MVHC’s goal is to create a home-like environment and to help each resident realize their individual preferences.

North Valley Job Training Consortium 505 W. Olive Avenue, Suite 550 Sunnyvale, CA 94086 Phone: (408) 730-7232 http://www.novapic.org North Valley Job Training Consortium (NOVA) Private Industry Council is a federally funded employment and training agency administered by the City of Sunnyvale. NOVA serves companies needing recruitment and outplacement assistance, displaced workers desiring retraining or job searching, and workers with special needs.

Outreach Paratransit 926 Rock Avenue, Suite 10 San Jose, CA 95131 Phone: (408) 436-2865 http://www.outreach1.org Outreach Paratransit provides pre-scheduled door-to-door transportation for people with limited mobility by taxi, accessible van, and/or escort.

Pheonix Data Center http://www.phoenixdatacenter.org The Pheonix Data Center is a searchable directory of service providers in Santa Clara County with links to agency and provider websites. Information is listed from a consumer perspective with clear descriptions of the services provided. Categories include meals, groceries, shelter, healthcare, legal, transportation, and seniors.

Regional Medical Center of San Jose 225 North Jackson Avenue San Jose, CA 95116 Phone: (408) 259-5000 http://www.regionalmedicalsanjose.com/ Regional Medical Center’s (RMC) Comprehensive Stroke Center treats and cares for patients at elevated risk for stroke. The center also increases education and awareness of stroke symptoms

200 to both healthcare professionals and the community. Inpatient and outpatient neurorehabilitation programs are designed to help patients regain physical and speech function and adapt to their new lifestyles with optimum capabilities. RMC’s neurological services diagnose and treat disorders of the brain, spinal cord, and peripheral nerves and muscles. Commonly treated neurological diseases include stroke, epilepsy, sleep disorders, headache and related pain syndromes, and infections of the nervous system involving nerves and/or muscles.

San Jose City College – Disabilities Support Program & Services 2100 Moorpark Avenue San Jose, CA 95128 Phone: (408) 288-3746 http://www.sjcc.edu/current-students/support-programs/dsp-s Disabilities Support Program & Services (DSPS) provides support services to students with disabilities at San Jose City College. Services may include accommodations, alternate media services, counseling, learning disability services, equipment loans, note takers, sign language interpreters, test-taking accommodations, and use of computers for tests.

San Jose State University Kay Armstead Center for Communication Disorders One Washington Square San Jose, CA 95192 Phone: (408) 924-3688 http://www.sjsu.edu/cds/clinic The Kay Armstead Center for Communication Disorders (KACCD) provides clinical services in speech, language and hearing evaluations, treatments, and consultations. They are qualified to diagnose and treat disorders in the areas of articulation, phonology, language, stuttering, voice, hearing, oral motor, cognition, and social aspects of communication. Services are provided at no charge to registered SJSU students and at a competitive cost to all others. Most sessions are one or two 50-minute visits per week.

San Jose Veterans Center 278 North Second Street San Jose, CA 95112 Phone: (408) 993-0729 http://www.va.gov/directory/guide/facility.asp?ID=5469 The San Jose Veterans Center provides readjustment counseling services and psychotherapy for veterans. Veterans Affairs (VA) operates the nation’s largest health care system with hospitals, clinics, community-living centers, readjustment-counseling centers, and other facilities.

Santa Clara County Transportation Agency (VTA) 3331 North First Street San Jose, CA 95134 Phone: (408) 321-2300 http://www.vta.org Santa Clara Valley Transportation Authority (VTA) is an independent special district providing sustainable, accessible, community-focused transportation options that are innovative,

201 environmentally responsible, and promote the vitality of their region. Services are available to the general public as well as for people with disabilities.

Santa Clara Valley Medical Center – Brain Injury Rehabilitation Research Center 751 South Bascom Avenue San Jose, CA 95128 Phone: (408) 885-5000 http://www.scvmc.org The Rehabilitation Research Center for TBI & SCI (at Santa Clara Valley Medical Center) consists of a brain injury unit, a rehabilitation trauma unit, and a spinal cord injury unit. The Brain Injury Unit is a 40-bed unit with patients who may have sustained head injuries, strokes, or other neuromuscular disorders as well as medical-surgical conditions requiring rehabilitation. A comprehensive brain injury program including post-discharge community support is offered. The environment in this unit offers several unique challenges to the professional nurses.

Senior Housing Solutions 512 Valley Way Milpitas, CA 95126 Phone: (408) 645-5962 The Senior Housing Solutions’ program can be an excellent housing alternative for people with TBI. They match seniors who want to share their home with people seeking a place to live. Services include counseling the involved people on the process of living interdependently. They ask all parties for references and tell both parties about each other. They encourage and can supply roommate agreements and provide monthly follow-ups.

Services for Brain Injury 60 Daggett Drive San Jose, CA 95134 Phone: (408) 434-2277 http://www.sbicares.org Services for Brain Injury (SBI) provides comprehensive rehabilitation all under one roof for people with traumatic brain injuries (TBI) or acquired brain injuries (ABI), including veterans. SBI’s services range from post-acute programs to vocational immersion and job placement, with supported employment including a job coach at the work site. An emphasis on comprehensive cognitive rehabilitation provided through a unique continuum of services is at the heart of all of SBI’s programming. SBI’s Rehabilitation Program is designed for people with brain injuries to relearn skills lost due to injury or illness; reintegrate from hospital to home to community; and provide support, respite, and resources for families and friends. It is part of a unique continuum of programming individualized for the person with a brain injury to account for his/her social needs and recovery goals. It includes all rehabilitative therapies and interactive programming to build skills and modify behavior. SBI’s Vocational Services address the barriers people with brain injuries face as they work toward increased independence and gainful employment.

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Services for Brain Injury Touchstones Support Group 60 Daggett Drive San Jose, CA 95134 Phone: Steve Gutierrez (209) 914-8064 Touchstones Support Group is for TBI survivors, family members, caregivers, or anyone interested in TBI awareness. It meets every Wednesday from 5:30pm-7:30pm.

Silicon Valley Independent Living Center (Gilroy) 7800 Arroyo Circle, Suite A Gilroy, CA 95020 Phone: (408) 846-1480 http://www.svilc.org/ Silicon Valley Independent Living Center (SVILC) provides information and referrals regarding available, accessible housing options and a computer list of available housing. They offer personal assistant recruitment and referrals, training in the management of personal assistants, advocacy and legal services, information and referrals regarding available and accessible housing, counseling, individual and group support, independent living skills, vocational services, residential training program, and equipment rental and loans. Personal assistants are people who are paid to help people with disabilities (including those with TBI) take care of their basic needs (e.g., dressing, bathing, and perhaps getting things in order). SVILC refers prescreened and trained Personal Care Attendants (PCAs) to people who need them. Please call for information on the SVILC location in San Jose, CA.

Skills Plus 1840 Benton Street Santa Clara, CA 95050 Phone: (408) 983-2100 http://www.skillsplusprogram.org Skills Plus provides skills based classes for people who have a need for further therapy after a stroke. They help people regain functional, social, cognitive, and physical skills. Clients work hard to improve their functional skills, such as learning to walk and being able to communicate with loved ones. It is mastering these basic skills that allows the stroke survivor to live at home and continue to be part of their family.

Sub-Acute Saratoga Hospital 13425 Sousa Lane Saratoga, CA 95070 Phone: (408) 378-8875 http://www.subacutesaratoga.com Sub-Acute Saratoga Hospital serves people up to 21 years of age. They service children with genetic disorders, spinal cord injuries, developmental delay, congenital anomalies, cardiac conditions, premature birth, failure to thrive, feeding disorders, seizure disorders, respiratory insufficiency, traumatic brain injury, and encephalopathy.

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Talking Heads – Rehabilitation Research Center 751 Bascom Avenue San Jose, CA 95128 Contact: (408) 793-6430 http://www.tbimatters.org The Talking Heads’ brain injury newsletter, distributed by the Santa Clara Valley Medical Center, addresses many areas of interest for people with TBI and their families. It also includes a calendar listing of local TBI meetings and events.

Transitions Rehabilitation Group 7101 Monterey Street Gilroy, CA 95020 Phone: (408) 842-6868 Transitions Rehabilitation Group offers speech, occupational, and physical therapy as well as the services of clinical social workers, registered nurses, physiatry (specializing in physical medicine and rehabilitation), and neurology. Their services include cognitive retraining, computer assisted therapy, and community resource referrals.

United Way of Silicon Valley 1400 Parkmoor Avenue, Suite 250 San Jose, CA 95126 Phone: (408) 345-4300 http://www.uwsv.org United Way provides community resources to help families and individuals fully engage in increasing their self-sufficiency, educational achievement, and opportunity for success. Over 600 community resources can be accessed through this agency.

Vasona Creek Healthcare 16412 Los Gatos Boulevard Los Gatos, CA 95032 Phone: (408) 356-2191 http://www.vasonacreekhealthcare.com Vasona Creek Healthcare (VCH) provides skilled nursing and rehabilitation services to patients so they may become as independent as possible. The main goal of VCH is to help patients reach their maximum potential in a caring and supportive environment.

VCI Mobility Works 3155 Williamsburg Drive San Jose, CA 95117 Phone: (888) 463-5715 http://www.vanconinc.com/ The evaluations of the VCI Mobility Works (formerly Adaptive Driving Aid) are based out of the home of the client and, when appropriate, with the clients’ own car. Adaptive Driving Aid provides training for drivers and can install adaptive equipment as well. Prospective clients must have a driver’s license or temporary permit. It serves all areas in Central and Northern California with an emphasis on San Francisco and Monterey Bay areas.

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West Valley College – Disability & Educational Support Program 14000 Fruitdale Avenue Saratoga, CA 95070 Phone: (408) 741-2010 http://www.westvalley.edu/services/academic-success/desp/index.html Disability & Educational Support Program (DESP) assists students with disabilities affecting their education to achieve their educational goals. DESP provides a variety of services and specialized courses designed to ensure access to all campus programs, services, and facilities and to facilitate maximum student independence and success.

**For more brain injury resources near Santa Clara County, please see Alameda County, Merced County, Monterey County, San Benito County, San Mateo County, Santa Cruz County, and Stanislaus County.**

Santa Cruz

Access Options, Inc. - Equipment Installers 109 Lee Road, Suite D Watsonville, CA 95076 Phone: (831) 722-6804 http://www.accessoptions.com Access Options is dedicated to increasing mobility for persons with disabilities by improving access in several areas. They provide a wide range of services to eliminate architectural and transportation barriers.

Brain Injury Peer Support Group 1350 41st Ave, Suite 101 Capitola, CA 95010 Phone: (831) 578-2861 The Brain Injury Peer Support Group (held at the Department of Rehabilitation) is for individuals with brain injuries and their caregivers who meet regularly to support each other by discussing

205 common problems affecting them in their everyday lives. Please contact Alisa Sutherland for more information.

Cabrillo College – Disabled Students Program & Services 6500 Soquel Drive Aptos, CA 95003 Phone: (831) 479-6379 http://www.cabrillo.edu/services/dsps/ The Disabled Students Program & Services (DSPS) offers a variety of support services helping students with disabilities be independent and ensuring their educational success at Cabrillo College. Services include but are not limited to ASL interpreting, registration assistance, extended time on placement tests, lockers, adaptive physical education classes, Assistive Technology classes, note taking, equipment loans, textbooks and tests/exams in alternate formats, and referral services.

Cabrillo College Stroke & Disability Learning Center 501 Upper Park Road Santa Cruz, CA 95065 Phone: (831) 425-0622 http://www.strokecenter.com The Stroke and Disability Learning Center (SDLC) provides an educational program for adults who have survived a stroke or are living with disabling conditions. The SDLC is a unique program at Cabrillo College that starts where medical rehabilitation leaves off. The goal of the SDLC is to support independence and promote maximum function for adults adapting to functional losses. Students participate in small-group instruction in mobility and fitness, speech, communication, and counseling support.

Central Coast Center for Independent Living (Capitola Branch) 1350 41st Avenue, Suite 101 Capitola, CA 95010 Phone: (831) 462-8720 http://www.cccil.org/ Central Coast Center for Independent Living (CCCIL) promotes the independence of people with disabilities by supporting their equal and full participation in life. CCCIL provides advocacy; education; and support to people with disabilities, their families, and the community. CCCIL provides the following services: information and referral, individual and systems change advocacy, benefits counseling, housing assistance, personal assistance services, peer support, independent-living skills training, and assistive technology. Call for information on the CCCIL location in Watsonville, CA.

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Department of Rehabilitation (Capitola Branch) 1350 41st Avenue, Suite 101 Capitola, CA 95010 Phone: (831) 465-7100 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Easter Seals Disability Services: Central California 9010 Soquel Drive, Suite 1 Aptos, CA 95003 Phone: (831) 684-2166 http://www.centralcal.easterseals.com/ Easter Seals Central California provides innovative therapy, training, education, and support services to individuals from birth through young adulthood living with disabilities. Easter Seals Bay Area helps them address life’s challenges, achieve personal goals, and gain greater independence in everyday living.

Santa Cruz METRO Transit 2880 Research Park Drive, Suite 160 Soquel, CA 95073 Phone: (831) 425-4664 http://www.scmtd.com Santa Cruz METRO’s top priority is to provide safe and reliable access to the community. METRO operates a fleet of safe, clean, modern, and accessible large buses, small buses, and minivans to connect riders to multiple destinations. All METRO fixed-route buses and ParaCruz vehicles are accessible to anyone needing use of a ramp or lift to board a METRO vehicle.

**For more brain injury resources near Santa Cruz County, please see Monterey County, San Mateo County, and Santa Clara County.**

Shasta

Brain Injury Guidance Group (BIGG) 2100 Market Street Redding, CA 96001 Contact: Harold Lord (530) 222-1806 The Brain Injury Guidance Group (BIGG) is for individuals with brain injuries who meet regularly to support each other by discussing common problems affecting them in their everyday lives. BIGG meets the third Thursday of the month at 5:30pm.

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Department of Rehabilitation (Redding Branch) 1900 Churn Creek Road, Suite 100 Redding, CA 96002 Phone: (530) 224-4708 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Easter Seals Disability Services 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals helps individuals and families with disabilities live better lives. Services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living.

Independent Living Services of Northern California 169 Hartnell Avenue, Suite 128 Redding, CA 96002 Phone: (530) 242-8550 http://www.ilsnc.org/index.html Independent Living Services of Northern California (ILSNC) is a nonprofit organization helping people with disabilities achieve and/or maintain their optimal level of self-reliance and independence. ILSNC provides support services (e.g., information, housing assistance, and provider referrals) and eliminates barriers to increase opportunities for participation in the community. ILSNC also works to ensure clients get the services they need while supporting consumers’ rights to live independently.

Passages Caregiver Resource Center 2491 Carmichael Drive, Suite 400 Chico, CA 95928 Phone: (530) 898-5925 http://www.passagescenter.org/caregivers/ Passages Caregiver Resource Center offers services for family caregivers who provide care to adults with brain and neurological impairment. The staff provides information, support, assistance, and community connections to help local caregivers.

Shasta College – Disabled Students Programs & Services 11555 North Old Oregon Trail Redding, CA 96049 Phone: (530) 225-3973 http://www.shastacollege.edu/Student%20Services/DSPS/pages/447.aspx Disabled Students Programs & Services (DSPS) is a program for students with disabilities. The program is available to students attending either the main Shasta College campus or the extended

208 education locations throughout the district. DSPS works with students to evaluate the educational impact of their disability and authorize reasonable accommodations and services.

The Rose Center Physical Therapy 3278 Bechelli Lane Redding, CA 96002 Phone: (530) 223-9474 http://www.therosecenter.com The Rose Center is a private outpatient therapy practice dedicated to quality patient care through use of evidence-based treatment. It was founded with the mission of providing cutting-edge and specialty therapy to the greater Redding area. As a leader and innovator in the rehabilitation field, their clinic offers an array of services, expertise, advocacy, and partnerships that promote quality of life, independence, and community integration for individuals with physical injuries and/or disabilities as well as their families and care providers.

**For more brain injury resources near Shasta County, please see Lassen County, Modoc County, Plumas County, Siskiyou County, Tehama County, and Trinity County.**

Sierra

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living. Easter Seals Bay Area serves Sierra County.

Foundation Resources for Equality and Employment for the Disabled (FREED) 154 Hughes Road, Suite 1 Grass Valley, CA 95945 Phone: (530) 272-1732 http://www.freed.org FREED’s mission is to eliminate barriers for people with disabilities through programs promoting independent living and effecting systems change while honoring dignity and self-determination. FREED has a number of programs focusing on the issues that arise with aging and disabilities. They work with clients to figure out what they need and to get connected. FREED serves multiple counties, including Sierra County.

**For more brain injury resources near Sierra County, please see Butte County, Nevada County, Plumas County, and Yuba County.**

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Siskiyou

College of the Siskiyous – Disabled Students Programs & Services 800 College Avenue Weed, CA 96094 Phone: (530) 938-5297 http://www.siskiyous.edu The Disabled Students Programs & Services (DSPS) is the campus office responsible for determining and providing required academic accommodations for students with disabilities. DSPS provides support services, specialized instruction, and educational accommodations to students with disabilities so they can fully participate and benefit from college.

Department of Rehabilitation (Yreka Branch) 500 North Main Street Yreka, CA 96097 Phone: (530) 842-1662 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Dignity Health Mercy Medical Center/Mt. Shasta 914 Pine Street Mt. Shasta, CA 96067 Phone: (530) 926-6111 http://www.mercymtshasta.org/Medical_Services/204331 The goal of physical, speech, and occupational therapies at Dignity Health Mercy Medical Center/Mt. Shasta is to improve and/or restore a patient’s highest level of functioning after a stroke or other injury to the brain. Therapy services can help alleviate pain; bring back optimal motion, strength, and coordination; find creative ways to overcome movement disabilities; and improve the thinking tasks important to daily life including use of memory, reasoning, and problem-solving skills. Mercy also helps individuals with disabilities return to the job safely and quickly with rehabilitation and work conditioning programs and helps athletes return to their sports by using state-of-the-art sports rehabilitation.

Easter Seals Disability Services 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living. Easter Seals Bay Area serves many counties, including Siskiyou County.

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Independent Living Services of Northern California 1161 East Avenue Chico, CA 95926 Phone: (530) 893-8527 http://www.ilsnc.org/index.html Independent Living Services of Northern California (ILSNC) is a nonprofit organization helping people with disabilities to achieve and/or maintain their optimal level of self-reliance and independence. ILSNC provides support services (e.g., information, housing assistance, and provider referrals) and eliminates barriers to increase opportunities for participation in the community. ILSNC also works to ensure provision of needed services, identified by persons with disabilities and other community members, while supporting consumers’ rights to live independently.

Passages Caregiver Resource Center 2491 Carmichael Drive, Suite 400 Chico, CA 95928 Phone: (530) 898-5925 http://www.passagescenter.org/caregivers/ Passages Caregiver Resource Center offers services for family caregivers who provide care to adults with brain and neurological impairment. The staff provides information, support, assistance, and community connections to help local caregivers. Passages Caregiver Resource Center serves multiple counties, including Siskiyou County.

**For more brain injury resources near Siskiyou County, please see Del Norte County, Humboldt County, Modoc County, Shasta County, and Trinity County.**

Solano

Department of Rehabilitation (Fairfield Branch) 450 Chadbourne Road, Suite A Fairfield, CA 94534 Phone: (707) 428-2080 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Driving Specialties Ltd. 215 Commercial Street Vallejo, CA 94589 Phone: (707) 553-1515 http://www.drivingspecialties.com Driving Specialties Ltd. aims to help people with mobility limitations have the freedom and independence of accessible transportation. Driving Specialties provides a comprehensive list of

211 mobility services. They sell and maintain a complete range of products including van conversions; raised roofs and raised doors; hand controls; electronic gas and brake systems; wheelchair and scooter lifts; and a wide range of steering, braking, and secondary control systems.

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living. Easter Seals serves multiple counties, including Solano County.

Independent Living Resources 470 Chadbourne Road, Suite B Fairfield, CA 94534 Phone:(707) 435-8174 http://www.ilrscc.org/ Independent Living Resources (ILR) is dedicated to helping people with any type of disability live normal, independent lives. Through education empowerment and advocacy, ILR strives to fully incorporate those with disabilities into the community and eliminate institutional, social, and attitudinal barriers that hinder progress.

Jed Sussman, Ph.D. 4466 Block Avenue, Suite H Pleasanton, CA 94566 Phone: (925) 600-8199 Jed Sussman is a psychotherapist. Psychotherapists are trained in neuropsychology and offer neuropsychological assessment, which can be very helpful in both demonstrating that brain damage occurred and that the person has deficits from the TBI, all while evaluating cognitive strengths and weaknesses so compensation strategies can be made.

Kaiser Foundation Rehabilitation Center 975 Sereno Drive Vallejo, CA 94589 Phone: (707) 651-1044 http://www.permanente.net/homepage/kaiser/pages/d14029-top.html Kaiser’s rehabilitation program is designed to help clients treat the impairments and disabling conditions caused by a brain injury so he or she can return to normal daily activities to the greatest extent possible. Kaiser wants to prevent and treat medical complications and enhance function and quality of life of those with brain injuries.

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NCS Brain Injury Rehabilitation 450 S Porter Road, Suite A Dixon, CA 95620 Phone: (707) 678-7394 NCS Brain Injury Rehabilitation is a clinic based in Dixon serving patients throughout Solano County and the Sacramento area. It offers services in neurological therapy as well as occupational and speech therapy. For more information on NCS Brain Injury Rehabilitation, or to schedule an appointment, please call the listed number.

PRIDE Industries Foundation (Fairfield Branch) 2339 Courage Drive, Suite D Fairfield, CA 94533 Phone: (707) 399-3601 http://www.prideindustries.com/ PRIDE provides the support, training, and opportunity necessary to help people with disabilities overcome obstacles and find meaningful employment. PRIDE aims to be the premiere employer of people with disabilities, the vendor of choice in the markets they serve, and the recognized leader in meeting the needs of individuals in overcoming barriers to employment.

Solano Community College – Disability Services Program 4000 Suisun Valley Road Suisun, CA 94585 Phone: (707) 864-7000 ext. 249 http://www.solano.edu/dsp/ The Disability Services Program (DSP) at Solano Community College empowers students with disabilities for success, provides services to minimize the limiting effects of disability, advocates for the needs and rights of students with disabilities, and creates a level playing field in classes.

**For more brain injury resources near Solano County, please see Contra Costa County, Marin County, Napa County, Sacramento County, and Yolo County.**

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Sonoma

Accessible Mobility Center 2975 Dutton Avenue Santa Rosa, CA 95407 Phone: (707) 575-6997 http://www.adaptabilityca.com Accessible Mobility Center’s mission is to provide expert sales and service in the fields of wheelchair vans and other accessibility products. They offer installation services for new and used wheelchair accessible vans, Americans with Disabilities Act (ADA) compliant vans, wheelchair and scooter lifts, driving controls, restraint systems, and other vehicle modifications.

Canine Companions for Independence P.O. Box 446 Santa Rosa, CA 95402 Phone: (707) 577-1700 http://www.caninecompanions.org Canine Companions is an organization enhancing the lives of people with disabilities by providing highly trained assistance dogs and ongoing support to ensure quality partnerships.

Department of Rehabilitation (Redwood Empire District) 50 D Street, Suite 425 Santa Rosa, CA 95404 Phone: (707) 576-2233 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Disability Services and Legal Center 521 Mendocino Avenue Santa Rosa, CA 95401 Phone: (707) 528-2745 http://www.disabilityserviceandlegal.org/ Disability Services and Legal Center (DSLC) operates as a non-profit organization dedicated to enhancing the lives and advancing the rights of people with disabilities in Sonoma, Napa, Lake and Mendocino counties in California.

214 and gain greater independence for everyday living. Easter Seals Bay Area serves many counties, including Sonoma County.

Neuropsychological Associates 1260 North Dutton Avenue, Suite 225 Santa Rosa, CA 95401 Phone: (707) 526-5424 http://www.neuropsychologicalassociates.org/ Neuropsychological Associates provides a variety of neuropsychological and forensic evaluations, consulting services, psychotherapy, and comprehensive case management for clients who may experience a broad range of emotional, behavioral, and brain related issues.

Redwood Caregiver Resource Center 141 Stony Circle, Suite 200 Santa Rosa, CA 95401 Phone: (707) 542-0282 http://www.redwoodcrc.org The mission of Redwood Caregiver Resource Center (CRC) is to help families and communities master the challenges of caring for adults with brain disorders. The goal is accomplished through programs and services addressing the emotional, physical, and financial needs of family caregivers. CRC also provides information and assistance to families and caregivers of adults with brain impairments due to injury or disease as well as to the caregivers of the frail elderly.

Santa Rosa CityBus 100 Santa Rosa Avenue Santa Rosa, CA 95402 Phone: (707) 543-3333 http://www.ci.santa-rosa.ca.us/default.aspx?PageId=156 Santa Rosa CityBus provides transportation to the general public within the city of Santa Rosa and is wheelchair accessible. The city of Santa Rosa uses MV Transportation to provide paratransit services to those people with disabilities who are unable to use CityBus.

Santa Rosa Junior College – Disability Resources Department and Acquired Brain Injury Program 1501 Mendocino Avenue Santa Rosa, CA 95401 Phone: (707) 527-4906 http://www.online.santarosa.edu/presentation/?4928 The Disability Resources Department at Santa Rosa Junior College provides people with disabilities equal access to a community college education through specialized instruction, disability related support services, and advocacy activities. The Acquired Brain Injury Program at Santa Rosa Junior College provides services to individuals with diagnoses including traumatic brain injury, stroke, brain tumor, and other brain-related illnesses. Services include academic accommodations, academic advising, instruction in disability management, early registration, specialized classes, and access to assistive technology.

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Sonoma County Transit 355 West Robles Avenue Santa Rosa, CA 95407 Phone: (707) 576-7433 http://www.sctransit.com Sonoma County Transit (SCT) provides transportation to the general public and to people with disabilities throughout Sonoma County. SCT is wheelchair accessible and provides paratransit services for people with disabilities who are unable to use the regular transit services.

**For more brain injury resources near Sonoma County, please see Lake County, Marin County, Mendocino County, and Napa County.**

Stanislaus

Department of Rehabilitation (Modesto Branch) 1209 Woodrow Avenue, Suite B1 Modesto, CA 95350 Phone: (209) 576-6220 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Disability Resource Agency for Independent Living (DRAIL) 920 12th Street Modesto, CA 95354 Phone: (209) 521-7260 http://www.drail.org/ Disability Resource Agency for Independent Living (DRAIL) works to ensure a life filled with possibility and independence is a reality for members of the community living with a disability. DRAIL supports clients with technology and helps them get connected to resources and services optimizing clients’ quality of life.

Modesto Area Express (MAX) – City of Modesto Transit Division P.O. Box 642 Modesto, CA 95353 Phone: (209) 577-5295 http://www.modestoareaexpress.com Modesto Area Express (MAX) provides transportation services (as well as service to connect to ACE and BART trains) to the general public and people with disabilities living in the Modesto area. Buses are wheelchair accessible, and MAX also provides specialized Dial-A-Ride transportation services for people with disabilities.

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Modesto Junior College – Disabled Student Programs & Services 435 College Avenue Modesto, CA 95350 Phone: (209) 575-6225 http://www.mjc.edu/studentservices/disability/ Disabled Student Programs & Services (DSPS) provides provides people with disabilities (including brain injuries) equal access to a community college education through specialized instruction, disability related support services, and advocacy activities.

PRIDE Industries Foundation (Modesto Branch) 1215 7th Street Modesto, CA 95354 Phone: (209) 596-2676 http://www.prideindustries.com/ PRIDE provides the support, training, and opportunity necessary to help people with disabilities overcome obstacles and find meaningful employment. PRIDE aims to be the premiere employer of people with disabilities, the vendor of choice in the markets they serve, and the recognized leader in meeting the needs of individuals in overcoming barriers to employment.

Stanislaus Regional Transit (StaRT) 1010 10th Street, Suite 4200 Modesto, CA 95354 Phone: (800) 262-1516 http://www.srt.org StaRT provides transportation services for residents and visitors of Stanislaus County, including people with disabilities.

**For more brain injury resources near Stanislaus County, please see Alameda County, Calaveras County, Mariposa County, Merced County, San Joaquin County, and Santa Clara County.**

Sutter

Department of Rehabilitation (Yuba City Branch) 1237-B Live Oak Boulevard Yuba City, CA 95991 Phone: (530) 822-4591 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

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PRIDE Industries Foundation (Yuba City Branch) 950 Tharp Road, Suite 601 Yuba City, CA 95993 Phone: (530) 755-1736 http://www.prideindustries.com/ PRIDE provides the support, training, and opportunity necessary to help people with disabilities overcome obstacles and find meaningful employment. PRIDE aims to be the premiere employer of people with disabilities, the vendor of choice in the markets they serve, and the recognized leader in meeting the needs of individuals in overcoming barriers to employment.

**For more brain injury resources near Sutter County, please see Butte County, Colusa County, Placer County, Sacramento County, Yolo County, and Yuba County.**

Tehama

Department of Rehabilitation (Red Bluff Branch) 705 Pine Street Red Bluff, CA 96080 Phone: (530) 529-4270 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living. Easter Seals serves multiple counties, including Tehama County.

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**For more brain injury resources near Tehama County, please see Butte County, Glenn County, Mendocino County, Plumas County, Shasta County, and Trinity County.**

Trinity

Easter Seals Disability Services: Bay Area 391 Taylor Boulevard, Suite 250 Pleasant Hill, CA 94523 Phone: (925) 849-8999 http://www.easterseals.com/bayarea/ Easter Seals Bay Area helps individuals and families with disabilities live better lives. Their services enable individuals with disabilities to address life’s challenges, achieve personal goals, and gain greater independence for everyday living. Easter Seals serves multiple counties, including Trinity County.

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**For more brain injury resources near Trinity County, please see Humboldt County, Mendocino County, Shasta County, Siskiyou County, and Tehama County.**

Tulare

Center for Independent Living – Visalia 121 E Main Street, Suite 101 Visalia, CA 93291 Phone: (559) 622-9276 http://www.cil-fresno.org/ The Center for Independent Living (Visalia) is a consumer based organization empowering people with disabilities through a flexible range of services and opportunities to make informed choices and be in control of their lives.

College of the Sequoias – Disability Resource Center 915 South Mooney Boulevard Visalia, CA 93277 Phone: (559) 730-3805 http://www.cos.edu/StudentServices/StudentSupportServices/DRC/Pages/DRC%20Home.aspx The Disability Resource Center (DRC) assists students in maximizing their potential and preparing for a productive life after college. DRC services are individualized to aid each student’s independence, productivity, and self-esteem. Services are provided to enhance students’ access to and success in all classes and activities offered in college.

Department of Rehabilitation (Visalia Branch) 4930 West Kaweah Court, Suite 100 Visalia, CA 93277 Phone: (559) 735-3838 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

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Porterville College – Disability Resource Center 100 East College Avenue Porterville, CA 93527 Phone: (559) 791-2281 http://www.portervillecollege.edu/student-services/DRC/index.html The mission of the Porterville College Disability Resource Center (DRC) is to facilitate learning, promote independence, and encourage life-long learning for students with disabilities. The goal of the DRC is to provide students the opportunity to succeed through a student-centered approach focused on providing equal access. DRC also provides accommodations assisting students in reaching their true potential.

Resources for Independence (Central Valley) 2606 Valley Oak Drive Visalia, CA 93291 Contact: Nachi Kinsel (559) 622-9276 http://www.ricv.org/ Resources for Independence (Central Valley) (RICV) encourage people with disabilities to be in control of their lives and live more independently through a diverse range of choices and opportunities. Services include assistive technology, high school transitions, job development, communication access, housing resources, information/referral, peer support, and systems change advocacy.

**For more brain injury resources near Tulare County, please see Fresno County, Inyo County, Kern County, and King County.**

Tuolumne

Columbia College – Disabled Student Programs & Services 11600 Columbia College Drive Sonora, CA 95370 Phone: (209) 588-5134 http://www.columbia.yosemite.edu/dsps/ Disabled Student Programs & Services (DSPS) provides academic support for those with disabilities. Services include individual assessment review/evaluation, individualized learning strategies to remediate or compensate for basic skill deficits, test facilitation, and other in-class accommodations as needed. Tutoring may be offered by specially trained staff and students for general educational and vocational college coursework.

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Department of Rehabilitation (Sonora Branch) 19900 Cedar Road North Sonora, CA 95370 Phone: (209) 536-2988 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Disability Resource Agency for Independent Living (DRAIL) 67 Linoberg Street, Suite A Sonora, CA 95370 Phone: (209) 532-0963 http://www.drail.org/ Disability Resource Agency for Independent Living (DRAIL) works to ensure a life filled with possibility and independence is a reality for the members of the community living with a disability. DRAIL supports clients with technology and helps them get connected to resources and services optimizing clients’ quality of life.

**For more brain injury resources near Tuolumne County, please see Alpine County, Calaveras County, Madera County, Mariposa County, Merced County, Mono County, and Stanislaus County.**

Ventura

Brain Injury Center of Ventura County 3687 E. Las Posas, Building H Camarillo, CA 93011 Phone: (805) 482-1312 http://www.braininjurycenter.org/ The Brain Injury Center of Ventura County aims to help brain injury survivors and their families living in Ventura County. Their objectives are to identify the on-going needs of the brain injury survivor; ensure access to appropriate community health and social services; and to provide specialized caregiver support, training, and information to assist brain injury survivors in remaining as independent as is reasonably and realistically possible. In addition, they enthusiastically engage brain injury survivors in problem-solving issues through supportive coaching and education techniques. They provide support for family members when their loved one is in initial intensive stages of hospitalization. During this time, they refer families to peers who have experienced this type of trauma.

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Brain Injury Specialists 1746 S Victoria Avenue, Suite F Ventura, CA 93003 Phone: (805) 643-0123 http://www.braininjspecialists.com Brain Injury Specialists is comprised of neurorehabilitation experts and offers final steps in the continuum of care on the road to wellness (following a catastrophic neurological event). Services include speech/cognitive therapy, physical therapy, occupational therapy, family/caregiver education and training, and return to work/job coaching.

Department of Rehabilitation (Oxnard-Ventura Branch) 1701 Pacific Avenue, Suite 120 Oxnard, CA 93033 Phone: (805) 385-2400 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Department of Rehabilitation (Thousand Oaks Branch) 101 Hodencamp Road, Suite 212 Thousand Oaks, CA 91360 Phone: (805) 371-6279 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

Independent Living Resource Center (ILRC-Ventura County) 1802 Eastman Avenue, Suite 112 Ventura, CA 93003 Phone: (805) 650-5993 http://www.ilrc-trico.org/home.html The mission of the Independent Living Resource Center, Inc. (ILRC) is to promote independent living and full access for individuals with disabilities through advocacy, education, and action in our communities.

Life After Brain Injury 1918 Erringer Road Simi Valley, CA 93065 Phone: (805) 493-5555 http://www.lifeafterbraininjury.org Life After Brain Injury (LABI) is a place where survivors are encouraged to participate, belong, and grow. LABI is an independent-living-based organization and provides free support services to the brain injured community in and around Ventura County, CA.

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Moorpark College – ACCESS 7075 Campus Road Moorpark, CA 93021 Phone: (805) 378-1461 http://www.moorparkcollege.edu/services_for_students/access/index.shtml Accessibility Coordination Center & Educational Support Services (ACCESS) coordinates services and accommodations needed by eligible students to ensure full accessibility to the campus and curriculum is achieved. The accommodations and services required are individually determined by the student and the ACCESS Specialist. Some available services include specialized classes, alternative text, assistive equipment, note takers, test-taking accommodations, and registration assistance.

Oxnard College – Educational Assistance Center 4000 South Rose Avenue Oxnard, CA 93033 Phone: (805) 986-5830 http://www.oxnardcollege.edu/departments/student_services/educational_assistance_center/index .shtml The Educational Assistance Center (EAC) works with students with disabilities to develop educational plans/contracts in line with their goals for educational development and employment. Such plans, as well as the courses required to meet them and the accommodations needed to neutralize the disabilities, are reviewed each semester with an EAC counselor.

Ventura College – Disabled Students Programs & Services 4667 Telegraph Road Ventura, CA 93003 Phone: (805) 654-6300 http://www.venturacollege.edu/departments/student_services/dsps_eac/index.shtml Disabled Students Programs & Services (DSPS) promotes the educational and vocational potential of students with disabilities by supporting each student’s integration into the mainstream of college life. Students with learning disabilities; mobility, visual, hearing, speech, or psychological impairments; acquired brain injuries; seizure disorders; and other disabilities are eligible for support services needed to fully participate in the educational process.

**For more brain injury resources near Ventura County, please see Kern County, Los Angeles County, and San Luis Obispo County.**

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Yolo

Department of Rehabilitation (Woodland Branch) 1100 Main Street, Suite 340 Woodland, CA 95695 Phone: (530) 668-6824 http://www.dor.ca.gov The California Department of Rehabilitation (DOR) works in partnership with consumers and other stakeholders to provide services and advocacy resulting in employment, independent living, and equality for individuals with disabilities.

PRIDE Industries Foundation (Woodland Branch) 327 College Street, Suite 210 Woodland, CA 95695 Phone: (530) 666-3475 http://www.prideindustries.com/ PRIDE provides the support, training, and opportunity necessary to help people with disabilities overcome obstacles and find meaningful employment. PRIDE aims to be the premiere employer of people with disabilities, the vendor of choice in the markets they serve, and the recognized leader in meeting the needs of individuals in overcoming barriers to employment.

Woodland Community College- Disabled Students Programs & Services 2300 E. Gibson Road Woodland CA 95776 Phone: (530) 661-5797 http://www.wcc.yccd.edu/ The Woodland Community College Disabled Students Programs & Services (DSPS) is designed to provide access to educational opportunities for students with disabilities. Their main objective is to provide an opportunity for all individuals to gain maximum benefit from their educational experience. Woodland Community College encourages students with disabilities to participate within the limits of their disabilities in the same activities and courses as other students.

**For more brain injury resources near Yolo County, please see Colusa County, Lake County, Napa County, Sacramento County, Solano County, and Sutter County.**

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Yuba

Foundation Resources for Equality and Employment for the Disabled (FREED) 508 J Street Marysville, CA 95901 Phone: (530) 742-4474 http://www.freed.org FREED’s mission is to eliminate barriers for people with disabilities through programs promoting independent living and effecting systems change while honoring dignity and self-determination. FREED has a number of programs focusing on the issues that arise with aging and disabilities. They work with clients to figure out what they need to get connected.

Rideout Rehabilitation Services 725 4th Street Marysville, CA 95901 Phone: (530) 749-4529 http://www.frhg.org Rideout Rehabilitation Services (RRS) is made up of physical, occupational, and speech therapists. RRS provides a wide spectrum of highly specialized rehabilitation services to ensure complete coverage for the needs of the whole community. Services range from inpatient to outpatient rehabilitation. The physical therapy team has developed a comprehensive treatment program for stroke and neurological rehabilitation, swallowing evaluation and retraining, cognitive retraining, back care, orthopedic injuries, sports injury, and post-surgical care.

Yuba College – Disabled Students Programs & Services 2088 North Beale Road Marysville, CA 95901 Phone: (530) 741-6795 http://www.yccd.edu The goals of Disabled Students Programs & Services (DSPS) are to equip students with tools to successfully navigate their college education, assist them in understanding their disability (including strengths and weaknesses), and teach students to communicate their needs to others regarding the services they need to achieve their goals.

**For more brain injury resources near Yuba County, please see Butte County, Nevada County, Placer County, Plumas County, Sierra County, and Sutter County.**

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ADDITIONAL RESOURCES

The following brain injury resources are not listed by county but are general resources beneficial to anyone in California. Many of the following resources are professional associations related to brain injury while others simply have useful information. The reader would benefit by exploring these websites.

American Brain Tumor Association 2720 River Road, Suite 146 Des Plaines, IL 60018 Phone: (800) 886-2282 http://www.abta.org/ The mission of the American Brain Tumor Association (ABTA) is to advance the understanding and treatment of brain tumors with the goals of improving, extending, and ultimately saving the lives of those impacted by a brain tumor diagnosis. ABTA accomplishes these goals through interactions with brain tumor patients and their families, collaborations with allied groups and organizations, and the funding of brain tumor research.

American Stroke Association 7272 Greenville Avenue Dallas, TX 75231 http://www.strokeassociation.org/STROKEORG/ The American Stroke Association is dedicated to prevention, diagnosis, and treatment to save lives from stroke: America’s number four killer and a leading cause of serious disability. They fund scientific research, help people better understand and avoid stroke, encourage government support, guide healthcare professionals, and provide information to enhance the quality of life for stroke survivors.

American Veterans with Brain Injury 4960 Highway 90, Box #173 Pace, FL 32571 http://www.avbi.org/ American Veterans with Brain Injury (AVBI) is an organization offering support to the families of American service members and veterans who have sustained brain injuries through a web- based peer-support network and information. AVBI provides medical alert dog tags and identity cards in a small carrying case, and AVBI members have access to web-based exercise programs to improve brain health and cognitive performance. Such programs encourage self-improvement and recovery of service members and veterans who have sustained a brain injury. There are many other programs and supports for those with brain injury through AVBI.

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Aphasia Center of California 200 Grand Avenue Oakland, CA 94602 Phone: (510) 336-0112 http://www.aphasiacenter.org Aphasia is a loss or reduction of language (i.e., speaking, understanding, reading, and/or writing) following brain damage, typically as a result of a stroke. The Aphasia Center of California provides high quality treatment programs enhancing communication skills, quality of life, and overall wellbeing for those affected by aphasia. They offer clients a community of people who support and understand one another while providing stories of hope and success.

Beach Center on Disability – The University of Kansas 1200 Sunnyside Avenue Lawrence, KS 66045 Phone: (785) 864-7600 http://www.beachcenter.org The Beach Center on Disability is a multidisciplinary research and training center committed to making a significant and sustainable positive difference in the quality of life of individuals and families affected by disability and the professionals who support them.

Brain and Spinal Cord Injury Resource Center Phone: (877) 216-6020 http://www.brainandspinalcord.org/ Sponsored by Newsome Melton LLP., BrainandSpinalCord.org is a resource for brain and spinal cord injury survivors and their families to learn more information about medical conditions, rehabilitation, and legal options.

Brain Injury Association of America (BIAA) 1608 Spring Hill Road, Suite 110 Vienna, VA 22182 Phone: (703) 761-0750 http://www.biausa.org/ The Brain Injury Association of America (BIAA) is the leading national organization serving and representing individuals, families, and professionals who are touched by traumatic brain injury (TBI). The BIAA provides information, education, and support to assist the 5.3 million Americans currently living with traumatic brain injury and their families. It is dedicated to improving the quality of life of people with brain injuries and their families as well as promoting prevention of brain injury. The website offers information, education, advocacy, support, and prevention. The BIAA consists of 42 state associations, 200 chapters, and over 800 support groups across the U.S.

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Brain Injury Association of California (BIACAL) 2658 Mt. Vernon Avenue Bakersfield, CA 93306 Phone: (661) 872-4903 http://www.biacal.org The Brain Injury Association of California (BIACAL) is a non-profit membership organization providing information, resources, education, advocacy, and support for those affected by brain injury. It is also the country’s oldest and largest nationwide brain injury advocacy organization. Through advocacy, they bring help, hope, and healing to millions of individuals living with brain injury, their families, and the professionals who serve them. For a list of BIACAL’s brain injury resources, please visit http://biacal.org/brain-injury-resources-california.htm.

Brain Injury Coalition P.O. Box 3497 Chico, CA 95927 http://www.braininjurycoalition.info/index_files/Page415.htm The Brain Injury Coalition is an advocacy and educational organization dedicated to promoting brain injury awareness and creating opportunities for individuals with brain injury, their caregivers, and families.

Brain Injury.com Phone: (866) 882-7246 http://www.braininjury.com/ Brain Injury.com is the largest collection of medical and legal information about brain injury on the web. The website provides a nationwide network of legal services to serve those with cases involving brain injury, and they provide cutting edge information for those in need.

Brain Injury Information NETwork http://www.tbinet.org/ The Brain Injury Information NETwork (TBINET) was started by a small group of caregivers who had loved ones with various types of brain injuries. TBINET is dedicated to helping people find information on ABI/TBI.

Brain Injury Law Group 212 Whitetail Run Lane Sheboygan, WI 54923 Phone: (800) 992-9447 http://www.tbilaw.com The Brain Injury Law Group is a community of trial lawyers across the U.S. serving the rights of persons with TBI. The website provides a number of services to assist survivors of TBI in locating a lawyer specializing in brain injury in the state where they were injured. The website also features articles, information, and graphics about TBI.

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Brain Injury Network 707 Hahman Drive, #9276 Santa Rosa, CA 95405 Phone: (707) 544-4323 http://www.braininjurynetwork.org/ The Brain Injury Network (BIN) is the first international and U.S.A. national advocacy organization operated by people with brain injuries. BIN is a worldwide organization promoting ABI survivor advocacy, citizen action, and brain injury legal rights. BIN provides advocacy, awareness, education, information sharing, networking, peer support, policy, referral, and social community.

Brain Injury News and Information Blog 427 Bedford Road, Suite 260 Pleasantville, NY 10570 http://www.braininjury.blogs.com/ The Brain Injury News and Information Blog’s mission is to improve the quality of life for persons with brain injuries, their spouses, and family members. They believe the best cure for a brain injury is prevention, and they represent clients with compassion to see that justice is done.

Brain Injury Research Center of Mount Sinai 5 East 98th Street, B-15 New York, NY 10029 Phone: (888) 241-5152 http://www.icahn.mssm.edu/research/centers/brain-injury-research-center-of-mount-sinai The Brain Injury Research Center of Mount Sinai (BIRC-MS) conducts cutting-edge research, with a primary focus on addressing the challenges of living with TBI. In several recent studies, they evaluated the effectiveness of interventions on the cognitive, emotional, and behavioral functioning of people with brain injuries. Their research has greatly expanded the knowledge base with respect to long-term challenges faced by people with TBI as well as approaches to leading better lives after injury.

Brainline 2275 South Quincy Street Arlington, VA 22206 http://www.brainline.org/ Brainline offers information and resources about preventing, treating, and living with TBI. It serves those whose lives have been affected by TBI, including people with brain injury, their families, professionals in the field, and anyone else in a position to help prevent the toll of TBI.

Brain Train 8343 Currant Way Parker, CO 80134 http://www.brain-train.com Brain Train provides cognitive retraining software available for purchase. Volume 1, Basic Cognitive Skills, contains 55 computer programs designed to assist in remediating cognitive and

230 behavioral deficits. Volume 2, Vocational Readiness, consists of 15 programs designed to provide a bridge between cognitive rehabilitation and retraining.

Brain Trauma Foundation 250 Greenwich Street New York, NY 10007 http://www.braintrauma.org/ The Brain Trauma Foundation (BTF) dedicated its mission to improving TBI patient outcomes worldwide by developing best practice guidelines, conducting clinical research, and educating medical professionals and consumers. BTF continues to conduct clinical research to provide solutions and raise public awareness and understanding about concussions and TBI. By educating healthcare professionals on the immediate care for coma patients, BTF estimates thousands of lives could be saved each year in the U.S.

California Association of Health Facilities (CAHF) 2201 K Street Sacramento, CA 95853-7004 Phone: (916) 441-6400 http://www.cahf.org California Association of Health Facilities (CAHF) is a professional organization that represents long-term care providers; publishes information about acute care; and provides nursing and physical, occupational, and speech therapy. They publish a brochure, Information About Acute Care in a Nursing Facility, which discusses acute care facilities and what to expect from these facilities.

California Department of Veteran Affairs 1227 O Street Sacramento, CA 95814 Phone: (800) 324-5966 http://www.calvet.ca.gov California Department of Veteran Affairs aims to help veterans learn about the state and federal benefits to which they are entitled. Benefits could compensate veterans for a service-connected disability, allow them to begin or resume college education, help them care for their health, assist them in training for or finding employment, and help them buy a home.

California Foundation for Independent Living Centers 1234 H Street, Suite 100 Sacramento, CA 95814 Phone: (916) 325-1690 http://www.cfilc.org The California Foundation for Independent Living Centers (CFILC) provides a comprehensive list of independent living centers in California. They work in collaboration with the AT Network, Disability Organizing Network, Disabled and Proud, California Assistive Technology Reuse Coalition, and Disability Action Coalition.

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Caregiver Action Network 2000 M Street NW, Suite 400 Washington, DC 20036 Phone: (202) 772-5050 http://www.caregiveraction.org The mission of the Caregiver Action Network (CAN) is to promote resourcefulness and respect for the more than 65 million family caregivers across the country. CAN serves a broad spectrum of family caregivers ranging from the parents of children with special needs to the families and friends of wounded soldiers.

Center for Neuro Skills TBI Resource Guide http://www.neuroskills.com/ The TBI Resource Guide from the Center for Neuro Skills (CNS) is a main source of information, services, and products relating to traumatic brain injury, brain injury recovery, and post-acute rehabilitation. New on the website are an online drugstore and a virtual tour of the CNS brain injury rehab facilities.

Charles Maddock Foundation http://www.charlesmaddockfoundation.org/ The Charles Maddock Foundation (CMF) supports research in the fields of neurology and neurosurgery to enhance medical knowledge and improve treatments for those with brain injuries. The primary purpose of CMF is to help educate physicians on the most efficient methods of dealing with brain injury and to serve as a resource of knowledge and support for those who have a traumatic brain injury.

Database on Traumatic Brain Injury Educational Resources 1333 Moursund Street Houston, TX 77030 Phone: (713) 797-7105 http://www.braininjuryresearch.org This TBI community database contains information about videos and non-published materials such as pamphlets, booklets, and manuals developed around the country including a wide variety of topics.

Deaf and Disabled Telecommunications Program Phone: (800) 854-7784 http://www.ddtp.cpuc.ca.gov/homepage.aspx The California Telephone Access Program distributes telecommunications equipment and services for individuals who have functional limitations in hearing, vision, mobility, speech, and/or interpretation of information. A person with a speech disability can use Speech-to-Speech (STS) to make telephone calls using his or her own voice or voice synthesizer. STS operators serve as “voicers” for users with speech disabilities who have difficulty being understood over the phone. There is no charge to use this service. You only pay for the price of the call. The service also works in reverse, so anyone may use STS to initiate a call to a person with a speech disability.

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Defense and Veterans Brain Injury Center (DVBIC) 1335 East-West Highway, Suite 6-100 Silver Spring, MD 20910 Phone: (800) 870-9244 http://www.dvbic.org/ The Defense and Veterans Brain Injury Center (DVBIC) serves active duty military, their dependents, and veterans with traumatic brain injury (TBI) through state-of-the-art medical care, innovative clinical research initiatives, and educational programs.

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury 2345 Crystal Drive, Suite 120 Arlington, Virginia 22202 Phone: (800) 510-7897 http://www.dcoe.health.mil/default.aspx Defense Centers of Excellence (DCOE) leads a collaborative effort toward optimizing psychological health and traumatic brain injury (TBI) treatment for the Department of Defense. The DCOE establishes quality standards for clinical care, education and training, prevention, community outreach, and program excellence.

Disability Rights California 1831 K Street Sacramento, CA 95811 Phone: (916) 504-5800 http://www.disabilityrightsca.org/ Disability Rights California works to bring about fairness and justice for people with disabilities. To reach those goals of fairness and justice, they may file lawsuits on behalf of individuals or groups, investigate charges of abuse and neglect, build peer/self-advocacy groups, forge community partnerships, advocate for change in regulations, and provide information to those who may not know about their rights. Disability Rights California has locations in Sacramento, Oakland, Fresno, Los Angeles, and San Diego.

Disability Rights Education and Defense Fund 2212 6th Street Berkeley, CA 94710 Phone: (510) 644-2555 http://www.dredf.org The Disability Rights Education and Defense Fund (DREDF) is a leading national civil rights law and policy center directed by individuals with disabilities and parents who have children with disabilities. DREDF’s mission is to advance the rights of people with disabilities through legal advocacy, training, education, public policy, and legislative development.

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Disabled and Alone: Life Services for the Handicapped, Inc. 352 Park Avenue South New York, NY 10010 Phone: (212) 532-6740 http://www.disabledandalone.org Disabled and Alone/Life Services for the Handicapped, Inc. (Life Services) believes no person should have to live life in loneliness and isolation because of a disability. Life Services is a nonprofit organization established to help families plan for and implement changes taking place after the death of a caregiver.

Employment Development Department (EDD) 722 Capital Mall Sacramento, CA 95814 Phone: (916) 653-0707 http://www.edd.ca.gov The Employment Development Department (EDD) is one of the largest state departments with employees at hundreds of service locations throughout the state, and they have connected millions of job seekers and employers in an effort to build the economy of the Golden State. They offer a wage replacement program for non-work related injuries (i.e., disability).

Epilepsy Foundation of Northern California 155 Montgomery Street, Suite 309 San Francisco, CA 94104 Phone: (415) 677-4011 http://www.epilepsynorcal.org The Epilepsy Foundation of Northern California is a charitable organization leading the fight to stop seizures, find a cure, and overcome the challenges created by epilepsy. They direct information, resources, and support toward Northern Californians living with epilepsy.

Epilepsy Foundation of America 8301 Professional Place Landover, MD 20785 Phone: (800) 332-1000 http://www.epilepsyfoundation.org The Epilepsy Foundation of America is the national voluntary health agency dedicated solely to the welfare of the people with epilepsy in the U.S. The mission of the Epilepsy Foundation is to stop seizures, find a cure, and overcome the challenges created by epilepsy through efforts including education, advocacy, and research.

Fair Employment and Housing Commission 2218 Kausen Drive, Suite 100 Elk Grove, CA 95758 Phone: (916) 478-7251 http://www.dfeh.ca.gov/ The Fair Employment Housing Commission (FEH) receives and investigates discrimination complaints in its five district offices throughout California. FEH handles employment, housing,

234 public accommodations, hate-violence cases, and systemic discrimination cases statewide. In addition, there are three legal offices that prosecute cases. The FEH routinely provides technical assistance to employers, business establishments, and housing providers regarding their responsibilities under the law.

Family Caregiver Alliance 785 Market Street, Suite 750 San Francisco, CA 94103 Phone: (415) 434-3388 http://www.caregiver.org Family Caregiver Alliance (FCA) is a public voice for caregivers. Their information, education, services, research, and advocacy support and sustain the important work of families caring for loved ones with chronic, disabling health conditions nationwide.

Friends of Californians with Disabilities http://www.disabilityemployment.org Friends of Californians with Disabilities, Inc., is a leader in developing statewide and national partnerships to increase employment and independent-living opportunities for people with disabilities. They played a major leadership role in the partnership that created such innovative, nationally acclaimed projects as the California Youth Leadership Forum for Students with Disabilities (YLF), the Media Access Office and Awards, and the “Windmills” Disability Awareness Diversity Training Program.

Greyhound Bus Phone: (800) 752-4841 http://www.greyhound.com Greyhound is the nation’s primary bus company; it travels all over California and from Canada to the south side of the Mexican border. Greyhound has services for customers with disabilities; please call for more information.

International Brain Injury Association http://www.internationalbrain.org/ The International Brain Injury Association is dedicated to the development and support of multidisciplinary medical and clinical professionals, advocates, policymakers, consumers, and others who work to improve outcomes and opportunities for persons with brain injuries.

Job Accommodation Network (JAN) P.O. Box 6080 Morgantown, WV 26506 Phone: (800) 526-7234 http://askjan.org/ The Job Accommodation Network (JAN) is the leading source of free, expert, and confidential guidance on workplace accommodations and disability employment issues. Working toward practical solutions benefiting both employer and employee, JAN helps people with disabilities enhance their employability and shows employers how to capitalize on the value and talent people with disabilities add to the workplace.

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Job Seeking Skills for People with Disabilities: A Guide to Success http://www.gpo.gov/fdsys/pkg/ERIC-ED466056/pdf/ERIC-ED466056.pdf The Job Seeking Skills Guide is a handbook for service providers to use as a counseling tool or for individuals with disabilities to use on their own. It provides an overview of the career- planning process, including considerations for the applicant with a disability.

Limited Examination and Application Program (LEAP) 801 Capital Mall Sacramento, CA 95814 Phone: (916) 445-0538 ext. 300 https://www.jobs.ca.gov/Job/Leap The State Personnel Board’s Limited Examination and Application Program (LEAP) helps persons with disabilities secure state jobs. Department of Rehabilitation counselors can certify clients, help them fill out the application, and help clients with the examination and hiring process.

Medicare Information Phone: (800) 633-4227 Call for more information on eligibility information. Medicare pays for doctors, ambulance trips, and X-rays but will not pay for dentists, hearing aids, or glasses (except for cataracts and eye exams). Medicare also pays for preventative care such as mammograms and prenatal care.

NAMI Veterans Resource Center 3803 N. Fairfax Drive, Suite 100 Arlington, VA 22203 Phone: (703) 524-7600 http://www.nami.org/ The National Alliance on Mental Illness (NAMI) Veterans Resource Center provides resources for veterans and active duty military members as well as their families, friends, and advocates on topics related to mental health such as post-traumatic stress disorder (PTSD), health benefits and eligibility, and traumatic brain injury (TBI).

National Association of State Head Injury Administrators P.O. Box 878 Waitsfield, VT 05673 Phone: (802) 498-3349 http://www.nashia.org/ The National Association of State Head Injury Administrators assists state governments in promoting partnerships and building systems to meet the needs of individuals with brain injuries and their families. They also deal with brain injury policy, programs, and service resources for state employees and others interested in state government.

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National Brain Tumor Society 22 Battery Street, Suite 612 San Francisco, CA 94111 Phone: (800) 934-CURE http://www.braintumor.org The National Brain Tumor Society is committed to finding better treatments, and ultimately a cure, for people living with a brain tumor today and anyone who will be diagnosed tomorrow; this requires effecting change in the system at all levels. The website also has a directory of brain tumor related support groups.

National Dissemination Center for Children with Disabilities P.O. Box 1492 Washington, DC 20013 Phone: (800) 695-0285 http://www.nichcy.org The National Dissemination Center for Children with Disabilities is devoted to providing information on disabilities for families, educators, and other professionals. Special focus is on children and youth (birth to age 22). Services include personal responses to specific questions, publications, and referrals to other disability organizations.

National Easter Seal Society 230 West Monroe, Suite 1800 Chicago, IL 60606 Phone: (312) 726-6200 http://www.easterseals.com Easter Seals provides educational evaluation services, technological assistance, speech and language therapy, vocational evaluation, occupational therapy and training, psychosocial evaluation and counseling, and recreational and social services for people with disabilities. Call or visit the website for the Easter Seals office near you.

National Institute of Neurological Disorders and Stroke P.O. Box 5801 Bethesda, MD 20824 Phone: (800) 352-9424 http://www.ninds.nih.gov The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.

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National Institute on Disability and Rehabilitation Research (NIDRR) – Office of Special Education and Rehabilitative Services 400 Maryland Avenue, S.W. Washington, DC 20202 Phone: (202) 245-7316 http://www.ed.gov/about/offices/list/osers/nidrr/ The National Institute on Disability and Rehabilitation Research (NIDRR) funds research in the field of rehabilitation. They have an emphasis on employment outcomes, health and function, technology for access and function, independent living and community integration, associated disability research areas, knowledge dissemination and utilization, Americans with Disabilities Act (ADA) technical assistance projects, and capacity building for rehabilitation research and training.

National Intrepid Center of Excellence 4860 South Palmer Road Bethesda, MD 20889-5649 Phone: (301) 319-3600 http://www.nicoe.capmed.mil/About%20Us/SitePages/Home.aspx The mission of the National Intrepid Center of Excellence (NICoE) is to be a leader in advancing TBI and psychological health treatment, research, and education. Their overarching mission is accomplished through three primary categories of activity: research, clinical, and education.

National Organization on Disability 910 Sixteenth Street, NW, Suite 600 Washington, DC 20006 Phone: (202) 293-5960 http://www.nod.org The National Organization on Disability (NOD) promotes the full participation of people with disabilities in all aspects of life. Today, NOD focuses on increasing employment opportunities for the 79% of working-age Americans with disabilities who are not employed.

National Rehabilitation Association 633 South Washington Street Alexandria, VA 22314 Phone: (703) 836-0850 http://www.nationalrehab.org The National Rehabilitation Association (NRA) is a member organization promoting ethical and state-of-the-art practice in rehabilitation with the goal of personal and economic independence for persons with disabilities.

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National Rehabilitation Information Center (NARIC) 4200 Forbes Boulevard, Suite 202 Lanham, MD 20706 Phone: (301) 459-4263 http://www.naric.com The National Rehabilitation Information Center is funded by the National Institute on Disability and Research (NIDRR); it serves anyone, professional or client, interested in disability and rehabilitation. NIDRR provides 60,000 disability-related records regarding literature, organizations, timely information, and research.

National Resource Center for Traumatic Brain Injury – Department of Physical Medicine and Rehabilitation P.O. Box 980542 Richmond, VA 93298 Phone: (804) 828-9055 http://www.neuro.pmr.vcu.edu The National Resource Center for Traumatic Brain Injury (NRCTBI) is produced by the Virginia Commonwealth University. The website includes guides for survivors about families, friends, and caregivers; living and working productively; and rehabilitation providers. NRCTBI provides TBI frequently asked questions (FAQ’s) and a directory of experts.

National Resource Directory https://www.nrd.gov/ The National Resource Directory provides access to services and resources at the national, state, and local levels that support recovery, rehabilitation, and community reintegration. Such resources are specifically for wounded warriors, service members, veterans, and the family and caregivers who support them.

NeuroRestorative Phone: (800) 743-6802 http://www.neurorestorative.com/ As a pioneer in post-acute services, NeuroRestorative sets the pace for community-based care for people with brain injuries and has evolved into a nationally recognized center of excellence in treating post-acute neurological trauma.

Neurotrauma Law Nexus http://www.neurolaw.com/ The Neurotrauma Law Nexus is provided as a resource for people with brain injury (BI) and spinal cord injury (SCI), family members, health care providers, social workers, and all other interested individuals whose lives and experiences are affected by BI, SCI, or other complex neurological events. The site is an information resource for understanding the legal system’s involvement in brain and spinal cord injury cases. The website discusses the role of the neurolawyer, understanding brain and spinal cord injury, medico-legal issues, and provides a glossary of terms. It is provided through the Law Offices of Fick & May.

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North American Brain Injury Society http://www.nabis.org/ The North American Brain Injury Society was created specifically to address the needs of multidisciplinary professionals dedicated to brain injury, provide education programs, offer scientific updates, and provide a platform for communication and professional exchange. NABIS welcomes the opportunity to work with other brain injury groups to address the key issues for professionals in North America.

Parrot Software/Brain Train http://www.parrotsoftware.com Parrot Software provides treatment for aphasia and brain injury by providing tools for communication, memory, attention, speech, and cognition.

Pediatric Brain Injury Foundation http://www.pedsbif.org/ The Pediatric Brain Injury Foundation provides knowledge and support to families and caregivers of children with brain injury, and they advocate for those children.

Planning and Execution Assistant Trainer (PEAT) 650 Castro Street, Suite 120-197 Mountain View, CA 94041 Phone: (888) 224-7328 http://www.brainaid.com Planning and Execution Assistant Trainer (PEAT) is an Android smartphone or tablet application that provides cueing and scheduling assistance for individuals with memory, attention, and cognitive disorders. PEAT users include patients with traumatic brain injury; stroke; hypoxia; and neurodegenerative conditions including autism, multiple sclerosis (MS), Alzheimer’s disease, and attention deficit hyperactivity disorder (ADHD).

Project Hired 1270 Franklin Square Santa Clara, CA 95050 http://www.projecthired.org Project Hired (Helping Industry Recruit Employees with Disabilities) assists individuals with disabilities in securing jobs appropriate for their qualifications and career goals. They also maintain a range of services for job placement and career development.

Social Security Disability Resource Center http://www.ssdrc.com/ The Social Security Disability Resource Center informs readers about how the Social Security Disability and SSI Disability process works from start to finish. Such information includes what to expect before, during, and after a disability application has been processed; common mistakes that need to be avoided; and what to do and how to react in specific situations (for example, receiving notices of denial, obtaining the status of the claim at different points, providing needed evidence, and undergoing a disability interview with a Social Security Claims Representative).

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Stiggy’s Dogs http://www.stiggysdogs.org/ Stiggy’s Dogs is a non-profit organization dedicated to the support of military veterans suffering from post-traumatic stress disorder and traumatic brain injury. They offer another way to heal through psychiatric therapy dogs. The dogs are rescued and trained specifically for each veteran. By uniting these military heroes and dogs, they are “Rescuing One to Rescue Another.”

The American Association of People with Disabilities http://www.aapd.com/ The American Association of People with Disabilities is the nation’s largest disability rights organization. They promote equal opportunity, economic power, independent living, and political participation for people with disabilities. Members (including people with disabilities and their family, friends, and supporters) represent a powerful force for change.

The American Occupational Therapy Association 4720 Montgomery Lane P.O. Box 31220 Bethesda, MD 20824 Phone: (301) 652-6611 http://www.aota.org The American Occupational Therapy Association (AOTA) is the national professional association established to represent the interests and concerns of occupational therapy practitioners and students of occupational therapy and is dedicated to improving the quality of occupational therapy services.

The Brain Aneurysm Foundation 269 Hanover Street Hanover, MA 02339 Phone: (781) 826-5556 http://www.bafound.org/ The Brain Aneurysm Foundation provides support and educational materials to the medical community, survivors, family members, friends, and the general public regarding the facts, treatment options, and recovery process for brain aneurysms. With the help of the medical community, they remain steadfast and earnest in the pursuit of brain aneurysm research that can directly benefit those affected.

The Brain Injury Recovery Network 840 Central Avenue Carlisle, OH 45005 Phone: (877) 810-2100 http://www.tbirecovery.org/ The Brain Injury Recovery Network is dedicated to helping victims and families of brain and other serious injuries. They do not give medical advice or suggest particular treatments for those with brain injuries. Instead, they try to inform readers of some of the possible options so they can weigh those options with the specifics of the situation and participate with the medical team to make the best decisions they can at the time.

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The Brain Tumor Foundation for Children 6065 Roswell Road NE, Suite 505 Atlanta, GA 30328 Phone: (770) 458-5554 http://www.braintumorkids.org/ The mission of the Brain Tumor Foundation for Children is to provide financial assistance, social support, and information for families of children with brain and spinal cord tumors. They fund research projects that improve treatment options and search for a cure as well as raise public awareness of the disease and advocate on behalf of children who are affected.

The Cal State University: Working for California http://www.calstate.edu/search_find/campus.shtml On this website is a list of all 23 California State University colleges. Many students with disabilities attend these schools successfully. For extra support while attending these schools, search for a specific campus’ Disabled Students Programs & Services (DSPS).

The Center for Outcome Measurement in Brain Injury (COMBI) http://www.tbims.org/combi The Center for Outcome Measurement in Brain Injury (COMBI) is an online resource for individuals needing detailed information regarding outcome and assessment measures for brain injuries. The COMBI is a collaborative project of 13 brain-injury centers across the United States, covering detailed information on 26 different instruments.

The Journey Home – Center of Excellence for Medical Multimedia Security Drive, Building 8110 USAFA, CO 80840 http://www.traumaticbraininjuryatoz.org/ The Journey Home provides an informative and sensitive exploration of traumatic brain injury (TBI), including information for patients, family members, and caregivers. Topics include types and symptoms of brain injury, TBI treatment and recovery, and helpful insights about the potential long-term effects of brain injury.

The National Spinal Cord Injury Association (NSCIA) 75-20 Astoria Boulevard Jackson Heights, NY 11370 Phone: (718) 803-3782 http://www.spinalcord.org/ The mission of the National Spinal Cord Injury Association is to improve the quality of life of all people living with a spinal cord injury. They provide active-lifestyle information, peer support, and advocacy to empower individuals to achieve their highest potential in all facets of life.

TIRR Foundation http://www.tirrfoundation.org/ The TIRR Foundation seeks to improve the recovery, health, and quality of life for people who have sustained a spinal cord or brain injury by funding innovative research to find a cure and by

242 fostering programs advancing rehabilitative medicine. TIRR Foundation is advancing medical science, improving care, and enhancing lives.

Traumatic Brain Injury National Data Center http://www.tbindc.org The Traumatic Brain Injury National Data Center includes an introduction and links to the model systems, publications, current research, and a Facts and Figures newsletter. The Traumatic Brain Injury Model System (TBIMS) program was created to demonstrate the benefits of a coordinated system of neurotrauma and rehabilitation care and to conduct innovative research on all aspects of care for those who sustain traumatic brain injuries. Each center systematically collects important data about each individual included and sends this information to the TBI National Data Center.

Traumatic Brain Injury Resource Directory (TBIRD) http://www.tbi-sci.org/tbird The Traumatic Brain Injury Resource Directory (TBIRD) is an online directory of resources intended for use by persons with traumatic brain injuries in Northern California. It is produced by the Rehabilitation Research Center at Santa Clara Valley Medical Center and funded by the National Institute of Disability and Rehabilitation Research and Firedoll foundation.

Traumatic Brain Injury Support Groups http://www.bcftbi.org/tbi-resources/support-groups.asp The Betty Clooney Center lists traumatic brain injury support groups throughout the entire state of California, as well as some in other states. They also list Internet TBI support groups. Support groups help people with brain injury and/or their caregivers and family interact with others who share similar experiences.

Traumatic Brain Injury Survival Guide http://www.tbiguide.com The Traumatic Brain Injury Survival Guide is an online TBI survival guidebook written by Glen Johnson, Ph.D. and clinical neuropsychologist from Michigan. Easy to read chapters include common indicators of a head injury, understanding how the brain works, coping with common problems, dealing with doctors, emotional stages of recovery, and returning to school.

United States Brain Injury Alliance http://www.usbia.org/ The mission of the United States Brain Injury Alliance is to engage the community in preventing brain injury and improving lives. They value integrity, excellence, and impact to make a difference for those with brain injuries.

University of California http://www.admission.universityofcalifornia.edu/campuses/ On this website is a list of all nine University of California colleges. Many students with disabilities attend these schools successfully. For extra support while attending these schools, search for a specific campus’ Disabled Students Programs & Services (DSPS).

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U.S. Department of Health Resources and Services Administration (HRSA) TBI Program http://www.hhs.gov/asl/testify/2012/03/t20120319a.html HRSA’s Traumatic Brain Injury Program was established to ensure individuals with TBI and their families have access to appropriate, adequate care to support recovery, maximize independence, and promote reintegration. The Traumatic Brain Injury Grant Program funds the development and implementation of statewide systems ensuring access to comprehensive and coordinated TBI services including transitional services, rehabilitation, education, employment, and long-term community support.

U.S. Department of Veterans Affairs – Vocational Rehabilitation and Employment (VR&E) http://www.va.gov Veterans may receive help with job training, employment accommodations, resume development, and job-seeking skills coaching. Other services may be provided to assist veterans in starting their own businesses or offering independent-living services for those who are severely disabled and unable to work in traditional employment.

World Institute on Disability (WID) 3075 Adeline Street, Suite 280 Berkeley, CA 94703 Phone: (510) 225-6400 http://www.wid.org The World Institute on Disability (WID) eliminates barriers to full social integration and increases employment, economic security, and health care for persons with disabilities. WID creates innovative programs and tools, conducts research and training, and provides technical assistance.

While You are Waiting http://www.waiting.com While You are Waiting is the work of those whose lives have been changed by brain injury. The website is directed to individuals waiting while someone is in a coma. It provides information about brain injury, the ICU guide, grief process and testimonials, frequently asked questions about prognosis, legal issues, what to expect at discharge, support, and resources.

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