Common use of Transitional Rehabilitation Clause in Contracts

Transitional Rehabilitation. The residential program is a time-limited and goal-oriented program designed to improve the resident’s physical, cognitive retraining and rehabilitation, communicative, behavioral, psychological and social functioning with the necessary support and supervision. A dedicated interdisciplinary team provides treatment and therapeutic activities seven days per week as well as 24/7 nursing care on the bed unit.‌‌ (b)‌ Polytrauma/TBI Day Transitional Rehabilitation Program. Service members and veterans that do not require an inpatient setting and have living arrangements in the community may participate in the PTRP as a day patient. An individual treatment plan is developed for each patient and typically includes three to five hours of treatment each‌‌ day based on clinical need. DoD/DVA MOU - APPENDIX A POLYTRAUMA, SCI, TBI, AND BLINDNESS (3)‌ Polytrauma Network Sites (PNSs) PNSs provide post-acute rehabilitation for veterans and Service members with polytrauma and TBI who reside within their Veterans Integrated Service Network (VISN) catchment area. This includes inpatient rehabilitation for those transitioning closer to home, comprehensive outpatient Xxx evaluations, a full range of outpatient therapy services, evaluations for DME and assistive technology, access to other consultative specialists, and follow up evaluations and case management for ongoing rehabilitation needs.‌ (4)‌ Polytrauma Support Clinic Teams (PSCTs) PSCTs provide interdisciplinary outpatient rehabilitation services in their catchment areas for veterans and Service members with mild and/or stable impairments from polytrauma and TBI. Services include comprehensive TBI evaluations, outpatient therapy services, management of stable rehabilitation plans referred from PRCs and PNSs, coordinating access to DVA and non-DVA services, and follow up evaluations and case management for ongoing rehabilitation needs.‌ (5)‌ Polytrauma Point of Contact (PPOC) DVA Medical Centers (DVAMCs) designated as PPOC sites have the capability of providing some outpatient rehabilitation therapies and may have the expertise to complete a TBI evaluation. A designated PPOC ensures that patients with polytrauma and TBI are referred to a facility and program capable of providing the level of rehabilitation services required.‌ (6)‌ Polytrauma/TBI Case Management and Care Coordination Clinical case management and coordination of care is provided to individuals with polytrauma and TBI across the PSC and in collaboration with other agencies and institutions, e.g., Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), DoD, state, and local agencies. DVA PSC case managers are knowledgeable of the resources available across the DVA for specialized care.‌ A list of DVA Polytrauma/TBI Rehabilitation Centers and Network Sites (PNSs) is in Appendix B, Table 1. This does not include all of the DVA facilities that serve Service members under this MOA. PRCs and PNSs are familiar with DVA services available in their VISN and assist with coordination of referrals.‌‌‌

Transitional Rehabilitation. The residential program is a time-limited and goal-oriented program designed to improve the resident’s physical, cognitive retraining and rehabilitation, communicative, behavioral, psychological and social functioning with the necessary support and supervision. A dedicated interdisciplinary team provides treatment and therapeutic activities seven days per week as well as 24/7 nursing care on the bed unit.‌‌ (b)‌ Polytrauma/TBI Day Transitional Rehabilitation Program. Service members and veterans that do not require an inpatient setting and have living arrangements in the community may participate in the PTRP as a day patient. An individual treatment plan is is‌‌ developed for each patient and typically includes three to five hours of treatment each‌‌ each day based on clinical need. DoD/DVA MOU - APPENDIX A POLYTRAUMA, SCI, TBI, AND BLINDNESS (3)‌ Polytrauma Network Sites (PNSs) PNSs provide post-acute rehabilitation for veterans and Service members with polytrauma and TBI who reside within their Veterans Integrated Service Network (VISN) catchment area. This includes inpatient rehabilitation for those transitioning closer to home, comprehensive outpatient Xxx evaluations, a full range of outpatient therapy services, evaluations for DME and assistive technology, access to other consultative specialists, and follow up evaluations and case management for ongoing rehabilitation needs.‌ (4)‌ Polytrauma Support Clinic Teams (PSCTs) PSCTs provide interdisciplinary outpatient rehabilitation services in their catchment areas for veterans and Service members with mild and/or stable impairments from polytrauma and TBI. Services include comprehensive TBI evaluations, outpatient therapy services, management of stable rehabilitation plans referred from PRCs and PNSs, coordinating access to DVA and non-DVA services, and follow up evaluations and case management for ongoing rehabilitation needs.‌ (5)‌ Polytrauma Point of Contact (PPOC) DVA Medical Centers (DVAMCs) designated as PPOC sites have the capability of providing some outpatient rehabilitation therapies and may have the expertise to complete a TBI evaluation. A designated PPOC ensures that patients with polytrauma and TBI are referred to a facility and program capable of providing the level of rehabilitation services required.‌ (6)‌ Polytrauma/TBI Case Management and Care Coordination Clinical case management and coordination of care is provided to individuals with polytrauma and TBI across the PSC and in collaboration with other agencies and institutions, e.g., Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), DoD, state, and local agencies. DVA PSC case managers are knowledgeable of the resources available across the DVA for specialized care.‌ A list of DVA Polytrauma/TBI Rehabilitation Centers and Network Sites (PNSs) is in Appendix B, Table 1. This does not include all of the DVA facilities that serve Service members under this MOA. PRCs and PNSs are familiar with DVA services available in their VISN and assist with coordination of referrals.‌‌‌