TBI State and

1

• TBI State and
• Federal Policy
• Overview

2
Advocacy

• Brain Injury Association of America
• (formerly National Head Injury Foundation)
• National and State
• OSERS/Vocational Rehabilitation
• Congress/State Legislators

3
Barriers to Services

• Lack of Information
• Eligibility
• Complexity of Needs
• Lack of Expertise
• Lack of Services Providers
• Lack of Funding for TBI Services

4
State Efforts

• Beginning in the 1980s . . .
• State Funded TBI Rehab Units
• Registries
• Linkages, Surveillance
• Advisory Councils/Boards

5
State Efforts

• State TBI Services/Lead Agencies
• State Appropriations
• Trust Funds, Dedicated Funding
• Expanded Existing Programs
• VR, DD, Medicaid

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Injury In AmericaA Continuing Public Health
Problem

• Surveillance
• Research
• EMS, Acute Care Rehab Research
• Injury Prevention
• Link individuals to services
• CDCs Role
• . . . 1985

7
Federal Interagency Task Force

• Recommendations
• Establish "traumatic brain injury" as a category
  in reporting systems
• Designate a lead Federal agency
• State and local working groups
• --1989 Report

8

• A national network of regional research centers
• A decentralized system of care
• Study and document the financial issues
• societal cost and related economic impact
• --1989 Report

9
Federal Efforts

• US Department of Education
• -- NIDRR Model Systems (1987)
• -- NIDRR Research Training Centers
• (1987)
• -- RSA Regional Grants (1989-1996)
• IDEA (1990)

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Introduction of TBI Act (1991)

• Prevention
• Proposed marketing standards
• Practice guidelines
• Outcome studies
• State grants

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TBI Act of 1996

• HRSA was specifically designated
• Changed language for State Grant
• Program
• Required State cash match
• (1 State for every 2 Federal)

12
TBI Act of 1996(PL 104-66)

• CDC
• Prevention Data
• NIH
• -- Consensus Conference
• HRSA
• -- State Grant Program

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Traumatic Brain Injury 2000 P.L. 106-310

• Definition
• Expanded surveillance
• Soft Match
• Role of Individual in Service
• Delivery
• Added PA Program

14
Emerging Trends and Issues

• Emphasis on Community Supports
• -- Olmstead Decision
• Aging Caregivers
• Limited Fiscal Resources
• Sustainability of Efforts

15
Proposed TBI Act of 2005

• HRSA State Grant Program
• May eliminate State match (soft)
• Formula-based
• Add American Indian Consortium