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Traumatic Brain Injury (TBI) Program

On this page:
Program Vision | State Grants | Protection and Advocacy System Grants | TBI Technical Assistance Center | Collaboration | Systems Change | Publications

Background
Current estimates state that at least 5.3 million Americans have a long-term or lifelong need for help to perform activities of daily living as a result of a TBI1. These individuals and their families are often faced with challenges, such as improper diagnosis, inability to access support or rehabilitation services, institutional segregation, unemployment, and being forced to navigate complicated and cumbersome service and support systems.

Recognizing the large number of individuals and families struggling to access appropriate and community-based services, Congress authorized the Federal TBI Program in the TBI Act of 1996 (PL 104-166). The TBI Act of 1996 launched an effort to conduct expanded studies and to establish innovative programs for TBI. It gave the Health Resources and Services Administration (HRSA) authority to establish a grant program for States to assist it in addressing the needs of individuals with TBI and their families. It also delegated responsibilities in the areas of research, prevention, and surveillance to the National Institutes of Health and the Centers for Disease Control and Prevention respectively.

Title XIII of the Children's Health Act of 2000 (PL 106-310) reauthorized the programs of the TBI Act of 1996. The TBI Act reauthorization also recognized the importance of protection and advocacy (P&A) services for individuals with TBI and their families by authorizing HRSA to make grants to State P&A Systems.

The HRSA Maternal and Child Health Bureau administers the Federal TBI Program. The Fiscal Year 2008 appropriation was $8,910,000.

Goals

  • Assist States in expanding and improving State and local capability which, in turn, will enhance access to comprehensive and coordinated services for individuals with TBI and their families;
  • Use existing research-based knowledge, state-of-the-art systems development approaches and the experience and products of previous TBI grantees in meeting program goals; and
  • Generate support from local and private sources for sustainability of funded projects after Federal support terminates, through State legislative, regulatory, or policy changes which promote the incorporation of services for individuals with TBI and their families into the State service delivery systems.

Program Vision
All individuals with TBI and their families will have accessible, available, acceptable, and appropriate services and supports.

What Does the Federal TBI Program Do?
Grants to States: The Program administers three types of grants to State agencies:

  • Planning grants are available for up to two years and allow States to build infrastructure through the Program's four core components-establishing a TBI Statewide Advisory Board, identifying of a Lead Agency, conducting a Needs and Resources Assessment, and developing a TBI State Action Plan.
  • Implementation grants are for three years and up to $200,000 per year for the purposes of improving access to services for individuals with TBI and their families.
  • Implementation Partnership grants are available for up to three years and up to $118,600 per year for States and up to $85,000 per year for Territories. Created in April 2006, this category supplants the former Planning, Implementation, and Post-Demonstration grants. These grants allow State agencies to conduct any of the activities of the former grant categories, depending on what needs to be done to expand or improve their systems of services and supports, and what is best suited to the development of a State.

Between 1997 and 2007, 48 States, two Territories, plus the District of Columbia received at least one State agency grant. For 2008, 47 States, the District of Columbia and one Territory have received funding for Implementation Partnership grants.

Grants to Protection and Advocacy Systems: The P&A grant program is a formula-based program that allows 57 States, Territories, and the Native American Protection and Advocacy Project to assess their State P&A Systems' responsiveness to TBI issues and provide advocacy support to individuals with TBI and their families.

Traumatic Brain Injury Technical Assistance Center (TAC): The Federal TBI Program supports a TBI TAC at the National Association of State Head Injury Administrators. The TBI TAC was established to help States in the planning and development of effective programs that improve access to health and other services for individuals with TBI and their families. TBI TAC staff specialists provide States with individualized technical assistance. Additionally, the TBI TAC develops and disseminates a variety of specialized documents and initiatives for the Federal TBI Program.

For example, TBI TAC has developed a set of benchmarks that can be used by grantees to assess their progress in meeting Program goals and objectives. The TBI TAC is also developing outcome measures that the Program will be able to use to better assess the impact TBI State and P&A Grants have on person-centered services and sustainable systems change.

Collaboration: The Federal TBI Program provides for the collaboration and communication between and among governmental, professional, and private organizations representing leaders and policymakers concerned with TBI-related issues.

Why is State Systems Change Important?
TBI is not just a medical issue. A TBI can affect every aspect of a person's life (e.g., education, employment, social and family relationships, emotional health, and mobility). As a result, individuals and their families must often find and gain access to an array of services. Because individual needs are different and can change over time, it is important that systems provide person-centered services and supports. In other words, service systems should be flexible enough to meet the unique needs of individuals and their families. Unfortunately, few systems are equipped to provide this form of person-centered service. The Federal TBI Program supports systems change activities so that individual States can evaluate their current structure and policy with the goal of ensuring that their systems better meet the needs of individuals with TBI and their families.

Publications

Traumatic Brain Injury in the United States: Assessing Outcomes in Children: Summary and Recommendations from the Expert Working Group, Atlanta, GA, October 26-27, 2000


1 In the Children's Health Act of 2000, Congress recognized that the estimated figure of 5.3 million Americans living withTBI-related disability is an under-count. This figure is based on the number of individuals discharged from a hospital following an overnight stay. This estimate fails to capture individuals who are seen in emergency departments but not admitted to hospitals, individuals who have visited physician's offices, or individuals who have not sought treatment for a head injury.
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