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TBI State and Federal Policy Overview. Advocacy. Brain Injury Association of America (formerly National Head Injury Foundation) National and State OSERS/Vocational Rehabilitation Congress/State Legislators. Barriers to Services. Lack of Information Eligibility Complexity of Needs
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TBI State and Federal Policy Overview
Advocacy • Brain Injury Association of America (formerly National Head Injury Foundation) • National and State • OSERS/Vocational Rehabilitation • Congress/State Legislators
Barriers to Services • Lack of Information • Eligibility • Complexity of Needs • Lack of Expertise • Lack of Services & Providers • Lack of Funding for TBI Services
State Efforts Beginning in the 1980s . . . • State Funded TBI Rehab Units • Registries • Linkages, Surveillance • Advisory Councils/Boards
State Efforts • State TBI Services/Lead Agencies • State Appropriations • Trust Funds, Dedicated Funding • Expanded Existing Programs • VR, DD, Medicaid
Injury In America:A Continuing Public Health Problem • Surveillance • Research • EMS, Acute Care & Rehab Research • Injury Prevention • Link individuals to services • CDC’s Role . . . 1985
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
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
Federal Efforts • US Department of Education • -- NIDRR Model Systems (1987) • -- NIDRR Research Training Centers • (1987) -- RSA Regional Grants (1989-1996) • IDEA (1990)
Introduction of TBI Act (1991) • Prevention • Proposed marketing standards • Practice guidelines • Outcome studies • State grants
TBI Act of 1996 • HRSA was specifically designated • Changed language for State Grant Program • Required State cash match ($1 State for every $2 Federal)
TBI Act of 1996(PL 104-66) • CDC • Prevention & Data • NIH -- Consensus Conference • HRSA -- State Grant Program
Traumatic Brain Injury2000 P.L. 106-310 • Definition • Expanded surveillance • Soft Match • Role of Individual in Service Delivery • Added P&A Program
Emerging Trends and Issues • Emphasis on Community Supports -- “Olmstead Decision” • Aging Caregivers • Limited Fiscal Resources • Sustainability of Efforts
Proposed TBI Act of 2005 HRSA State Grant Program • May eliminate State match (soft) • Formula-based • Add American Indian Consortium