05/19/2022
Traumatic Brain Injury
A traumatic brain injury (TBI) is an injury to the brain that is caused by an external physical force such as hitting your head or other types of blunt force trauma.
The most common causes of TBI include slips and falls, motor vehicle accidents and struck by or against events.
The injury can cause physical and mental challenges.
Every injury to the brain has different effects or consequences.
(Federal TBI Grant)
The North Carolina (TBI) Program was awarded a 5 year grant from the Federal Administration for Community Living (ACL). The main grant objectives include:
A (TBI) grant has been approved and funded by the Federal Administration
for Community Living (ACL).
N.C. (TBI) Grant is for
$200,179 per year for a total of $1,000,895 over the five-year grant period.
DHHS contracts with BIANC to implement most grant objectives and deliverables.
Grant Goal- To facilitate the continued development and expansion of a
comprehensive, multi-disciplinary, and easily accessible system of care for individuals with lived experience and their families.
Main Grant Objectives:
Contribute to infrastructure development of the whole care system to ensure individuals with Traumatic Brain Injury (TBI) are receiving culturally responsive, quality care in the new managed care system.
100% of individuals in N.C. who seek behavioral health services through a Local Management Entity-Managed Care Organization (LME-MCO) will be screened for a potential TBI,
Increased provider knowledge, skill and ability across all service programs,
Develop new partnerships with emphasis on the criminal justice system and domestic violence programs;
Expanded options for online support groups;
increase education to individuals with (TBI's) to promote person-
centeredness, empowerment, skill building and other topics.
TBI Grant Products
The following are products that will be developed during the five-year grant cycle.
A new Symptoms Questionnaire (SQ) database for professionals and others (TBI) screening and referral.
The addition of at least one active online support group Implementation of Employment and SUD training modules,
Updated Sales force database feasibility review of potential Peer Support pilot program training curriculum for individuals with (TBI)
Updated TBI Needs Assessment
(Bi-annually)...
Training plan for behavioral health providers with emphasis on (TBI) Waiver, SUD Waiver and MCOs Updated (TBI) state plan (Annually).
(TBI State Funded Programming)
Based upon legislative appropriation, the State funded (TBI) program operates on approximately $3.9 million dollars for the purposes of services, supports, education and awareness.
Out of this appropriation, each Local Management Entity-Managed Care Organization (LME-MCO) is allocated funding to provide (TBI) specific services and supports to individuals living with (TBI) in their respective catchment area.
The Brain Injury Association of N.C. (BIANC) also receives funding out of the same legislative appropriation.
$3,413,868 for the LME-MCO’s services and supports...
$559,218 for the Brain Injury Association of N.C. (BIANC) education and awareness...
Click on the link below for the name and contact information of the LME-MCO that serves your county.
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Local Management Entity/Manage Care Organization Directory Map
(TBI Waiver)
The (TBI) Waiver has been operational for three years.
The program is currently available to eligible individuals living in the Alliance Health (LME-MCO) catchment area (Wake, Durham, Johnston and Cumberland counties).
It offers a variety of services and supports to eligible individuals.
Division of Health Benefits (DHB) has submitted the TBI Waiver renewal application to the Centers for Medicare and Medicaid Services (CMS). The renewal will include:
Expansion of the Waiver into the two additional counties that are transitioning into the Alliance catchment area (Mecklenburg and Orange); increase federal poverty level to 300%, lowered age of date of Traumatic Brain Injury down from 22 to 18; and supported living as a service.
Other changes are as identified in the renewal application.
The draft (TBI) Waiver renewal application can be found hereOpen PDF.
This draft Waiver application is currently being reviewed by the Center for Medicare and Medicaid Services (CMS).
The Waiver renewal is anticipated to start in Spring 2022. Until the new application is approved, the current (TBI) Waiver remains in place.
The original (TBI) Waiver application to the Centers for Medicare and Medicaid Services (CMS) can be found here.
More information about the TBI Waiver can be found at Alliance Health here.
(Data)
The CDC estimates that 2% of the population will have a TBI, which equates to approximately 208,000 people in NC.
Overall 365,719 individuals received Behavioral Health Services during SFY 2018.
Of the 365,719 individuals receiving Behavioral Health Services during SFY 2018, 36,068 (10%) indicated a TBI Dx on NC Tracks records.
These 36,068 clients are unduplicated across both systems, Medicaid and DMH.
During 2019, there were 29,081 Traumatic Brain Injuries sustained by North Carolinians (NC DHHS-DPH, TBI Special Emphasis Report, 2019).
(Data Initiatives)
The (TBI) Program is engaged in several data initiatives to assist in determining the number of individuals living with TBI throughout North Carolina.
Data initiatives include:
(TBI) Screenings at six LME-MCO’s and a Domestic/Intimate Partner Violence (D/IPV) Pilot program;
Youth Sport initiative: (TBI) screening with all twenty-four teams in the Carolina Champions Soccer League; Claims Data Reviews...
The (TBI) Program is working with the Quality Management Section at the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS) to determine the number of individuals that have accessed publicly funded services such as physical health, mental health and substance use service systems.
Collaborations on data collection with state partners such as Division of Health Benefits (DHB) and Division of Public Health (DPH).
There are 113,852 consumers who had a (TBI) diagnosis in at least one of seven diagnosis code positions using applicable ICD-9 codes, based on paid claims for any Medicaid-
funded service or non-
Medicaid-funded (DMH/DD/SAS) mental health service paid through the NCTracks system after July 1, 2013 for services beginning on or before September 30, 2015.
July 1, 2013 is when N.C. Tracks began and 10/1/2015 is when use of ICD-10 codes was required.
Please note that there are likely many more people with (TBI's) in N.C. than this number.
This is one of many indicators. For example, it does not include people that have private insurance who have never accessed publicly funded services.
(Training and Outreach)
The (TBI) program provides some direct training opportunities:
What if There's a TBI? - Webinar
Password:NCTBIProgram1
Event evaluation form
The (TBI) Program also contracts with the Brain Injury Association of North Carolina (BIANC) to provide a variety of education, outreach and training activities.
Some of the training opportunities available include Brain Injury Basics, (TBI) and Co-Occurring Mental Health and Substance Use Disorders, (TBI) and Aging, (TBI) and Post-Traumatic Stress Disorder (PTSD) in the Military and Crisis Intervention Training.
Many of these trainings are offered in-person (as permitted) and/or in webinar format.
The online training modules include topics such as Identification of (TBI) among Medical Professionals and the Primary Care Workforce as well as (TBI) and Public Services in N.C.
Online training opportunities can be found here.
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