Traumatic Brain Injury (TBI)

Traumatic Brain Injury (TBI) State Partnership Grant Program

For more information about the TBI State Partnership Program, visit: https://tbi.acl.gov/.

What is a TBI?

A traumatic brain injury (TBI) can happen when an external force causes severe damage to the brain. Common causes of TBI include falls, automobile accidents, and sports injuries. There are many different names for TBI such as concussion, Shaken Baby Syndrome, head injury, or anoxia (loss of oxygen) due to trauma. Data from NIDILRR-supported research finds 1.56 million TBIs are sustained in one year. 

TBI can affect many parts of a person's life. People living with TBI and their families often require a range of services and supports. Individual needs are different and can change over time, so it is important that systems provide person-centered services and supports.

Other Resources:

• Model Systems Knowledge Translation Center: Traumatic Brain Injury (funded by NIDILRR)
• National Data and Statistical Center for TBI

About the TBI State Partnership Grant Program

The TBI State Partnership Grant Program provides funding to help states increase access to services and supports for individuals with TBI throughout the lifetime. This grant program is one component of the federal TBI Program, along with Protection & Advocacy, which is expected to:

• Help states expand and improve state and local capability so individuals with TBI and their families have better access to comprehensive and coordinated services.

• Generate support from local and private sources for sustainability of funded projects after federal support terminates. This is done through state legislative, regulatory, or policy changes that promote the integration of TBI-related services into state service delivery systems.

• Encourage systems change activities so that individual states can 1) evaluate their current structures and policies and 2) improve their systems as needed to better meet the needs of individuals with TBI and their families.

Authorizing Legislation

See this page for information about the Traumatic Brain Injury Reauthorization Act of 2014.

TBI Programs Transition to ACL

The TBI Reauthorization Act of 2014 allowed the Department of Health and Human Services Secretary to review oversight of the federal TBI Program and reconsider which administration should lead it. With support from TBI stakeholders, the Secretary found that the federal TBI Programs' goals closely align with ACL's mission to advance policy and implement programs that support the rights of older Americans and people with disabilities to live in their communities. As a result, the federal TBI Program moved from the Health Resources and Services Administration to ACL on Oct. 1, 2015.

State Grantee Information

Grants to States

Federal TBI Program grants to states have undergone several changes since the TBI Act of 1996 mandated the program. The most recent state grants were awarded in 2014 and require that grant activities increase access to rehabilitation and other services. Specifically, the states must address four barriers to needed services by:

• Screening to identify individuals with TBI

• Building a trained TBI workforce by providing professional training

• Providing information about TBI to families and referrals to appropriate service providers

• Facilitating access to needed services through resource facilitation

State Partnership Grants (SPGs) cannot be used to support primary injury prevention initiatives, research initiatives, or the provision of direct services. Funds may be used, however, to educate the public about the causes, symptoms, and treatment of TBI.

Between 1997 and 2013, 48 states, two territories, and the District of Columbia received at least one state agency grant. As of October 2016, 19 states receive funding for SPGs.

TBI Coordinating Center

The TBI Coordinating Center helps demonstrate the federal TBI Program’s success in providing long-term benefits to public health and provides grantees access to resources that will help them build partnerships, promote positive outcomes, increase access, and build capacity.

The TBI Coordinating Center:

• Provides grantees with individualized technical assistance to help plan and develop effective programs that improve access to health and other services for individuals with TBI and their families

• Shares promising practices and lessons learned on implementing project activities and creating and/or incorporating TBI services, funding, etc.

• Communicates TBI-related information and research findings

• Offers best practices and tools for grantees to conduct state needs and resource assessments

• Responds to questions about the federal TBI Program and facilitates participation in program-related events

Legislation

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. The Act 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. The TBI Act also delegated responsibilities in research to the National Institutes of Health, and prevention and surveillance to the Centers for Disease Control and Prevention.

The Traumatic Brain Injury Act of 2008 (P.L. 110-206) reauthorized the programs of the TBI Act of 1996. The 2000 Amendments (PL 106-310—Title XIII of the Children’s Health Act) recognized the importance of protection and advocacy (P&A) services for individuals with TBI and their families by authorizing HRSA to make grants to federally mandated state protection and advocacy systems. As a result of the TBI Reauthorization Act of 2014, the TBI Program transitioned from HRSA to ACL on October 1, 2015. The fiscal year 2015 appropriation was $9.321 million.

State Program Contacts

Alabama

State Grantee: Alabama Department of Rehabilitation Services

Project Name: Expanding the Alabama System of Care for People with TBI

Population Focus: Incarcerated children and youth

Summary: Alabama is ensuring TBI screenings for youth in the juvenile justice system. The program provides training for criminal justice and juvenile justice professionals to recognize and provide appropriate supports for youth with TBIs. They produce information to raise awareness about TBI, and offer referral services to connect youth and their families to appropriate resources.

Available Services: The Alabama Department of Rehabilitation Services offers information and referral, education assistance, pre-vocational resources, employment assistance, and extended support provision. For more information on TBI and available services visit the Alabama Department of Rehabilitation Services website.  

Contact: Maria Crowley, 205-290-4590, maria.crowley@rehab.alabama.gov 

Alaska

State Grantee: Alaska Department of Health and Social Services

Project Name: Alaska TBI Project

Population Focus: Tribal/Native populations, rural populations, victims of domestic violence

Summary: Alaska is working to serve brain injury survivors through the development of an infrastructure system that provides for the culturally competent treatment and rehabilitation services specific to TBI survivors who experience cognitive, emotional, and behavioral manifestations as a result of head trauma. The program is also establishing on-going capacity of the Alaska TBI Advisory Board, survivors, and their families to sustain their oversight of statewide planning.

Available Services: The program offers a series of support groups for individuals with TBIs and their family members. Alaska provides small subgrants to individuals with brain injury to be used for healthcare, employment, and other independent living needs. The program also provides screening, assessment, and resource facilitation services. For more information on TBI and available services visit the Alaska Division of Behavioral Health website.

Contact: Lisa Morley, (907) 465-4996 or 1-800-465-3165, lisa.morley@alaska.gov 

Arizona

State Grantee: Department of Economic Security

Project Name: Arizona Transition Program for Youth with TBI

Population Focus: Children and youth, parents of school-aged children, families

Summary: Arizona is increasing access to appropriate and comprehensive vocational services for youth who have sustained a TBI and are transitioning to adulthood through a Vocational Rehabilitation pilot program. Arizona conducts outreach activities that increase the availability of information, education, referrals, and resources for youth who have sustained a TBI as they transition into adulthood

Available Services: The Governor’s Council on Spinal and Head Injuries (Council) offers TBI identification and referral services as well as vocational rehabilitation supports. The Council also offers TBI literature and informs educators through five TBI regional one-day programs. Additionally, the program offers information and referral services and resource facilitation. For more information on TBI and available services visit the Arizona Governor’s Council on Spinal and Head Injuries website.

Contact: Ann Tarpy, 602-774-9147, atarpy@azdes.gov

Colorado

State Grantee: Colorado Department of Human Services Division of Vocational Rehabilitation

Project Name: Colorado Brain Injury Program

Population Focus: Incarcerated children and youth, incarcerated adults, families

Summary: Colorado brings appropriate and comprehensive TBI support services to individuals in the corrections system, including a promising practice protocol for screening, identifying, and assessing TBIs within adults and youth. The program screens individuals for TBIs, trains corrections and judicial personnel, and connects incarcerated individuals to information and referral services.

Available Services: The Colorado Brian Injury Program (CBIP) offers services specifically to incarcerated individuals and corrections professionals. CBIP contracts with the University of Denver Graduate School of Professional Psychology to conduct neuropsychological screenings at 19 criminal justice sites. The program also provides information and referral, case management, and educational materials for those who screened positive for a TBI. For more information on TBI and available services visit the Colorado Division of Vocational Rehabilitation website or CBIP website. 

Contacts:
Judy Dettmer, 303-866-4085, judy.dettmer@state.co.us 
Regina Rodriguez, 303-866-4779, regina.rodriguez@state.co.us

Idaho

State Grantee: Idaho State University – Institute of Rural Health

Project Name: Idaho TBI State Implementation Partnership Grant Program

Population Focus: Children and youth, parents of school-aged children, families, uninsured/underinsured Individuals, Hispanic and Latino/a individuals, Native American tribal populations, veterans, and service members

Summary: Idaho provides TBI screening, education, and other useful resources to individuals with TBIs from many populations throughout the state. The program hosts comprehensive community health screening events that bring together professionals from many disciplines to screen for TBIs, as well as other physical, mental, and emotional disabilities. Idaho also educates parents of children with TBIs, connects Native American tribal populations to TBI services, and is developing a TBI trust fund.

Available Services: The program offers TBI screenings at community health screening events and refers those without insurance who screen likely for TBI to their healthcare partners who provide services for little to no cost to the individual. ISU-IRH also works with Idaho Parents Unlimited to provide information, resources, and online support groups to parents whose children have sustained a TBI. For more information on TBI and available services, visit the Idaho TBI-VPC.

Contact: Russell Spearman, 208-373-1773, spearuss@isu.edu

Indiana

State Grantee: Indiana Department of Correction

Project Name: Indiana Department of Correction TBI State Implementation Partnership Grant Program  

Population Focus: Incarcerated children and youth, families, incarcerated adults, veterans

Summary: Indiana works with the justice system to decrease recidivism for formerly incarceration individuals who have sustained a TBI. The program screens individuals in the justice system for TBIs, offers resource facilitation, trains justice professionals about TBI, and provides information and referral services to families.

Available Services: The program offers TBI screenings for incarcerated and formerly incarcerated individuals and provides evaluations for those who screen likely for a TBI. Indiana operates a Brain Injury Coping Skills group for individuals with TBIs and their family members. Additionally, resource facilitators work with incarcerated veterans to provide post-release referral and planning services. The program provides resource facilitation services, cognitive testing, case conferencing, support and educational groups, case management, staff trainings, and referrals. For more information on Indiana’s TBI program and available services, visit the Resource Facilitation Research and Training Center website or the Public Advocates in Community Re-Entry (PACE) website.

Contacts:
Frances Osburn, 317-232-5711, fosburn@idoc.in.gov 
Melanie Jimerson,(317)  233-0677, mjimerson@idoc.in.gov
Lena Hackett, 317-423-1770, lena@communitysolutionsinc.net

Iowa

State Grantee: Iowa Department of Public Health

Project Name: Iowa Brain Injury State Implementation Partnership Grant Program

Population Focus: Children and youth, incarcerated children and youth, families, incarcerated adults, patients with co-occurring conditions, rural populations

Summary: Iowa is increasing access to TBI screenings and coordinates ongoing, comprehensive care for individuals with TBIs and their caregivers. The program is developing capacity within Iowa’s public education system to provide improved identification and transitional outcomes for youth with TBIs, including the high-risk population of student athletes. The program is increasing the availability of appropriate supports and services for individuals exhibiting challenging brain injury-based symptoms, especially in vulnerable populations, by increasing the capacity of the Iowa Brain Injury Resource Network.

Available Services: There are 270 Iowa Brain Injury Resource Network (IBIRN) sites, listed on the Brain Injury Alliance of Iowa (BIAIA) website, which provide resource facilitation services. The Iowa High School Athletic Association and Iowa Department of Education distribute the CDC’s Heads Up resources to athletes, coaches, and families. For more information on TBI and available services, visit the Iowa Department of Public Health website.

Contacts:
Cheryl Christie, cheryl.christie@idph.iowa.gov
Kathy Stone, 515-281-8021, kathy.stone@idph.iowa.gov
Maggie Ferguson, 515-281-8465, maggie.ferguson@idph.iowa.gov 

Maine

State Grantee: Maine Department of Health and Human Services

Project Name: Maine’s TBI State Implementation Partnership Grant

Population Focus: Infants, children and youth, parents of school-aged children, victims of domestic violence, athletes, veterans, service members

Summary: Maine operates a TBI Home and Community Based Services waiver to improve access to appropriate TBI services and supports for individuals who have sustained a TBI. Maine maintains a specialized set of residential services for individuals who have sustained a TBI and provides training for professionals, including medical providers.

Available Services: The program researches sports-related concussions in youth and provides awareness and education services. Alpha One, a Center for Independent Living, hosts the Brain Matters website, Maine’s primary resource for individuals with TBI. The program also provides resource facilitation and information and referral services, and delivers outreach presentations. For more information about TBI and available services visit the Maine Office of Aging and Disability Services Brain Injury Services webpage.

Contact: Toni Wall, 207-287-6338, toni.g.wall@maine.gov

Massachusetts

State Grantee: Massachusetts Rehabilitation Commission

Project Name: Statewide Head Injury Program: Improving MA Systems of Care for Elders Sustaining a TBI

Population Focus: families, older adults

Summary: Massachusetts focuses on training professionals to accurately and reliably screen for TBI. The program’s efforts focus on individuals who are 60 years of age and older and have sustained a TBI. Targeted areas are populations in the northeast and metrowest portions of the state, as well as families and professionals who work with these individuals. Massachusetts improves awareness, screening, and identification efforts, as well as access to information, resources, and supports. The program uses the “No Wrong Door” approach to provide streamlined consumer-directed access to services.

Available Services: The Massachusetts Rehabilitation Commission (MRC) collaborates with local Aging and Disability Resource consortia to develop TBI training curricula on older adults. The training includes information on the HELPS screening tool. MRC also offers a free web-based course on brain injury in older adults. For more information on TBI and available services, visit the MRC website.

Contacts:
Sandy Biber, sandy.biber@massmail.state.ma
Gabby Lawrence-Soto, 617-204-3662, Gabriela.Lawrence-Soto@MassMail.State.MA.US 

Missouri

State Grantee: Missouri Department of Health and Senior Services

Project Name: Missouri TBI State Implementation Partnership Grant Program

Population Focus: Infants, children and youth, families, incarcerated adults, athletes, veterans, service members

Summary: Missouri is enhancing collaboration between the Missouri Brain Injury Advisory Council and partners. It improves access to TBI services for young children, school-aged youth who experience sports concussions, service members and veterans, and incarcerated individuals. It also engages and disseminates TBI educational information to diverse groups including communities of culturally, linguistically, socioeconomically, and geographically diverse backgrounds.

Available Services: Missouri provides an online Early Childhood Toolkit with information about TBI for parents and educators available in English, Spanish, and Bosnian. The program facilitates referrals of individuals who have sustained a TBI to the Health Insurance Marketplace. The program also provides training to early childhood professionals and pediatricians. Missouri facilitates five regional seminars, called “Sports Concussions: Facts, Fallacies, and New Frontiers.” For more information on TBI and available services visit the Missouri Department of Health & Senior Services website.

Contacts:
Bret Fischer, grants@health.mo.gov
Venice Wood, 573-751-6446, venice.wood@health.mo.gov 
Dean Anderson, 573-751-6423, dean.andersen@health.mo.gov

Nebraska

State Grantee: Nebraska Department of Education Division of Vocational Rehabilitation

Project Name: Access 4 All

Population Focus: Children and youth, parents of school-aged children, families, athletes, older adults

Summary: Nebraska trains key service providers and professionals serving children, youth, and older adults on potential long-term effects of TBI, implications for housing, work, community living, and TBI screening methods. Nebraska is also implementing sustainable resource facilitation services that connect individuals with appropriate services.

Available Services: The program and partners provide information and referral services and host a website with information about TBI. Nebraska’s Division of Vocational Rehabilitation collaborates with the Department of Education, Office of Special Education, and the Brain Injury Regional School Support Teams to train schools on “Return to Learn” strategies. The program also trains professionals who provide employment and residential supports to individuals with TBIs and provides TBI screening for school-aged children. For more information on TBI and available services visit the Nebraska Brain Injury Advisory Council website.

Contacts:
Keri Bennett, 308-865-5012, keri.bennett@nebraska.gov
Tresa Christensen, 308-865-5023, tresa.christensen@nebraska.gov

New Hampshire

State Grantee: New Hampshire Division of Public Health Services

Project Name: Concussion Chalk Talk: Expanding the TBI System of Care in New Hampshire for Youth with mTBI/Concussion

Population Focus: Children and youth, parents of school-aged children, families, athletes

Summary: New Hampshire works with the public school systems and educational professionals to develop a network of educators knowledgeable about the neurobehavioral results of a TBI. The program standardizes TBI management procedures in education settings, and increases knowledge about available TBI resources. The program also helps youth who have sustained a TBI and their families access TBI resource facilitation services.

Available Services: The program provides support to eight high schools and two middle schools and their Concussion Management Teams. New Hampshire provides neuropsychological consultation, trainings, resource facilitation, and education about concussions to school communities. For more information on TBI and available resource visit the New Hampshire Bureau of Developmental Services website.

Contacts:
John Capuco, 603-271-5161, jcapuco@dhhs.state.nh.us 
John Lichtenstein, Johnathan.D.Lichtenstein@hitchcock.org
Ellen Edgerly, 603-332-9891, ellenedge@metrocast.net 

New York

State Grantee: Health Research, Inc.

Project Name: New York State TBI Program

Population Focus: Children and youth, incarcerated children and youth, families, parents of school-aged children, victims of domestic violence, families

Summary: New York is training emergency medical service personnel to identify and initiate treatment for mild TBIs, and facilitating the routine dissemination of TBI information to persons who refuse medical transport. The program trains school and emergency shelter personnel in how to accommodate individuals who have sustained a TBI. New York is creating an easily accessible web-based directory of TBI providers to promote access to community-based TBI services and is implementing web-based curricula for emergency medical personnel and medical students.

Available Services: The program offers trainings for K-12 school personnel, early childhood education professionals, and the staff of juvenile residential centers and domestic violence shelters. Additionally, the program collaborated with the Medical Society of the State of New York (MSSNY) to produce a webinar and podcast training about mild TBI for physicians, available with an account on the MSSNY website. New York created a wallet card that lists symptoms of brain injury and sources of information and help. It can be found as a PDF through the New York State Department of Health.

Contacts:
Mark Kissinger, 518-402-5673, mark.kissinger@health.ny.gov 
Jessica Preston, Jessica.Preston@healthresearch.org

North Carolina

State Grantee: North Carolina Department of Health and Human Services

Project Name: North Carolina TBI State Implementation Partnership Grant Program

Population Focus: Individuals 22 years of age and older

Summary: North Carolina is working to improve the continuum of care for adults who sustain a TBI at age 22 and older. The program increases knowledge about TBI services and supports, screens individuals for TBIs, improves access to information and technical assistance for professionals in this community, promotes collaboration among healthcare service providers, and increases understanding of those involved in the TBI continuum of care. North Carolina is implementing TBI screening in federally qualified healthcare center pilot programs throughout the state.

Available Services: The program, with partner the Brain Injury Association of North Carolina (BIANC), maintains a website with an online resource guide and information and referral services, as well as online training modules. The program partners with federally qualified healthcare centers and managed care organizations to conduct TBI screenings. More information can be found on the North Carolina Department of Health and Human Services website. 

Contact: Scott Pokorny, 919-715-2255, Scott.Pokorny@dhhs.nc.gov

Ohio

State Grantee: Ohio State University Research Foundation

Project Name: Identification of TBI and Accommodations for Living in the Community

Population Focus: Children and youth, incarcerated children and youth, parents of school-aged children, incarcerated adults, individuals with co-occurring conditions, older adults

Summary: Ohio provides professional staff with new skills for identification and accommodation of TBIs. The program raises awareness in professional staff and consumers regarding identification and the supports available to Ohioans who sustain a TBI. Ohio is working to make adult and disability waiver programs in Ohio more responsive to individuals with TBI.

Available Services: The Ohio Brain Injury program created TBI trainings for healthcare professionals and case managers, available on the Ohio State University (OSU) website. The program also provides information and referral services and resource facilitation. For more information on TBI and available services visit the Ohio Valley Center for Brain Injury Prevention and Rehabilitation website.   

Contact:
John Corrigan, 614-293-3830, johncorrigan1@me.com
Monica Lichi, 614-293-3802, monica.lichi@osumc.edu

Pennyslvania

State Grantee: Pennsylvania Department of Health, Bureau of Family Health

Project Name: Pennsylvania TBI State Implementation Partnership Grant Program

Population Focus: Children and youth, incarcerated children and youth, parents of school-aged children, athletes

Summary: Pennsylvania is increasing TBI knowledge and awareness among parents, professionals, students, and youth throughout the state. The program is implementing a system to screen youth in juvenile detention for TBIs and then connect them with appropriate services. Pennsylvania is training juvenile justice personnel and youth sports personnel in the identification and creation of accommodations for youth who have sustained a TBI.

Available Services: The program provides outreach around protections for youth athletes in sporting activities and provides trainings for individuals to become ConcussionWise instructors. The program also provides resource facilitation and educational materials and training on TBI screening to juvenile justice professionals. For more information on TBI and available services visit the Pennsylvania Department of Health website.

Contacts:
Carolyn Cass, 717-772-2762, ccass@pa.gov 
Nicole Adams,717-772-2762, nicadams@pa.gov
Mike Yakum, 717-547-3380, myakum@pa.gov

Tennessee

State Grantee: Tennessee Department of Health

Project Name: Project BRAIN (Brain Resource and Information Network)

Population Focus: Infants, children and youth, parents of school-aged children, families, athletes

Summary: Tennessee is working to improve the continuum of care from hospital to home to school for children and youth who have sustained a TBI, with the overall goal of improving educational outcomes for children and youth with TBIs. Tennessee is training school personnel and other professionals working with children who have sustained a TBI to facilitate optimal education outcomes for those children and their caregivers.

Available Services: The program has Brain Injury Transition Liaisons (BITLs) who follow up with families after a child presents at an emergency department with a TBI. The BITLs also contact schools and connect families with Resource Specialists, who provide consultations to school personnel. Project BRAIN also helped develop Return to Learn/Return to Play guidelines which can be accessed in PDF form through the Tennessee Department of Health. For more information on TBI and available services visit the Project BRAIN website.

Contacts:
Jean Doster, 615-741-1230, jean.doster@tn.gov 
Paula Denslow, 615-383-9442 x8616, paula_d@tndisability.org

Virginia

State Grantee: Virginia Department for Aging and Rehabilitative Services

Project Name: Facilitating Access to Care and Enhancing Services  

Population Focus: Incarcerated children and youth, families, athletes, homeless individuals

Summary: Virginia conducts outreach to newly injured Virginians to provide timely information and referral services and support family caregivers. The program provides resource facilitation, educational materials, and trainings on screening for TBI and is building the capacity for resource facilitation in state-funded community-based brain injury clinics.

Available Services: The Virginia Department for Aging and Rehabilitative Services (DARS) provides information and referral and resource facilitation services. The program also hosts state plan and advisory council information online and provides information about the statewide Brain Injury Report Out Day. For more information about TBI and available services visit the DARS website.

Contacts:
Patti Goodall, 804-662-7615, patti.goodall@dars.virginia.gov 
Donna Cantrell, 804-662-7069, Donna.Cantrell@dars.virginia.gov

West Virginia

State Grantee: Center for Excellence in Disabilities at West Virginia University

Project Name: TBI Implementation Partnership Grant Program

Population Focus: Children and youth, incarcerated children and youth, victims of domestic violence, rural populations, service members

Summary: West Virginia is working to establish a person-centered system of services for individuals with TBI by conducting outreach activities for professionals, caregivers, and individuals who have sustained a TBI and their families. The program’s goal is to share information about resources available in West Virginia for the TBI community. West Virginia is also improving access to services and benefits that will return individuals to work after sustaining a TBI.

Available Services: The Center for Excellence in Disabilities at West Virginia University (WVU CED) works with partners to distribute HELPS screenings through trainings, special events, fairs, and conferences. WVU CED provides technical assistance to TBI support groups. WVU CED also provides information and referral, resource facilitation, and professional training. For more information about TBI and available services visit the WVU CED website.

Contacts:
Teresa McCourt, 304-290-1380, tmccourt@hsc.wvu.edu 
Brandi Robinson, 877-724-8244, brobins5@hsc.wvu.edu