Coordinated and Adequately Funded State Streams for Rehabilitation of Newly Injured Persons with TBI

Traumatic brain injury (TBI) rates are highest among families with the lowest income levels. A paucity of appropriate funding streams for low-income, recently injured TBI patients is reported to cause delays in provision of early postacute rehabilitation or to cause patients to be discharged without receiving rehabilitation. There are also reports of patients remaining in hospitals with minimal care or being returned home, both because of a lack of a discharge site. The purposes of this exploratory study were to: (1) identify model aspects of existing publicly supported and administered programs for postacute individuals with TBI; (2) present results of a survey measuring to what extent state Medicaid programs fund postacute rehabilitation services for recently injured patients with TBI; (3) present results of interviews with trauma center social workers affiliated with the National Institute on Disability and Rehabilitation Research (NIDRR) TBI Model Systems projects to determine whether and how delays in receiving Medicaid coverage occur; and (4) make recommendations for improved systems of care for postacute individuals with TBI.