Traumatic Brain Injury (TBI)
Program
The Traumatic Brain Injury (TBI) Program provides
information and referral and services to individuals with traumatic brain
injury and their families. It assists with relocating people with TBI in
out-of-state facilities to community-based residential and day programs. It can
also help individuals currently residing in nursing homes, psychiatric
facilities or in their family's homes to be re-situated into more appropriate
community settings, where they can live more independent lives. This program,
whose motto is "Working hand-in-hand with people who have experienced brain
injury...to build bridges within their communities.", can identify and help to
address the gaps that exist in the continuum of care for TBI - from coma to
re-entry into the community.
What is Traumatic Brain Injury (TBI)?
Traumatic Brain Injury (TBI) is any damage to the
brain caused by an external physical force such as:
- motor vehicle accidents;
- falls;
- sports injuries;
- assaults;
- gunshot wounds;
It may also result from violently shaking a child, as
well as the following:
- too much or too little oxygen in the brain (e.g.,
near drowning);
- toxic substances;
- allergic reactions;
- electric shock (e.g., lightning);
- acute medical/clinical incidents.
People with TBI may experience temporary or permanent
difficulties with language, thinking, memory, attention, reasoning, judgment,
problem-solving, and fatigue. Other physical and motor problems, as well as
changes in mood and personality, may also be experienced.
TBI does not include:
- Alzheimer's disease or other progressive
dementias;
- depression/psychiatric disorders with no obvious
central nervous system damage;
- mental retardation;
- neurological conditions present at birth.
Program Background
The New York State Department of Health Traumatic
Brain Injury Program was created by the New York State Legislature in 1994 to
further develop and coordinate statewide services for people with traumatic
brain injury and their families. The Home & Community Based Services
Medicaid Waiver for Individuals with Traumatic Brain Injury (HCBS/TBI WAIVER)
was developed by New York State to provide a cost effective, community based
alternative to nursing facility placement. From the on-set of the TBI Waiver in
April of 1995, the Waiver has provided individually tailored services to
comprehensively meet the needs of individuals with TBI.
What is a Waiver?
The Federal Government "waives" certain Medicaid rules
enabling New York to select a portion of the population on medicaid to receive
specialized services not available to all Medicaid recipients.
Eligibility
The Waiver Applicant:
- . Must be a Medicaid recipient.
- Diagnosed with TBI or other type of brain injury,
such as stroke, anoxia, etc.
- Must be 22-64 years old with the injury occurring
on or after 22nd birthday. For individuals injured before age 22, contact OMRDD
at (518) 473-1890 (individuals 18-22 years old can be served by DOH when OMRDD
does not have available funds).
- Must be eligible for a nursing facility level of
care (determined by PRI/Screen).
- Must choose to live in the community rather than
in a nursing facility.
- Can identify a safe living arrangement that will
meet their needs.
- Can be supported safely within the community with
the funds and services available under the HCBS/TBI Waiver.
Services Available
In addition to services available through State Plan
Medicaid, individuals determined eligible for the Waiver Program may also
develop an individual Service Plan including any of the services listed
below.
- Service Coordination - a
coordinator is chosen by the Waiver participant and/or guardian to work with
them in identifying and coordinating supports and services.
- Independent Living Skills Training -
provides one-to-one support to focus on increasing independence in
practical skills, such as cooking, shopping, banking, etc.
- Structured Day Program - provides
an environment focused on task oriented activities and social skill
building.
- Community Integration Counseling -
counseling is provided to participant or family members to assist with issues
related to community integration.
- Home and Community Support Services
- provides guidance and assistance to enable the Waiver participant to
reside safely within the home and community environments.
- Substance Abuse Program - services
implemented are based on the unique challenges associated with TBI to reduce
and/or eliminate substance abuse that interferes with integration into the
community.
- Intensive Behavioral Program -
provision of direct technical assistance to individuals with challenging
behaviors and staff training for development of program support
strategies.
- Environmental Modification -
provides adaptations to residences to promote independent and to
ensure safety.
- Respite - provides short-term
relief to care-givers.
- Special Medical Equipment & Supplies
- provides durable and non-durable equipment not funded under state
plan Medicaid.
- Transportation - provides access
to non-medical services in the community.
Housing Program The Rent
Subsidies and Housing Support Program provides subsidies to individuals
participating in the HCBS/TBI Waiver. Rent subsidies allow participants to
obtain safe affordable housing at a fair market value.
Program Coordination The NY
state-wide TBI Program is divided into twelve (12) regional centers. WILC,
which is the Hudson Valley Region center, provides services for the residents
of seven (7) lower Hudson Valley counties (Westchester, Rockland, Orange,
Sullivan, Putnam, Dutchess, and Ulster counties).
Program Philosophy An individual
with a Traumatic Brain Injury (TBI) has:
- the right to be in control of his or her own
life.
- the right to choose where and with whom he or she
will live.
- the right to take risk and learn through
experience.
For more information about the HCBS/TBI Waiver,
contact WILC's TBI Coordinator at (914) 682-3926 (Voice), (914) 682-0926 (TDD),
(914) 682-8518 (FAX), or E-mail at: info@wilc.org.
Other agencies that can provide information on
TBI:
- Brain Injury Association of New York State
(BIANYS)
A chapter of the National Brain Injury Association,
BIANYS, serves as a centralized advocacy, educational and information source
for people with TBI and their families. BIANYS has 42 chapters and support
groups across the state. (800) 228-8201
- Research and Training Center on Community
Integration of Individuals with TBI (TBI NET) at Mt. Sinai Medical
Center
(888) 241-5152
- Long Island Head Injury Association
An advocacy and educational organization for people with TBI and
their families on Long Island. (516) 543-2245
- COMA Recovery, Inc.
An
advocacy and information organization for people with TBI and their families on
Long Island. (516) 355-0951
- Headway for the Brain Injured
An advocacy and information organization for people with TBI and their families
in the Buffalo/Western New York area. (716) 822-2261
- FACTS: Family Advocacy, Counseling
and Training Services
A program of BIANYS, FACTS is a support service for
individuals who sustained a brain injury and their families. (518) 459-7911
(800) 228-8201 Family Help Line
- Office of Mental Retardation &
Developmental Disabilities (OMRDD)
Education, rehabilitation and
residential services for people whose injury occurred before the age of 22. A
statewide coordinator and a TBI coordinator in each regional DDSO provides
access to services. (518) 473-1890
New York State Department Of Health TBI
Programs:
- Long Island Region
(516) 543-2245
- Lower Hudson Region -
Westchester,
Rockland, Orange, Sullivan, Putnam, Dutchess, and Ulster (914)
682-3926
- New York City -
Boroughs of
Manhattan, Brooklyn, and Staten Island (212) 564-8769 and (212)
564-8646
- New York City -
Boroughs of Bronx and
Queens (718) 515-5500 ext. 2003
- Albany South -
Albany, Schenectady,
Greene, Rensselaer, Schoharie, Otsego, and Columbia (518) 437-5769
- Albany North -
Fulton, Montgomery,
Saratoga, Washington, Warren, Hamilton, Essex, Franklin, and
Clinton (518) 773-2047
- Syracuse North -
Onondaga, Madison,
Herkimer, Oneida, Oswego, Lewis, Jefferson, and St. Lawrence
(315) 797-4642
- Syracuse South -
Broome, Tioga,
Delaware, Tompkins, Cortland, Chenango, and Cayuga (607) 770-8187
- Rochester North -
Monroe, Wayne,
Ontario, Seneca, Livingston, and Yates (716) 442-6420
- Rochester South -
Steuben, Schuyler,
and Chemung (607) 962-8225
- Buffalo North -
Erie, Chautauqua,
Wyoming, Genesee, Orleans, and Niagra (716) 822-2261
- Buffalo South -
Cattaraugus and
Allegany (716) 373-4602
For complaints about the quality of care in
facilities and services licensed by DOH, call the appropriate area office.
- Buffalo Area Office
(716) 847-4302
- New Rochelle Area Office
(914) 632-3701
- New York City Area Office
(212) 613-4900
- Northeastern Area Office
(518) 271-2600
- Rochester Area Office
(716) 423-8041
- Syracuse Area Office
(315) 426-7710
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