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CONTENTS EXECUTIVE SUMMARY 1 OVERVIEW OF THE TRAUMATIC BRAIN INJURY PROGRAM Approach to the Study Organization of the Report Legislative Mandate for the HRSA TBI Program The HRSA TBI Program¿s Place in the HRSA Bureaucracy Budget for the HRSA TBI Program Staffing for the HRSA TBI Program Grants Provided Under the HRSA TBI Program TBI State Grants Program Protection and Advocacy for TBI (PATBI) Program 2 EPIDEMIOLOGY AND CONSEQUENCES OF TRAUMATIC BRAIN INJURY: AN INVISIBLE DISABILITY Epidemiology of TBI TBI Incidence and Prevalence Estimates Causes of TBI Risk Factors for TBI Range in Severity Consequences of TBI for Individuals, Family Members, and Society Consequences of TBI for Individuals Ability to Perform Activities of Daily Living (ADLs) Ability to Return to Work, School, and Productive Activity Ability to Develop and Maintain Relationships Consequences of TBI for Family Members Consequences of TBI for Society Summary 3 SERVICE NEEDS AND SOURCES OF FUNDING FOR PEOPLE WITH TBI- RELATED DISABILITIES What Services Do People with TBI-Related Disabilities Need? Case Management Medical Health Care Services Cognitive and Physical Rehabilitation Services Behavioral Health Care Family and Caregiver Supports Vocational Rehabilitation Services Legal and Advocacy Services Sources of Funding and Supports for People with TBI-Related Disabilities Summary 4 ASSESSMENT OF THE HRSA TBI PROGRAM The Impact of HRSA¿s TBI State Grants Program Effect of the TBI State Grants Program on States¿ TBI Infrastructure Effect of the TBI State Grants Program on States¿ TBI Service Systems HRSA¿s New Design for TBI Program Grants in FY 2006 Impact of HRSA¿s Protection and Advocacy for TBI (PATBI) Grants Program Adequacy of the Management and Oversight of the HRSA TBI Program Administration of the HRSA TBI Program TBI Technical Assistance Center (TBI TAC) Summary APPENDIXES A Methods of the Study B Interview Guide Developed by the IOM Committee on Traumatic Brain Injury C State TBI Programs and Protection and Advocacy Systems: Characteristics and Accomplishments, by State Table C-1 Characteristics of State Traumatic Brain Injury Programs by State, 2005 Table C-2 Accomplishments of State Traumatic Brain Injury (TBI) Programs by State, 1997¿2005 Table C-3 State Protection and Advocacy (P&A) Systems for Individuals with Developmental Disabilities: Goals and Accomplishments Related to P&A for Individuals with Traumatic Brain Injury (PATBI) by State, 2005 D Profiles of TBI Initiatives in Seven States E Stakeholders Assess the HRSA TBI Program: A Report on National Interviews and Interviews in Seven States F Glossary, Abbreviations, and Acronyms LIST OF BOXES, FIGURES, AND TABLES Chapter 1 Boxes 1-1 Charge to the Committee on Traumatic Brain Injury 1-2 Federal TBI Initiatives Mandated by the TBI Act of 1996 1-3 State Protection and Advocacy Systems 1-4 TBI State Program Grants Awarded by HRSA on a Competitive Basis, 1997-2005 1-5 1-6 Federal Statutory Guidance on the Use of TBI State Program Grants State-Based Protection and Advocacy (P&A) Systems for Individuals with Disabilities Figures 1-1 The HRSA TBI Program¿s Place in the HRSA Bureaucracy, 2005 Tables 1-1 HRSA TBI Program Appropriations and Spending, FY 1997 to FY 2005 Chapter 2 Boxes 2-1 TBI¿The Invisible Disability 2-2 TBI Among Veterans of the War in Iraq 2-3 2-4 ¿Mild¿ TBI¿Its Impact May Be Far from ¿Mild¿ Children with Traumatic Brain Injury Figures 2-1 Average Annual Number of TB-Related Emergency Department Visits, Hospitalizations, and Deaths, U.S., 1995-2001 2-2 Average Annual TBI-Related Emergency Department Visits, Hospitalizations, and Deaths, Percent by External Cause, U.S. 1995¿2001 2-3 Average Annual Traumatic Brain Injury-Related Rates for Emergency Department Visits, Hospitalizations, and Deaths, by Age Group and External Cause, United States 1995-2001 2-4 Average Annual Number of TBI-Related Emergency Department Visits, Hospitalizations, and Deaths, by Sex, U.S. 1995-2001 2-5 Architecture of the Brain Tables 2-1 TBI-Related Emergency Department Visits, Hospitalizations, and Deaths, Number and Percent by Age Group, U.S., 1995-2001 2-2 Rate of TBI-Related Hospital Stays, Emergency Department Visits, and Death, by Age, United States, 1995¿2001 2-3 Constellation of Physical, Cognitive, and Behavior Changes After a TBI Chapter 3 Boxes 3-1 One TBI Survivor¿s Challenges in Obtaining Needed Services 3-2 One TBI Survivor¿s Journey from a Nursing Home to the Community 3-3 A TBI Survivor¿s Return to Work Figures 3-1 Continuum of Needs Post Traumatic Brain Injury 3-2 Persistent Need for Services One-Year Post TBI Hospitalization 3-3 Public and Private Systems Serving Persons with Traumatic Brain Injury Tables 3-1 Types of Services Needed by Persons with TBI and Their Families 3-2 Selected Government and Private Programs Supporting Acute and Post Acute Service Needs of Persons with TBI-Related Disabilities Chapter 4 Boxes 4-1 The Quality and Coordination of Post-Acute TBI Service Systems 4-2 The Impact of HRSA¿s State Grants Program 4-3 Selected Comments from TBI Stakeholders in the Seven Study States on Their State¿s TBI Infrastructure 4-4 Selected Comments from TBI Stakeholders in the Seven Study States on Their State¿s TBI Resources 4-5 4-6 4-7 4-8 4-9 4-10 Special TBI Trust Funds in the States Selected Comments from TBI Stakeholders in the Seven Study States on Their State¿s TBI Systems Improvement HRSA¿s Review Criteria for Implementation Grants Under the TBI State Grants Program, 2006 The Impact of HRSA¿s Protection and Advocacy for TBI (PATBI) Grant Program Selected Comments from TBI Stakeholders in the Seven Study States on Their State¿s P&A for TBI Adequacy of the Management and Oversight of the HRSA TBI Program Figures 4-1 TBI Program Grants by State, 2005 Tables 4-1 Number of States Participating in HRSA¿s TBI State Grants Program, by Type of Grant, 2005 4-2 Summary of the Four Core Components of TBI Infrastructure, by State, 2005 4-3 Dedicated TBI Funding by State, 2005 4-4 Examples of State TBI Program Accomplishments Reported by the Seven Study States, 1997-2005 4-5 Review Criteria for FY 2006 TBI State Implementation Grants, FY 2006 4-6 PATBI Grant Activities Reported by the Seven Study States, 2005
Library of Congress Subject Headings for this publication:
HRSA Traumatic Brain Injury Program.
HRSA Traumatic Brain Injury Program.
Brain damage -- Patients -- Rehabilitation -- United States.
Brain damage -- Patients -- Services for -- United States -- Evaluation.
Brain Injuries -- rehabilitation -- United States.
Brain Injuries -- economics -- United States.
Disabled Persons -- United States.
Government Programs -- organization & administration -- United States.
Program Evaluation -- United States.