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 3 year grant from the federal Administration for Community Living (ACL). The main grant objectives include:

Educate and train individuals with TBI, caregivers and professionals: Increased understanding and knowledge by those involved in the TBI continuum of care statewide.
Screening: Increased identification of people who sustain TBI statewide and improved data collection and analysis.
Modernize Information and Referral System to include natural supports: Increased knowledge about TBI, including services and supports for individuals with TBI, their families, professionals and other stakeholders.
Collaborate and Coordinate: Increased collaboration and coordination between primary health care and behavioral health care service systems statewide to promote the increase in availability of TBI-informed services.
Update online training modules including Substance Use (focus on Opioid use) and mental health.
Provide Resource Facilitation statewide which offers technical assistance as well as information and resource options to professionals, individuals who have TBI and their families.
Expansion of employment opportunities for individuals with TBI.
Create an online TBI support group pilot.
Update statewide TBI Needs and Resources Assessment.
Update statewide TBI Action Plan
There is a focus to engage with TBI survivors who are on the Brain Injury Advisory Council and other survivors who are interested in contributing to TBI initiatives throughout NC communities.

TBI State Funded Programming

Based upon legislative appropriation, each Local Management Entity-Managed Care Organization (LME-MCO) is allocated funding to provide TBI specific services and supports to individuals with TBI living in their respective catchment area. Click on the link below for the name and contact information of the LME-MCO that serves your county.
Local Management Entity/Manage Care Organization Directory Map

TBI Waiver

The TBI Waiver pilot begain in September 2018. 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 Center for Medicare and Medicaid Services(CMS). The renewal will include:

Expansion of the Waiver into a second LME-MCO catchment area
Increase federal poverty level to 300%
Add supported living as a service
Other changes as identified in the renewal application

The draft TBI Waiver renewal application can be found here. This draft Waiver application is currently being reviewed by the Center for Medicare and Medicaid Services (CMS) and has a proposed start date of 7/1/2021. 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 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.
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.

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 Sep. 30, 2015. July 1, 2013 is when NCTracks 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 in NC 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
So, There's a TBI - Webinar
- Password: NCTBIProgram1

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 NC.

Online training opportunities can be found here.

TBI Legislation

North Carolina TBI Definitions

North Carolina Traumatic Brain Injury Waiver legislation
North Carolina Traumatic Brain Injury State Funds legislation
Federal Traumatic Brain Injury Act

Educational Resources

A variety of other TBI educational materials on topic such as crisis management, falls, suicide, interacting with patients, veterans can be found here.

Additional Resources

Brain Injury Advisory Council

The purpose of the Brain Injury Advisory Council (BIAC) is to review the nature and cause of traumatic and other acquired brain injuries in North Carolina. The Council also makes recommendations to the Governor, the General Assembly, and the Secretary of Health and Human Services regarding the planning, development, funding, and implementation of a comprehensive statewide service delivery system to address the needs of brain injury survivors.

BIAC Meeting Notice

This is formal notice of the upcoming BIAC meetings for the remainder of 2020 and 2021. The meetings will occur as follows:
Date	Location
Wednesday Dec. 9, 2020 9:30 a.m. - 12:30 p.m.	Go To Webinar (please email TBIContact@dhhs.nc.gov to request link to the meeting)
Wednesday March 10, 2021 9:30 a.m. - 12:30 p.m.
Wednesday June 9, 2021 9:30 a.m. - 12:30 p.m.
Wednesday Sept. 8, 2021 9:30 a.m. - 12:30 p.m.
Wednesday Dec. 8, 2021 9:30 a.m. - 12:30 p.m.