On October 12, 2009, Governor Schwarzenegger singed Assembly Bill 398 which impacts TBI services and programs.  One of the significant changes outlined in the bill is the transfer of the administrative duties and oversight of the California TBI Programs effective January 1, 2010, from the Department of Mental Health (DMH) to the Department of Rehabilitation (DOR). 

DMH and DOR are pleased to present the May 2010 Advancing California’s Traumatic Brain Injury Services System: Next Steps Report. The report summarizes two principle objectives: 1) findings from an interactive stakeholder process with members of the TBI Advisory Board and other TBI stakeholders (persons with TBI, family members and other caregivers, and providers) addressing key TBI issues and needs; and 2) an evaluation of Medicaid (Medi-Cal) waiver and/or State Plan Amendment options to enhance TBI services with additional federal support.  Advancing California’s Traumatic Brain Injury Services System: Next Steps Report - (Accessible Version)

Hard copies of the report can be requested by contacting Cielo Avalos at cielo.avalos@dmh.ca.gov or by phone at (916) 651-5769.

Traumatic Brain Injury (TBI) is a cognitive, psychological, neurological or anatomical change in brain functions caused by an external blunt force trauma to the head. Approximately 1.4 million Americans sustain a TBI each year in the United States resulting in 50,000 deaths, 235,000 hospitalizations, and 1.1 million emergency department visits.  In 2007, 29,354 patients were hospitalized with a TBI in California of these 7 percent died, and 25% were sent to another facility. The Brain Injury Association of America (BIAUSA) reports that TBI can cause epilepsy and increases the risk for conditions such as Alzheimer's disease, Parkinson's disease, and other brain disorders that become more prevalent with age. The U.S. Department of Veteran’s Affairs, which established a TBI Administration after the Gulf War, noted that while 14 percent of previous war veterans had TBI, the number of brain-injured veterans from the Iraq and Afghanistan wars ”is much higher”.  Some providers estimate that as many as 60 percent of injured veterans from these wars have TBI (United States Department of Veterans Affairs http://www.va.gov. Accessed January 29, 2010)

DOR contracts statewide with organizations that demonstrate diverse approaches to service delivery and resource coordination. Availability of services can be determined by visiting the website of the organizations (below) that serve your region. Family members and caregivers may also wish to consult with Caregiver Resource Centers for additional support and information available in their region. DOR does not provide direct funding assistance to individuals or directly administer TBI programs.

Supported Living Services provide a range of training, support, and appropriate supervision to maximize independence where the participant lives: private home, assisted living arrangements, or group settings. The sites provide a coordinated service model, directly or by arrangement. Core services include the following:

• Community Reintegration Services maximize independent functioning with the goal of living in the community and participating in community life. These services include providing or arranging for:
  • access to housing
  • transportation
  • medical care
  • rehabilitative therapies
  • day programs
  • chemical dependency recovery programs
  • personal assistance
  • education
    
• Services Coordination assesses and identifies participants' challenges and develops services to meet the needs. Services coordination should:
  • be participant driven
  • expand individual empowerment
  • maintain linkages to services
  • support and encourage growth and recovery
  • provide personal advocacy and outreach when needed
  • monitor progress and reassess needs


• Vocational Supportive Services include prevocational and educational services to individuals who are un-served or under-served by existing vocational rehabilitation services and provide assistance in the following four areas:
  • identify service participants who lack the prospect for unassisted competitive employment;
  • provide ongoing training, supervision and support services;
  • advocate for the same workplace benefits, income levels, security, mobility, and workplace quality enjoyed by others; and
  • negotiate work site flexibility and support mechanisms that allow the participant to function competitively.

In 1998, the DMH and the Department of Rehabilitation (DOR) teamed up to develop vocational rehabilitation programs specifically focused upon the needs of adults with TBI. Currently, three of the sites participate in the interagency agreement with DOR.

Family and Community Education keeps families and communities informed of the nature and consequences of TBI, early detection, service referral processes for persons with TBI, and monitors for continuous improvement opportunities within the system of available services.

• Advancing California’s Traumatic Brain Injury Services System: Next Steps Report - (Accessible Version) - 06/25/2010
• Independent Evaluation of the Traumatic Brain Injury Services of California:Legislative Report, January 30, 2005
• Independent Evaluation of the Traumatic Brain Injury Services of California: Addendum to Legislative Report, January 30, 2005
• California’s Needs and Resources Assessment, Spring 2002
• California’s Traumatic Brain Injury Statewide Action Plan, Fall 2002