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H H S Department of Health and Human Services
Health Resources and Services Administration
Maternal and Child Health

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Traumatic Brain Injury Program

Do you know someone who's had a Traumatic Brain Injury? Chances are you do...

It may have been called by a different name: a concussion, Shaken Baby Syndrome, head injury, or anoxia due to trauma. These are just a few of the other names for Traumatic Brain Injury (TBI), but all of them have the potential to kill or leave an individual with a need for life-long assistance.

  • A bus sideswiped Melissa as she was driving her car to work. She moved in and out of consciousness during the ambulance ride, but was coherent when she arrived at the hospital. She was treated for cracked ribs and a ruptured spleen and was given an MRI which showed no apparent brain injury. Several months later she began having memory problems and serious depression. She began drinking heavily to deal with the depression and lost her job as a legal secretary.  She is attempting to live off of unemployment insurance.
  • A babysitter shook Alfred when he was 6 months old. He was in a coma for 2 days and diagnosed with Shaken Baby Syndrome. Alfred walked and talked much later than other children his age.  He was evaluated for developmental disability services and enrolled in special education when he started school.
  • Ricardo was blindsided by a check in a high school hockey game. He was diagnosed with a concussion resulting in his missing two games. He began having problems concentrating in class and his grades dropped. As a result his parents are concerned about his being admitted to college.

Despite their outward differences, all of these people have experienced a Traumatic Brain Injury (TBI). These examples provide a glimpse into the complex and unique nature of TBI and its effects.

Program Vision

The goals of the Federal Traumatic Brain Injury Program focus on helping State and local agencies develop resources so that all individuals with TBI and their families will have accessible, available, acceptable, and appropriate services and supports.

Goals

  • Assist States in expanding and improving State and local capability which, in turn, will enhance access to comprehensive and coordinated services for individuals with TBI and their families;
  • Use existing research-based knowledge, state-of-the-art systems development approaches and the experience and products of previous TBI grantees in meeting program goals; and
  • Generate support from local and private sources for sustainability of funded projects after Federal support terminates, through State legislative, regulatory, or policy changes which promote the incorporation of services for individuals with TBI and their families into the State service delivery systems.

Background

Current estimates state that at least 3.2 million Americans have a long-term or lifelong need for help to perform activities of daily living as a result of a TBI1. These individuals and their families are often faced with challenges, such as improper diagnosis, inability to access support or rehabilitation services, institutional segregation, unemployment, and being forced to navigate complicated and cumbersome service and support systems.

Recognizing the large number of individuals and families struggling to access appropriate and community-based services, Congress authorized the Federal TBI Program in the TBI Act of 1996 (PL 104-166). The TBI Act of 1996 launched an effort to conduct expanded studies and to establish innovative programs for TBI. The Act gave the Health Resources and Services Administration (HRSA) authority to establish a grant program for States to assist it in addressing the needs of individuals with TBI and their families. The TBI Act also delegated responsibilities in research to the National Institutes of Health, and prevention and surveillance to the Centers for Disease Control and Prevention.

The Traumatic Brain Injury Act of 2008 (P.L. 110-206) reauthorized the programs of the TBI Act of 1996.  The 2000 Amendments (PL 106-310 – Title XIII of the Children’s Health Act) recognized the importance of protection and advocacy (P&A) services for individuals with TBI and their families by authorizing HRSA to make grants to Federally mandated State P&A Systems. 

The HRSA Maternal and Child Health Bureau administers the Federal TBI Program. The Fiscal Year 2012 appropriation is $9.878M, level‐funded from Fiscal Year 2011.

1 Current Centers for Disease Control and Prevention estimates (Selassie et al., 2009) include only TBI emergency department visits, hospitalizations and deaths in the United States (2002-2006). In the Children's Health Act of 2000, Congress recognized that the estimated figure of Americans living with TBI-related disability is an under-count. Estimates fail to capture individuals who have visited physician's offices, individuals who have not sought treatment for a head injury, State-level TBI data, or TBIs counted from Federal, military or Veterans Affairs hospitals.