TBI/SCI Trust Fund

VISION

In an effort to enable Mississippians with spinal cord injury and traumatic brain injury to achieve their maximum level of independence, the 1996 Mississippi Legislature established the Traumatic Brain Injury/Traumatic Spinal Cord Injury (TBI/SCI) Trust Fund. The goal of the Trust Fund Program is to assist individuals who are severely disabled by traumatic spinal cord injury or traumatic brain injury to resume activities of daily living and to reintegrate into the community with as much dignity and independence as possible.

ELIGIBILITY

Any resident of Mississippi, regardless of age, who has a severe disability as a result of a traumatic spinal cord injury or a traumatic brain injury, is eligible for services from the TBI/SCI Trust Fund Program. Individualized services can be provided to medically stable individuals. Medical stability is defined as the absence of (a) an active, life threatening condition (e.g., sepsis, respiratory, or other condition requiring systematic therapeutic measures); (b) IV drip to control or support blood pressure; and (c) intercranial pressure or arterial monitoring.

For the purposes of this program, traumatic brain injury is defined as an insult to the skull, brain, or its covering, resulting from external trauma which produces an altered state of consciousness or anatomic, motor, sensory or cognitive/behavioral deficits. Spinal cord injury is defined as an acute traumatic insult to the spinal cord, not of a degenerative or congenital nature, but caused by an external trauma resulting in any degree of motor or sensory deficit.

The Trust Fund Program is the payer of last resort. An individual must seek assistance from all available resources prior to the Trust Fund’s participation in a service.

FUNDING

Motor vehicle accidents are the leading cause of both traumatic spinal cord injuries and traumatic brain injuries in Mississippi. Funding for the TBI/SCI Trust Fund is provided through fees and surcharges on moving traffic violations. A $25.00 surcharge is collected from every violation of the Mississippi Implied Consent (Driving Under the Influence) Law, and $6.00 from all other moving vehicle violations. Collection of these surcharges began July 1, 1996.

The permission to spend Trust Fund monies was approved during the 1997 Legislative session, and expenditures for consumer services began in July 1997.

PROGRAM ADMINISTRATION

The Mississippi Department of Rehabilitation Services (MDRS) was designated by the Legislature to administer the TBI/SCI Trust Fund Program. The MDRS Office of Special Disability Programs coordinates the direct services to eligible consumers, and a full-time program coordinator oversees the coordination of services. A variety of community-related integration programs are also provided through the TBI/SCI Trust Fund via contracts with community organizations and agencies.

TBI/SCI WAIVER

MDRS received approval from CMS in 2001 to implement the Traumatic Brain Injury/Traumatic Spinal Cord Injury (TBI/SCI) Waiver. This home and community-based services program is operated in partnership with the Mississippi Division of Medicaid. The program utilizes matching dollars from the TBI/SCI Trust Fund to draw down federal dollars to extend services to more individuals with traumatic brain and spinal cord injuries. Individuals enrolled in the TBI/SCI Waiver may receive attendant care, respite, limited home modifications and medical equipment and supplies. All services are provided pursuant to an individualized plan of care.

Direct Client Services

Equipment/Modification Services

Many times an individual is restricted in his/her activities due to limited access to the environment. With appropriate equipment and assistive technology devices, independence can be greatly enhanced. This component of the Trust Fund Program provides a wide range of devices and equipment such as specialized wheelchairs; environmental controls to operate household devices such as lights, telephones, appliances; and communication devices which allow non-verbal individuals to express themselves. There is a $35,000 lifetime cap.

Additionally, this component provides modifications to homes to make them accessible to individuals with spinal cord injuries or traumatic brain injuries. Examples of such modifications include adding a ramp, widening doorways, and installing grab bars. Vehicles can also be modified to accommodate wheelchairs or other mobility devices through the Trust Fund Program.

Respite Services

The Trust Fund Program pays temporary, short-term caregivers to provide respite to the family member or other caregiver that regularly assists the survivor of TBI or SCI. Family members often provide care twenty-four hours a day, seven days a week. Brief respites can offer the relief necessary to allow caregivers to continue this ongoing care. Payments are made for the following levels of care, based on a physician’s determination of need: 1) Companion 2) Nurse Aide 3) Licensed Practical Nurse and 4) Registered Nurse. An individual may receive up to 288 hours of respite services per year.

Transitional Personal Care Attendant Services

Personal care attendants assist an individual with physical activities of daily living such as bathing and grooming or with cognitive activities such as planning daily schedules and participating in community reintegration activities such as grocery shopping, banking, etc. There is a twelve-month time limit on transitional attendant services. During this time, the client or family members will be assisted with seeking other attendant care options.

GRANT PROJECTS

Prevention and Education Projects

Mississippi has one of the highest incidence rates of traumatic brain injuries in the United States. However, most spinal cord and brain injuries are preventable. If Mississippians practiced better safety measures such as eliminating drunk driving, wearing motorcycle/bicycle helmets, and properly using safety belts/child restraints, the number of SCI and TBI injuries would be drastically reduced.

The TBI/SCI Trust Fund promotes prevention activities by annually funding projects that increase awareness and acceptance of safety practices. These campaigns may be targeted toward a specific activity (e.g., diving safety, seat belt usage, drinking and driving) or a particular age group (children, teens, etc.) or they may be more general in scope.

Projects may also be funded to promote awareness and education regarding SCI and TBI. Target groups could include any of the following: individuals with SCI and TBI; family members; employers; professionals such as educators, social workers, and health care providers; or the general public.

Transitional Living Projects

Transition from a medical setting to the home and community after a traumatic injury involves numerous changes and adjustments for the survivor and family members. The Trust Fund Program traditionally funds project(s) that assist with this reintegration. These projects will address activities such as increasing/accommodating physical functioning; cognitive retraining; behavior modification; socialization; recreational activities; and adjustment to disability by the consumer and family members.

Recreation Projects

People with spinal cord and brain injuries may have physical limitations, but there is no limit to their desire for social and recreational activities.

SCI and TBI Registry

A surveillance system was established by the Mississippi State Department of Health in 1992 to determine the epidemiology of SCI and TBI among Mississippi residents. The information from this registry is used in developing and evaluating programs relating to SCI and TBI.

ANNUAL NURSING HOME SURVEY

The TBI/SCI Trust Fund legislation requires an annual survey of Mississippi nursing homes to identify all residents, under the age of fifty-five, who have traumatic spinal cord or brain injuries. Survey forms are mailed to all nursing homes; additional contacts are pursued to ensure responses from each facility. Staff of the Mississippi Department of Rehabilitation Services, Office of Special Disability Programs, conducts follow-up interviews and evaluations. Referrals are made, when appropriate, to other organizations.

TBI/SCI Advisory Council

Traumatic Brain/Spinal Cord Injury Trust Fund Program
P.O. Box 1698
Jackson, MS 39215-1698
Allison Lowther, Coordinator
601-853-5397
alowther@mdrs.ms.gov