Traumatic Brain Injury (TBI) Waiver
Traumatic brain injury (TBI) is an injury to the brain caused by an outside force, it can be caused by a forceful bump, blow or jolt to the head or body or from an object entering the brain. The most common causes of TBI include falls, motor vehicle accidents and struck by or against events.
Some types of TBI can cause temporary or short-term problems with brain function, including problems with how a person thinks, understands, moves, communicates and acts. Every brain injury has different effects or consequences.
TBI Waiver Eligibility
The NC TBI Waiver is available to eligible individuals 18 years of age and older, living in the Alliance Health Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan catchment area (Cumberland, Durham, Harnett Johnston, Mecklenburg, Orange and Wake counties).
The TBI Waiver provides community-based rehabilitative services and support to help with recovery and promote choice, independence and community involvement. These services provide a community-based alternative to institutional care for persons who continue to require a specialty hospital or skilled nursing facility (SNF) level of care.
Goals of the TBI Waiver
The TBI Waiver provides community-based rehabilitative services and support to help with recovery and promote choice, independence and community involvement. These services provide a community-based alternative to institutional care for persons who continue to require a specialty hospital or skilled nursing facility (SNF) level of care.
Goals of the TBI Waiver include:
- Value and support waiver beneficiaries to be fully functioning members of their community
- Promote rehabilitation; evidence-based practices and promising practices that result in real life outcomes for beneficiaries
- Offer person-centered service options to facilitate each beneficiary’s ability to live in homes of their choice, have employment or engage in a purposeful day of their choice and achieve life goals
- Provide the opportunity for all beneficiaries to contribute to the development of their services
- Provide training and support to foster the development of strong natural support networks that enable beneficiaries to be less reliant on formal support systems
- Ensure the well-being and safety of the people served
- Maximize the beneficiary’s self-determination, self-advocacy and self-sufficiency
- Increase opportunities for community integration through work, life-long learning, recreation and socialization
- Provide quality services and improve outcomes.
Updates
NC Medicaid 1915(c) Traumatic Brian Injury (TBI) Waiver Amendments Approved
The Centers for Medicare & Medicaid Services (CMS) approved requested amendments to NC Medicaid’s 1915(c) TBI Waiver.
The amendments, effective July 1, 2024, through April 30, 2026, include the addition of Harnett County to the Alliance Health TBI network and updates the Waiver to include the operation of the Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan (Tailored Plans).