 March 27, 2006 The Honorable Ralph Regula Dear Chairman Regula: The undersigned organizations urge you to provide $30 million in funding for programs under the Traumatic Brain Injury Programs (TBI) Act for FY 2007. Specifically, we request $15 million for the TBI State Grant Program and $6 million for the Protection and Advocacy Grant Program, both administered by the Health and Resources Services Administration (HRSA), to improve and coordinate access to State service delivery systems. In addition, $9 million is needed for the Centers for Disease Control and Prevention (CDC) for prevention, public information, and surveillance projects, which help in determining incidence, costs, causes, contributing factors, and other data that is necessary to insure the delivery of effective services for individuals with brain injuries. Traumatic Brain Injury is the leading cause of death for Americans between birth and age 44. The major domestic causes of brain injury are motor vehicle crashes and falls. It is also becoming the signature wound of the Iraq War with a growing number of soldiers suffering from blast injuries. Initially brain injuries may go undiagnosed when there are other physical combat injuries present only to be discovered later. While the Department of Defense and the Veterans Administration has worked hard to provide appropriate acute care for these solders, long-term support will require a coordinated effort between state government and federal agencies. TBI is a complex disability that challenges States’ ability to respond to the needs of persons with this disabling condition and their families. These individuals need services from multiple state programs including Medicaid, vocational rehabilitation, employment services, education, home health care, mental health, substance abuse, and long-term care services. Without coordinated systems of care, individuals are often placed inappropriately in nursing homes or cared for by family members with little or no support or assistance. When families are no longer able to care for these individuals, the families turn to the State as the only source of help. The HRSA TBI program is the only Federal program that specifically addresses the issues faced by individuals with TBI in accessing the array of rehabilitation, community and family support services, and long-term care needed to assist individuals to return to their community, home, families, school, and work. In a just released report by the Institute of Medicine (IOM) evaluating the HRSA State and P&A Systems Grant Programs, the IOM finds that:
Since the TBI Program was implemented in 1997, 49 States, Territories and the District of Columbia have received limited grants under this program. Without funding most States will be unable to continue the level of support necessary to develop service systems that assist individuals with traumatic brain injury to live in their communities to avoid institutionalization. Furthermore, the 2000 Amendments authorized funding for the state Protection and Advocacy Systems (P&As) to further assist individuals in accessing necessary services and care. Individuals with traumatic brain injury have an array of protection and advocacy needs including assistance with returning to work, finding a place to live, accessing needed supports and services such as attendant care and assistive technology, and obtaining appropriate mental health, substance abuse, and rehabilitation services. Very often, these individuals are the victims of stigma and discrimination because so little is understood about the effects of TBI. In addition, many people with TBI -- including returning veterans – are forced to remain in extremely expensive institutional settings far longer than necessary because the community-based supports and services they need are not available. Without funding, these services would be eliminated – and people and families will suffer. We would appreciate your full support of adequate funding this much needed program. A request for $30 million is modest in contrast to the enormity of the problem posed by Traumatic Brain Injury. Sincerely, American Association of People with Disabilities cc: House and Senate members of the Labor-HHS-Ed Subcommittee on Appropriations
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