knowledge it has not been done," said David Sudbeck, ombudsman
for behavioral health for the DHHR.
Injury Association of West Virginia said the state should apply
for a federal Medicaid waiver for citizens with TBI. This waiver
would allow the state to forgo certain Medicaid requirements to
cover a broader array of services for people with brain
injuries, as an alternative to being institutionalized.
Davis, founder and president of the Brain Injury Association of
West Virginia, said waivers would provide flexibility to
patients for the kinds of medical support they need. Twenty-two
states have waivers for TBI, allowing individuals to receive
flexible coverage that could include living skills, crisis
management, family counseling and rehabilitation.
"A lot of
folks can't hold down a job, but don't qualify for unemployment.
They're the walking wounded," Davis said. "There are hundreds of
West Virginians not being served."
3,800 brain injuries are estimated to occur in the state every
year, with 600 resulting in death. But Davis said it is
impossible to estimate how many people actually suffer because
of a fall, vehicle accident or domestic violence, and don't
realize a brain injury is responsible for their pain, behavioral
change or inability to function.
waiver program, the state would be responsible for a third of
the medical expenses, with the federal government paying the
rest. Davis said his association has suggested using a
percentage of money generated by video lottery machines to cover
the cost of care.
has filed a motion, which has been sealed by the court, asking
the judge to reconsider the order. The motion addresses whether
the judge has overstepped his authority. It will be taken up at
an Aug. 28 hearing.
that [DHHR] thinks, more or less, that it is out of his
jurisdiction," Sudbeck said.
said there are alternative solutions to receiving a state
Medicaid waiver for brain injuries.
other ideas that could be utilized to fund a program for TBI.
There are other federal waivers available," Sudbeck said.
has several types of waivers that can be used to aid those with
brain injuries, including the Aged and Disabled waiver and the
MR/DD waiver, which will provide comprehensive coverage for
people who received their injuries before the age of 22.
Injury Association is concerned about adults who sustain brain
injury after they pass the age limit. Some do not qualify for
other care, but are still unable to hold a job or function
normally because of their injuries.
problem could escalate as soldiers return from war zones with
brain injuries, Davis said. High profile sufferers, such as
journalist Bob Woodruff who was severely injured by a roadside
bomb in Iraq, have drawn attention to TBI.
many West Virginians who suffer head injuries cannot afford
expensive treatment and may not have a support system of friends
and family to help with recovery, Davis said.
people are released from acute care in the hospital, many of the
injured have no money to pay for rehabilitation. Some recover
with family or in nursing homes, but others land on the streets
or in jail, unable to cope with the behavioral changes.
difficulty with judgment and making proper decisions. They can
be impulsive or say things that get them into trouble," said
Jennifer Rhule, a board member who suffered a brain injury
during a car crash that left her with vision problems that
required several brain surgeries.
will end up paying the costs, if it does not leverage federal
dollars, the Brain Injury Association said. They believe a
waiver program would save the state money on treating brain
injuries and be the right thing for those with injuries.
"If we had
a waiver, we'd get care providers and specialists. There aren't
that many available in the state," Rhule said. "We serve every
other disability, but brain injuries are, many times,
Kellen Henry at
khe...@wvgazette.com or 348-5179.
Post a Comment
P Jackson (2 minutes ago)
professional in the field for over 25 years and more recently as
a family member as well, a waiver program, which has been
successful in so many other states, seems like it should be a
'no brainer'!! If you consider that there are 36,000 West
Virginians who have experienced a brain injury, just think about
the actual total of those effected by the trauma when you
include their families and loved ones. Wouldn't it have to be
well over 100,000.......perhaps 200,000? Personally, now more
than ever, I believe one's perspective can change greatly when
impacted on a personal level and that in itself is unfortunate.
It all boils down to quality of life issues for those who have
suffered the injury......AND their loved ones. Traumatic Brain
Injury is not for the faint of heart, for the weak, the poor or
otherwise underprivileged. It is an equal opportunity event for
which everyone may qualify with NO application required.
Susan H. Connors (18 hours ago)
Injury Association of America strongly supports upholding the
court order to establish a Medicaid Waiver for West Virginian's
with brain injury. Such a waiver would allow DHHR to provide
healthcare services to meet the specific needs of brain injury
patients. The cost would be equal to or less than institutional
care and would be shared by the federal government.
Nearly half of the states in this country use Medicaid waivers
to provide care for patients with brain injury thereby
minimizing disability, enhancing prospects for return to work
and previous social roles, and preventing homelessness,
incarceration, and inappropriate placement in nursing homes
and/or psychiatric institutions. In the long-term, use of a
Medicaid waiver will reduce future burdens on the state and
therefore the tax-payers. Frankly, this is a "no-brainer" and
DHHR should jump on it.
I agree with
Stacy. Medicaid Waiver Programs, where family members and paid
to take care of family members is a "cash cow" for some. I know
of one case where a lady in Boone county was pulling in approx
$5,000 pr month taking for her two adult "mentally challenged"
adult children. Plus, they were receiving free care provider(s)
help. She was reimbursed by the state every time she even ran
family errands. Why is it some qualify for this type of help and
others cannot get help (such as Medicaid for chronic illness or
rehabilitation for substance abuse?
Stacy (4:25pm 07-25-2008)
As long as
the DHHR doesn't consider paying family members to provide care,
I'm on board. Paying family members to take care of their family
members just opens a Pandora's Box that is in large part
estimates that at least 5.3 million Americans, approximately 2%
of the U.S. population, currently have a long-term or lifelong
need for help to perform activities of daily living as a result
of TBI. ( www.cdc.gov) The population of WV is currently over
1.8 million. Two percent of that is 36,000 West Virginians with
a long-term or lifelong need for help to perform activities of
daily living as a result of TBI. That is probably a very low
estimate given the higher than average elderly population
(falls) and higher incidence of ATV accidents in our state. This
estimate also neglects the higher proportion of troops from WV
that see combat. The Rand Corporation just released a study that
estimates that up to 20% of our military men and women returning
from the Middle East have sustained a TBI. It doesnít take a
genius or a psychic to predict what is going to happen when our
troops come home to a state that canít or wonít provide needed
services to current TBI survivors.
bkerr (11:15am 07-25-2008)
too many benefits associated with a state based waiver program
for adults with TBI for this to not be considered / move
forward. No one would have to reinvent the wheel here.
Neighboring states already have successful waiver programs. A
state based waiver program would allow these individuals to
access appropriate care in setting that not only understand TBI
but specialize in it!
can be a lifelong injury. Medicaid waivers have been used in
other states to effectively offer services that keep people with
brain injury out of jails, nursing homes, and psychiatric
hospitals. Why would a state be willing to let people with brain
injury end up in those types of places? As someone who works in
the field of brain injury, it is a story we hear too often.
State agencies that don't understand the injury think if a
person with a brain injury ends up in jail or a psychiatric
hospital that must be where they belong. It is sad commentary
that the courts have to step in to make an agency develop a plan
for citizens they should already be serving!
Charleston native and Founder of the Brain Injury Assn. of FL I
strongly support the Medicaid waiver proposed by the Brain
Injury Assn. of WV. Medicaid recipients between the ages of 22
and 59 are underserved and pose a severe financial burden for
the State of WV. Their care would be more cost effectively
managed with the waiver. Florida's TBI waiver program annually
serves large numbers of uninsured or underinsured persons with
traumatic brain injuries who might otherwise live out their
lives in nursing homes or on the streets as homeless