Traumatic Brain Injury (TBI) Program

Photo of patient receiving an MRI

The HCBS/TBI program is for individuals who have sustained a traumatic brain injury and provides the services needed after injury to ensure that individuals can stay in their homes and be as independent as possible in a safe, healthy environment. The HCBS/TBI program serves individuals 16 to 65 years of age who would otherwise require institutionalization in a TBI Rehabilitation Facility.

 

The TBI Program is not considered a long-term care program and is designed to be a rehabilitative program for consumers to receive therapies and services that enable them to rely less on supports as the consumer's independence increases.

 

The brain injury must be traumatically-acquired, i.e., caused by an external physical force, such as blunt or penetrating trauma or from accelerating-decelerating forces. The injury must temporarily or permanently impair an individual’s behavioral, cognitive or physical functions. The common injuries resulting in trauma to the brain includes, but is not limited to, the following:

  • Falls, which involve a forceful blow to the head, not generally consistent with concussion or minor injury.
  • Motor vehicle accidents with resulting head trauma.
  • Struck by/against, including collision with a moving or stationary object.
  • Assaults, repeated blows to the brain.

If a traumatic brain injury is obtained prior to the age of 21 years, the individual may be considered developmentally disabled and will be referred to the Community Developmental Disability Organizations (CDDOs) prior to TBI screening. CDDOs are required to assess all persons with developmental disabilities for the I/DD Program.

In order to qualify for the HCBS/TBI program, consumers must meet the following eligibility guidelines:

  1. Have a traumatic brain injury.
  2. Be 16 to 65 years of age.
  3. Meet the criteria for TBI rehabilitation hospital placement (which is determined by the screening).
  4. Meet the financial guidelines to qualify for Medicaid.

Local ADRCs do the screening and begin the process of determining if someone qualifies for HCBS/TBI services.


How Do I Apply?

The application process is as follows:

Step 1:

Functional Eligibility: Contact the local Aging and Disability Resource Center (ADRC) and request Functional Assessment for TBI services. The Functional Assessment tool will determine if you meet functional eligibility criteria for the TBI program.

Step 2:

Program Eligibility: KDADS TBI Program Manager will determine if your supporting documentation clearly indicates a TBI and you meet program eligibility criteria.

Eligibility for TBI program services will not be determined if supporting TBI documentation is not available for the TBI Program Manager. 

Step 3:

Financial Eligibility: Local Department for Children and Families (DCF) offices determine if a person is financially eligible for TBI program services. If a person is determined program-eligible by the TBI Program Manager, that person or his/her guardian will need to contact the local DCF and complete an application for medical assistance.

Individuals are required to contact the local DCF office and complete an application for medical assistance even if currently receiving Medicaid

Persons determined to be financially eligible will work with their selected or assigned Managed Care Organization (MCO) to determine what TBI program services will best meet their needs. The MCOs are as follows:

Amerigroup: (866) 305-5147 or TTY (800) 766-3777

Sunflower: (877) 644-4623

United Healthcare: (877) 542-9238, #771 for hearing impaired

Frequently Asked Questions

  • What is a Traumatic Brain Injury Rehabilitative Facility (TBIRF)?

  • What is the difference between acute hospitals, rehabilitation facilities, and postacute rehabilitation?

  • How do I know if I qualify for a rehabilitative facility or HCBS TBI program services?

  • What TBIRF options do I have in the state of Kansas?