NC’s TBI WAIVER
What is TBI?

What is Traumatic Brain Injury (TBI)?

A traumatic brain injury (TBI) is an injury to the brain that is caused by an external physical force such as hitting your head or other types of blunt force trauma. The most common causes of TBI include slips and falls, motor vehicle accidents and struck by or against events. The injury can cause physical and mental challenges. Every injury to the brain has different effects or consequences.

Traumatic brain injury defined in North Carolina General Statute 122C-3 (38a):

An injury to the brain caused by an external physical force resulting in total or partial functional disability, psychosocial impairment, or both, and meets all of the following criteria: a. Involves an open or closed head injury. b. Resulted from a single event, or resulted from a series of events which may include multiple concussions. c. Occurs with or without a loss of consciousness at the time of injury. d. Results in impairments in one or more areas of the following functions: cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. e. Does not include brain injuries that are congenital or degenerative.

What is NC’s TBI Waiver?

The TBI Waiver provides an array of home and community based services, through a three-year Medicaid waiver pilot. The waiver is designed to provide an alternative to nursing facility care or specialty rehabilitation hospital care for eligible individuals with a traumatic brain injury.

Who may be eligible?

• Adults with cognitive, behavioral and or physical support needs.
• Individuals who have sustained a diagnosed TBI on or after their 22nd birthday.
• Adults who meet specialty rehabilitation hospital or skilled nursing level of care and who meet financial eligibility requirements may be eligible to participate in this Medicaid waiver.

More information can be found at www.ncdhhs.gov/assistance/disability-services/traumatic-brain-injury 

Alliance Health, the managed care organization for publicly-funded behavioral healthcare services for the
people of Durham, Wake, Cumberland and Johnston counties, provides the resources below:

Additional resource: http://www.bianc.net/resource-book