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 objects. The injury can cause physical and mental challenges. Every injury to the brain has different effects or consequences. The current TBI Waiver does not provide services for congenital or degenerative brain injuries (brain injury at birth, strokes, etc.).    

There is no waitlist for this waiver as of 2024. 

 

What is NC’s TBI Waiver?  

The TBI Waiver is a Medicaid program that provides an array of home and community-based services that would otherwise be unavailable through Medicaid. 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. While the waiver is currently limited to counties served by Alliance Health,  it is expected to expand statewide in 2025. If you want to inquire about TBI services, call Alliance at 800-510-9132. 

Who is eligible? 

Individuals who have sustained a diagnosed TBI on or after their 18th birthday.  Beneficiaries who sustained a diagnosed TBI prior to their 18th birthday may be eligible for the Innovations Waiver. 

  • Adults with cognitive, behavioral and or physical support needs. 
  • 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. 

 What Kinds of Services Does the Waiver Provide? 

  • Assistive Technology Equipment and Supplies 
  • Cognitive Rehabilitation 
  • Community Networking Services 
  • Home and vehicle Modifications 
  • Life Skills Training 
  • Occupational Therapy, Physical Therapy, Speech Therapy 
  • Residential Supports 

For more information about the full array of Waiver services, check the Alliance Health website    

 

Resources 

 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 those living in Cumberland, Durham, Harnett, Johnston, Mecklenburg, Orange, and Wake counties, has a TBI Handbook for beneficiaries in English and Spanish that can be found here: 

 NC Medicaid Managed Care Behavioral Health and Intellectual/ Developmental Disabilities Tailored Plan Traumatic Brain Injury Waiver Member Handbook December 2022 (alliancehealthplan.org) 

 Manual para afiliados del programa de exención por TBI de salud conductual e intelectual/discapacidades del desarrollo de NC Medicaid Managed Care 

You can also find more information and resources from the Brain Injury Association of North Carolina (BIANC):  https://www.bianc.net/resources/   About BIANC – Brain Injury Association of North Carolina  

Resource Guide – Brain Injury Association of North Carolina (bianc.net)