Traumatic Brain Injury (TBI) is typically defined as a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain (Brain Injury Association of America 2006).
While recent attention has been brought to TBI because of veterans returning from Iraq and Afghanistan, more awareness about the prevalence and prevention is needed. TBI is an issue of major public health significance both nationally and throughout California. There are approximately 350,000 TBI survivors in California (extrapolated from Centers for Disease Control data). Medical and mental health care costs for a single TBI often exceed 4.6 million dollars (California Dept. Health Services’ 2007 statistics). The societal effects of a mild, moderate or severe TBI multiply significantly. Now more than ever, TBI services are needed.
In 1988 California passed Senate Bill 2232 (Chapter 1292, Statutes of 1988) which authorized minimal funding for a TBI pilot project dedicated to providing a continuum of services for TBI survivors and their families. As of 2015, FREED is one of seven TBI sites offering the following core services to people with Traumatic Brain Injury: information and referral; supportive living services; community re-integration; and public-professional education and at some sites, outreach and prevention education.
To strengthen the statewide system of TBI services, the seven TBI sites formed a coalition in 2004 called The Traumatic Brain Injury Services of California (TBISCA). The mission of TBISCA is to provide a unified voice for TBI survivors, their families, and the community through collaborative partnerships, legislative advocacy, and TBI education.
The most critical TBI service gaps that TBI sites provide include case management, supportive living, community integration, and vocational supportive services. The service needs of individuals with TBI and cognitive disabilities are unique in the following ways:
Supported Living Services include a range of training, support, and appropriate supervision to maximize independence where the participant live. These services include support with maintaining housing; paying bills; shopping; coordination of personal care, medical, and transportation services; and, connection to community resources. Depending on the extent of the TBI, some individuals may need monthly, weekly, or even daily supported living services and case management to remain living independently in their residence.
Community Reintegration Services maximizes independent functioning with the goal of living in the community and participating in community life. These services include providing or arranging for access to housing; transportation; medical care; rehabilitative therapies; day programs; chemical dependency recovery programs; personal assistance; and, education. For many physical and sensory disabilities, community reintegration services is provided immediately after injury and individuals learn new skills and get connected to resources to assist them with managing their lives and navigating the world with a disability. For individuals with TBI, community reintegration services may be needed multiple times throughout the year or over the span of their lives when life circumstances change and they need more comprehensive supports to live successfully in the community.
Vocational Supportive Services This provides prevocational and educational services to individuals who are unserved or underserved by existing vocational rehabilitation services. In order to find and maintain employment, individuals with TBI often need extensive and on-going training, supervision and support services; advocacy for workplace equality; and, support to negotiate worksite flexibility and support mechanisms that allow the participant to function competitively. On-going job coach service are critical to supportive finding and maintaining employment.
TBI sites are the only organizations providing these services to individuals with TBI regardless of age, residential living arrangements, and in appropriate community based settings.
FREED provides TBI services in Nevada, Yuba, and Sutter Counties and through a partnership with Disability Advocacy Center to serve Butte and Shasta Counties.