How three states gather and spend fund dollars
Each of the 10 states that now has a brain injury trust fund allocates the money raised differently. Although all 10 states receive money from traffic violations, there is a great variation in how — and how much — is gathered. Here’s a quick look at how three states operate their brain injury trust funds.
The state of Florida has one of the most established trust fund programs in the nation. In 1993, legislation passed that merged the state’s existing Spinal Cord Injury Program with the Brain Injury Program to create the Florida Brain and Spinal Cord Injury Program, which was given budget authority from the governor for $17 million for the year 2000.
The sizeable funds are generated through a variety of traffic fines and other sources:
• $1 for each temporary license tag issued in the state.
• 8.2% of every traffic-related civil penalty.
• $60 for each driving under the influence (DUI) and boating under the influence conviction.
The trust fund provides a wide range of direct and indirect services for traumatic brain injury (TBI) survivors, but the heart and soul of the program are the brain and spinal cord injury registry, says Thom DeLilla, CDMS, CIRS, program administrator for the Florida Brain and Spinal Cord Injury Program in the Florida Department of Health in Tallahassee. "The registry requires every hospital in the state to report new TBIs and spinal cord injuries within five days. The information is reported to this office, and within 10 days survivors and their families are contacted by the trust fund office to initiate services."
Case managers and service coordinators initially work with families and survivors to help them identify resources. "That’s the important thing. Families are confused at this point. Life doesn’t look very promising. We just want them to know support is available," says DeLilla.
Other services provided by Florida’s trust fund include:
• direct funds for rehabilitation;
• prevention programs;
• home and van modifications;
• two statewide resource centers;
• funding for research on TBI and TBI prevention provided to local universities;
• community service coordinators for long-term case management needs. (For more information on community service coordination programs, see cover story.)
The Alabama brain injury trust fund was established by a series of legislative efforts that began in 1992. "The first piece of legislation established a 17-member advisory board and charged them with the responsibility for investigating the needs of people in the state with TBI," explains Charlie D. Priest, executive director of the Alabama Head Injury Foundation in Birmingham, which spearheaded the effort that established Alabama’s brain injury trust fund in 1992.
It took several years and additional legislation before funds actually were released to survivors beginning in 1995. "This year, we passed still another piece of legislation that provides an additional fine of $100 for every reckless driving conviction. Even after a state trust fund is established, you have to keep looking for new ways to fund and protect it," he notes.
The Alabama trust also receives $100 for every drunk driving conviction in the state and operates a budget of about $2 million annually. Services provided with those funds include:
• personal assistant services;
• long-term supported employment of up to $1,500 annually to help employers accommodate injured employees;
• vocational rehabilitation programs;
• community support network and resource coordination.
The Tennessee Department of Health in Nashville houses the state’s Traumatic Brain Injury Program, which was established in 1993. The trust fund receives $2 for every speeding ticket, $25 for every reckless driving conviction, $10 for every DUI conviction, and $10 for every revoked license conviction, which totals to an operating budget of about $600,000 annually.
Roughly half of that money pays for the trust fund staff and the state’s brain injury registry, says Jean Doster, program director of the Traumatic Brain Injury Program. The remaining $300,000 provides grants to programs that support TBI survivors and their families. Some examples of grants awarded by the trust include:
• $40,000 a year for three years to expand a day treatment program;
• $40,000 a year for three years to support the development of an accessible housing project that provided homes for 24 disabled individuals;
• $100,00 a year for three years to a community mental health center to provide in-home counseling and behavioral intervention for TBI students in 24 counties in middle Tennessee;
• $100,000 a year for three years to the Tenn essee Emergency Services for Children Project to improve the capability of 54 rural hospitals to provide quality care in the early management of acutely injured children;
• $75,000 a year for three years to provide supported living services, such as personal attendant care for six residents of the accessible housing project;
• $45,000 a year to pay the salary, office space, travel expenses, and direct training of community service coordinators.
"The legislation mandated that we develop a statewide case management system for TBI survivors. Since it is difficult to establish new state positions, we provide grants to local nonprofit agencies, including the Brain Injury Association of the Mid-South in Memphis, to hire the coordinators," notes Doster, adding that the state trust fund currently supports six community service coordinators. "Through the grants, we can provide direct services to individuals. They also allow us to develop pilot programs and see what works and what doesn’t work to meet the needs of our state TBI population. The service coordinators submit quarterly and annual reports to us, and we conduct site visits at least once a year."
In addition, the trust fund awards smaller one-year or one-time grants, such as a $5,000 grant to regional health departments for TBI prevention programs.
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