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Cutler Institute, Population Health and Health Policy, USM Aging Initiative, Health and Wellness


The Acquired Brain Injury Advisory Committee requested this report to inform members of its committee, consumers, service providers, legislators, and state agencies as legislation to create the Acquired Brain Injury Fund is considered. Contained in the report is a review of the development of trust funds as a funding stream to provide services to individuals with brain injury with unmet needs. There are currently 19 active state trust funds. Trust fund revenue sources and the uses of those funds vary from state-to-state. Revenues from trust funds generally support the access and delivery of cognitive rehabilitation, registries, education, community supports and case management. Cognitive rehabilitation is recognized as central to the treatment and long-term recovery of individuals with a brain injury, yet private and public healthcare coverage of this service remains under-funded across states. Case management for individuals with brain injury is not a usual covered benefit for MaineCare members and coverage of cognitive rehabilitation is limited.

The unmet needs and barriers of Maine residents with brain injury and their service providers were detailed in a recent state-wide needs assessment. In particular, case management, supported housing, vocational, and education are identified as high priority areas for resource development. The needs assessment recommendations include policy development, collaboration and coalition building to strengthen the service delivery system, coordination of services and supports, and the development of educational opportunities for clinicians, service providers, employers and general public. The Department of Health and Human Services was recently designated as the Lead State Agency for the coordination of brain injury services in Maine and the new position of Director of Brain Injury Services was created. Recent developments in Maine such as a decreasing number of brain injury service providers, the implementation of a new medical model of reimbursement under MaineCare, and an expected return of recent military veterans with brain injury have prompted the Acquired Brain Injury Advisory Committee to renew focus on the development of a new funding stream to support unmet needs.

Funding Organization or Grant

This document was developed under Grant No. 11P-92023/1-011 from the U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services. This grant was made to the Maine Department of Behavioral and Developmental Services, which has contracted with the Edmund S. Muskie School of Public Service at the University of Southern Maine. However, the contents herein do not necessarily represent the policy of HHS or the Maine State DHHS and you should not infer any endorsement by the Federal or Maine State government. Please include this disclaimer whenever copying or using all or any part of this document in dissemination activities.