Medical Rehabilitation


	South Carolina Brain Injury Leadership Council

SCBILC-Home Life with Brain Injury

The South Carolina Brain Injury Leadership Council identified availability of medical rehabilitation services during the first 18 months following injury as one of the most serious needs in SC. It is estimated that over 500 people each year with brain injury or spinal cord injury do not receive medical rehabilitation because of Medicaid limitations or lack of insurance.

Each year in South Carolina almost one third of people with brain injury do not have coverage for medical rehabilitation (either inpatient or outpatient)
In most cases South Carolina Medicaid does not cover rehabilitation offered in specialized rehabilitation hospitals
About 20 percent do not have any medical coverage
For those with insurance, many medical insurance policies have severe restrictions on medical rehab benefits

BACKGROUND:

Currently in South Carolina, most people who survive traumatic brain injury or spinal cord injury can initially receive timely and adequate acute medical treatment through a system of emergency services and transport, designated trauma centers, and acute care hospitals. People with less severe injuries may be treated in hospital emergency departments and discharged without hospitalization.

Following medical stabilization, rehabilitation specialized for brain/spinal cord injury is very important. Without appropriate rehabilitative treatment and therapies in the first weeks or months after injury, people may not be able to achieve optimal neurological recovery and maximum functional improvement. Research shows this results in higher levels of permanent disability and limits the ability to work. As a consequence, there are greater needs for long term care, and other health, mental health and social services. It directly impacts the numbers of people who seek services from public agencies and intensity of supports needed. Lack of rehabilitation options causes extended acute care hospital stays following injury for many people. There are also higher rates of subsequent hospitalizations for people who do not receive rehabilitation.

Currently in South Carolina, there is a serious gap in access to medical rehabilitation that is specialized for traumatic brain as well as spinal cord injury. While some people receive some rehabilitation or therapy benefits through private health insurance, Medicare, and other sources, such as Worker’s Compensation, adequacy of the coverage varies. Some private insurance carriers fund only acute care or a limited amount of generic rehabilitation, rather than specialized. The South Carolina Medicaid program presently does not adequately fund inpatient/outpatient rehabilitation specialized for traumatic brain/spinal cord injury. The state also has a large number of uninsured persons who cannot access rehabilitation. Many of these people become disabled as a result of their injury, and later qualify for Medicaid. Subsequent costs to the Medicaid program are higher than if these people had received specialized rehabilitation.

NEW FUNDING:

During the most recent budget, the Department of Disabilities and Special Needs (DDSN) took the lead in order to address this pressing need for rehabilitation. In collaboration with the Department of Health and Human Services (DHHS), DDSN requested $8.7 million dollars to address the post-acute medical rehabilitation needs of persons with traumitic brain injury or spinal cord injury.

A total of $2.1 million was approved in the budget for 2007-2008. Although this will not be enough to cover all persons with TBI and Spinal Cord Injury needing rehab, it will allow DDSN to begin developing a network of approved rehab providers across the state. The leadership of DDSN is committed to continuing to educate our state legislators about brain and spinal cord injury in efforts to secure full funding for medical rehab in the state.

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