Fighting the silent epidemic - The Florida brain and spinal cord injury program

This article describes a statewide model program that provides a range of services for individuals with traumatic brain injury in Florida. The article answers questions regarding the organization, delivery, and financing of a system that includes surveillance data, case management, health services, a network of contractors, and a Medicaid waiver. With an annual budget of more than $15 million, the primary source of financing is a trust fund established through state statute with revenues from fines levied for driving while intoxicated. Lessons from Florida that will be useful to states as they respond to Olmstead and develop Medicaid waivers include (a) how a data registry laid the foundation for a service delivery system, (b) how early and aggressive case management has the potential for Medicaid savings, and (c) how a statewide system, critical mass of patients, and standards for providers can improve the quality of services for persons with traumatic brain injury.