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Alliance was selected by the NC Department of Health and Human Services to operate a pilot waiver for Traumatic Brain Injury in Durham, Wake, Cumberland and Johnston counties. The TBI Waiver Pilot Project was approved by CMS on May 1, 2018, and is now operational in Alliance’s four-county service area.
Alliance may be able to offer help for people who sustained a head injury at on or after their 22nd birthday. To learn more about the TBI waiver and to see whether you or someone you care about might be eligible, call the Alliance Access and Information Center 24/7 at (800) 510-9132.
Questions and Answers
What is the TBI Waiver Program?
If you or someone you care about has a traumatic brain injury (TBI), the TBI Waiver Program is designed to provide community-based rehabilitative services and support to help with your recovery. This is a pilot program managed by Alliance Health in four North Carolina counties (Durham, Wake, Cumberland and Johnston). The services are provided in your own home and community, or in a group living setting – giving you choices and promoting your independence. Under this three-year pilot, 49 individuals will have the opportunity to participate in the TBI waiver the first year, 99 in the second and 107 in the third year.
Who may be eligible to participate in the TBI Waiver Program?
A TBI is defined as an injury to the brain caused by an external force that can result in impairments to cognition (thinking) and physical, behavioral and emotional functioning. Such an injury may have been caused by a motor vehicle accident, fall, gunshot wound, occupational/recreational injury, abuse or military action.
If you have cognitive, behavioral and physical support needs, your TBI occurred on or after your 22nd birthday, you need specialty hospital care or skilled nursing care, and you meet certain financial eligibility, you may be eligible to participate in this program.
If you have questions about eligibility call Alliance’s 24-hour Access and Information line at (800) 510-9132 and request information about the TBI Waiver. Callers should expect to experience a brief crisis screening initially.
What services are available through the TBI Waiver Program?
Support for survivors may include (but are not limited to):
- Staff supports to enable you to live independently or in a group-living situation
- Personal care services
- Life-skills training
- Cognitive rehabilitation
- Home and/or vehicle modification
- Technology supports
- Occupational, physical and speech therapy
- Activities to do during the day or help in finding a job
- Family/caregiver support
View the TBI Waiver Services flyer.
What is Alliance Health and what is its role in this program?
Alliance Health is a North Carolina organization that contracts with the Division of Medical Assistance (DMA) to administer specialty medical plans for TBI survivors in Wake, Durham, Johnston and Cumberland counties. Alliance manages a group of healthcare providers to provide services, and coordinates the care of survivors participating in the TBI Waiver Program. This includes identifying appropriate community resources, developing support plans, and coordinating benefits.
What do I do if I’m interested in learning more about the TBI Waiver Program and applying for it?
Simply call Alliance’s 24-hour Access and Information line at (800) 510-9132. Please specifically ask for information on the TBI Waiver. Callers should expect to experience a brief crisis screening initially. You may find other helpful information through the Brain Injury Association of North Carolina by calling 1 (800) 377-1464.
View the story of a Fuquay-Varina man helped by the TBI waiver
(courtesty WRAL)
Informational Resources
TBI Waiver Overview
TBI Waiver Services Overview
TBI Waiver Individual and Family Guide
Information for TBI Waiver Providers
Stakeholder Meetings
Please join us for Alliance’s upcoming TBI Waiver Stakeholder Committee meetings. The goal of this committee is to provide collective and diverse stakeholder feedback to DHB around the implementation of NC’s first TBI waiver pilot project.
Alliance TBI Waiver Stakeholder Commitee meets the 3rd Tuesday of each month at 12:30pm. Please RSVP to Sandy Valdes at svaldes@AllianceHealthPlan.org.
Note: Remote call-in option is available via Zoom. Please contact Sandy Valdes at svaldes@AllianceHealthPlan.org to obtain Zoom information.
Additional Resources and Presentations
If you are a provider interested in our current TBI service needs, please visit our Current Service Needs page. For information on becoming a Medicaid provider in NC, please go to www.nctracks.nc.gov.
Access a TBI screening tool.
Access our printable TBI Waiver flyer.
Access the TBI Waiver Services flyer.
Access questions and answers from TBI Waiver Provider Listening Sessions. The presentation provided at the Listening Sessions can be found below.
If you have questions, please reach us at TBIInfo@AllianceHealthPlan.org.
