Masters Thesis

Policy evaluation of the Brain Injury Association of California's effort to pass legislation to improve health delivery systems for brain injury

Acquired Brain Injury is a growing concern both at the state level and national level. The incidence rate and prevalence rate of brain injury is increasing from year to year. Research and advocacy for reducing and/or preventing brain injury is not as extensive as research for other major sicknesses and accidents. As a result, the, awareness of the incidence and prevalence rate for brain injury is below awareness of other major sicknesses such as cancer and mental disorders. Government and health insurance carriers are failing the brain injured population by not changing the healthcare delivery system in response to increased brain injury survival rates. Many individuals suffering a brain injury are relying on Accident and health insurance policy benefits to cover emergency response care and long term rehabilitation services. However, accident and health insurance policies are not designed to provide the long term rehabilitation needed following a brain injury. The following policy evaluation will be conducted to highlight current efforts by the Brain Injury Association of California (BIACAL) to pass legislation in California that will mandate health insurance benefits that will allow greater access to the recommended model of continuum of care for traumatic brain injury. Brain injured individuals and their families need strong advocates that will fight for their rights for equality of health insurance benefits provided to individuals with cancer. Individuals recovering from a brain injury should not be limited by insurance coverage when rehabilitation is medically necessary; typically, people with moderate to significant brain injury will face setbacks due to interruption in the rehabilitation program. As an advocate for brain injured individuals, BIACAL must ask the question, is enough being done to raise awareness about the growing incidence and prevalence rate of brain injury. Therefore, it is necessary to evaluate BIACAL effort to raise public awareness and offer recommendations to improve advocacy efforts for the brain injured population. Increased awareness can lead to public support and legislative action to improve health care delivery system for brain injury. Michigan and Texas currently have legislation and or policies in place that provides access to the model of continuum of care recommended for brain injury. BIACAL’s effort to study and adapt those states policies for use in California was evaluated with recommendations provided as to possible methods to raise awareness of other state legislation and policies benefitting the brain injured population. BIACAL has introduced a new senate bill to mandate coverage for acquired brain injury. The only acceptable result to BIACAL (as an advocate for individuals living with an acquired brain injury) is passage of legislation mandating medically necessary coverage for acquired brain injury. Advocates for brain injured individuals in California must understand that the health insurance industry is a market driven industry and inform consumers of adequate coverage needed for recovery from an brain injury. Consumers, when having knowledge of types of health insurance plans, demand more comprehensive health insurance plans The Brain Injury Association of California’s collaborative efforts need to be evaluated to ensure a common policy of advocacy is being used by all partners, and if not provide recommendations on how to improve collaboration among partners and communities across California.

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