NOTE: The application approval process will take a minimum of 6 to 8 weeks after all required supporting documentation and forms are submitted. Please do not schedule any appointments until after you have received approval in writing. Any treatments scheduled and received prior to approval are not eligible to be paid for by Delaware’s TBI Fund. Thank you for understanding.
Since July 2013, the General Assembly has allocated funding to the State Council for Persons with Disabilities (SCPD) to administer a Traumatic Brain Injury Fund. Eligibility for funding assistance is limited to legal Delaware residents with a qualifying, medically documented traumatic brain injury who would benefit from covered services which are otherwise not available to residents through the Department of Health & Social Services (DHSS) or any other state agency.
Covered services may include, but are not limited to, the following service(s), treatment(s), therapy, or equipment directly related to a traumatic brain injury that are not covered by the applicant’s existing medical insurance provider(s):
- home or environmental modifications (e.g. accessible ramp, accessible bathroom modifications, change of room setup, modification of materials or equipment, or specialized equipment);
- driver evaluation assessment and driver rehabilitation training;
- assistive technology (e.g. Tablet, assistive software, readers, etc.);
- medical equipment recommended by their treating medical provider (MD, DO, Physician’s Assistant, Licensed Physical, Occupational and/or Speech Therapist) as beneficial (e.g. Specialized wheelchairs, braces, medically necessary bed wedge, etc.)
- short-term/temporary attendant services not covered under other funding sources,
- medically necessary eyeglasses for individuals with a traumatic brain injury;
- limited sessions of alternative therapy;
- medically approved summer day camps approved by SCPD (e.g. Point of Hope, Easterseals Camp Fairlee); and
- Such other services directly related to the applicant’s traumatic brain injury as approved by the SCPD Director or his or her designee in consultation with the Traumatic Brain Injury Application Review Committee not covered by the applicant's healthcare insurance or other state department or agency.
Services NOT Covered
The Traumatic Brain Injury Fund is a limited fund, payer of last resort that does not cover cost-prohibitive request. Items not covered include, but are not limited to:
- Services, treatment, therapy, and equipment purchased or received prior to written approval from the Traumatic Brain Injury Fund;
- services, treatment, therapy, and equipment not directly related to a traumatic brain injury;
- accessible vehicles or major vehicle modifications;
- long-term care;
- ongoing case management;
- dental services;
- payment of utility bills;
- ongoing medical bills;
- prescription costs;
- home and environmental modifications that are not specific to accessibility needs for an individual with a traumatic brain injury;
- Gyro Stim Therapy;
- Ongoing alternative therapy treatment; or
- Services, treatment, therapy, and equipment provided through the Department of Health & Social Services, Department of Education, Division of Vocational Rehabilitation, or any other state agencies since the Brain Injury Fund is a limited special fund "Payer of Last Resort."
Eligibility for Traumatic Brain Injury Fund assistance is limited to full-time Delaware residents with a qualifying traumatic brain injury who would benefit from covered services which otherwise would not be readily available to the resident through the Department of Health and Social Services (DHSS) or other state agencies.
In order for the State Council for Persons with Disabilities, Traumatic Brain Injury Fund Application Review Committee to determine eligibility, applicants or their designated representative must fully complete and sign the application below attaching required supporting documentation listed below within 60 days of application submission.
Documentation of a brain injury may include a letter from the applicant's treating physician verifying treatment for a traumatic brain injury that includes the date of injury, mechanism of injury, recent physician's treatment notes for a traumatic brain injury, neurological examinations noting a traumatic brain injury, neuropsychological evaluation noting a traumatic brain injury or neuroimaging records showing a traumatic brain injury.
The State Council for Persons with Disabilities (SCPD) currently has funding for the Brain Injury Fund and encourages people who may benefit to apply.
Required Supporting Documentation
- A completed and signed brain injury fund application.
- A letter from the applicant’s primary care physician (PCP) or other treating medical professional (MD or DO), Physician’s Assistant, Licensed Physical, Occupational or Speech Therapist treating the applicant for their traumatic brain injury stating that the applicant has a traumatic brain injury, the mechanism of the injury (e.g. motor vehicle, motorcycle, or boating accident, fall, sports injury, etc.) and the date that the traumatic brain injury occurred recommending the requested service(s), treatment(s), therapy, or equipment. If you are unable to obtain a letter from the applicant’s physician or other medical provider listed above, a copy of the applicant’s current treatment notes for their traumatic brain injury will suffice.
- Treating medical providers for requested/recommended services, treatments, therapy, or equipment must submit a request for approval to the applicant's insurance company/companies. If the applicant's insurance denies the request the applicant must provide the SCPD/TBI Fund Program Manager a copy of the insurance provider(s) denial of coverage letter(s) that states the reason the insurance company refused to cover the requested service(s), treatment(s), therapy or equipment.
- A list of specific service(s), treatment(s), therapies, or equipment the applicant is requesting funding approval for prioritized from the most important or medically necessary to items requested that are beneficial or needed but not medically necessary that includes the estimated cost for each service, treatment, therapy, or equipment requested.
- A completed and signed medical release form.
- A written statement from the applicant or their designated representative stating what symptoms, functional goals, and activities of daily living that the applicant is hoping to improve by receiving the requested services(s), treatment(s), therapy, or equipment dated within 30-days of application submission. **NOTE: Application packages cannot be reviewed until receipt of all fully completed required documents and supporting documentation listed in this section.
Please fully complete an online application below or download a copy to your computer, to print out, and submit by email to SCPDBrainInjuryFund@delaware.gov, by U. S. mail to SCPD Brain Injury Fund, Margaret M. O'Neill Bldg., Suite 1, 410 Federal Street, Dover, DE 19901; or by fax to (302) 677-7066 or (302) 739-1124.
Contact SCPD by phone at (302) 739-3621 or (302) 739-3620 to speak with Director John McNeal or by email to SCPDBrainInjuryFund@delaware.gov or contact the Director at John.McNeal@delaware.gov for additional information.
Medical Information Release Form (Required)