Video Series: How Brain Injury Advocates Can Engage with Medicaid Policy
The National Association of State Head Injury Administrators (NASHIA), with funding from The Grassroots Project, is pleased to share a new seven-part video series focused on Medicaid advocacy.
Medicaid policies can significantly affect whether people with brain injury can access the services and supports they need. However, the policymaking process can often feel complicated or difficult to navigate. This series makes advocacy more approachable by explaining key Medicaid issues, introducing practical ways to participate, and showing how lived experience and data can help influence decisions.
Consensus Statement on Traumatic Brain Injury in First Responders: The 1st International Conference on TBI in First Responders
A major milestone for brain injury awareness and care: the first international consensus recommendations for traumatic brain injury (TBI) in first responders are now published. Developed by an interdisciplinary team of researchers, clinicians, first responders, people with lived experience, and policy and organizational experts, this work establishes an important foundation for recognizing, treating, and preventing brain injuries among law enforcement, firefighters, and EMS personnel. NASHIA contributed brain injury subject matter expertise as co-authors and helped design and facilitate the Delphi consensus process that brought experts together to develop and refine the recommendations.
Considerations for Working with Individuals with Brain Injury: A Guide for Employment Service Providers
Employment is more than what we do; for many, it is our identity. Additionally, the employment of people with disabilities is seen not only as a civil rights issue but also as a practical factor for business. However, in 2020, the US Bureau of Labor Statistics reported that 17.9 percent of individuals with a disability were employed, down from 19.3 percent in 2019. For those without a disability, 61.8 percent were employed in 2020, down from 66.3 percent in 2019. Unemployment rates for persons with and without a disability both increased from 2019 to 2020, to 12.6 percent and 7.9 percent, respectively. Data on both groups for 2020 reflect the impact of the coronavirus (COVID-19) pandemic and efforts to contain it. But the numbers are vastly different between the two groups, and there is a critical need to shrink that gap.
A methodological examination of intimate partner violence-related traumatic brain injury in a national panel survey
A new study featuring NASHIA staff as first author evaluates whether national online surveys can effectively measure how often intimate partner violence (IPV) results in traumatic brain injury (TBI). Analyzing responses from over 8,700 U.S. adults in the CDC's Rapid Surveys System, researchers found that an estimated 6.0% of all U.S. adults have experienced an IPV-related TBI in their lifetime, demonstrating that internet panel surveys are a viable method for capturing the scope, symptoms, and medical response to these injuries. Overall, the results indicate that millions of Americans - disproportionately women - are affected, yet the vast majority go without a medical evaluation due to underestimating the severity of the injury or being actively blocked from seeking care by an abusive partner.
Disparities in traumatic brain injury-related deaths — United States, 2023
A new study featuring NASHIA staff as co-author examined the nearly 69,000 TBI-related deaths in 2023 and found important differences by age, sex, race and ethnicity, and cause of injury. Overall, suicide and unintentional falls were the leading contributors to TBI-related deaths, while older adults, males, and American Indian/Alaska Native people experienced the highest rates. The findings also show that the causes of TBI-related deaths vary considerably across different populations.
Making Brain Injury Data Work
There are myriad data sources available to brain injury programs. These sources can help:
Determine just how common brain injury is in your state.
Discover how many people are living with long-term effects of brain injury.
Assist in program and resource planning.
However, sometimes it is difficult to know where to start. Which types of data are most common? How can you access them? How can you use the different types? This short guide is meant to help you answer some of those questions to ensure that the data that are available to you are making a difference.
Exploring the New 1915(c)(11) Waiver Opportunity: What States Should Consider and How NASHIA Can Help
A new Medicaid 1915(c)(11) waiver authority (effective July 1, 2028) lets states serve people with brain injury who don't meet an institutional level of care — a population that often falls through the cracks of existing HCBS eligibility pathways. This resource outlines key factors states should weigh and how NASHIA can help with waiver design, stakeholder engagement, and preparation for the CMS application process.
Considerations for States and Partners in Implementing Medicaid Community Engagement Requirements for People with Brain Injury
Medicaid community engagement requirements require certain beneficiaries to participate in qualifying activities, such as work, education, job training, or community service, or to qualify for an exemption.
This resource outlines considerations for states and partners in implementing these requirements in ways that recognize how brain injury may affect memory, communication, organization, behavior, and the ability to navigate complex systems.
Cross-System Strategies to Support Children with Complex Behavioral Health Conditions
NASHIA is excited to join our partners with the Link Center, the National Association of State Directors of Developmental Disabilities Services (NASDDDS), and NADD, in announcing the release of a new groundbreaking publication, Cross-System Strategies to Support Children with Complex Behavioral Health Conditions, authored by Nancy Thaler with contributions from Stacy L. Nonnemacher, PhD. This important resource responds directly to one of the most urgent challenges facing states and families: how to better support children with complex behavioral health needs who are often served across multiple systems, including behavioral health, child welfare, Medicaid, developmental disabilities, acquired brain injury, education, and juvenile justice.
Motivational Interviewing and Brain Injury: A Guide to Supporting Change in the Criminal Legal System
Developed for Community Supervision Officers and other professionals across the criminal legal system, this resource provides an overview of brain injury, screening considerations, and practical applications of motivational interviewing when working with individuals who have experienced a brain injury. It is intended to complement, not replace, formal motivational interviewing training.
Brain Injury After Overdose Toolkit
This toolkit is intended for deflection teams, first responders, and partners involved in post-overdose response. It provides practical guidance for identifying potential brain injury after overdose and adjusting outreach, communication, and expectations to reduce harm and support engagement.
TBI Clinical Common Data Elements v3.0
The National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH) assembled an external working group of international subject matter experts to update the Traumatic Brain Injury v2.0 Common Data Elements (CDEs) based on user feedback and research advances.
The Art and Science of Medicaid Budget Forecasting
NAMD's newest brief explores how states navigate one of their most consequential and most complex fiscal responsibilities. Drawing on interviews with state Medicaid agency financial leaders, The Art and Science of Medicaid Budget Forecasting examines how states build and refine expenditure forecasts, the complexities introduced by new policy, public health events, and data gaps, and innovations states are using to improve accuracy and manage uncertainty.
Peer Support Best Practices for Working with Individuals with Brain Injury
This brain injury curriculum package is designed for professionals and individuals working in peer support, recovery, and behavioral health settings. This curriculum offers flexible, user-friendly resources to build knowledge and improve engagement for individuals with brain injury in these peer support settings.
Brain Injury Resource Facilitation Implementation Guide
In 2023, the National Association of State Head Injury Administrators (NASHIA) - funded by the Moody Endowment - led a Delphi Consensus process with national brain injury leaders, resulting in Brain Injury Resource Facilitation: A Consensus on Best Practices (the “Consensus” report). In 2024, Moody Endowment provided additional funding to NASHIA to establish the Moody Center for Brain Injury Best Practices. The first two-year cohort used the Consensus findings to develop this implementation guide.
Helping to Heal: Conversations About Trauma Informed Principles
This toolkit of videos, infographics, audio files, and transcripts representing key principles of a trauma-informed approach (as outlined in SAMHSA guidance) offers simple tips and strategies from people with lived experience of both trauma and disability to help you better support family members, friends, clients, or patients.
Engaging Service Members, Veterans, and Families: A Toolkit for Certified Community Behavioral Health Clinics
This toolkit is designed to help Certified Community Behavioral Health Clinics (CCBHCs) identify service members, veterans, and their families (SMVF) receiving services, understand military/veteran experiences, and apply this knowledge while providing mental health and substance use services under the CCBHC model of care.
Exploring Risks of Repeated Head Impacts in Youth and Strategies to Minimize Exposure: Proceedings of a Workshop
Traumatic brain injury (TBI) can have lasting physical, cognitive, and emotional health effects that extend well beyond the initial event. In March 2025, the National Academies' Forum on Traumatic Brain Injury convened a workshop to explore TBI as a chronic condition and to identify opportunities to improve lifelong care.
Participants examined evidence supporting the classification of TBI as a chronic condition, explored the biological mechanisms that drive long-term outcomes, and discussed the complex comorbidities that can persist or emerge years after injury. Lived experience perspectives shared throughout the workshop underscored the human impact of these issues and the importance of sustained, multidisciplinary support for recovery and well-being. This Proceedings of a Workshop summarizes presentations and discussions from the workshop.
Strong Infrastructure Components for Brain Injury (BI): State Self-Assessment Tool & Implementation Guide
Building a strong state infrastructure takes time, effort, and planning from many individuals and organizations. There are several key components necessary to create a comprehensive state system of services, partners, funding, and policy. Infrastructure building is a process and requires routine assessment, regardless of the level achieved. This tool, Strong Infrastructure Components for Brain Injury (BI): State Self-Assessment Tool, produced by ACL's Traumatic Brain Injury (TBI) Technical Assistance and Resource Center (TARC) was created to assist BI partners and collaborators in determining which level best describes their state’s progress, and to give some guidance to what a more comprehensive system could include. It is designed to be a guide, and states should consider re-assessing routinely, or at various points to assist in state planning efforts, such as conducting a new needs assessment, developing, or updating a state plan, or applying for a grant opportunity.
Map of TBI Death Rates, 2023
This map shows state-level rates of traumatic brain injury (TBI)-related deaths in 2023. NASHIA members can use these data to raise awareness of the burden of TBI in their state, inform prevention and service planning, strengthen funding proposals, and compare outcomes across states. Understanding where TBI deaths are highest helps guide strategies to improve brain injury prevention, care, and supports for survivors and families.
Also included are ways for NASHIA members and the brain injury community to action these data.
NASHIA would like to thank Dr. Dana Waltzman from Indiana University School of Medicine for working with us on this infographic.