Requires hospitals to include in discharge planning for brain insult patients, an evaluation for treatment in a state certified acute rehabilitation unit

Title of bill

An act to amend the public health law, in relation to discharge planning for patients diagnosed with moderate to severe brain insult

Purpose

This bill amends the Public Health Law regarding discharge planning for traumatic brain injury patients.

This bill instructs the commissioner to require general hospitals to include evaluation for admission to a State certified Traumatic Brain Injury unit in the discharge planning for traumatic brain injury patients. Any patient with acute acquired brain injury, including closed and open head injuries, stroke, anoxia, brain tumors and other neurological problems, accompanied by cognitive deficits or behavioral modification issues, should be evaluated for admission into an acute Rehabilitation/Coma Recovery Program in one of the designated Traumatic Brain Injury Units as an alternative to admission to standard sub-acute rehabilitation in specialized nursing homes.

Summary of provisions

Section 1 adds new subdivision 8-a to Section 2803-i of the public health law.

Section 2 establishes the effective date as 30 days after the act becomes law.

Existing law

JUSTIFICATION : Traumatic brain injury is operationally defined as "damage to brain tissue caused by external mechanical forces as evidenced by at least one of the following: loss of consciousness; post-traumatic amnesia; skull fracture; objective neurological findings of brain trauma." (TBIMS, 2003) According to the National Institute on Disability and Rehabilitation Research, the ideal system of care for traumatic brain injury "should demonstrate coordinated, cost effective neurotrauma and rehabilitation services to maximize recovery and reintegration through early effective and efficient intervention, a sophisticated multi-disciplinary team of TBI professionals, and support services available in the community to facilitate optimal level of physical and psychosocial functioning."

Designated traumatic brain injury units provide specialized acute rehabilitation programs for individuals with acquired brain injuries. Because the medical, physical, cognitive and emotional problems that can result from brain injury are extremely complex, individualized assessment and treatment is vital. Designated TBI units provide interdisciplinary teams of psychiatrists specialized in brain injury rehabilitation and neuropsychologists, who can provide cognitive guidance.

Rehabilitation in TBI units is significantly more intensive than sub-acute rehabilitation in nursing homes, both in terms of the quality and variety of rehabilitation services available and the times per day these services are offered to patients.

Acute rehabilitation programs for traumatic brain injuries are currently available in all five NYC boroughs, Long Island, Binghamton, Schenectady, Syracuse, Rochester, and Buffalo, as well as several other locations throughout New York State. However, many physicians and social workers who work on the discharge planning ofTBI patients are not aware of these options and their benefits. Some hospitals discharge patients only to specialized nursing homes, which provide long-term sub-acute rehabilitation programs for head-injured patients. For example, the five designated TBI units in New York City, despite their advantages in terms of quality of care and long-term cost effectiveness, are not operating at capacity.

Legislative history

2007-2008: S.1975 - Referred to Health 2006: S.6949 - Referred to Health

Local fiscal implications

EFFECTIVE DATE : 30 days after enactment.