stances for persons with TBI. It appears that P&A systems for people with disabilities in the states have begun to focus on TBI significantly for the first time. To evaluate the impact of the PATBI Grants, HRSA should collect data on P&A systems TBI-related activities. In addition, HRSA should ensure that people with TBI-related disabilities and their families are aware of P&A services in their communities.

Further progress in the development of TBI systems and services in the states will be elusive if HRSA does not address the program’s fundamental need for greater leadership, data systems, additional resources, and improved coordination among federal agencies. It is worrisome that the modestly budgeted HRSA TBI Program has been vulnerable to budget cuts. The states are now at a critical stage and will need continue federal support if they are to build an effective, durable service system for meeting the needs of individuals with TBI and their families. The state TBI programs will find it difficult to maintain the momentum of HRSA grant-funded TBI activities when the HRSA funds run out. The HRSA TBI Program should be a priority for HRSA.

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