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The state of West Virginia is seeking a federal Medicaid waiver so it can offer a program that will help people with traumatic brain injuries (TBI) remain in their homes, rather than forcing them into nursing homes or other facilities.

Earlier last month, the West Virginia state Supreme Court upheld a County Circuit Court ruling that issued a requirement that the Department of Health and Human Resources had to seek the waiver from the federal entity and that they had to get funding for the program.

A DHHR spokesman told a Lawyer that the program will begin when the federal Centers for Medicare and Medicaid Services approves the waiver. Though the agency can’t pinpoint when the waiver will be approved, they did say it plans to provide services to 75 people in the first year, 100 in the second year, and 125 at the third year of the program.

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War, while terrible, can often bring many innovations, such as new medical concepts, according to sources. A committee of British clinical neurosurgeons in World War II sought to develop a standardized terminology for states of impaired consciousnessand published a glossary of their work. This committee included several preeminent neurosurgeons and others were quick to adopt their terminology. The original publication did not have a graded scale of levels of consciousness, but the glossary was used to help build such a scale. Eventually, the Glasgow Coma Scale was created in 1974.

The GCS has been used for decades and has become a widely-accepted way of measuring consciousness, studies have learned. There are some who do not like some of the details of this scale, however, and the way it is used has changed since its first implementation. Differing levels of stimulus and response were experimented with in an effort o create a universal scale that most physicians could agree upon.

Criteria such as sensitivity to pain, reflexes, and eye motion were all taken into account. Eventually, it came to be understood that all patients with a GCS score of 7 or less were comatose, while many with a score of 8 could also be called comatose, with the maximum score being 15, at fully unimpaired consciousness. doctors in The Bronx and Brooklyn have learned the final value of the GCS is in early evaluation of the primary effects of a head impact, and it helps to track the progress of an injury in order to treat any complications that might arise.

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