(1) The board shall determine the percentage of moneys credited to the trust fund to be spent annually on direct services for persons with traumatic brain injuries; however, no less than fifty-five percent of the moneys annually credited to the trust fund pursuant to sections 30-15-402 (3), 42-4-1307 (10)(c), and 42-4-1701 (4)(e), C.R.S., shall be used to provide direct services to persons with traumatic brain injuries.

(2) To be eligible for assistance from the trust fund, an individual shall have exhausted all other health or rehabilitation benefit funding sources that cover the services provided by the trust fund. An individual shall not be required to exhaust all private funds in order to be eligible for the program. Individuals who have continuing health insurance benefits, including, but not limited to, medical assistance pursuant to articles 4, 5, and 6 of title 25.5, C.R.S., may access the trust fund for services that are necessary but that are not covered by a health benefit plan, as defined in section 10-16-102 (32), C.R.S., or any other funding source.

(3) (a) All individuals receiving assistance from the trust fund shall receive case management services from the designated entity pursuant to section 26-1-303 or the department.

(b) The case management agency, in coordination with the eligible individual, the individual's family or guardian, and the individual's physician, shall include in each case plan a process by which the eligible individual may receive necessary care, which may include respite care, if the eligible individual's service provider is unavailable due to an emergency situation or unforeseen circumstances. The eligible individual and the individual's family or guardian shall be duly informed by the case management agency of these alternative care provisions at the time the case plan is initiated.

(4) The board may monitor, and, if necessary, implement criteria to ensure that there are no abuses in expenditures, including, but not limited to, reasonable and equitable provider's fees and services.

(5) (a) Services covered by the trust fund may include, but shall not be limited to:

(I) Case management;

(II) Community residential services;

(III) Structured day program services;

(IV) Psychological and mental health services for the individual with the traumatic brain injury and the individual's family;

(V) Prevocational services;

(VI) Supported employment;

(VII) Companion services;

(VIII) Respite care;

(IX) Occupational therapy;

(X) Speech and language therapy;

(XI) Cognitive rehabilitation;

(XII) Physical rehabilitation; and

(XIII) One-time home modifications.

(b) Covered services shall not include institutionalization, hospitalization, or medications.