REPORT TITLE:
Traumatic Brain Injury Fund
DESCRIPTION:
Creates traumatic brain injury (TBI) trust fund under the control
of the traumatic brain injury board to disburse moneys, with the
concurrence of the director of health, for programs relating to
victims of TBI. Establishes the TBI Contribution. (HB2160 CD1)
2160
HOUSE OF REPRESENTATIVES H.B. NO. H.D. 2
TWENTIETH LEGISLATURE, 2000 S.D. 2
STATE OF HAWAII C.D. 1
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A BILL FOR AN ACT
RELATING TO THE TRAUMATIC BRAIN INJURY TRUST FUND.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
1 SECTION 1. The legislature finds that every year one
2 million nine hundred thousand Americans experience traumatic
3 brain injury. About half of these cases result in short-term
4 disability. Of traumatic brain injury survivors, seventy
5 thousand to ninety thousand endure lifelong debilitating losses
6 of function.
7 Traumatic brain injury is defined as an insult to the brain
8 that is not degenerative or inherited and that is caused by an
9 external physical force that produces:
10 (1) A diminished or altered state of consciousness which
11 results in an impairment of cognitive abilities or
12 physical functioning; and
13 (2) Disturbances of behavioral and emotional functioning.
14 The legislature further finds that physical consequences of
15 brain injury include impairment of speech, vision and hearing
16 loss, headaches, muscle spasticity, paralysis, and seizure
17 disorders.
18 Cognitive consequences of brain injury include memory
19 deficit, limited concentration, impaired perception and
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1 communication, and difficulties with reading, writing, planning,
2 and judgment.
3 Psychosocial-behavioral-emotional consequences of brain
4 injury include fatigue, mood swings, denial, anxiety, depression,
5 lack of motivation, and decreased social skills.
6 Advances in neurosurgery and rehabilitation therapy have
7 dramatically increased the number of individuals who survive
8 traumatic brain injury and have made the hope of returning to the
9 community more realistic. However, little has been done to
10 assist traumatic brain injury survivors to adjust to life after
11 the injury.
12 The average medical cost for a three- to six-month initial
13 hospitalization for traumatic brain injury is $75,000. The
14 survivor of a severe brain injury typically faces five to ten
15 years of intensive treatment at an estimated cost in excess of
16 $4,000,000. Nationally, the direct medical costs for treatment
17 of traumatic brain injury have been estimated at more than
18 $4,000,000,000 per year. The total economic costs of brain
19 injury have been estimated to approach $25,000,000,000 per year.
20 In Hawaii, the Hawaii health systems corporation estimates
21 that twelve hundred people are discharged annually from Hawaii's
22 hospitals with traumatic brain injury. Currently, Hawaii lacks a
23 system that provides, manages, and monitors services for
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1 individuals with traumatic brain injuries and effective and
2 affordable treatment and rehabilitation programs are not
3 available. Support programs for family members and caregivers
4 are also lacking.
5 The purpose of this Act is to establish a dedicated trust
6 fund to:
7 (1) Provide services relating to traumatic brain injuries,
8 including programs to educate the public about
9 prevention of traumatic brain injuries, public health
10 consequences of traumatic brain injuries, and services
11 needed to treat and rehabilitate people who are victims
12 of traumatic brain injuries;
13 (2) Train and educate professionals involved with
14 individuals with traumatic brain injuries; and
15 (3) Fund research, evaluation, and advocacy activities to
16 identify cost-effective strategies to meet the needs of
17 traumatic brain injury survivors and their families to
18 reduce the outlay of federal and state dollars under
19 medicaid.
20 SECTION 2. The Hawaii Revised Statutes is amended by adding
21 a new chapter to be appropriately designated and to read as
22 follows:
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1 "CHAPTER
2 TRAUMATIC BRAIN INJURY
3 § -1 Definitions. As used in this chapter, unless the
4 context requires otherwise:
5 "Board" means the traumatic brain injury board established
6 under section 321-28.
7 "Traumatic brain injury" means an insult to the brain that
8 is not degenerative or inherited and that is caused by an
9 external physical force that produces:
10 (1) A diminished or altered state of consciousness which
11 results in an impairment of cognitive abilities or
12 physical functioning; and
13 (2) Disturbances of behavioral and emotional functioning.
14 § -2 Traumatic brain injury trust fund.(a) There is
15 created in the state treasury the traumatic brain injury trust
16 fund as a separate fund in the state treasury. The traumatic
17 brain injury board established under section 321-28 shall have
18 custody of the trust fund and shall credit to the trust fund all
19 amounts transferred to the fund and shall invest the trust fund
20 moneys in the same manner as authorized for investing other
21 moneys in the state treasury.
22 (b) The board may, with the approval of the director of
23 health, authorize the disbursement of available moneys from the
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1 trust fund for the purpose of funding services relating to
2 traumatic brain injuries, including:
3 (1) Programs to educate the public about:
4 (A) Prevention of traumatic brain injuries;
5 (B) Public health consequences of traumatic brain
6 injuries; and
7 (C) Services needed to treat and rehabilitate people
8 who are victims of traumatic brain injuries;
9 (2) Programs to train and educate professionals involved
10 with individuals with traumatic brain injuries;
11 (3) Programs to fund research, evaluation, and advocacy
12 activities to identify cost-effective strategies to
13 meet the needs of traumatic brain injury survivors and
14 their families; and
15 (4) Necessary administrative expenses to carry out the
16 purposes of this chapter.
17 (c) Moneys collected under section 286- shall be
18 deposited into the trust fund. The board may also accept federal
19 funds granted by Congress or executive order for the purposes of
20 this chapter, as well as gifts and donations from individuals,
21 private organizations, or foundations. The acceptance and use of
22 federal funds shall not commit state funds for services and shall
23 not place an obligation upon the legislature to continue the
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1 purposes for which the federal funds are made available. All
2 funds received in the manner described in this section shall be
3 transmitted to the board for deposit into the trust fund to be
4 disbursed as other moneys in the trust fund."
5 SECTION 3. Chapter 286, Hawaii Revised Statutes, is amended
6 by adding a new section to be appropriately designated and to
7 read as follows:
8 "§286- Traumatic brain injury contribution.
9 Notwithstanding any law to the contrary, beginning July 1, 2000,
10 donations may be collected upon designation by an individual or
11 entity from the initial issuance of a driver's license and each
12 subsequent renewal, to be deposited on a quarterly basis into the
13 traumatic brain injury trust fund pursuant to section -2."
14 SECTION 4. Section 321-28, Hawaii Revised Statutes, is
15 amended to read as follows:
16 "[[]§321-28 Traumatic brain injury [advisory] board.[]]
17 (a) There is established within the department of health the
18 traumatic brain injury [advisory] board. The [advisory] board
19 shall [advise]:
20 (1) Advise the department in the development and
21 implementation of a comprehensive plan to address the
22 needs of persons [affected by disorders and
23 disabilities that involve the brain. Further, the
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1 advisory board shall advise] with traumatic brain
2 injury;
3 (2) Advise the department of the feasibility of
4 establishing agreements with private sector agencies to
5 develop services for persons with brain injuries[.];
6 (3) With the approval of the director of health, have
7 jurisdiction and control over the traumatic brain
8 injury trust fund established in section -2 and
9 authorize disbursement of moneys from the trust fund
10 for the purposes of chapter and do all things as
11 authorized under section -2;
12 (4) Maintain records of:
13 (A) All expenditures of the traumatic brain injury
14 trust fund;
15 (B) Moneys received as gifts and donations to the
16 trust fund; and
17 (C) Disbursements made from the trust fund;
18 (5) Provide the legislature with an annual accounting of
19 activity in the traumatic brain injury trust fund no
20 later than twenty days prior to the convening of each
21 regular session; and
22 (6) Adopt rules in accordance with chapter 91 to carry out
23 the purposes of this section and of chapter .
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1 (b) The [advisory] board shall consist of nine members who
2 shall be appointed by the director of health in accordance with
3 section 26-35. The director of health shall designate a member
4 to be the chairperson of the [advisory] board. The director of
5 health or a designee shall serve as an ex officio nonvoting
6 member of the [advisory] board. The members shall serve for a
7 term of four years; provided that upon the initial appointment of
8 the members, two shall be appointed for a term of one year, two
9 for a term of two years, two for a term of three years, and three
10 for a term of four years. In establishing the [advisory] board,
11 the director of health shall appoint at least:
12 (1) Two members representing private sector businesses that
13 provide services for brain injured persons;
14 (2) Two survivors of traumatic brain injury; and
15 (3) One member representing trauma centers that provide
16 services for brain injured persons.
17 (c) The members shall serve without compensation but shall
18 be reimbursed for actual expenses, including travel expenses,
19 that are necessary for the performance of their duties."
20 SECTION 5. Statutory material to be repealed is bracketed.
21 New statutory material is underscored.
22 SECTION 6. This Act shall take effect on July 1, 2000.