REPORT TITLE:
TBI Trust Fund


DESCRIPTION:
Creates traumatic brain injury trust fund commission/trust fund
to disburse moneys to applicants for care and rehabilitative
services for traumatic brain injury victims.  Assesses fines, for
deposit into the fund, of 10% of original fines for traffic code
violations and operation of motor vehicles violations.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        
THE SENATE                              S.B. NO.           2654
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
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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 1.9
 
 2 million Americans experience traumatic brain injury.  About half
 
 3 of these cases result in short-term disability.  Of traumatic
 
 4 brain injury survivors, seventy thousand to ninety thousand
 
 5 endure lifelong debilitating losses of function.
 
 6      Traumatic brain injury is defined as an insult to the brain
 
 7 that is not degenerative or inherited and that is caused by an
 
 8 external physical force that produces a diminished or altered
 
 9 state of consciousness, which results in an impairment of
 
10 cognitive abilities or physical functioning, and disturbances of
 
11 behavioral and emotional functioning.
 
12      The legislature further finds that physical consequences of
 
13 brain injury include impairment of speech, vision and hearing
 
14 loss, headaches, muscle spasticity, paralysis, and seizure
 
15 disorders.  Cognitive consequences of brain injury include memory
 
16 deficit, limited concentration, impaired perception and
 
17 communication, and difficulties with reading, writing, planning,
 
18 and judgment.  Psychosocial-behavioral-emotional consequences of
 
19 brain injury include fatigue, mood swings, denial, anxiety,
 

 
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 1 depression, lack of motivation, and decreased social skills.
 
 2      Advances in neurosurgery and rehabilitation therapy have
 
 3 dramatically increased the number of individuals who survive
 
 4 traumatic brain injury and have made the hope of returning to the
 
 5 community more realistic.  However, little has been done to
 
 6 assist traumatic brain injury survivors to adjust to life after
 
 7 the injury.  The average medical cost for a three- to six-month
 
 8 initial hospitalization for traumatic brain injury is $75,000.
 
 9 The survivor of a severe brain injury typically faces five to ten
 
10 years of intensive treatment at an estimated cost in excess of
 
11 $4,000,000.  Nationally, the direct medical costs for treatment
 
12 of traumatic brain injury have been estimated at more than
 
13 $4,000,000,000 per year.  The total economic costs of brain
 
14 injury have been estimated to approach $25,000,000,000 per year.
 
15      In Hawaii, the Hawaii health systems corporation estimates
 
16 that twelve hundred people are discharged annually from Hawaii's
 
17 hospitals with traumatic brain injury.  Currently, Hawaii lacks a
 
18 system that provides, manages, and monitors services for
 
19 individuals with traumatic brain injuries, and effective and
 
20 affordable treatment and rehabilitation programs are not
 
21 available.  Support programs for family members and caregivers
 
22 are also lacking.
 
23      The purpose of this Act is to establish a dedicated trust
 

 
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 1 fund to help defray the costs of treating brain injuries.
 
 2      SECTION 2.  The Hawaii Revised Statutes is amended by adding
 
 3 a new chapter to be appropriately designated and to read as
 
 4 follows:
 
 5                             "CHAPTER
 
 6                 TRAUMATIC BRAIN INJURY TRUST FUND
 
 7      §   -1 Definitions.  As used in this chapter, unless the
 
 8 context requires otherwise:
 
 9      "Authority" means the traumatic brain injury trust fund
 
10 authority.
 
11      "Trust fund" means the traumatic brain injury trust fund.
 
12      §   -2 Traumatic brain injury trust fund commission;
 
13 established.(a)  There is established the traumatic brain
 
14 injury trust fund commission which shall be placed within the
 
15 department of health for administrative purposes only.  The
 
16 commission shall be headed by a board of directors.
 
17      (b)  The board shall consist of nine members who shall be
 
18 appointed by the governor in accordance with section 26-34.  The
 
19 members shall be as follows:
 
20      (1)  The director of health, or designee, as a member ex
 
21           officio;
 
22      (2)  The director of human resources, or designee, as a
 
23           member ex officio;
 

 
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 1      (3)  The superintendent of education, or designee, as a
 
 2           member ex officio;
 
 3      (4)  Three individuals who have sustained brain or spinal
 
 4           cord injury or members of these persons' immediate
 
 5           families; and
 
 6      (5)  Three members nominated by the Hawaii Medical
 
 7           Association who have experience in rehabilitation of
 
 8           victims of traumatic brain injury.
 
 9      (c)  Except for ex officio members, members shall serve for
 
10 a term of two years, except that of the members initially
 
11 appointed under paragraphs (4) and (5), two members shall serve
 
12 for three years, two members shall serve for two years, and two
 
13 members shall serve for one year.
 
14      (d)  The director of health shall serve as chairperson.  The
 
15 members shall elect from among themselves a vice chairperson and
 
16 treasurer.
 
17      (e)  A member whose term has expired may continue in office
 
18 as a holdover member until a successor is elected; provided that
 
19 the holdover shall not hold office beyond the end of the second
 
20 regular legislative session following the expiration of the
 
21 member's term.
 
22      (f)  Vacancies occurring before the expiration of a member's
 
23 term shall be filled in the same manner as the original
 

 
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 1 appointments.  Individuals elected to fill a vacancy shall serve
 
 2 only for the remainder of the unexpired term.
 
 3      (g)  If four vacancies exist at any one time, no remaining
 
 4 member shall resign until at least one vacancy has been filled in
 
 5 accordance with this section.
 
 6      (h)  Five members shall constitute a quorum, whose
 
 7 affirmative vote shall be necessary for all actions by the board.
 
 8      (i)  Members shall serve without compensation, but may be
 
 9 reimbursed for the necessary expenses, including travel expenses,
 
10 incurred in the performance of their duties.
 
11      §   -3 Meetings; notice; open to public.  (a)  The board
 
12 shall hold regular meetings at least once every two months and
 
13 shall keep records and minutes for all regular and special
 
14 meetings pursuant to chapter 92.
 
15      (b)  Either the chairperson or any five members may convene
 
16 a special meeting by notifying the entire membership of the board
 
17 in writing of the time and place of the special meeting.  The
 
18 chairperson or the five members shall give the written notice at
 
19 least seven calendar days or at least ten calendar days,
 
20 respectively, prior to the date of the special meeting.  A
 
21 special meeting may be convened with the concurrence of the
 
22 entire membership of the board.
 
23      (c)  All board meetings shall be open to the public pursuant
 

 
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 1 to chapter 92.  However, when it is necessary for the board to
 
 2 receive information that is proprietary or confidential, the
 
 3 board may enter into closed executive session.
 
 4      §   -4  Powers and duties.  (a)  The commission shall:
 
 5      (1)  Adopt rules in accordance with chapter 91 to carry out
 
 6           the purposes of this chapter, including:
 
 7           (A)  Eligibility of applicants to receive disbursements
 
 8                from the trust fund;
 
 9           (B)  Manner of application for disbursement of moneys
 
10                from the trust fund;
 
11           (C)  Manner of review of applications;
 
12           (D)  Criteria for award of disbursements from the trust
 
13                fund;
 
14           (E)  Conditions for the use of moneys disbursed such as
 
15                specification of the types of services that the
 
16                disbursed moneys may be used to pay for; and
 
17           (F)  Limits, if any, to the amounts of disbursements to
 
18                be awarded;
 
19      (2)  Accept applications for and award disbursements of
 
20           available money from the trust fund for the purposes of
 
21           this chapter;
 
22      (3)  Maintain records of all expenditures of the commission,
 
23           funds received as gifts and donations, and
 

 
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 1           disbursements made from the trust fund; and
 
 2      (4)  Employ staff, exempt from chapters 76 and 77, that the
 
 3           commission deems necessary to carry out the purposes of
 
 4           this chapter; provided that the commission shall
 
 5           utilize existing state resources and staff of the
 
 6           departments of human services, education, and health,
 
 7           to the greatest extent practicable.
 
 8      (b)  The commission shall recommend to the governor and the
 
 9 legislature changes in state programs, statutes, policies,
 
10 budgets, and standards relating to the care and rehabilitation of
 
11 persons with brain or spinal cord injuries, improve coordination
 
12 among state agencies that provide care and rehabilitative
 
13 services, and improve the condition of residents who are in need
 
14 of rehabilitative services.
 
15      §   -5  Traumatic brain injury trust fund.(a)  There is
 
16 created in the state treasury the traumatic brain injury trust
 
17 fund as a separate fund in the state treasury.  The director of
 
18 finance shall have custody of the trust fund and shall credit to
 
19 the trust fund all amounts transferred to the fund and shall
 
20 invest the trust fund moneys in the same manner as authorized for
 
21 investing other moneys in the state treasury.
 
22      (b)  The commission may authorize the disbursement of
 
23 available money from the trust fund for purposes of providing
 

 
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 1 care and rehabilitative services to residents of the State who
 
 2 have survived a traumatic brain or spinal cord injury.
 
 3      (c)  The trust fund shall be funded by fines collected
 
 4 pursuant to sections 291-    and 291C-161(f).  The commission may
 
 5 also accept federal funds granted by Congress or executive order
 
 6 for the purposes of this chapter, as well as gifts and donations
 
 7 from individuals, private organizations, or foundations.  The
 
 8 acceptance and use of federal funds shall not commit state funds
 
 9 and shall not place an obligation upon the legislature to
 
10 continue the purposes for which the federal funds are made
 
11 available.  All funds received in the manner described in this
 
12 section shall be transmitted to the director of finance for
 
13 deposit into the trust fund to be disbursed as other moneys in
 
14 the trust fund.
 
15      §   -6 Traumatic brain injury advisory board.(a)  There
 
16 is established within the department of health the traumatic
 
17 brain injury advisory board.  The advisory board shall advise the
 
18 department and the traumatic brain injury trust fund commission:
 
19      (1)  In the development and implementation of a
 
20           comprehensive plan to address the needs of persons
 
21           affected by disorders and disabilities that involve the
 
22           brain; and
 
23      (2)  Of the feasibility of establishing agreements with
 

 
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 1           private sector agencies to develop services for persons
 
 2           with brain injuries.
 
 3      (b)  The advisory board shall consist of nine members who
 
 4 shall be appointed by the director of health in accordance with
 
 5 section 26-35.  The director of health shall designate a member
 
 6 to be the chairperson of the advisory board.  The director of
 
 7 health or a designee shall serve as an ex officio nonvoting
 
 8 member of the advisory board.  The members shall serve for a term
 
 9 of four years; provided that upon the initial appointment of the
 
10 members, two shall be appointed for a term of one year, two for a
 
11 term of two years, two for a term of three years, and three for a
 
12 term of four years.  In establishing the advisory board, the
 
13 director of health shall appoint at least:
 
14      (1)  Two members representing private sector businesses that
 
15           provide services for brain injured persons;
 
16      (2)  Two survivors of traumatic brain injury; and
 
17      (3)  One member representing trauma centers that provide
 
18           services for brain injured persons.
 
19      (c)  Members shall serve without compensation but shall be
 
20 reimbursed for actual expenses, including travel expenses, that
 
21 are necessary for the performance of their duties."
 
22      SECTION 3.  Chapter 291, Hawaii Revised Statutes, is amended
 
23 by adding a new section to part I to be appropriately designated
 

 
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                                     S.B. NO.           2654
                                                        
                                                        

 
 1 and to read as follows:
 
 2      "§291-     Fines; traumatic brain injury trust fund.  In
 
 3 addition to any fines imposed under this chapter, every person
 
 4 who violates part I shall be fined an additional ten per cent of
 
 5 the amount of the original fine, which shall be deposited into
 
 6 the traumatic brain injury trust fund under chapter     ."
 
 7      SECTION 4.  Section 291C-161, Hawaii Revised Statutes, is
 
 8 amended to read as follows:
 
 9      "§291C-161  Penalties.(a)  It is a violation for any
 
10 person to violate any of the provisions of this chapter except as
 
11 otherwise specified in subsection (c) [of this section] and
 
12 unless the violation is by other law of this State declared to be
 
13 a felony, misdemeanor, or petty misdemeanor.
 
14      (b)  Except as provided in subsection (c) every person who
 
15 violates any provision of this chapter for which another penalty
 
16 is not provided shall be fined:
 
17      (1)  Not more than $200 for a first conviction thereof;
 
18      (2)  Not more than $300 for conviction of a second offense
 
19           committed within one year after the date of the first
 
20           offense; and
 
21      (3)  Not more than $500 for conviction of a third or
 
22           subsequent offense committed within one year after the
 
23           date of the first offense;
 

 
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 1 provided that upon a conviction for a violation of section
 
 2 291C-12, 291C-12.5, 291C-12.6, or 291C-95, the person shall be
 
 3 sentenced in accordance with that section.
 
 4      (c)  Every person who violates section 291C-13 or 29lC-18
 
 5 shall:
 
 6      (1)  Be fined not more than $200 or imprisoned not more than
 
 7           ten days for a first conviction thereof;
 
 8      (2)  Be fined not more than $300 or imprisoned not more than
 
 9           twenty days or both for conviction of a second offense
 
10           committed within one year after the date of the first
 
11           offense; and
 
12      (3)  Be fined not more than $500 or imprisoned not more than
 
13           six months or both for conviction of a third or
 
14           subsequent offense committed within one year after the
 
15           date of the first offense.
 
16      (d)  The court may assess a sum not to exceed $50 for the
 
17 cost of issuing a penal summons upon any person who fails to
 
18 appear at the place within the time specified in the citation
 
19 issued to the person for any traffic violation.
 
20      (e)  The court may require a person who violates any of the
 
21 provisions of this chapter to attend a course of instruction in
 
22 driver retraining as deemed appropriate by the court, in addition
 
23 to an other penalties imposed.
 

 
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 1      (f)  In addition to the fines imposed under this chapter and
 
 2 subsections (a) to (e), every person who violates this chapter
 
 3 shall be fined an additional ten per cent of the original amount
 
 4 of the fine, which shall be deposited into the traumatic brain
 
 5 injury trust fund under chapter      ."
 
 6      SECTION 5.  Section 321-28, Hawaii Revised Statutes, is
 
 7 repealed.
 
 8      ["[§321-28  Traumatic brain injury advisory board.]  There
 
 9 is established within the department of health the traumatic
 
10 brain injury advisory board.  The advisory board shall advise the
 
11 department in the development and implementation of a
 
12 comprehensive plan to address the needs of persons affected by
 
13 disorders and disabilities that involve the brain.  Further, the
 
14 advisory board shall advise the department of the feasibility of
 
15 establishing agreements with private sector agencies to develop
 
16 services for persons with brain injuries.
 
17      The advisory board shall consist of nine members who shall
 
18 be appointed by the director of health in accordance with section
 
19 26-35.  The director of health shall designate a member to be the
 
20 chairperson of the advisory board.  The director of health or a
 
21 designee shall serve as an ex officio nonvoting member of the
 
22 advisory board.  The members shall serve for a term of four
 
23 years; provided that upon the initial appointment of the members,
 

 
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 1 two shall be appointed for a term of one year, two for a term of
 
 2 two years, two for a term of three years, and three for a term of
 
 3 four years.  In establishing the advisory board, the director of
 
 4 health shall appoint at least:
 
 5      (1)  Two members representing private sector businesses that
 
 6           provide services for brain injured persons;
 
 7      (2)  Two survivors of traumatic brain injury; and
 
 8      (3)  One member representing trauma centers that provide
 
 9           services for brain injured persons.
 
10      The members shall serve without compensation but shall be
 
11 reimbursed for actual expenses, including travel expenses, that
 
12 are necessary for the performance of their duties."]
 
13      SECTION 6.  Statutory material to be repealed is bracketed.
 
14 New statutory material is underscored.
 
15      SECTION 7.  This Act shall take effect on July 1, 2000,
 
16 except that section 5 which repeals section 321-28, Hawaii
 
17 Revised Statutes, shall take effect on June 30, 2000.
 
18 
 
19                              INTRODUCED BY:______________________