SB594

Report Title:

Relating to Neurotrauma

Description:

Establishes a neurotrauma special fund and commission.

THE SENATE	S.B. NO.	594
TWENTY-FIRST LEGISLATURE, 2001
STATE OF HAWAII

A BILL FOR AN ACT

Relating to neurotrauma.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that every year one million nine hundred thousand Americans experience neurotrauma injury. About half of these cases result in short-term disability. Of neurotrauma injury survivors, seventy thousand to ninety thousand endure lifelong debilitating losses of function.

Neurotrauma injury is defined as:

(1) A head injury that resulted in partial or total disability that is caused by damage to the brain or its coverings, that is not degenerative in nature and that results in a decrease in mental, cognitive, behavioral or physical functioning. It includes a trauma to the central nervous system that prevents a person from being completely self-sufficient, but does not include vascular accidents, aneurysms, or congenital defects; or

(2) A spinal injury that results in a severance or severe injury to the spinal cord caused by trauma which may result in partial or total paralyses of the arms or legs or both and which may also impair vital functions.

The legislature further finds that the physical consequences of brain injury include impairment of speech, vision and hearing loss, headaches, muscle spasticity, paralysis, and seizure disorders. The cognitive consequences of brain injury include memory deficit, limited concentration, impaired perception and communication, and difficulties with reading, writing, planning, and judgment. The psychosocial-behavioral-emotional consequences of brain injury include fatigue, mood swings, denial, anxiety, depression, lack of motivation, and decreased social skills.

Advances in neurosurgery and rehabilitation therapy have dramatically increased the number of individuals who survive neurotrauma injury and have made the hope of returning to the community more realistic. However, little has been done to assist neurotrauma injury survivors to adjust to life after the injury.

The average medical cost for a three- to- six-month initial hospitalization for neurotrauma injury is $85,000. The survivor of a severe head injury typically faces five to ten years of intensive treatment at an estimated cost in excess of $4,000,000. Nationally, the direct medical costs for treatment of neurotrauma injury have been estimated at more than $4,000,000,000 per year. The total economic costs of head injuries have been estimated to approach $25,000,000,000 per year.

In Hawaii, the Hawaii health systems corporation estimates that twelve hundred people are discharged annually from Hawaii's hospitals with neurotrauma injury. Currently, Hawaii lacks a system that provides, manages, and monitors services for individuals with neurotrauma injuries and effective and affordable treatment and rehabilitation programs and community supports to facilitate independent living are not available. Support programs for family members and caregivers are also lacking.

The purpose of this Act is to create a neurotrauma board and to establish a dedicated special fund to:

(1) Provide services relating to neurotrauma injuries, including but not limited to programs to educate the public about the prevention of neurotrauma injuries, public health consequences of neurotrauma injuries, and services needed to treat and rehabilitate people who are victims of neurotrauma injuries;

(2) Train and educate professionals involved with individuals with neurotrauma injuries;

(3) Fund research, evaluation, and advocacy activities to identify cost-effective strategies to meet the needs of neurotrauma injury survivors and their families to reduce the outlay of federal and state dollars under medicaid; and

(4) Establish a neurotrauma injury registry.

SECTION 2. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"Chapter

Neurotrauma

§ -1 Definitions. As used in this chapter, unless the context requires otherwise:

"Board" means the neurotrauma advisory board established under section -2.

"Director" means the director of health.

"Department" means department of health.

"Neurotrauma" means:

(1) A traumatic brain injury that resulted in partial or total disability that is caused by damage to the brain or its coverings, that is not degenerative in nature and that results in a decrease in mental, cognitive, behavioral, or physical functioning. It includes a trauma to the central nervous system that prevents a person from being completely self-sufficient, but does not include vascular accidents, aneurysms, or congenital defects; or

(2) A spinal injury that results in a severance or severe injury to the spinal cord caused by trauma that may result in partial or total paralyses of the arms or legs or both and that may also impair vital functions.

§ -2 Neurotrauma advisory board. (a) There is established within the department of health a neurotrauma advisory board to advise the director in implementing this chapter.

(b) The board shall consist of nine members who shall be appointed by the director. The director shall designate a member to be the chairperson of the advisory board. The director or a designee shall serve as an ex officio nonvoting member of the advisory board. The members shall serve for a term of four years; provided that upon the initial appointment of members, two shall be appointed for a term of one year, two for a term of two years, two for a term of three years, and three for a term of four years. In establishing the advisory board, the director shall appoint:

(1) Four survivors of neurotrauma or their family members (two each for traumatic brain injuries and spinal cord injuries);

(2) One member representing public sector agencies that provide services for neurotrauma survivors;

(3) Two members representing private sector businesses that provide services for neurotrauma survivors;

(4) One member representing trauma centers that provide services for neurotrauma persons; and

(5) A member of the public.

(c) The members shall serve without compensation but shall be reimbursed for actual expenses, including travel expenses, that are necessary for the performance of their duties.

§ -3 Neurotrauma special fund. (a) There is established the neurotrauma special fund to be administered by the department with advisory recommendations from the neurotrauma advisory board. The fund shall consist of:

(1) Moneys raised pursuant to the surcharges levied under sections 291-4, 291-11.5, 291-11.6, 291C-12, 291C-12.5, 291C-12.6, and 291C-102;

(2) Federal funds granted by congress or executive order, for the purpose of this chapter; provided that the acceptance and use of federal funds shall not commit state funds for services and shall not place an obligation upon the legislature to continue the purpose for which the federal funds are made available; and

(3) Funds appropriated by the legislature for the purpose of this chapter.

(b) The fund shall be used for the purpose of funding services relating to neurotrauma, including but not limited to:

(1) Programs to educate the public about:

(A) Prevention of neurotrauma;

(B) Public health consequences of neurotrauma; and

(2) Programs to train and educate professionals involved with individuals with neurotrauma;

(3) Programs to fund research, evaluation, and advocacy activities to identify cost-effective strategies to meet the needs of neurotrauma injury survivors and their families;

(4) Programs to fund, research, and create a registry of neurotrauma injuries within the State; and

(5) Necessary administrative expenses to carry out this chapter not to exceed five per cent of the total amount collected.

(d) In administering the fund, the director shall maintain records of all expenditures and disbursements made from the neurotrauma special fund.

(e) The director shall submit to the legislature an annual report on the activities under the neurotrauma special fund no later than twenty days prior to the convening of each regular session.

§ -4 Rules. The director may adopt any rules under chapter 91 necessary to carryout this chapter."

SECTION 3. Section 36-27, Hawaii Revised Statutes, is amended to read as follows:

"§36-27 Transfers from special funds for central service expenses. Except as provided in this section, and notwithstanding any other law to the contrary, from time to time, the director of finance, for the purpose of defraying the prorated estimate of central service expenses of government in relation to all special funds, except the:

(1) Special summer school and intersession fund under section 302A-1310;

(2) School cafeteria special funds of the department of education;

(3) Special funds of the University of Hawaii;

(4) State educational facilities improvement special fund;

(5) Convention center capital and operations special fund under section 206X-10.5;

(6) Special funds established by section 206E-6;

(7) Housing loan program revenue bond special fund;

(8) Housing project bond special fund;

(9) Aloha Tower fund created by section 206J-17;

(10) Domestic violence prevention special fund under section 321-1.3;

(11) Spouse and child abuse special account under section 346-7.5;

(12) Spouse and child abuse special account under section 601-3.6;

(13) Funds of the employees' retirement system created by section 88-109;

(14) Unemployment compensation fund established under section 383-121;

(15) Hawaii hurricane relief fund established under chapter 431P;

(16) Hawaii health systems corporation special funds;

(17) Boiler and elevator safety revolving fund established under section 397-5.5;

(18) Tourism special fund established under section 201B-11;

(19) Department of commerce and consumer affairs' special funds;

(20) Compliance resolution fund established under section 26-9;

(21) Universal service fund established under chapter 269;

(22) Integrated tax information management systems special fund under section 231-3.2;

(23) Insurance regulation fund under section 431:2-215;

(24) Hawaii tobacco settlement special fund under section 328L-2;

(25) Emergency budget and reserve fund under section 328L-3;

(26) Probation services special fund under section 706-649; [~~and~~]

(27) High technology special fund under section 206M-15.5; and

(28) Neurotrauma special fund under section -3;

shall deduct five per cent of all receipts of all other special funds, which deduction shall be transferred to the general fund of the State and become general realizations of the State. All officers of the State and other persons having power to allocate or disburse any special funds shall cooperate with the director in effecting these transfers. To determine the proper revenue base upon which the central service assessment is to be calculated, the director shall adopt rules pursuant to chapter 91 for the purpose of suspending or limiting the application of the central service assessment of any fund. No later than twenty days prior to the convening of each regular session of the legislature, the director shall report all central service assessments made during the preceding fiscal year."

SECTION 4. Section 36-30, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) Each special fund, except the:

(1) Transportation use special fund established by section 261D-1;

(2) Special summer school and intersession fund under section 302A-1310;

(3) School cafeteria special funds of the department of education;

(4) Special funds of the University of Hawaii;

(5) State educational facilities improvement special fund;

(6) Special funds established by section 206E-6;

(7) Aloha Tower fund created by section 206J-17;

(8) Domestic violence prevention special fund under section 321-1.3;

(9) Spouse and child abuse special account under section 346-7.5;

(10) Spouse and child abuse special account under section 601-3.6;

(11) Funds of the employees' retirement system created by section 88-109;

(12) Unemployment compensation fund established under section 383-121;

(13) Hawaii hurricane relief fund established under chapter 431P;

(14) Convention center capital and operations special fund established under section 206X-10.5;

(15) Hawaii health systems corporation special funds;

(16) Tourism special fund established under section 201B-11;

(17) Compliance resolution fund established under section 26-9;

(18) Universal service fund established under chapter 269;

(19) Integrated tax information management systems special fund;

(20) Insurance regulation fund under section 431:2-215;

(21) Hawaii tobacco settlement special fund under section 328L-2;

(22) Emergency and budget reserve fund under section 328L-3;

(23) Probation services special fund under section 706-649; [~~and~~]

(24) High technology special fund under section 206M-15.5; and

(25) Neurotrauma special fund under section -3;

shall be responsible for its pro rata share of the administrative expenses incurred by the department responsible for the operations supported by the special fund concerned."

SECTION 5. Section 291-4, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

"(b) A person committing the offense of driving under the influence of intoxicating liquor shall be sentenced as follows without possibility of probation or suspension of sentence:

(1) For the first offense, or any offense not preceded within a five-year period by a conviction for driving under the influence of intoxicating liquor under this section or section 291-4.4 by:

(A) A fourteen-hour minimum alcohol abuse rehabilitation program including education and counseling, or other comparable program deemed appropriate by the court; and

(B) Ninety-day prompt suspension of license with absolute prohibition from operating a motor vehicle during suspension of license, or the court may impose, in lieu of the ninety-day prompt suspension of license, a minimum thirty-day prompt suspension of license with absolute prohibition from operating a motor vehicle and, for the remainder of the ninety-day period, a restriction on the license that allows the person to drive for limited work-related purposes and to participate in alcoholism treatment programs; and

(i) Seventy-two hours of community service work;

(ii) Not less than forty-eight hours and not more than five days of imprisonment; or

(iii) A fine of not less than $150 but not more than $1,000[.]; and

(D) A surcharge of $25 to be deposited into the neurotrauma special fund.

(2) For an offense that occurs within five years of a prior conviction for driving under the influence of intoxicating liquor under this section or section 291-4.4 by:

(A) Prompt suspension of license for a period of one year with the absolute prohibition from operating a motor vehicle during suspension of license;

(B) Either one of the following:

(i) Not less than two hundred forty hours of community service work; or

(ii) Not less than five days but not more than fourteen days of imprisonment of which at least forty-eight hours shall be served consecutively; and

(D) A surcharge of $25 to be deposited into the neurotrauma special fund.

(3) For an offense that occurs within five years of two prior convictions for driving under the influence of intoxicating liquor under this section or section 291-4.4 by:

(A) A fine of not less than $500 but not more than $2,500;

(B) Revocation of license for a period not less than one year but not more than five years; [~~and~~]

(C) Not less than ten days but not more than thirty days imprisonment of which at least forty-eight hours shall be served consecutively[.]; and

(D) A surcharge of $25 to be deposited into the neurotrauma special fund.

(4) Any person eighteen years of age or older, who is convicted under this section and who operated or assumed actual physical control of a vehicle with a passenger, in or on the vehicle, who was younger than fifteen years of age, shall be sentenced to an additional mandatory fine of $500, and an additional mandatory term of imprisonment of forty-eight hours; provided, however, that the total term of imprisonment for a person convicted under this section shall not exceed thirty days.

Notwithstanding any other law to the contrary, any conviction for driving under the influence of intoxicating liquor under this section or section 291-4.4 shall be considered a prior conviction for purposes of imposing sentence under this section.

No license suspension or revocation shall be imposed pursuant to this subsection if the person's license has previously been administratively revoked pursuant to part XIV of chapter 286 for the same offense; provided that, if the administrative revocation is subsequently reversed, the person's license shall be suspended or revoked as provided in this subsection."

SECTION 6. Section 291-11.5, Hawaii Revised Statutes, is amended by amending subsection (e) to read as follows:

"(e) Violation of this section shall be considered an offense as defined under section 701-107(5) and shall subject the violator to the following penalties:

(1) For a first conviction, the person shall:

(A) Be fined not more than $100;

(B) Be required by the court to attend a child passenger restraint system safety class conducted by the division of driver education; provided that:

(i) The class may include video conferences as determined by the administrator of the division of driver education as an alternative method of education; and

(ii) The class shall not exceed four hours; [~~and~~]

(D) Pay a $10 surcharge to be deposited into the neurotrauma special fund;

(2) For a conviction of a second offense, the person shall:

(A) Be fined not more than $200;

(B) Be required by the court to attend a child passenger restraint system safety class not to exceed four hours in length conducted by the division of driver education if the person has not previously attended such a class; [and]

(C) Pay a $50 driver education assessment as provided in section 286G-3 if the person has not previously attended a child passenger restraint system safety class conducted by the division of driver education; and

(D) Pay a $10 surcharge to be deposited into the neurotrauma special fund; and

(3) For a conviction of a third or subsequent offense, the person shall:

(A) Be fined not more than $500;

(D) Pay a $10 surcharge to be deposited into the neurotrauma special fund."

SECTION 7. Section 291-11.6, Hawaii Revised Statutes, is amended by amending subsection (e) to read as follows:

"(e) A person who fails to comply with the requirements of this section shall be subject to a fine of $20 for each violation[.] and shall pay a $10 surcharge to be deposited into the neurotrauma special fund."

SECTION 8. Section 291C-12, Hawaii Revised Statutes, is amended to read as follows:

"§291C-12 Accidents involving death or serious bodily injury. (a) The driver of any vehicle involved in an accident resulting in serious bodily injury to or death of any person shall immediately stop the vehicle at the scene of the accident or as close thereto as possible but shall then forthwith return to and in every event shall remain at the scene of the accident until the driver has fulfilled the requirements of section 291C-14. Every such stop shall be made without obstructing traffic more than is necessary.

(b) Any person who violates subsection (a) shall be guilty of a class B felony.

(d) Any violation under this section is subject to a $500 surcharge in addition to any other penalties imposed to be deposited into the neurotrauma special fund."

SECTION 9. Section 291C-12.5, Hawaii Revised Statutes, is amended to read as follows:

"[[]§291C-12.5[]] Accidents involving substantial bodily injury. (a) The driver of any vehicle involved in an accident resulting in substantial bodily injury to any person shall immediately stop the vehicle at the scene of the accident or as close thereto as possible but shall then forthwith return to and in every event shall remain at the scene of the accident until the driver has fulfilled the requirements of section 291C-14. Every such stop shall be made without obstructing traffic more than is necessary.

(b) Any person who violates subsection (a) shall be guilty of a class C felony.

(c) Any violation under this section is subject to a $250 surcharge in addition to other penalties imposed to be deposited into the neurotrauma special fund."

SECTION 10. Section 291C-12.6, Hawaii Revised Statutes, is amended to read as follows:

"[[]§291C-12.6[]] Accidents involving bodily injury. (a) The driver of any vehicle involved in an accident resulting in bodily injury to any person shall immediately stop the vehicle at the scene of the accident or as close thereto as possible but shall then forthwith return to and in every event shall remain at the scene of the accident until the driver has fulfilled the requirements of section 291C-14. Every such stop shall be made without obstructing traffic more than is necessary.

(b) Any person who violates subsection (a) shall be guilty of a misdemeanor.

(c) Any violation under this section is subject to a $100 surcharge in addition to other penalties imposed to be deposited into the neurotrauma special fund."

SECTION 11. Section 291C-102, Hawaii Revised Statutes, is amended to read as follows:

"§291C-102 Noncompliance with speed limit prohibited. (a) No person shall drive a vehicle at a speed greater than a maximum speed limit and no person shall drive a motor vehicle at a speed less than a minimum speed limit established by county ordinance.

(b) The director of transportation with respect to highways under the director's jurisdiction may place signs establishing maximum speed limits or minimum speed limits. Such signs shall be official signs and no person shall drive a vehicle at a speed greater than a maximum speed limit and no person shall drive a motor vehicle at a speed less than a minimum speed limit stated on such signs.

(c) Any violation under this section is subject to the following surcharge in addition to any penalties imposed to be deposited into the neurotrauma special fund:

(1) If the maximum speed limit is exceed by less than ten miles per hour, the surcharge shall be $5; and

(2) If the maximum speed limit is exceed by more than ten miles per hour, the surcharge shall be $10."

SECTION 12. There is appropriated out of the neurotrauma special fund the sum of $ , or so much thereof as may be necessary for fiscal year 2001-2002, to be expended for the purpose of chapter , Hawaii Revised Statutes. The sum appropriated shall be expended by the director of health.

SECTION 13. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 14. This Act shall take effect on July 1, 2001.

INTRODUCED BY:	_____________________________