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 for
programs relating to victims of TBI.  Imposes a surcharge for
each speeding ticket and DUI conviction, for deposit into the
fund.  (HB2160 HD2)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        2160
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 2
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   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 a diminished or altered
 
10 state of consciousness, which results in an impairment of
 
11 cognitive abilities or physical functioning, and disturbances of
 
12 behavioral and emotional functioning.
 
13      The legislature further finds that physical consequences of
 
14 brain injury include impairment of speech, vision and hearing
 
15 loss, headaches, muscle spasticity, paralysis, and seizure
 
16 disorders.  Cognitive consequences of brain injury include memory
 
17 deficit, limited concentration, impaired perception and
 
18 communication, and difficulties with reading, writing, planning,
 
19 and judgment.  Psychosocial-behavioral-emotional consequences of
 

 
Page 2                                                     2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

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

 
Page 3                                                     2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1      The purpose of this Act is to establish a dedicated trust
 
 2 fund to provide services relating to traumatic brain injuries
 
 3 including programs to educate the public about prevention of
 
 4 traumatic brain injuries, public health consequences of traumatic
 
 5 brain injuries, and services needed to treat and rehabilitate
 
 6 people who are victims of traumatic brain injuries; programs to
 
 7 train and educate professionals involved with individuals with
 
 8 traumatic brain injuries; and programs to fund research,
 
 9 evaluation, and advocacy activities to identify cost-effective
 
10 strategies to meet the needs of traumatic brain injury survivors
 
11 and their families that reduce the outlay of federal and state
 
12 dollars under medicaid.
 
13      SECTION 2.  The Hawaii Revised Statutes is amended by adding
 
14 a new chapter to be appropriately designated and to read as
 
15 follows:
 
16                             "CHAPTER
 
17                      TRAUMATIC BRAIN INJURY
 
18      §   -1 Definitions.  As used in this chapter, unless the
 
19 context requires otherwise:
 
20      "Board" means the traumatic brain injury board established
 
21 under section 321-28.
 
22      "Traumatic brain injury" means an insult to the brain that
 
23 is not degenerative or inherited and that is caused by an
 

 
Page 4                                                     2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1 external physical force that produces a diminished or altered
 
 2 state of consciousness, which results in an impairment of
 
 3 cognitive abilities or physical functioning, and disturbances of
 
 4 behavioral and emotional functioning.
 
 5      §   -2  Traumatic brain injury trust fund.(a)  There is
 
 6 created in the state treasury the traumatic brain injury trust
 
 7 fund as a separate fund in the state treasury.  The traumatic
 
 8 brain injury board established under section 321-28 shall have
 
 9 custody of the trust fund and shall credit to the trust fund all
 
10 amounts transferred to the fund and shall invest the trust fund
 
11 moneys in the same manner as authorized for investing other
 
12 moneys in the state treasury.
 
13      (b)  The board may authorize the disbursement of available
 
14 money from the trust fund for the purpose of funding services
 
15 relating to traumatic brain injuries including:
 
16      (1)  Programs to educate the public about:
 
17           (A)  Prevention of traumatic brain injuries;
 
18           (B)  Public health consequences of traumatic brain
 
19                injuries; and
 
20           (C)  Services needed to treat and rehabilitate people
 
21                who are victims of traumatic brain injuries;
 
22      (2)  Programs to train and educate professionals involved
 
23           with individuals with traumatic brain injuries;
 

 
Page 5                                                     2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1      (3)  Programs to fund research, evaluation, and advocacy
 
 2           activities to identify cost-effective strategies to
 
 3           meet the needs of traumatic brain injury survivors and
 
 4           their families; and
 
 5      (4)  Necessary administrative expenses to carry out the
 
 6           purposes of this chapter.
 
 7      (c)  The trust fund shall be funded by a $      surcharge to
 
 8 fines and penalties imposed under sections 286-151.5, 286-157.3,
 
 9 286-261, 291-4, 291-4.3, 291-4.4, and 291C-102.  The board may
 
10 also accept federal funds granted by Congress or executive order
 
11 for the purposes of this chapter, as well as gifts and donations
 
12 from individuals, private organizations, or foundations.  The
 
13 acceptance and use of federal funds shall not commit state funds
 
14 for services and shall not place an obligation upon the
 
15 legislature to continue the purposes for which the federal funds
 
16 are made available.  All funds received in the manner described
 
17 in this section shall be transmitted to the board for deposit
 
18 into the trust fund to be disbursed as other moneys in the trust
 
19 fund."
 
20      SECTION 3.  Section 286-151.5, Hawaii Revised Statutes, is
 
21 amended by amending subsection (c) to read as follows:
 
22      "(c)  If the district judge finds the statements contained
 
23 in the affidavit are true, the judge shall suspend the arrested
 
24 person's operating privilege as follows:
 

 
Page 6                                                     2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1      (1)  For a first suspension, or any suspension not preceded
 
 2           within a five-year period by a suspension under this
 
 3           section, for a period of twelve months; and
 
 4      (2)  For any subsequent suspension under this section, for a
 
 5           period not less than two years and not more than five
 
 6           years.
 
 7 In addition to the period of revocation imposed under this
 
 8 subsection, the person shall be ordered to pay a $     surcharge
 
 9 to be deposited into the traumatic brain injury trust fund under
 
10 section    -2."
 
11      SECTION 4.  Section 286-157.3, Hawaii Revised Statutes, is
 
12 amended by amending subsection (b) to read as follows:
 
13      "(b)  Upon receipt of the affidavit, the district court
 
14 judge shall hold a hearing, as provided in section 286-157.4, and
 
15 shall determine whether the statements contained in the affidavit
 
16 are true and correct.  If the district judge finds the statements
 
17 contained in the affidavit are true, the judge shall suspend the
 
18 arrested person's license, permit, or any nonresident operating
 
19 privilege as follows:
 
20      (1)  One year, if the arrestee's driving record shows no
 
21           prior revocations under this section during the five
 
22           years preceding the date of arrest;
 

 
 
 
Page 7                                                     2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1      (2)  Two years, if the arrestee's driving record shows one
 
 2           prior drug enforcement contact under this section
 
 3           during the five years preceding the date of arrest;
 
 4      (3)  Four years, if the arrestee's driving record shows two
 
 5           prior drug enforcement contacts under this section
 
 6           during the seven years preceding the date of arrest; or
 
 7      (4)  For life, if the arrestee's driving record shows three
 
 8           or more prior drug enforcement contacts under this
 
 9           section during the ten years preceding the date of
 
10           arrest.
 
11 In addition to the period of revocation imposed under this
 
12 subsection, the person shall be ordered to pay a $     surcharge
 
13 to be deposited into the traumatic brain injury trust fund under
 
14 section    -2."
 
15      SECTION 5.  Section 286-261, Hawaii Revised Statutes, is
 
16 amended by amending subsection (c) to read as follows:
 
17      "(c)  The license of an arrestee who refuses to be tested
 
18 after being informed of the sanctions of this part shall be
 
19 revoked under subsection (b)(1), (2), and (3) for a period of one
 
20 year, two years, and four years, respectively.  In addition to
 
21 the period of revocation imposed under this subsection, the
 
22 person shall be ordered to pay a $     surcharge to be deposited
 
23 into the traumatic brain injury trust fund under section    -2."
 

 
Page 8                                                     2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1      SECTION 6.  Section 291-4, Hawaii Revised Statutes, is
 
 2 amended by amending subsection (b) to read as follows:
 
 3      "(b)  A person committing the offense of driving under the
 
 4 influence of intoxicating liquor shall be sentenced as follows
 
 5 without possibility of probation or suspension of sentence:
 
 6      (1)  For the first offense, or any offense not preceded
 
 7           within a five-year period by a conviction for driving
 
 8           under the influence of intoxicating liquor under this
 
 9           section or section 291-4.4 by:
 
10           (A)  A fourteen-hour minimum alcohol abuse
 
11                rehabilitation program including education and
 
12                counseling, or other comparable program deemed
 
13                appropriate by the court; and
 
14           (B)  Ninety-day prompt suspension of license with
 
15                absolute prohibition from operating a motor
 
16                vehicle during suspension of license, or the court
 
17                may impose, in lieu of the ninety-day prompt
 
18                suspension of license, a minimum thirty-day prompt
 
19                suspension of license with absolute prohibition
 
20                from operating a motor vehicle and, for the
 
21                remainder of the ninety-day period, a restriction
 
22                on the license that allows the person to drive for
 
23                limited work-related purposes and to participate
 
24                in alcoholism treatment programs; and
 

 
Page 9                                                     2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1           (C)  Any one or more of the following:
 
 2                (i)  Seventy-two hours of community service work;
 
 3               (ii)  Not less than forty-eight hours and not more
 
 4                     than five days of imprisonment; or
 
 5              (iii)  A fine of not less than $150 but not more
 
 6                     than $1,000.
 
 7      (2)  For an offense that occurs within five years of a prior
 
 8           conviction for driving under the influence of
 
 9           intoxicating liquor under this section or section
 
10           291-4.4 by:
 
11           (A)  Prompt suspension of license for a period of one
 
12                year with the absolute prohibition from operating
 
13                a motor vehicle during suspension of license;
 
14           (B)  Either one of the following:
 
15                (i)  Not less than one hundred hours of community
 
16                     service work; or
 
17               (ii)  Not less than forty-eight consecutive hours
 
18                     but not more than fourteen days of
 
19                     imprisonment of which at least forty-eight
 
20                     hours shall be served consecutively; and
 
21           (C)  A fine of not less than $500 but not more than
 
22                $1,500.
 

 
 
 
Page 10                                                    2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1      (3)  For an offense that occurs within five years of two
 
 2           prior convictions for driving under the influence of
 
 3           intoxicating liquor under this section or section
 
 4           291-4.4 by:
 
 5           (A)  A fine of not less than $500 but not more than
 
 6                $2,500;
 
 7           (B)  Revocation of license for a period not less than
 
 8                one year but not more than five years; and
 
 9           (C)  Not less than ten days but not more than thirty
 
10                days imprisonment of which at least forty-eight
 
11                hours shall be served consecutively.
 
12      (4)  Any person eighteen years of age or older, who is
 
13           convicted under this section and who operated or
 
14           assumed actual physical control of a vehicle with a
 
15           passenger, in or on the vehicle, who was younger than
 
16           fifteen years of age, shall be sentenced to an
 
17           additional mandatory fine of $500, and an additional
 
18           mandatory term of imprisonment of forty-eight hours;
 
19           provided, however, that the total term of imprisonment
 
20           for a person convicted under this section shall not
 
21           exceed thirty days.
 
22      In addition to any other penalty imposed under this
 
23 subsection, the person shall be ordered to pay a $     surcharge
 

 
Page 11                                                    2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1 to be deposited into the traumatic brain injury trust fund under
 
 2 section    -2.
 
 3      Notwithstanding any other law to the contrary, any
 
 4 conviction for driving under the influence of intoxicating liquor
 
 5 under this section or section 291-4.4 shall be considered a prior
 
 6 conviction for purposes of imposing sentence under this section.
 
 7      No license suspension or revocation shall be imposed
 
 8 pursuant to this subsection if the person's license has
 
 9 previously been administratively revoked pursuant to part XIV of
 
10 chapter 286 for the same offense; provided that, if the
 
11 administrative revocation is subsequently reversed, the person's
 
12 license shall be suspended or revoked as provided in this
 
13 subsection."
 
14      SECTION 7.  Section 291-4.3, Hawaii Revised Statutes, is
 
15 amended by amending subsection (b) to read as follows:
 
16      "(b)  A person who violates this section shall be sentenced
 
17 as follows:
 
18      (1)  For a first violation or any violation not preceded
 
19           within a five-year period by a prior alcohol
 
20           enforcement contact:
 
21           (A)  The court shall impose:
 
22                (i)  A requirement that the person and, if the
 
23                     person is under the age of eighteen, the
 

 
Page 12                                                    2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1                     person's parent or guardian attend an alcohol
 
 2                     abuse education and counseling program for
 
 3                     not more than ten hours; and
 
 4               (ii)  One hundred eighty-day prompt suspension of
 
 5                     license with absolute prohibition from
 
 6                     operating a motor vehicle during suspension
 
 7                     of license, or in the case of a person
 
 8                     eighteen years of age or older, the court may
 
 9                     impose, in lieu of the one hundred eighty-day
 
10                     prompt suspension of license, a minimum
 
11                     thirty-day prompt suspension of license with
 
12                     absolute prohibition from operating a motor
 
13                     vehicle and, for the remainder of the one
 
14                     hundred eighty-day period, a restriction on
 
15                     the license that allows the person to drive
 
16                     for limited work-related purposes and to
 
17                     participate in alcohol abuse education and
 
18                     treatment programs; and
 
19           (B)  In addition, the court may impose any one or more
 
20                of the following:
 
21                (i)  Not more than thirty-six hours of community
 
22                     service work; or
 

 
 
 
Page 13                                                    2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1               (ii)  A fine of not less than $150 but not more
 
 2                     than $500.
 
 3      (2)  For a violation that occurs within five years of a
 
 4           prior alcohol enforcement contact:
 
 5           (A)  The court shall impose prompt suspension of
 
 6                license for a period of one year with the absolute
 
 7                prohibition from operating a motor vehicle during
 
 8                suspension of license; and
 
 9           (B)  In addition, the court may impose any of the
 
10                following:
 
11                (i)  Not more than fifty hours of community
 
12                     service work; or
 
13               (ii)  A fine of not less than $300 but not more
 
14                     than $1,000.
 
15      (3)  For a violation that occurs within five years of two
 
16           prior alcohol enforcement contacts:
 
17           (A)  The court shall impose revocation of license for a
 
18                period of two years; and
 
19           (B)  In addition, the court may impose any of the
 
20                following:
 
21                (i)  Not more than one hundred hours of community
 
22                     service work; or
 

 
 
 
Page 14                                                    2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1               (ii)  A fine of not less than $300 but not more
 
 2                     than $1,000.
 
 3     [(4)] In addition to any other penalty imposed under this
 
 4           subsection, the person shall be ordered to pay a $     
 
 5           surcharge to be deposited into the traumatic brain
 
 6           injury trust fund under section    -2.  Notwithstanding
 
 7           any other law to the contrary, any conviction or plea
 
 8           under this section shall be considered a prior alcohol
 
 9           enforcement contact."
 
10      SECTION 8.  Section 291-4.4, Hawaii Revised Statutes, is
 
11 amended by amending subsection (c) to read as follows:
 
12      "(c)  Habitually driving under the influence of intoxicating
 
13 liquor or drugs is a class C felony.  Any person convicted under
 
14 this section, in addition to any other penalty that may be
 
15 imposed, shall be ordered to pay a $     surcharge to be
 
16 deposited into the traumatic brain injury trust fund under
 
17 section    -2."
 
18      SECTION 9.  Section 291C-102, Hawaii Revised Statutes, is
 
19 amended by amending subsection (a) to read as follows:
 
20      "(a)  No person shall drive a vehicle at a speed greater
 
21 than a maximum speed limit and no person shall drive a motor
 
22 vehicle at a speed less than a minimum speed limit established by
 
23 county ordinance.  In addition to any other fine that may be
 

 
Page 15                                                    2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1 imposed for a violation of this section, the person shall be
 
 2 ordered to pay a $     surcharge to be deposited into the
 
 3 traumatic brain injury trust fund under section    -2."
 
 4      SECTION 10.  Section 321-28, Hawaii Revised Statutes, is
 
 5 amended to read as follows:
 
 6      "[[]§321-28  Traumatic brain injury [advisory] board.[]]
 
 7 (a)  There is established within the department of health the
 
 8 traumatic brain injury [advisory] board.  The [advisory] board
 
 9 shall [advise]:
 
10      (1)  Advise the department in the development and
 
11           implementation of a comprehensive plan to address the
 
12           needs of persons [affected by disorders and
 
13           disabilities that involve the brain.  Further, the
 
14           advisory board shall advise] with traumatic brain
 
15           injury;
 
16      (2)  Advise the department of the feasibility of
 
17           establishing agreements with private sector agencies to
 
18           develop services for persons with brain injuries[.];
 
19      (3)  Have jurisdiction and control over the traumatic brain
 
20           injury trust fund established in section    -2 and
 
21           authorize disbursement of moneys from the trust fund
 
22           for the purposes of chapter       and do all things as
 
23           authorized under section    -2;
 

 
Page 16                                                    2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1      (4)  Maintain records of all expenditures of the traumatic
 
 2           brain injury trust fund, moneys received as gifts and
 
 3           donations to the trust fund, and disbursements made
 
 4           from the trust fund;
 
 5      (5)  Provide the legislature with an annual accounting of
 
 6           activity in the traumatic brain injury trust fund no
 
 7           later than twenty days prior to the convening of each
 
 8           regular session; and
 
 9      (6)  Adopt rules in accordance with chapter 91 to carry out
 
10           the purposes of this section and of chapter      .
 
11      (b)  The [advisory] board shall consist of nine members who
 
12 shall be appointed by the director of health in accordance with
 
13 section 26-35.  The director of health shall designate a member
 
14 to be the chairperson of the [advisory] board.  The director of
 
15 health or a designee shall serve as an ex officio nonvoting
 
16 member of the [advisory] board.  The members shall serve for a
 
17 term of four years; provided that upon the initial appointment of
 
18 the members, two shall be appointed for a term of one year, two
 
19 for a term of two years, two for a term of three years, and three
 
20 for a term of four years.  In establishing the [advisory] board,
 
21 the director of health shall appoint at least:
 
22      (1)  Two members representing private sector businesses that
 
23           provide services for brain injured persons;
 

 
Page 17                                                    2160
                                     H.B. NO.           H.D. 2
                                                        
                                                        

 
 1      (2)  Two survivors of traumatic brain injury; and
 
 2      (3)  One member representing trauma centers that provide
 
 3           services for brain injured persons.
 
 4      (c)  The members shall serve without compensation but shall
 
 5 be reimbursed for actual expenses, including travel expenses,
 
 6 that are necessary for the performance of their duties."
 
 7      SECTION 11.  Statutory material to be repealed is bracketed.
 
 8 New statutory material is underscored.
 
 9      SECTION 12.  This Act shall take effect on July 1, 2000.