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.  (HB2160 SD2)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        2160
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 2
TWENTIETH LEGISLATURE, 2000                                S.D. 2
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 injury 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
 

 
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 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
 

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

 
 
 
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 1           officio;
 
 2      (2)  The director of human resources, or designee, as a
 
 3           member ex officio;
 
 4      (3)  The superintendent of education, or designee, as a
 
 5           member ex officio;
 
 6      (4)  Three individuals who have sustained brain or spinal
 
 7           cord injury or members of the immediate families of
 
 8           individuals who have sustained brain or spinal cord
 
 9           injury; and
 
10      (5)  Three members nominated by the Hawaii Medical
 
11           Association who have experience in rehabilitation of
 
12           victims of traumatic brain injury.
 
13      (c)  Except for ex officio members, members shall serve for
 
14 a term of two years, except that of the members initially
 
15 appointed under paragraphs (4) and (5), two members shall serve
 
16 for three years, two members shall serve for two years, and two
 
17 members shall serve for one year.
 
18      (d)  The director of health shall serve as chairperson.  The
 
19 members shall elect from among themselves a vice chairperson and
 
20 treasurer.
 
21      (e)  A member whose term has expired may continue in office
 
22 as a holdover member until a successor is elected; provided that
 

 
 
 
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 1 the holdover shall not hold office beyond the end of the second
 
 2 regular legislative session following the expiration of the
 
 3 member's term.
 
 4      (f)  Vacancies occurring before the expiration of a member's
 
 5 term shall be filled in the same manner as the original
 
 6 appointments.  Individuals elected to fill a vacancy shall serve
 
 7 only for the remainder of the unexpired term.
 
 8      (g)  If four vacancies exist at any one time, no remaining
 
 9 member shall resign until at least one vacancy has been filled in
 
10 accordance with this section.
 
11      (h)  Five members shall constitute a quorum, whose
 
12 affirmative vote shall be necessary for all actions by the board.
 
13      (i)  Members shall serve without compensation, but may be
 
14 reimbursed for the necessary expenses, including travel expenses,
 
15 incurred in the performance of their duties.
 
16      §   -3 Meetings; notice; open to public.  (a)  The board
 
17 shall hold regular meetings at least once every two months and
 
18 shall keep records and minutes for all regular and special
 
19 meetings pursuant to chapter 92.
 
20      (b)  Either the chairperson or any five members may convene
 
21 a special meeting by notifying the entire membership of the board
 
22 in writing of the time and place of the special meeting.  The
 

 
 
 
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 1 chairperson or the five members shall give the written notice at
 
 2 least seven calendar days or at least ten calendar days,
 
 3 respectively, prior to the date of the special meeting.  A
 
 4 special meeting may be convened with the concurrence of the
 
 5 entire membership of the board.
 
 6      (c)  All board meetings shall be open to the public pursuant
 
 7 to chapter 92.
 
 8      §   -4  Powers and duties.  (a)  The commission shall:
 
 9      (1)  Adopt rules in accordance with chapter 91 to carry out
 
10           the purposes of this chapter, including:
 
11           (A)  Eligibility of applicants to receive disbursements
 
12                from the trust fund;
 
13           (B)  Manner of application for disbursement of moneys
 
14                from the trust fund;
 
15           (C)  Manner of review of applications;
 
16           (D)  Criteria for award of disbursements from the trust
 
17                fund;
 
18           (E)  Conditions for the use of moneys disbursed such as
 
19                specification of the types of services that the
 
20                disbursed moneys may be used to pay for; and
 
21           (F)  Limits, if any, to the amounts of disbursements to
 
22                be awarded;
 

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

 
 
 
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 1 finance shall have custody of the trust fund and shall credit to
 
 2 the trust fund all amounts transferred to the fund and shall
 
 3 invest the trust fund moneys in the same manner as authorized for
 
 4 investing other moneys in the state treasury.
 
 5      (b)  The commission may authorize the disbursement of
 
 6 available money from the trust fund for purposes of providing
 
 7 care and rehabilitative services to residents of the State who
 
 8 have survived a traumatic brain or spinal cord injury.
 
 9      (c)  The trust fund shall be funded by appropriation from
 
10 the general revenues of the state.  The commission may also
 
11 accept federal funds granted by Congress or executive order for
 
12 the purposes of this chapter, as well as gifts and donations from
 
13 individuals, private organizations, or foundations.  The
 
14 acceptance and use of federal funds shall not commit state funds
 
15 and shall not place an obligation upon the legislature to
 
16 continue the purposes for which the federal funds are made
 
17 available.  All funds received in the manner described in this
 
18 section shall be transmitted to the director of finance for
 
19 deposit into the trust fund to be disbursed as other moneys in
 
20 the trust fund."
 
21      SECTION 3.  Section 321-28, Hawaii Revised Statutes, is
 
22 amended to read as follows:
 

 
 
 
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 1      "[[]§321-28  Traumatic brain injury advisory board.[]]  (a)
 
 2 There is established within the department of health the
 
 3 traumatic brain injury advisory board.  The advisory board shall
 
 4 advise the department [in] and the traumatic brain injury trust
 
 5 fund commission:  
 
 6      (1)  In the development and implementation of a
 
 7           comprehensive plan to address the needs of persons
 
 8           affected by disorders and disabilities that involve the
 
 9           [brain.  Further, the advisory board shall advise the
 
10           department of] brain; and
 
11      (2)  Of the feasibility of establishing agreements with
 
12           private sector agencies to develop services for persons
 
13           with brain injuries.
 
14      (b)  The advisory board shall consist of nine members who
 
15 shall be appointed by the director of health in accordance with
 
16 section 26-35.  The director of health shall designate a member
 
17 to be the chairperson of the advisory board.  The director of
 
18 health or a designee shall serve as an ex officio nonvoting
 
19 member of the advisory board.  The members shall serve for a term
 
20 of four years; provided that upon the initial appointment of the
 
21 members, two shall be appointed for a term of one year, two for a
 
22 term of two years, two for a term of three years, and three for a
 

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