Legislature(2019 - 2020)BARNES 124

03/05/2020 08:00 AM COMMUNITY & REGIONAL AFFAIRS

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 174 MIN. AGE TO POSSESS NICOTINE/ECIG PRODUCT TELECONFERENCED
Heard & Held
*+ HCR 14 BRAIN INJURY AWARENESS MONTH TELECONFERENCED
Moved HCR 14 Out of Committee
              HCR 14-BRAIN INJURY AWARENESS MONTH                                                                           
                                                                                                                                
8:20:40 AM                                                                                                                    
                                                                                                                                
CO-CHAIR  DRUMMOND announced  that  the final  order of  business                                                               
would be  HOUSE CONCURRENT RESOLUTION  NO. 14,  Proclaiming March                                                               
2020 as Brain Injury Awareness Month.                                                                                           
                                                                                                                                
8:21:02 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CHRIS TUCK,  Alaska State  Legislature, as  prime                                                               
sponsor, presented  HCR 14,  which would  proclaim March  2020 as                                                               
Brain Injury  Awareness Month in Alaska.   He said the  theme for                                                               
this year's campaign is "Change Your Mind."  He continued:                                                                      
                                                                                                                                
     This resolution seeks to draw  attention to the effects                                                                    
     of brain injuries and the  ways to prevent them.  Right                                                                    
     now  millions of  people worldwide  are  living with  a                                                                    
     brain  injury, and  they're categorized  as "traumatic"                                                                    
     and "acquired."  As noted  in the resolution, the Brain                                                                    
     Injury  Association of  America reports  that every  96                                                                    
     seconds someone in the U.S. sustains a brain injury.                                                                       
                                                                                                                                
REPRESENTATIVE  TUCK  directed  attention to  the  definition  of                                                               
traumatic brain  injury (TBI), on  page 1, lines [7-8],  which is                                                               
"a disruption  in the normal  function of  the brain that  can be                                                               
caused by a bump, blow, or  jolt to the head, or penetrating head                                                               
injury".   He offered  the following statistics:   12  percent of                                                               
the general  population has experienced at  least 1 TBI; 1  in 60                                                               
people in the  U.S. lives with a TBI related  injury; 50,000 each                                                               
year  die  of  traumatic  brain injuries;  an  estimated  3.5-5.3                                                               
million  Americans  live  with long-term  disabilities  resulting                                                               
from  traumatic brain  injuries;  and in  2016  and estimated  27                                                               
million cases of TBIs were reported worldwide.                                                                                  
                                                                                                                                
REPRESENTATIVE TUCK said TBIs can  be prevented.  He talked about                                                               
military  helmets   from  World  War   I  to  present   and  said                                                               
preventative  measures have  been around  for  a long  time.   He                                                               
expressed  that  he  feels  pride when  he  sees  people  wearing                                                               
helmets  when they  ride bicycles,  skateboard, and  rollerblade.                                                               
He shared  that as  an avid snow  machine rider  and motorcyclist                                                               
and  always wears  a helmet.   He  wrote a  report in  the eighth                                                               
grade  about   the  importance  of  wearing   helmets,  and  this                                                               
experience made a lasting impression.                                                                                           
                                                                                                                                
REPRESENTATIVE  TUCK  advised  that  TBI  is  an  underrecognized                                                               
health problem;  the Centers for  Disease Control  and Prevention                                                               
(CDC) notes  that everyone is  at risk for TBI,  especially young                                                               
children and  older adults.  He  said TBIs [result in]  a variety                                                               
of  physical,   cognitive,  social,  emotional,   and  behavioral                                                               
issues;  outcomes  can  vary from  total  recovery  to  permanent                                                               
disability  or even  death.   Immediately following  injury, some                                                               
signs of  TBI include being  dazed and confused,  persistent neck                                                               
pain, sensitivity to light or  noise, loss of balance, changes in                                                               
sleeping  patterns, and  not  remembering the  injury.   He  said                                                               
acquired  brain  injuries are  those  caused  by strokes,  oxygen                                                               
deprivation, seizures,  tumors, and  substance abuse.   The Brain                                                               
Injury  Association of  America estimates  that over  3.5 million                                                               
children and adults sustain acquired  brain injury each year.  He                                                               
related  a  story about  a  former  Representative who  sustained                                                               
brain  injury   and  the  importance   of  early   awareness  and                                                               
treatment.                                                                                                                      
                                                                                                                                
REPRESENTATIVE TUCK  stated his belief that  proclaiming March as                                                               
Brain Injury Awareness month would  increase awareness of TBI and                                                               
acquired brain  injury (ABI) and  hopefully prevent  future brain                                                               
injuries.  He said Annette  Alfonsi, from Unmasking Brain Injury,                                                               
would  provide invited  testimony,  and he  noted that  Unmasking                                                               
Brain Injury is mentioned in  the third-to-last "WHEREAS" clause.                                                             
As shown in  the second-to-last "WHEREAS" clause,  he pointed out                                                             
that  Brain Injury  Awareness  Month is  recognized  by the  U.S.                                                               
Department of Defense.                                                                                                          
                                                                                                                                
8:27:00 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  THOMPSON  questioned  why HCR  14  proposed  only                                                               
March 2020 rather than in perpetuity.                                                                                           
                                                                                                                                
REPRESENTATIVE  TUCK explained  that making  March of  every year                                                               
Brain Injury Awareness  Month would require a bill  rather than a                                                               
resolution.                                                                                                                     
                                                                                                                                
8:28:33 AM                                                                                                                    
                                                                                                                                
CO-CHAIR  DRUMMOND  announced  that   the  committee  would  hear                                                               
invited testimony on HCR 14.                                                                                                    
                                                                                                                                
8:28:44 AM                                                                                                                    
                                                                                                                                
ANNETTE ALFONSI, Alaska Coordinator, Unmasking Brain Injury,                                                                    
paraphrased her written testimony, which read as follows                                                                        
[original punctuation provided]:                                                                                                
                                                                                                                                
     Thank you for letting me  speak with you today. My name                                                                    
     is Annette Alfonsi.  Before 2012, I worked  for the 1%,                                                                    
     had  a college  degree, was  in great  health, and  was                                                                    
     looking at  grad school. After  I was a passenger  in a                                                                    
     rollover  car  accident  with  a  reckless  driver,  my                                                                    
     primary provider gave  me one day off of  work to rest.                                                                    
     I  had   multiple  internal  injuries   and  persistent                                                                    
     concussion symptoms  over time, and was  told different                                                                    
     things by  doctors. Some didn't  believe me  or assumed                                                                    
     my symptoms were only behavioral  and not physical, and                                                                    
     some  said my  healing would  not improve  and I  would                                                                    
     live my life  with my current symptoms  and would never                                                                    
     work again,  or that I  should be a housewife.  None of                                                                    
     them supported  treatments for healing. I  was laid off                                                                    
     one  business day  before I  would  have qualified  for                                                                    
     medical leave,  was denied disability, and  was told at                                                                    
     the  municipal and  state  level  that I  am  not in  a                                                                    
     category  people  care to  help.  I  no longer  have  a                                                                    
     retirement.   I   am   statistically  likely   to   get                                                                    
     reinjured,   experience    homelessness,   have   lower                                                                    
     lifetime outcomes,  and have greater risk  for comorbid                                                                    
     health  conditions  that  most health  providers  don't                                                                    
     currently   know   they   should  be   screening   for.                                                                    
     Multidisciplinary  treatment,  working   with  a  brain                                                                    
     injury  specialist  physician  and leaving  Alaska  for                                                                    
     treatment  is   what  helped   me.  Leaving   was  less                                                                    
     expensive and more  effective than what I  paid for and                                                                    
     experienced here.                                                                                                          
                                                                                                                                
     When the brain  injury doctor I was  seeing left Alaska                                                                    
     in 2015,  I planned  a TBI conference  while recovering                                                                    
     from  back  surgery, so  her  knowledge  could stay  in                                                                    
     Alaska. Over 100 people attended.  By request, this led                                                                    
     to   our  annual   conferences   with  different   host                                                                    
     organizations.   I've  been   told   I  cannot   attend                                                                    
     educational  events  because I  am  a  patient, so  the                                                                    
     events I  plan allow everyone  to learn the  same thing                                                                    
     and facilitates advocacy with knowledge.                                                                                   
                                                                                                                                
     This year, I am  planning another TBI conference hosted                                                                    
     by  Hope Community  Resources on  Friday, March  27 and                                                                    
     Saturday,  March  28.   We  have  continuing  education                                                                    
     credits approved  in 8  professional fields,  and we're                                                                    
     offering distance education, so  you are all invited to                                                                    
     attend for free. I plan  this with volunteers that want                                                                    
     standards  of   excellence  in   multidisciplinary  and                                                                    
     intercultural  health  care   around  brain  injury  in                                                                    
     Alaska. Go  to AlaskaBrainInjuryEducation.com  for more                                                                    
     info.                                                                                                                      
                                                                                                                                
     In 2017  I became the Alaska  Coordinator for Unmasking                                                                    
     Brain  Injury, an  internationally  known brain  injury                                                                    
     awareness  project, in  which people  with any  kind of                                                                    
     traumatic  or acquired  brain  injury  and their  loved                                                                    
     ones  can make  a mask,  with an  explanation of  their                                                                    
     art, to share  what it feels like to live  with a brain                                                                    
     injury.  We  work  with  groups  to  host  mask  making                                                                    
     events,    and   to    host   mask    exhibits.   Visit                                                                    
     unmaskingbraininjury.org for more info.                                                                                    
                                                                                                                                
     But I  am still  not employable,  because this  type of                                                                    
     work with my level of  education is only available full                                                                    
     time and I can't work 40 hours a week.                                                                                     
                                                                                                                                
     The past two years  I've hosted community conversations                                                                    
     with  groups  that tend  to  have  a higher  number  of                                                                    
     clients  that  have   experienced  brain  injury.  This                                                                    
     includes   organizations   in  fields   like   domestic                                                                    
     violence,  homelessness,  reentry, suicide  prevention,                                                                    
     substance  misuse, child  abuse,  and senior  citizens.                                                                    
     Directors and  project managers  know their  folks have                                                                    
     brain  injuries, their  client's brain  injuries affect                                                                    
     every part of life, and  they are often the first point                                                                    
     of  contact  for  clients. But  they  don't  understand                                                                    
     their  client's  symptoms  through the  lens  of  brain                                                                    
     injury. I am tired of  these groups asking you for more                                                                    
     money when  they are ignoring  an undercurrent  that is                                                                    
     the biggest issue for their clients.                                                                                       
                                                                                                                                
     There  aren't  social  service  programs  around  brain                                                                    
     injury compared to mental illness,  so if someone has a                                                                    
     brain injury and a mental  illness, and must choose one                                                                    
     diagnosis,  they may  disclose  the  mental illness  to                                                                    
     qualify for programs.                                                                                                      
                                                                                                                                
     So  I'd like  to  suggest two  concrete  ideas to  this                                                                    
     body:                                                                                                                      
                                                                                                                                
     Number One Idea: Make state  funding for any group that                                                                    
     is known  or suspected to  have more than 50%  of their                                                                    
     clients  experiencing   a  brain  injury  be   tied  to                                                                    
     education,  in other  words, state  funds would  not be                                                                    
     disbursed unless the staff  get brain injury education,                                                                    
     and the funding should not  be used for that education.                                                                    
     Unlike  medical professionals  that  tend  to focus  on                                                                    
     diagnosis, these  groups focus on function  and need to                                                                    
     understand the  client symptoms they are  witnessing. I                                                                    
     know program  directors in  social service  groups that                                                                    
     love this idea.                                                                                                            
                                                                                                                                
     Number  Two  Idea: create  or  support  a housing  unit                                                                    
     specifically for  brain injury,  the way  other housing                                                                    
     units  are  for  people  with  specific  diagnoses  and                                                                    
     health issues. This  would allow tailored environmental                                                                    
     modifications,  and   could  be  excellent   for  group                                                                    
     therapies, peer  support, and  individualized treatment                                                                    
     opportunities.  I know  directors that  love this  idea                                                                    
     also.                                                                                                                      
                                                                                                                                
     Damage to  the brain  can be healed  but the  amount of                                                                    
     that  healing is  dependent on  a number  of concurrent                                                                    
     factors not being  maximized in Alaska. We  need to get                                                                    
     away  from the  idea that  someone is  good enough,  or                                                                    
     looks fine, when  inside they are suffering.  We can do                                                                    
     better, and it starts  with awareness. Please pass this                                                                    
     resolution to raise that awareness.  Thank you for your                                                                    
     time.                                                                                                                      
                                                                                                                                
MS. ALFONSI added to her  last paragraph of written testimony the                                                               
following:  "There's a place  for everyone in our community, even                                                               
with brain injury symptoms."                                                                                                    
                                                                                                                                
8:34:08 AM                                                                                                                    
                                                                                                                                
CO-CHAIR  HANNAN shared  that she  is  a survivor  of two  severe                                                               
brain injuries -  one at the age  of 21, when she was  in a roll-                                                               
over  car accident,  and  one at  the  age of  32,  when she  was                                                               
severely  assaulted   when  living  abroad  in   Russia  and  was                                                               
hospitalized in a neurological unit.   She said it was probably a                                                               
decade  before  she  made  a  full  recovery.    Co-Chair  Hannan                                                               
emphasized that it is the  length of recovery that is astonishing                                                               
to  most people  living with  a brain  injury; it  can take  many                                                               
years,  and not  all survivors  are  as lucky  as she  was.   She                                                               
thanked Ms. Alfonsi for bringing  the awareness and statistics to                                                               
the committee.  She said Alaska is  a place where there are a lot                                                               
of accidental injuries resulting in traumatic brain injury.                                                                     
                                                                                                                                
8:35:12 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  THOMPSON  questioned why  HCR  14  should not  be                                                               
passed  out now  [after only  one hearing]  considering it  would                                                               
name  March 2020  as Brain  Injury  Awareness Month  [and it  was                                                               
already March 5].                                                                                                               
                                                                                                                                
8:35:47 AM                                                                                                                    
                                                                                                                                
CO-CHAIR DRUMMOND said  if there was no interest  in amending HCR
14, she would ask for a motion to move it out of committee.                                                                     
                                                                                                                                
8:35:56 AM                                                                                                                    
                                                                                                                                
CO-CHAIR  HANNAN moved  to report  HCR 14  out of  committee with                                                               
individual  recommendations  and  the  accompanying  zero  fiscal                                                               
note.  There  being no objection, HCR 14 was  reported out of the                                                               
House Community and Regional Affairs Standing Committee.                                                                        

Document Name Date/Time Subjects
20200225 signed HCR 14 hearing request for Community and Regional Affairs.pdf HCRA 3/5/2020 8:00:00 AM
HCR 14
HCR 14 Brain Injury Association of America Fact Sheet 2.25.2020.pdf HCRA 3/5/2020 8:00:00 AM
HCR 14
HCR 14 Sponsor Statement 2.25.2020.pdf HCRA 3/5/2020 8:00:00 AM
HCR 14
HCR 14 ver A 2.21.2020.pdf HCRA 3/5/2020 8:00:00 AM
HCR 14
HCR 14 Gov. Dunleavy TBI Awareness Month Proclamation 3.1.2019.pdf HCRA 3/5/2020 8:00:00 AM
HCR 14
HB 174 Ver. M 2.28.2020.PDF HCRA 3/5/2020 8:00:00 AM
HB 174
HB 174 Committee Substitute Work Draft Ver. S 2.28.2020.pdf HCRA 3/5/2020 8:00:00 AM
HB 174
HB 174 Sponsor Statement 2.25.2020.pdf HCRA 3/5/2020 8:00:00 AM
HJUD 3/16/2020 1:00:00 PM
HJUD 3/18/2020 1:00:00 PM
HB 174
HB 174 Supporting Document - States Should Enact Tobacco 21 to Reinforce New Federal Law 1.7.2020.pdf HCRA 3/5/2020 8:00:00 AM
HJUD 3/16/2020 1:00:00 PM
HJUD 3/18/2020 1:00:00 PM
HB 174
HB 174 Supporting Document - JUUL Labs letter 2.24.2020.pdf HCRA 3/5/2020 8:00:00 AM
HJUD 3/16/2020 1:00:00 PM
HJUD 3/18/2020 1:00:00 PM
HB 174
HB 174 Supporting Document - American Lung Association Letter 3.3.2020.pdf HCRA 3/5/2020 8:00:00 AM
HJUD 3/16/2020 1:00:00 PM
HJUD 3/18/2020 1:00:00 PM
HB 174
HB 174 Sectional Analysis v. K 3.4.2020.pdf HCRA 3/5/2020 8:00:00 AM
HJUD 3/16/2020 1:00:00 PM
HJUD 3/18/2020 1:00:00 PM
HB 174
HCR 14 Written Testimony--Alfonsi--3.5.2020.pdf HCRA 3/5/2020 8:00:00 AM
HCR 14