Legislature(2009 - 2010)BUTROVICH 205

02/11/2009 01:30 PM Senate HEALTH & SOCIAL SERVICES

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01:33:45 PM Start
01:34:37 PM Bring the Kids Home
02:22:36 PM SCR1
02:51:19 PM SB52
02:57:30 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Returning Kids from Out of State, TELECONFERENCED
Jeff Jessee, Mental Health Trust
Moved SCR 1 Out of Committee
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
        SCR  1-BRAIN INJURY AWARENESS MONTH: MARCH 2009                                                                     
2:22:36 PM                                                                                                                    
CHAIR DAVIS announced consideration of SCR 1.                                                                                   
SENATOR MCGUIRE, presented  the sponsor statement for  SCR 1. She                                                               
said she  brings this resolution  every year, hoping to  move one                                                               
heart  or  mind. This  resolution  draws  awareness to  traumatic                                                               
brain injury (TBI),  to those who have suffered as  well as their                                                               
families and care  providers. Traumatic brain injury  is a result                                                               
of damage  to the brain  as the result of  a blunt trauma  to the                                                               
head  or  violent  shaking.  Most  victims go  on  to  live  with                                                               
permanent disabilities. The tragedy of  TBI is exacerbated by the                                                               
fact that many  of these injuries are preventable; so  there is a                                                               
lot  of guilt  and  frustration associated  with this  particular                                                               
type  of  injury.  These injuries  are  life-altering  and  place                                                               
tremendous financial  and emotional strain on  families and their                                                               
victims. They  often occur  at an early  age, before  the victims                                                               
have secured a job, which  means many years of tremendous medical                                                               
expenses and no way to cover them.                                                                                              
2:25:15 PM                                                                                                                    
Alaska again  leads the  United States  for per  capita traumatic                                                               
brain  injury and  TBI itself  is one  of the  leading causes  of                                                               
death to  young people  in this state.  Over 800  traumatic brain                                                               
injuries  are reported  annually in  Alaska and  it is  estimated                                                               
that over 12,000  Alaskans now living in the  state have suffered                                                               
a traumatic brain  injury. She reminded the  committee that these                                                               
statistics are low; traumatic brain  injury is a silent epidemic.                                                               
Many  traumatic  brain  injuries  are not  reported  because  the                                                               
victims  minimize or  fail to  understand the  severity of  their                                                               
injury; often  they don't have access  to health care to  pay for                                                               
the MRI needed  to understand the impact  and potential long-term                                                               
damage. People with late stage  manifestation of symptoms such as                                                               
learning  problems,  difficulty  in judgment  from  frontal  lobe                                                               
injury,  difficulty in  maintaining jobs  and relationships,  are                                                               
simply  navigating   through  society  without   realizing  their                                                               
problems are due to a brain injury.                                                                                             
SENATOR MCGUIRE  continued; it is  easy to see and  understand an                                                               
injury like a  broken limb and as  a society we try  to help, but                                                               
with a traumatic brain injury, there  may be no visible signs. As                                                               
Alaskans, we  need to  be mindful  that many  of the  people with                                                               
traumatic brain  injury are living  among us and it  is incumbent                                                               
on us to do all we can.                                                                                                         
The  Brain Injury  Association of  America recognizes  March each                                                               
year as  Brain Injury Awareness  Month; so this  resolution would                                                               
comport  with national  recognition by  making Alaska  once again                                                               
recognize  March  2009  as  the   state  traumatic  brain  injury                                                               
awareness month.                                                                                                                
She stated that there isn't enough  done about TBI in this state;                                                               
they don't know how to reach  families and individuals who are in                                                               
high risk  categories and they  are still dealing  with insurance                                                               
issues,  the overarching  inability to  respond quickly  to treat                                                               
life-long  consequences. TBI  has economic  consequences for  the                                                               
state; it  has social implications  for the family and  the state                                                               
and it is  a preventable injury. Where the state  can prevent it,                                                               
she said, she  sees it as a place where  the Senate HSS Committee                                                               
and the  Senate as  a whole should  really direct  attention. The                                                               
legislature already  looks at  helmet use  and seat  belts, which                                                               
are both  very positive steps  in the right direction.  The Brain                                                               
Injury Network is  a non-profit board that was  formed five years                                                               
ago and  is made up  of TBI  survivors, their family  members and                                                               
those  who make  up the  social organizations  that respond,  but                                                               
they  are  overwhelmed with  the  task.  They don't  have  enough                                                               
money; they  don't have  enough support;  they don't  have enough                                                               
resources  to  get the  word  out.  This  resolution is  also  an                                                               
opportunity for  survivors and  their family  members to  get the                                                               
attention of the legislature.                                                                                                   
2:31:08 PM                                                                                                                    
She  spoke  about her  brother's  accident.  When he  survived  a                                                               
traumatic  brain injury  in an  automobile accident  at 17  years                                                               
old, there  was no one for  her family to  turn to and a  lack of                                                               
acute care. The landscape has changed,  but there is still a long                                                               
way to  go. She  expressed her  appreciation for  Senator Davis's                                                               
support of brain injury awareness and for the committee's time.                                                                 
2:32:04 PM                                                                                                                    
SENATOR  THOMAS shared  his support  for  this effort.  He has  a                                                               
nephew who  was injured  seven years ago.  He is  functioning now                                                               
but is having a lot of problems.                                                                                                
2:32:59 PM                                                                                                                    
SENATOR  PASKVAN also  supports this  resolution. He  understands                                                               
the difficulty  from his 25 years  of legal practice in  the area                                                               
of  personal injury.  He agreed  that to  make this  brain injury                                                               
awareness month is very appropriate.                                                                                            
2:34:16 PM                                                                                                                    
SENATOR  MCGUIRE  said she  knows  people  in Senator  Paskavan's                                                               
field  who,  in  cases  as  recent  as  a  month  ago,  have  had                                                               
difficulty making  jurors understand what traumatic  brain injury                                                               
is and how profound and life-altering it can be.                                                                                
She  informed the  committee  that  Alaska is  one  of 40  states                                                               
involved  in a  new pilot  program  called Impact  that is  being                                                               
carried out at  Providence and Alaska Regional;  they are working                                                               
with athletes in the schools,  sports trainers, neurosurgeons and                                                               
neuropsychologists to  understand cognitive brain damage  and how                                                               
it can  occur from seemingly  minimal concussions.  The hospitals                                                               
do  brain scans  immediately  [after an  incident]  and test  for                                                               
cognitive functions. The  results will be part  of the nationwide                                                               
results gathering effort that hopefully  will lead to much better                                                               
2:36:04 PM                                                                                                                    
CHAIR  DAVIS  thanked  Senator  McGuire  and  called  for  public                                                               
testimony on this resolution.                                                                                                   
NANCY  MICHAELSON,  representing  herself,  Palmer,  AK,  is  the                                                               
parent of a  young man who suffered a traumatic  brain injury six                                                               
years ago.  Her son,  Aaron was in  a coma for  two weeks  of the                                                               
month he  spent at Providence  Hospital. At that time,  they were                                                               
fortunate enough  to get Aaron  admitted to  Craig Rehabilitation                                                               
Hospital  in  Denver,  Colorado,  where he  spent  the  next  six                                                               
months.  She  pointed out  that  she  used the  word  "fortunate"                                                               
because  her   son  had  serious   medical  issues   that  needed                                                               
specialized care from  a full team of doctors and  he was able to                                                               
get  that care  in Denver  while participating  daily in  a rehab                                                               
program  specifically designed  for brain  injury patients.  As a                                                               
result,  although he  has fairly  low-level  function, is  mainly                                                               
immobile and speaks  only a few words,  he understands everything                                                               
that is said to him and is still improving even after six years.                                                                
2:37:58 PM                                                                                                                    
MS. MICHAELSON said that within the  first 20 hours of their stay                                                               
at Craig  Hospital, they  were met with  the attitude  that Aaron                                                               
had  widespread damage  and they  had  a lot  of work  to do,  so                                                               
they'd  better   get  started  right   away.  She   stressed  the                                                               
difference  between  that and  the  attitude  of the  doctors  in                                                               
Alaska both  before they left  and after they returned.  Yes, she                                                               
said, they  were lucky to  get Aaron into specialty  brain injury                                                               
rehab center.  The reason is  hope, for Aaron's future  and their                                                               
future as a family, for the  life they can have regardless of his                                                               
cognitive  difficulties or  physical  abilities.  They came  home                                                               
with the  realization that  they can fight  for, move  toward and                                                               
support quality of life for  persons with brain injury regardless                                                               
of  their stage  of  recovery  or injury.  They  also learned  to                                                               
appreciate the  ability to  look outside  the box  of traditional                                                               
physical rehab therapy and care  programs to find approaches that                                                               
work for persons with brain  injuries, always keeping in mind the                                                               
delicate  balance   between  the   physical  abilities   and  the                                                               
cognitive realities.                                                                                                            
2:39:22 PM                                                                                                                    
Insurance  policies cover  alternative approaches  and there  are                                                               
places these therapies  can be found all over  the United States;                                                               
but it has  been very difficult to find them  in Alaska. When the                                                               
Michaelsons  returned to  Alaska and  visited with  Aaron's rehab                                                               
doctor  and  staff  for  the   first  time,  they  expressed  how                                                               
wonderful  it was  to  have  Aaron home  with  them; the  medical                                                               
team's response was incredulity  and even insulting comments. She                                                               
attributes  their  response to  her  family's  outlook and  their                                                               
acceptance  that the  only  life  they have  is  with their  son,                                                               
regardless of  what progress he  makes or  doesn't make and  to a                                                               
general lack of awareness about brain injury.                                                                                   
MS. MICHAELSON  commented that  she finds  the lack  of awareness                                                               
about brain  injury here in  Alaska pretty amazing.  Victims with                                                               
high needs  and lower-level function,  like her son, may  look as                                                               
if  they don't  understand  anything until  they  hear the  right                                                               
joke, or  get to do something  they especially enjoy; then  it is                                                               
clear  that they  understand more  than is  obvious. She  thanked                                                               
Senator McGuire  for mentioning the  victims who show  no outward                                                               
signs of  damage. Some victims  may walk, talk, drive,  and teach                                                               
art, but be  unable to balance a checkbook, keep  a job, answer a                                                               
telephone or remember  the routine they have to  go through every                                                               
night to go to bed.                                                                                                             
MS. MICHAELSON said her family  has encountered a lot of problems                                                               
obtaining medical rehab or therapy  since they got back to Alaska                                                               
due in part  to the fact that Aaron started  his therapy outside.                                                               
She fears for  the growing number of returning  veterans [who may                                                               
face similar difficulties in dealing with brain injuries].                                                                      
Aaron's injury has affected his life  and the life of her family,                                                               
He will require guardianship for the  rest of his life; this kind                                                               
of psychological  and emotional reality  can and does  break most                                                               
families.  In  her  family,  his   care  totally  consumes  their                                                               
schedules and  finances since the  injury; she lost her  job when                                                               
he was injured because she had  to take care of him. Brain injury                                                               
is known  as "the  silent epidemic," but  it really  isn't; there                                                               
are  the sleepless  nights  and crying  from  pain Aaron  doesn't                                                               
Above all  else though, she is  thankful that he is  at home with                                                               
his  family and  that  is  where the  legislature  comes in.  She                                                               
believes Alaskans deserve a local  rehabilitation option that can                                                               
give them the  chance to get on the road  to whatever recovery is                                                               
possible and  learn to  live life to  its fullest  potential even                                                               
after  surviving  brain  injury.  But  before  that  can  happen,                                                               
Alaskans have  to talk  about awareness,  awareness of  the large                                                               
number of Alaskans who suffer  brain injuries annually, awareness                                                               
of the  wide scope  of their  rehabilitation needs,  awareness of                                                               
the impact  of brain injury  on families and awareness  that many                                                               
brain injuries can be prevented.  The legislature can help all of                                                               
that become reality by passing this resolution.                                                                                 
2:44:02 PM                                                                                                                    
JILL  HODGES, Director,  Alaska  Brain  Injury Awareness  Network                                                               
(ABIN), Anchorage, AK, thanked the  Senators and all of those who                                                               
shared their personal stories. She  feels very positive about the                                                               
future for  people with  brain injury here  in Alaska  and thinks                                                               
that they will soon move  toward getting services they need here.                                                               
She   wanted  to   highlight  some   successful  TBI   prevention                                                               
activities happening  in the state  and some  upcoming challenges                                                               
the  Brain  Injury Network  might  face  in preventing  recurring                                                               
brain injuries among civilians and returning service members.                                                                   
2:45:30 PM                                                                                                                    
With regard  to successful TBI  prevention activities,  she cited                                                               
passage of  the primary seatbelt  law in 2003, saying  that since                                                               
2001,  brain  injuries  due  to   motor  vehicle  accidents  have                                                               
decreased 38  percent. Motor vehicle accidents  still cause brain                                                               
injuries, however 56 percent of  those who suffer brain injury in                                                               
vehicle  accidents  were  not wearing  their  seatbelts.  Another                                                               
topic Senator McGuire touched on  is the Impact Program, which is                                                               
a  partnership   between  Providence  Neurosurgery   Clinic,  the                                                               
Anchorage School District, the Mental  Health Trust Authority and                                                               
the Brain  Injury Network dealing  with concussion  management. A                                                               
CNN article recently  covered brain injury among  NFL players who                                                               
suffer  concussions. In  the past,  people  thought a  concussion                                                               
might put  athletes out  of operation  for a  week or  two before                                                               
they would be back on their  feet; they are finding that multiple                                                               
concussions are causing lifelong damage  to the brain that is not                                                               
showing up on CT scans or MRIs.                                                                                                 
MS.  HODGES continued;  when people  talk about  prevention, they                                                               
are generally  talking about preventing the  primary injury; once                                                               
one has  had a brain injury  however, that person is  more likely                                                               
to  have  recurrences  with  even  more  disabling  effects.  For                                                               
example, a woman  came in to the Resource  Navigation Program for                                                               
brain  injury victims  earlier this  week;  she had  come in  two                                                               
years before  to talk about  her pregnant daughter,  who suffered                                                               
brain injury  in a  motor vehicle  accident and  needed a  lot of                                                               
help after she was released from  the hospital. She said that her                                                               
daughter recently  had another accident, incurred  a second brain                                                               
injury and is now in a nursing facility.                                                                                        
2:48:15 PM                                                                                                                    
She  expressed concern  about how  this problem  will affect  our                                                               
returning  service   members;  those  with  moderate   to  severe                                                               
injuries  remain in  the lower  48  for treatment,  but many  are                                                               
coming  home with  mild brain  injuries. These  veterans will  be                                                               
going  back  to rural  Alaska  and  statistics show  that  Alaska                                                               
Natives and residents  of rural Alaska have the  highest rates of                                                               
brain  injuries  from  causes  such   as  ATV  and  snow  machine                                                               
accidents; 69  percent of those  victims are not  wearing helmets                                                               
at the  time of their  injuries. ABIN worries that  the returning                                                               
service members  are going  to be very  active when  they return,                                                               
perhaps living subsistence lifestyles  and those communities need                                                               
to be  aware that  they need  to prevent  further injury  to this                                                               
2:49:06 PM                                                                                                                    
During  the month  of March,  the  Brain Injury  Network will  be                                                               
working closely with the Alaska  Native Tribal Health Consortium,                                                               
the Department of  Health and Social Services,  the Mental Health                                                               
Trust Authority and the veterans'  clinic at Elmendorf AFB, doing                                                               
press   conferences,   publishing   newspaper   ads,   television                                                               
commercials, and  YouTube and Facebook  video for the  youth. The                                                               
VA has offered  to sponsor a public health forum  in the month of                                                               
March as  well. They did that  last year and had  about 50 people                                                               
in Anchorage show up for their presentation.                                                                                    
MS.  HODGES   thanked  the  Senators  for   their  leadership  in                                                               
promoting healthy  lives and  said she  looks forward  to working                                                               
with them  on future  legislation to  improve the  service system                                                               
for people with brain injuries.                                                                                                 
2:50:23 PM                                                                                                                    
CHAIR DAVIS the will of the committee.                                                                                          
SENATOR  PASKVAN  moved  to  report SCR  1  from  committee  with                                                               
individual recommendations  and attached zero fiscal  note. There                                                               
being no objection, it was so ordered.                                                                                          

Document Name Date/Time Subjects
REVISED2 BB BTKH Leg Presentation Wed.ppt SHSS 2/11/2009 1:30:00 PM