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 understanding. 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 understand. 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 population. 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.