Neuroscience Industry

Appropriates funds to develop a neuroscience industry in the
State. (HB203 HD1)

HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 1
TWENTIETH LEGISLATURE, 1999                                     
STATE OF HAWAII                                                 

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that pediatric and
 2 adolescent traumatic brain injuries are at epidemic levels.
 3 Brain injury is the most frequent diagnosis reported in the
 4 national pediatric trauma registry and the leading cause of death
 5 and disability among children and young adults.  Traumatic brain
 6 injury survivors are at a higher risk for a second injury by
 7 three times and a third injury by eight times.
 8      The brain controls the body's many functions and actions.
 9 Children might have acquired brain injuries because of illness,
10 infections, loss of oxygen, tumors, strokes, or metabolic
11 disorders.  Brain injury is also the diagnosis most likely to
12 result in multiple limitations in function and long term
13 disabilities.  Consequently, traumatic and acquired brain
14 injuries can interrupt, delay, or alter the development of
15 infants, children, and adolescents.  The consequences of brain
16 injuries impact the individual, family members, caregivers, and
17 community.
18      Most survivors go directly home from hospitals and trauma
19 centers.  This discharge assumes that home is the most

Page 2                                                     203
                                     H.B. NO.           H.D. 1

 1 appropriate placement.  However, there are no community
 2 integration programs available to the general public in Hawaii to
 3 help survivors transition and cope with the profound changes they
 4 may face.  In the case of students, the school is the primary
 5 transition program for the survivor, however, the family members,
 6 caregivers, teachers, and peers are unprepared for the many
 7 changes that need to be addressed for each brain impaired special
 8 needs student.
 9      In 1996, the U.S. Congress enacted Public Law 104-166, known
10 as the Traumatic Brain Injury Act.  In section 2 of the Act the
11 National Institute of Health is charged with four objectives:
12      (1)  The development of new methods and modalities for the
13           more affective diagnosis, measurement of degrees of
14           injury, post-injury monitoring, and prognostic
15           assessment of head injury for acute, subacute, and
16           later phases of care;
17      (2)  The development, modification, and evaluation of
18           therapies that retard, prevent, or reverse brain damage
19           after acute head injury, that arrest further
20           deterioration following injury, and that provide the
21           restitution of function for individuals with long-term
22           injuries;

Page 3                                                     203
                                     H.B. NO.           H.D. 1

 1      (3)  The development of research on a continuum of care from
 2           acute care through rehabilitation, designed, to the
 3           extent practicable, to integrate rehabilitation and
 4           long-term outcome evaluation with acute care research;
 5           and 
 6      (4)  The development of programs that increase the
 7           participation of academic centers of excellence in
 8           brain injury treatment and rehabilitation research and
 9           training.
10      Despite the lack of effective early identification,
11 assessment, and treatment throughout the healthcare industry,
12 brain impairment community-based services are a profitable niche
13 medical market.  While there is a small body of research
14 supporting the effectiveness of neurotraining programs at
15 inpatient facilities, little is published about the effectiveness
16 of a more cost-effective outpatient intervention.
17      The neuropsychology services program at the Hawaii state
18 hospital is known for providing one of the first outpatient
19 neurotraining treatment programs in the United States.  This
20 program is unique in that it follows a standardized and highly
21 specific assessment and treatment protocol that is objectively
22 documented.  The Hawaii state hospital is fiscally unable to
23 expand neuropsychology services beyond the patients at the
24 hospital.

Page 4                                                     203
                                     H.B. NO.           H.D. 1

 1      The Hawaii neuropsychology community research bureau is a
 2 private-public collaborative effort to establish the research,
 3 education, and training infrastructure for neuropsychology and
 4 neurotraining programs.  These programs are based on developing a
 5 multi-disciplinary team approach that utilizes diverse sensory
 6 and intellectual stimulation as well as traditional
 7 rehabilitation programs.  
 8      The purpose of this Act is to develop profitable "centers of
 9 excellence" in the private sector and to establish Hawaii as the
10 health care center of the Pacific for neuropsychology and
11 neurotraining technology.
12      SECTION 2.  There is appropriated out of the general
13 revenues of the State of Hawaii the sum of $1 or so much thereof
14 as may be necessary for fiscal year 1999-2000 and the sum of $1
15 or so much thereof as may be necessary for fiscal year 2000-2001
16 to develop a neuroscience industry in the State.  The sums
17 appropriated shall be used for research infrastructure and
18 program development of brain impairment services and products
19 with a commercial market value.
20      SECTION 3.  The sums appropriated shall be expended by the
21 department of business, economic development, and tourism for the
22 purposes of this Act.

Page 5                                                     203
                                     H.B. NO.           H.D. 1

 1      The department of business, economic development, and
 2 tourism shall facilitate a public-private partnership with the
 3 Hawaii neuropsychology community research bureau, the University
 4 of Hawaii School of Public Health, the commission on the status
 5 of women, and representatives from the business community.
 6      SECTION 4.  This Act shall take effect on July 1, 1999.