Jack Rozance: Thank you Mr. Chairman. Committee Members, I'll be brief. My name is Jack Rozance. I'm the physician and chief at Kaiser Permanente in Sacramento, and have a particular clinical interest in the area of brain injury rehabilitation through my practice of neurology. I've also had the great fortune with Kaiser Permanente of Northern California to participate in the organization of regional rehabilitation services.

As that experience of our care program here in Northern California and its two-and-one-half million members, I'd like to share with you briefly, we know that since January 1, 1990, when the Kaiser Foundation rehabilitation center in Vallejo opened its doors to take in care and management of all patients with mild, moderate and severe traumatic brain injuries requiring complicated rehabilitation services, we know that in the first two years of operations we averaged six cases per year, six patients per year, admitted to that service for rehabilitation of severe and moderate head injury that were associated with motorcycle accidents, they were the drivers. We also know that all those patients were not wearing helmets.

There was one patient admitted who was wearing a helmet who had orthopedic limb injuries requiring rehabilitation and care. We also know that beginning January first, 1992, and I will say coincident I believe with the passage of the mandatory motorcycle helmet law, our numbers in the next four years -- '92, '93, '94 and '95 -- have shown a total of eight admissions. That is two per year to the rehabilitation center for rehabilitation for moderate, mild and severe traumatic brain injury. A dramatic difference.

And I can also tell you, and those are eight patients again with motorcycle related injuries, I can tell you that all eight had chosen not to use a helmet. We had no patients admitted who had used a helmet with severe traumatic brain injuries to that center during those four years -- '92, '93, '94 and '95.

My numbers are even skewed so that over the last year it appears that have been no admissions. So it even appears to be tailing off, which I presume in some way relates to increased and pervasive use of motorcycle helmets.

The last point I would make is that that is only the tip of the iceberg. For every severe head injury requiring complex acute rehabilitation therapy I can assure there are dozens more of more modern severity, yet the persistent cognitive memory personality behavioral changes that impair in a very serious way the ability to work, the one's on medical care management family family environment, the severe head injuries are the tip of the iceberg. We've seen an improvement in lessening of head injury frequency throughout all spectrums of care and levels of brain injury rehabilitation.

I would lastly comment that these experiences reflect those of the Santa Clara Medical Center and Doctor Jeff Englander, our counter-part there, has had similar numbers. Thank you very much.

Senator Kelley: Thank you. Next witness.

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