North Carolina’s Injury and Violence Prevention Team

www.injuryfreenc.ncdhhs.gov

The Injury & Violence Prevention Branch is less focused on programs

- a diverse group of partners implement the programs -

We provide a set of services:

Coordination • State Plan & Advisory Council• Communication with Partners• Training – Injury Free NC Academy, Summits – Falls, Suicide, Overdose• Evidence-based strategies

Policy – Evidence-Based strategies, with partners.NC Child Fatality Task Force, Trauma, Brain Injury, Highway Safety

Injury Epidemiology - Public Health date• Morbidity (hospital discharge, Emergency Department)

• Mortality (death certificate)

• Health Behavior (i.e. - BRFSS, YRBS, ACE)

Collaboration to Preserve North Carolina’s

Universal Motorcycle Helmet Law

Alan Dellapenna, Branch Head

Injury and Violence Prevention Branch

NC Division of Public Health

Who opposes H 109

NC Division of Public Health

NC Division of Medical Assistance (Medicaid)

Child Fatality Task Force (a standing legislative committee)

NC Association of Local Health Directors

NC Brain Injury Association

NC Brain Injury Advisory Council

NC College of Emergency Physicians

NC Medical Society

NC Safe Kids

Action for Children

UNC Injury Prevention Research Center

UNC Highway Safety Research Center

East Carolina Injury Prevention Center

Others?

Agency Bill Review

Resolutions Opposing H 109

Engage Lobbyist

Visit Legislator to Educate

Editorial letters in Newspapers

Action Alerts to Members

Technical Assistance

Editorials

Expert to reporters

Partners

• All Riders and passengers must wear a safety helmet when riding a motorcycle.

• $25.50 fine + ~$130 court costs for violating the law.

Current NC Universal Motorcycle Helmet Law

Like many states, NC faces an annual legislative effort to repeal our Universal Motorcycle Helmet Law.

In 2011, the Division of Public Health joined the effort to preserve the helmet law.

2011 CDC Report

CDC Findings:

North Carolina’s motorcycle helmet law results in greater savings in health care costs and productivity, per registered motorcycle, than any other state in the nation.

Naumann & Shults. MMWR June 15, 2012 / 61(23);425-430

Source: State Center for Health Statistics, Hospital Discharge File, 2011 (Provisional)Analysis by Injury Epidemiology and Surveillance Unit

Hospitalization Charges Associated with Motorcycle Injuries: North Carolina, 2011*

• $75.5 million in hospitalization charges associated with motorcyclist injuries.

• $25 millioncharged to Uninsured motorcyclists

*Charges may not reflect final costs.

$13.7

$5.4

$11.2

$23.7

$7.2

$14.3

$0 $5 $10 $15 $20 $25 $30 $35 $40

Insurance

FederalPrograms

Uninsured

Other Insurance

Unknown/Self Pay

Medicare Other Federal Programs

Medicaid

Blue Cross

$25M

(33%)

$12.6M

(17%)

$37.4M

(50%)

Societal loss of a

parent, employee,

community member

survivor, and family

caregiver.

$4.5M, average cost per

case of permanently

disabled brain injury

survivor

Currently $75.5M in NC

($25M Medicaid/Self Pay)

Death

Emergency &

Trauma Care

Rehabilitation

Long Term Care

Loss of Productivity

Insurance Rate

Increases for

everyone

Auto &

Motorcycle

Health

Death is the tip of the iceberg for the cost of

repealing a Universal Motorcycle Helmet Law

A person 21 years or older may operate a motorcycle without wearing a safety

helmet if the operator:

• Holds a motorcycle license more than 12 months or

• Successfully completes a Motorcycle Safety course and

• Has $10,000 medical insurance policy for motorcycle operation.*

• Passengers over 21 years or older can ride without a helmet if the operator is

allowed to operate a motorcycle without a helmet and has $10,000 medical

insurance.

• Remove Court Costs (~$130)

Proposed Changes of House Bill 109 (2013-15)(modeled on the FL law)

* Reportedly not permissible under NC’s Insurance law, no policy like this can be offered.

A full repeal of the law isn’t politically feasible.

Get the same results by weakening the current law so it isn’t enforced.

• Reduce fines, eliminate court costs• Exempt riders covered by age

Offer compromises that appear to address health and cost. • $10,000 Insurance requirements

Assert the current law is unfair, offer apparent compromises to the current law.

Render the law unenforceable.

Motorcycle Helmet Law Repeal Strategy

North Carolina Motorcycle Licenses by Age Group, 2014414,475 motorcycle licenses – 190k+ licensed motorcycles

Age Group

Licenses

• Deaths in the <21 age group increased 188% after partial repeal of the helmet law in Florida.

• When 99.25% of riders are exempted from wearing a helmet enforcement becomes a low priority for police.

• It’s a new driver issue; learning to drive is hard, learning to ride without reinforcement of helmet use is

deadly.

• Less than 1,000 dues

paying members,

• Organized, Focused,

Visible, Vocal,

• Have legislative

“champions”,

• Legislative success.

North CarolinaCBA/ABATE

Legislative ChampionRepresentative John Torbett, Gaston County

Gaston ABATE Chapter member

Gaston lawmaker wants to help motorcyclists lose their helmetsPublished: Friday, March 22, 2013

“What this is about to me is pretty much

the freedom of an adult to choose,”

Bill “Blastoff” Starnes

Legislative Coordinator

April 2013

Gaston County CBA/ABATE Newsletter

HELMET REPEAL BILL UPDATE

“Gaston County Rep Dana Bumgardner, also a Gaston County

CBA member, is Vice Chairman on the (Transportation) Committee

hearing this bill and is with us on this legislation.”

Rep. Dana Bumgardner (Rep)

Gaston Co.

House Transportation Committee

Vice Chair

Argument for Repeal

• Freedom - Its about the freedom of adults to chose.

• “Let those who ride decide.” Non-riders are imposing the helmet choice.

• Helmets aren’t effective, data used to promote helmet effectiveness is

wrong, data’s been manipulated by feds to hide the truth.

Don’t Mess with NC’s Universal Helmet Law

• The current law has worked very well for 47 years and is very

popular among a large majority of motorcyclists in NC.

• Changing the law is an expensive unfunded mandate that all tax

payers and insurance policy holders will fund.

• Helmets Laws work.

• 28 state have weakened their law; deaths, head injuries, and costs

have gone up 20-40% in all 28 states.

Two Stories about Motorcycle Helmets

The helmet law repeal effort’s goal is to displace the story of NC’s Universal

Helmet Law’s effectiveness, popularity, and value with their story of

A nanny state infringement on personal freedom.

We’re not trying to convince the pro-repeal advocates they’re wrong;

We are trying to remind and reinforce the public and law makers that the

current policy is sound, reasonable, popular, and effective and

reject the new argument.

Arguing their points legitimizes their argument and takes away from presenting our story.

Research on countering wrong messages shows it reinforces their point.(Try to convince a Trump or Bernie support they’re wrong.)

We’re not going to convince the pro-repeal advocates they’re wrong and we don’t have to;

We want to reinforce that the current policy is right.

What can Trauma do?

• Continue voicing your position on the issue.

• Let your legislators know where you stand on preserving the

motorcycle safety helmet law.

• Use Local Media:

• Tell your side of the story, what happens in your community with a

trauma case

• Invite reporters to tell the trauma story

• Challenge wrong stories

• Show up at Legislative Committee Meetings in “uniform”.

May 2013 - House Judiciary Committee B Hearing on H 109

Trauma showed up in force.

4 Committee members spoke in opposition to H-109, citing personal experience with brain injured survivors.

Committee adjourned with no vote on the bill, no member would make a motion.

H 109 was converted to a study bill, stayed in the Senate Rules Committee most of 2014, session ended before it was scheduled in the Senate Transportation Committee but session ended before the bill was heard in committee.

2015 Strategy• New Fact Sheet, Website

• 2 peer-review journal health cost studies

• Active coordination of groups with vested interested in preserving the current law

• Trauma• Emergency Physicians• Brain Injury• Child Advocacy

Groups• Dept. of Health &

Human Services• Highway Safety• UNC Research

Centers (IPRC, HSRC)

http://injuryfreenc.org/about/Resources

http://injuryfreenc.org/injury-topics/transportation-safety/motorcycle-safety/

What is the cost of weakening North Carolina’s universal motorcycle helmet law?

In 2015, 2 studies examined different aspects of the cost of repealing the NC motorcycle helmet law.

• Harmon et al. J Head Trauma Rehab. Motorcycle Crash-Related Emergency Department Visits and Hospitalizations for Traumatic Brain Injury in North Carolina. In press, 2015.

• Naumann et al. NC Med J, Impact of North Carolina’s Motorcycle Helmet Law on Hospital Admissions and Charges for Care of Traumatic Brain Injuries. 2015: 76(2).

0%

5%

10%

15%

20%

25%

30%

Pe

rce

nt

of

ho

sp

ita

liza

tio

ns

Expected hospital charges

Traumatic Brain Injury

non-TBI4% TBI7.4% non-TBI

1nd StudyExpected charges for NC hospitalizations due to motorcycle crashes, 3,737

motorcycle cases resulting in hospitalization, 2009-2011

Harmon et al. J Head Trauma Rehab. In press, 2015.

25.6%

15.2%

More than $100,000 per case

Less than $10,000 per case

What could North Carolina expect in terms of hospitalized motorcyclists with TBIs and associated charges if North Carolina

did not have a universal helmet law.

Methods Summary

Compare North Carolina motorcycle-related hospital charges tothree “surrogate” populations without helmet laws:

PA, FL, SC

Naumann et al. NC Med J, Impact of North Carolina’s Motorcycle Helmet Law on Hospital Admissions and Charges for Care of Traumatic Brain Injuries. 2015: 76(2).

2nd Study

TABLE 1. Actual and Counterfactual Hospital Inpatient Charges for Motorcyclists with Traumatic Brain Injury1, North Carolina, 2011

Source or

Substitute

Population

Annual

Number of

Motorcycle TBI

Inpatients

Average

Hospital

Charge per

Motorcycle TBI

Inpatient

Hospital Inpatient Charges for Motorcycle TBIs

Government &

Public Sources

Private

Sources &

Other

Payments Self-Payment

Total Charges,

All Sources

A. Universal

Motorcycle Helmet Law

In Effect (Actual)

North Carolina 2011 275 $83,428 $8,624,989 $11,430,761 $2,886,961 $22,942,711

B. No Universal

Motorcycle Helmet Law

(Counterfactual)

Florida 20002 501 $96,359 $18,150,504 $24,054,996 $6,075,347 $48,280,847

Pennsylvania 20033 490 $110,125 $20,265,264 $26,857,703 $6,783,201 $53,906,168

SC Residents

Treated in NC4

465 $104,814 $18,312,705 $24,269,962 $6,129,639 $48,712,307

190 fewer admissions for motorcyclists with TBIs with the universal helmet law

Total charges were approx. ½ with a universal helmet law • $22.9 million rather than $48.3 million

$25.4 million increase if universal law weakened

$9.5 million increase in public funding if helmet law weakened

Results Summary

• NCM Journal featuring Brain Injury arrived in mail boxes the week the helmet law went to committee.

• State Legislators are on the mailing list for the journal.

Rep. Darren Jackson (D-Raleigh) said he was in the process of reading an article in the North Carolina Medical Journal about motorcycle helmets when he received notice of the bill being sent to the Committee on Rules, Calendar, and Operations of the House.

Helmet Repeal Bill dramatically defeated in the House Rules Committee

2016

NC ABATE LEGISLATIVE AGENDA FOR 2016:• Motorcycle access to public facilities built with taxpayer monies• Amend autocycle legislation passed in 2015• Work with Dept. of Public Instruction (DPI) to have drivers ed part of the core

curriculum• Anit-profiling bill• Anti-discrimination bill

“As you can see the helmet bill is not a priority.

IN MY OPINION, this is a correct move.

There is not enough support in Raleigh to get this bill out of committee.

The governor has stated (through his staff) that he would veto any helmet modification bill.

So it makes no sense to ask our local House and Senate friends to fight a battle they already know they can’t win!”

Legislative Update, Gaston ABATE January 2016 Newsletter

NC ABATE’s President’s report: 2016 State of the Organization

“I’m not by any means saying we should give up that fight.

However, the helmet issue is just not that important to the average biker or the young biker.

They’ve had to wear helmets their whole lives and are used to it. Our society has become more safety driven.

Whether we agree with it or not, younger bikers have accepted it.”

President's Report NC ABATE 2nd Quarter 2016 Newsletter

We may have turned the tide, but remain vigilant and prepared to actively support the preservation of the most effective

motorcycle helmet law in the country.

“The Senate bill has been held up due to the Senate leadership saying

that they will not consider the bill without medical insurance of $30,000.

They seem to have received bad info from the Dept. of Insurance, as no

company will write that kind of insurance. We continue to work to rectify this situation.

You can find on the website who your reps are and contact info for them. Make those phone calls and send those emails!”

NC ABATE 2017 1st Quarter NewsletterSummary from Legislative Update

Update posted on NC ABATE’s Facebook site: April 25 at 6:28pm

“OK folks, here's the deal on the freedom of choice bill, HB91.

The votes to pass weren't there today so it was pulled from the agenda.

If we can get some more yes votes it can be heard tomorrow.

Call and/or email as many reps as you like. I believe the following will vote yes:

Brawley, Cleveland, Dollar, Hastings, Iler, Pittman, Sauls, Setzer, Speciale.

The rest I am unsure of. . . Tomorrow will be our last chance to get this passed.

You know what to do.”

Letters to the editor -Jean Andersen: No freedom with brain injury, N&O, April 29, 2017

”This is not a freedom issue. There is no freedom in brain injury.”

Jeanne Romeo: Free will consequences, N&O, April 29, 2017“Riders over 21 should be able to exercise their free will and ride without a helmet, provided that our hospitals also are allowed to exercise their free will and refuse to

treat motorcyclists with catastrophic head injures unless they can pay up front.”

Jesse Kaufmann: Wear a helmet, N&O, April 29, 2017“We called motorcyclists without helmets “donors.” Organ donors.”

Anthony Hatcher: Stop helmet bill, N&O, April 29, 2017“I’ve been riding motorcycles for 48 years and would never entertain the notion of riding on the highway without a helmet. . . those on the House Transportation Committee who

support this change apparently care little about the lives of fellow bikers.”

Jim Farrington: Laws save lives, N&O, April 29, 2017“Both the seat belt law and the helmet law save lives – period. If Torbett’s so big into

personal responsibility, I hope he’s prepared to accept responsibility for all the deaths that result from his action.”

Presumably the motorcycle helmet repeal bill is dead. However, at the legislature no bill is

ever completely dead. Legislative language is often dropped into the framework of another

bill, in a process known colloquially as “gut and amend.” The gut and amend process has

resulted in bills such as the infamous “motorcycle / vagina bill” in 2013, where abortion

restrictions were dropped into a bill on, you guessed it, motorcycle safety.

After an easy trip through the House

Transportation Committee on Monday, this

year’s bill skipped past several referrals to the

House Health and Insurance Committees and

went straight to the House floor for debate and

a vote on Tuesday morning.

But the bill was one of several withdrawn from

debate on Tuesday. It reappeared on the

calendar on Wednesday, only to be withdrawn

again. In the end, the bill did not make the

crossover deadline.

April 25, 2017 by Rose Hoban

A now-familiar bill would allow for motorcycle riders to ride bare-headed once they’re over 21 years old. The bill goes to

the House floor for vote today.

http://www.northcarolinahealthnews.org/2017/04/25/motorcycle-helmet-bill-zooms-ncga-committee/

www.statnews.com/2017/05/31/helmet-law-motorcycle/

Helmet activists see momentum on their side.

“The number of helmet requirement bills that were introduced this year is very affirming that the message that motorcycle helmets save lives and reduce injuries is getting out there,”

Persistence, Determination, Resiliency

As sure as the spring will follow the winter,

we will see another helmet repeal bill next year

and we’ll be there to meet the challenge.