REPORT TITLE:
Approp.; Child Protection


DESCRIPTION:
Appropriates funds for various programs and services for the
protection of children and families.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        1367
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

MAKING APPROPRIATIONS FOR THE PROTECTION OF CHILDREN AND
   FAMILIES.


BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1                              PART I.
 
 2      SECTION 1.  The purpose of this Act is to ensure that a
 
 3 continuum of services for the prevention of child abuse is
 
 4 available.
 
 5      The legislature is committed to preventing child abuse
 
 6 before it occurs.  Since child abuse is a complex problem with a
 
 7 multitude of causes, Hawaii's response to prevention must respond
 
 8 to a range of needs.
 
 9      During the interim of the regular session of 1998, child
 
10 protection legislative roundtable discussions were convened to
 
11 suggest statutory, guideline, rule, regulation, and other changes
 
12 to improve Hawaii's child protective system.  Legislators, the
 
13 departments of human services, health, and the attorney general,
 
14 the judiciary, private non-profit child and family serving
 
15 agencies, and concerned individuals communicated and collaborated
 
16 with one another, on behalf of abused and neglected children and
 
17 their families, to develop formal and informal mechanisms for
 
18 working together.
 

 
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 1      As a coordinated response, the roundtable cohesively
 
 2 designed a comprehensive strategy to prevent child abuse.
 
 3 Reflective of the phases of the family life cycle, the approach
 
 4 provides children and parents with the education and support
 
 5 necessary for healthy family functioning.
 
 6                              PART II
 
 7         DEPARTMENT OF HEALTH ADMINISTRATIVE EXPENDITURES
 
 8      SECTION 2.  The legislature finds that section 321-341,
 
 9 Hawaii Revised Statues, permits the department of health to
 
10 conduct multidisciplinary and multiagency reviews of child deaths
 
11 to reduce the incidence of preventable child deaths.  The primary
 
12 intent of child death reviews is to gain a better understanding
 
13 about deaths resulting from, among other things, child abuse and
 
14 neglect.  An accurate understanding of the cause of death allows
 
15 for the creation of more effective and earlier prevention
 
16 policies in order to avoid future deaths of Hawaii's children and
 
17 youth.  Prevention efforts which are based upon accurate data can
 
18 be evaluated to assure more effective outcomes for Hawaii's
 
19 children.
 
20      The purpose of this part is to establish permanent positions
 
21 to assure continuous implementation of child death review teams.
 
22      SECTION 3.  The department of health is authorized to
 
23 establish and fill one and one-half permanent professional
 

 
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                                     H.B. NO.           H.D. 1
                                                        
                                                        

 
 1 positions exempt from the provisions of chapters 76 and 77 to
 
 2 carry out the purposes of section 321-341, Hawaii Revised
 
 3 Statutes.
 
 4 t    SECTION 4.  There is appropriated out of the general
 
 5 revenues of the State of Hawaii the sum of $1 or so much thereof
 
 6 as may be necessary for fiscal year 1999-2000 and the sum of $1
 
 7 or so much thereof as may be necessary for fiscal year 2000-2001
 
 8 for the establishment of one and one-half full time equivalent
 
 9 (1.5 FTE) positions and operating expenses to assure continuous
 
10 implementation of the child death review teams.
 
11      The sums appropriated shall be expended by the department of
 
12 health for the purposes of this part.
 
13                             PART III
 
14  DEPARTMENT OF THE ATTORNEY GENERAL ADMINISTRATIVE EXPENDITURES
 
15      SECTION 5.  The legislature finds that the department of the
 
16 attorney general lacks the sufficient number of staff to
 
17 adequately carry out its functions relating to chapter 587,
 
18 Hawaii Revised Statutes.
 
19      The purpose of this part is to appropriate funds to
 
20 establish and fill three permanent deputy attorney general
 
21 positions to carry out the purposes of chapter 587, Hawaii
 
22 Revised Statutes.
 

 
 
 
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 1      SECTION 6.  The department of the attorney general is
 
 2 authorized to establish and fill three full-time equivalent (3.0
 
 3 FTE) permanent deputy attorney general positions exempt from the
 
 4 provisions of chapters 76 and 77 to carry out the purposes of
 
 5 chapter 587, Hawaii Revised Statutes.
 
 6      SECTION 7.  There is appropriated out of the general
 
 7 revenues of the State of Hawaii the sum of $1 or so much thereof
 
 8 as may be necessary for fiscal year 1999-2000 and the sum of $1
 
 9 or so much thereof as may be necessary for fiscal year 2000-2001
 
10 for the establishment of three full-time equivalent (3.00 FTE)
 
11 permanent deputy attorney general positions, and support staff
 
12 for the family law division of the department of the attorney
 
13 general; provided that the department of human services shall
 
14 annually reimburse the department of the attorney general thirty-
 
15 three and one-third per cent of the total appropriation, from
 
16 federal funds.
 
17      The sums appropriated shall be expended by the department of
 
18 the attorney general for the purposes of this part.
 
19                              PART IV
 
20               MEDICAL/HEALTH CASE MANAGEMENT SYSTEM
 
21      SECTION 8.  The legislature finds that medical management of
 
22 child protective services children is complicated and has been
 
23 wholly dependent on the individual social worker's priority
 

 
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 1 assignments.  Problems already exist in the medical management of
 
 2 these children, including:
 
 3      (1)  When a child protective services child is assigned a
 
 4           new physician, the physician is not informed until the
 
 5           child comes in for an office visit, and the child
 
 6           usually has from little to no medical information
 
 7           available at the time of the visit;
 
 8      (2)  The physician often has from little to no communication
 
 9           with the child protective services social worker or
 
10           foster parent because children are often transported to
 
11           appointments by a transport worker;
 
12      (3)  When a child is discharged from the hospital with a
 
13           diagnosis of child abuse, follow-up with the child's
 
14           doctor and other specialists are almost always needed.
 
15           There is no system in place to ensure this gets done.
 
16           Furthermore, these follow-ups are sometimes overlooked;
 
17           and
 
18      (4)  When a multidisciplinary team meeting is held, there
 
19           are often medical problems identified that need to be
 
20           addressed.  There is no system in place to ensure that
 
21           these problems are followed up.
 
22      While child welfare services has amended its procedures to
 
23 comply with Act 134, Session Laws of Hawaii 1998, increasing even
 

 
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 1 more is the complex medical management that is expected of the
 
 2 social worker.  The legislature finds that more needs to be done
 
 3 to ensure that mandated health exams occur, or that communication
 
 4 and follow-up are enhanced.
 
 5      The purpose of this part is to appropriate funds to
 
 6 establish a medical/health case management system.
 
 7      SECTION 9.  The department of human services is authorized
 
 8 to establish and fill one half-time equivalent (0.5 FTE)
 
 9 permanent physician position exempt from the provisions of
 
10 chapters 76 and 77 to carry out the purposes of section 587-   ,
 
11 Hawaii Revised Statutes.
 
12      SECTION 10.  There is appropriated out the general funds of
 
13 the State of Hawaii the sum of $1 or so much thereof as may be
 
14 necessary for fiscal year 1999-2000 and the sum of $1 or so much
 
15 thereof as may be necessary for fiscal year 2000-2001 for the
 
16 establishment of one half-time equivalent (0.5 FTE) permanent
 
17 physician position for ongoing consultation and forensic review
 
18 of cases to prevent further child abuse and neglect; provided
 
19 that funds be designated to a child protection multidisciplinary
 
20 team for the implementation of the medical/health case management
 
21 system.
 
22      The sums appropriated shall be expended by the department of
 
23 human services for the purpose of this part.
 

 
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 1      SECTION 11.  There is appropriated out of the general funds
 
 2 of the State of Hawaii the sum of $1 or so much thereof as may be
 
 3 necessary for fiscal year 1999-2000 and the sum of $1 or so much
 
 4 thereof as may be necessary for fiscal year 2000-2001 to fill
 
 5 eleven vacant public health nursing positions within the
 
 6 department of health for the implementation of the medical/health
 
 7 case management system.
 
 8      The sums appropriated shall be expended by the department of
 
 9 health for the purposes of this part.
 
10                              PART V
 
11                   HOSPITAL-BASED RISK SCREENING
 
12      SECTION 12.  The legislature finds that child abuse
 
13 prevention and neglect among young children during their
 
14 formulative years are imperative as research on early brain
 
15 development indicates that "by age three, a child who has been
 
16 seriously abused or neglected bears scars that are difficult, if
 
17 not impossible, to erase."
 
18      The legislature further finds that the department of health
 
19 has been an integral factor in mitigating the number of child
 
20 abuse cases in the State by providing intensive support to at-
 
21 risk families from the onset.  In fact, the rate of children
 
22 hospitalized for abuse and neglect on Oahu is four times higher
 
23 per thousand, among families who do not receive support from the
 

 
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 1 department.  However, the legislature also finds that funding
 
 2 these programs have been reduced by thirty per cent, and similar
 
 3 programs have been cut entirely.
 
 4      The legislature recognizes the importance of funding such
 
 5 programs that provide necessary services to children and their
 
 6 families.  Although hospital-based risk screening is proposed to
 
 7 be increased to reach all families of newborns, as part of the
 
 8 Felix Consent Decree, there is no provision for funds for
 
 9 services for families identified as at-risk through this process.
 
10      The purpose of this part is to appropriate funds for
 
11 services for families identified as "at risk".
 
12      SECTION 13.  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 $1 or so much
 
15 thereof as may be necessary for fiscal year 2000-2001 for
 
16 hospital-based risk screening services for families identified as
 
17 "at-risk".
 
18      The sums appropriated shall be expended by the department of
 
19 health for the purposes of this part.
 
20                              PART VI
 
21                SUBSTANCE ABUSE TREATMENT SERVICES
 
22        FOR PREGNANT AND PARENTING WOMEN AND THEIR FAMILIES
 
23      SECTION 14.  The legislature finds that families are the
 
24 foundation upon which our society is built.  Mothers, in
 

 
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                                     H.B. NO.           H.D. 1
                                                        
                                                        

 
 1 particular, have a profound influence as the ones responsible in
 
 2 large part for the development and growth of their children.
 
 3      Substance abuse can have a devastating effect on families,
 
 4 especially if the mother has a substance abuse problem.  A
 
 5 substance-abusing mother would not be able to discern whether a
 
 6 child is in need of protection from harm or abuse.  In fact, a
 
 7 substance-abusing mother may not even be aware that she is the
 
 8 one responsible for harming her own child.
 
 9      The purpose of this part is to increase funding for
 
10 substance abuse treatment services to assist pregnant women,
 
11 mothers, and their families involved in the child protective
 
12 services system.
 
13      SECTION 15.  There is appropriated out of the general
 
14 revenues of the State of Hawaii the sum of $1 or so much thereof
 
15 as may be necessary for fiscal year 1999-2000 and the sum of $1
 
16 or so much thereof as may be necessary for fiscal year 2000-2001
 
17 to provide substance abuse treatment services for pregnant and
 
18 parenting women and their families as follows:
 
19                                          FY 1999-2000  FY 2000-2001
 
20      (1)  Comprehensive substance abuse
 
21           treatment services, including
 
22           six certified substance abuse
 
23           counselors and training for
 
24           program staff; and                      $1          $1
 
25      (2)  Assessments                              1           1
 

 
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 1      The sums appropriated shall be expended by the department of
 
 2 human services for the purposes of this part.
 
 3      SECTION 16.  There is appropriated out of the general
 
 4 revenues of the State of Hawaii the sum of $1 or so much thereof
 
 5 as may be necessary for fiscal year 1999-2000 and the sum of $1
 
 6 or so much thereof as may be necessary for fiscal year 2000-2001
 
 7 to provide substance abuse treatment services for pregnant and
 
 8 parenting women and their families as follows:
 
 9                                          FY 1999-2000  FY 2000-2001
 
10      (1)  Pre-treatment services for
 
11           pregnant women, including
 
12           outreach and screening;                 $1          $1
 
13      (2)  Early intervention services;             1           1
 
14      (3)  Treatment services, including
 
15           therapeutic living and
 
16           intensive outpatient treatment;          1           1
 
17      (4)  Special residential treatment
 
18           facility;                                1           1
 
19      (5)  Unfunded beds;                           1           1
 
20      (6)  Intensive outpatient treatment
 
21           on Maui; and                             1           1
 
22      (7)  Intensive outpatient treatment
 
23           on Oahu                                  1           1
 

 
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                                     H.B. NO.           H.D. 1
                                                        
                                                        

 
 1      The sums appropriated shall be expended by the department of
 
 2 health for the purposes of this part.
 
 3                             PART VII
 
 4              DIVERSION AND CHILD PROTECTION SERVICES
 
 5      SECTION 17.  The legislature finds that one of the
 
 6 recommendations of a 1994-1996 task force on child protective
 
 7 services reform was to implement a community partnership for
 
 8 child protection.  A major component of this partnership was to
 
 9 be the establishment of facilities to deliver diversion services
 
10 and child protective services to targeted families.
 
11      These facilities provide a community-based center for
 
12 services and community support for abused or neglected children
 
13 and their families as well as for families at-risk of child
 
14 abuse.  Each facility has been based on the needs of the specific
 
15 community and has included a physical site for these families to
 
16 work with private and public service providers.  A wide range of
 
17 services and resources are available from early response to
 
18 continued services for families already facing problems.
 
19      Limited start-up funding for these facilities were obtained
 
20 through local foundation grants and Federal Title IV-B moneys.
 
21 However, without continued funding for the pilot period, these
 
22 facilities will not be able to accomplish the system reform that
 
23 the task force and the legislature recommended.
 

 
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 1      The purpose of this part is to appropriate funds to
 
 2 establish additional facilities to deliver diversion services and
 
 3 child protection services.
 
 4      SECTION 18.  There is appropriated out of the general
 
 5 revenues of the State of Hawaii the sum of $1 or so much thereof
 
 6 as may be necessary for fiscal year 1999-2000 and the sum of $1
 
 7 or so much thereof as may be necessary for fiscal year 2000-2001
 
 8 for staffing and services for facilities to deliver diversion
 
 9 services and child protection services to targeted families.
 
10      The sums appropriated shall be expended by the department of
 
11 human services for the purposes of this part.
 
12                             PART VIII
 
13                    TRAINING FOR FOSTER PARENTS
 
14      SECTION 19.  The legislature finds that the department of
 
15 human services is responsible for ensuring that prospective
 
16 foster and adoptive parents are prepared for their new roles.  As
 
17 such, the department is responsible for administering a
 
18 competency-based, comprehensive pre-service training and
 
19 assessment program for all foster parents and adoptive parents
 
20 seeking general certification or approval as parents.
 
21      The purpose of this part is to allow the department of human
 
22 services to:
 

 
 
 
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 1      (1)  Increase the pool of foster homes and adoptive homes
 
 2           for better matching of children in need of out-of-home
 
 3           care; and
 
 4      (2)  Strengthen the quality of family foster care and
 
 5           adoptive services by providing a standardized,
 
 6           consistent framework for the competency-based training,
 
 7           preparation, and selection of foster parents and
 
 8           adoptive parents.
 
 9      SECTION 20.  There is appropriated out of the general
 
10 revenues of the State of Hawaii the sum of $1 or so much thereof
 
11 as may be necessary for fiscal year 1999-2000 and the sum of $1
 
12 or so much thereof as may be necessary for fiscal year 2000-2001
 
13 for:
 
14      (1)  Foster parent training for foster parents of licensed
 
15           foster homes;
 
16      (2)  Foster parent training for relative foster parents of
 
17           special licensed foster homes; and
 
18      (3)  Follow-up foster parent training for foster parents of
 
19           licensed foster homes.
 
20      SECTION 21.  There is appropriated out of the general
 
21 revenues of the State of Hawaii the sum of $1 or so much thereof
 
22 as may be necessary for fiscal year 1999-2000 and the sum of $1
 
23 or so much thereof as may be necessary for fiscal year 2000-2001
 
24 to increase foster board payments for children with special
 
25 needs.
 

 
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 1      SECTION 22.  The sums appropriated shall be expended by the
 
 2 department of human services for the purposes of this part.
 
 3                              PART IX
 
 4                   PSYCHOSOCIAL SUPPORT SERVICES
 
 5      SECTION 23.  The legislature finds that intervention
 
 6 services is a key factor in preventing stressful situations in
 
 7 the home from escalating to unmanagable proportions.  The
 
 8 legislature finds that the department of health has been
 
 9 successful in providing a healthy outlet for families to express
 
10 their concerns and anger with regard to child management,
 
11 development, and behavior, and in giving much-needed support and
 
12 respite to families.
 
13      The department of health provides counseling, support, and
 
14 community referrals to over four thousand parents and caregivers
 
15 that have phoned-in their questions regarding their children's
 
16 development and behavior.  The department also provides short-
 
17 term home visitation to four hundred families that have been
 
18 identified through the call-in services as being at-risk for
 
19 social, emotional, or behavioral programs.  Those persons using
 
20 the short-term visitation services require family intervention
 
21 beyond a phone call to resolve a family parenting concern or
 
22 crisis.
 

 
 
 
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 1      The legislature finds that these services are overburdened
 
 2 due to the increase in the number of clients requiring
 
 3 assistance.
 
 4      The purpose of this part is to appropriate the necessary
 
 5 funds to broaden the scope of these services to properly meet the
 
 6 needs of the community.
 
 7      SECTION 24.  There is appropriated out of the general
 
 8 revenues of the State of Hawaii the sum of $1 or so much thereof
 
 9 as may be necessary for fiscal year 1999-2000 and the sum of $1
 
10 or so much thereof as may be necessary for fiscal year 2000-2001
 
11 to increase the capacity of the phone-in and short-term home
 
12 visitation services to properly meet the needs of the community.
 
13      The sums appropriated shall be expended by the department of
 
14 health for the purposes of this part.
 
15                              PART X
 
16      SECTION 25.  All specified sums in this Act shall be made in
 
17 addition to the respective departmental budgets.
 
18      SECTION 26.  This Act shall take effect on July 1, 1999.