REPORT TITLE:
Approp.; Child Protection


DESCRIPTION:
Appropriates funds for various programs and services for the
protection of children and families.  (SD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        1367
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 2
TWENTIETH LEGISLATURE, 1999                                S.D. 1
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                 PURPOSE AND LEGISLATIVE FINDINGS
 
 3      SECTION 1.  The purpose of this Act is to ensure that a
 
 4 continuum of services for the prevention of child abuse is
 
 5 available.
 
 6      The legislature is committed to preventing child abuse
 
 7 before it occurs.  Since child abuse is a complex problem with a
 
 8 multitude of causes, Hawaii's response to prevention must respond
 
 9 to a range of needs.
 
10      During the interim of the regular session of 1998, child
 
11 protection legislative roundtable discussions were convened to
 
12 suggest statutory, guideline, rule, regulation, and other changes
 
13 to improve Hawaii's child protective system.  Legislators, the
 
14 departments of human services, health, and the attorney general,
 
15 the judiciary, private non-profit child and family serving
 
16 agencies, and concerned individuals communicated and collaborated
 
17 with one another, on behalf of abused and neglected children and
 
18 their families, to develop formal and informal mechanisms for
 
19 working together.
 

 
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 1      As a coordinated response, the roundtable cohesively
 
 2 designed a comprehensive strategy comprised of community-based
 
 3 programs to prevent child abuse.  Reflective of the phases of the
 
 4 family life cycle, the approach provides children and parents
 
 5 with the education and support necessary for healthy family
 
 6 functioning.
 
 7                              PART II
 
 8         DEPARTMENT OF HEALTH ADMINISTRATIVE EXPENDITURES
 
 9      SECTION 2.  The legislature finds that section 321-341,
 
10 Hawaii Revised Statutes, permits the department of health to
 
11 conduct multidisciplinary and multiagency reviews of child deaths
 
12 in order to reduce the incidence of preventable child deaths.
 
13 The primary intent of child death reviews is to gain a better
 
14 understanding about deaths resulting from, among other things,
 
15 child abuse and neglect.  An accurate understanding of the cause
 
16 of death allows for the creation of more effective and earlier
 
17 prevention policies in order to avoid future deaths of Hawaii's
 
18 children and youth.  Prevention efforts which are based upon
 
19 accurate data can be evaluated to assure more effective outcomes
 
20 for Hawaii's children.
 
21      SECTION 3.  The department of health is authorized to
 
22 establish and fill one and one-half permanent professional
 
23 positions exempt from chapters 76 and 77, Hawaii Revised
 

 
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 1 Statutes, to carry out the purposes of section 321-341, Hawaii
 
 2 Revised Statutes.
 
 3      SECTION 4.  There is appropriated out of the general
 
 4 revenues of the State of Hawaii the sum of $       , or so much
 
 5 thereof as may be necessary for fiscal year 1999-2000, and the
 
 6 sum of $       , or so much thereof as may be necessary for
 
 7 fiscal year 2000-2001, for the establishment of one and one-half
 
 8 full time equivalent (1.5 FTE) positions and operating expenses
 
 9 to assure continuous implementation of the child death review
 
10 teams.
 
11      SECTION 5.  The sums appropriated shall be expended by the
 
12 department of health for the purposes of this Act.
 
13                             PART III
 
14  DEPARTMENT OF THE ATTORNEY GENERAL ADMINISTRATIVE EXPENDITURES
 
15      SECTION 6.  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.
 
23      SECTION 7.  The department of the attorney general is
 

 
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 1 authorized to establish and fill three permanent deputy attorney
 
 2 general positions exempt from chapters 76 and 77, Hawaii Revised
 
 3 Statutes, to carry out the purposes of chapter 587, Hawaii
 
 4 Revised Statutes.
 
 5      SECTION 8.  There is appropriated out of the general
 
 6 revenues of the State of Hawaii the sum of $       , or so much
 
 7 thereof as may be necessary for fiscal year 1999-2000, and the
 
 8 sum of $       , or so much thereof as may be necessary for
 
 9 fiscal year 2000-2001, for the establishment of three full-time
 
10 equivalent (3.00 FTE) permanent deputy attorney general positions
 
11 and support staff for the family law division of the department
 
12 of the attorney general; provided that the department of human
 
13 services shall annually reimburse the department of the attorney
 
14 general $60,000, or thirty-three and one-third per cent of the
 
15 total appropriation, from federal funds.
 
16      SECTION 9.  The sums appropriated shall be expended by the
 
17 department of the attorney general for the purposes of this Act.
 
18                              PART IV
 
19               MEDICAL/HEALTH CASE MANAGEMENT SYSTEM
 
20      SECTION 10.  The legislature finds that medical management
 
21 of child protective services children is complicated and has been
 
22 wholly dependent on the individual social worker's priority
 
23 assignments.  Problems already exist in the medical management of
 

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

 
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 1 social worker.  The legislature finds that more needs to be done
 
 2 to ensure that mandated health exams occur, or that communication
 
 3 and follow-up are enhanced.
 
 4      The purpose of this part is to appropriate funds to
 
 5 establish a medical/health case management system.
 
 6      SECTION 11.  The department of human services is authorized
 
 7 to establish and fill one half-time equivalent (0.5 FTE)
 
 8 permanent physician position exempt from chapters 76 and 77,
 
 9 Hawaii Revised Statutes, to carry out sections 587-85 and 587-86,
 
10 Hawaii Revised Statutes.
 
11      SECTION 12.  There is appropriated out the general funds of
 
12 the State of Hawaii the sum of $      , or so much thereof as may
 
13 be necessary for fiscal year 1999-2000, and $      , or so much
 
14 there of as may be necessary for fiscal year 2000-2001, for the
 
15 establishment of one half-time equivalent (0.5 FTE) permanent
 
16 physician position for ongoing consultation and forensic review
 
17 of cases to prevent further child abuse and neglect; provided
 
18 that funds shall be allocated to a child protection
 
19 multidisciplinary team for the implementation of the medical and
 
20 health case management system.
 
21      SECTION 13.  The sums appropriated shall be expended by the
 
22 department of human services for the purpose of this Act.
 
23      SECTION 14.  There is appropriated out of the general funds
 

 
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 1 of the State of Hawaii the sum of $       , or so much thereof as
 
 2 may be necessary for fiscal year 1999-2000, and $       , or so
 
 3 much thereof as may be necessary for fiscal year 2000-2001, to
 
 4 fill eleven vacant public health nursing positions within the
 
 5 department of health for the implementation of the medical and
 
 6 health case management system.
 
 7      SECTION 15.  The sums appropriated shall be expended by the
 
 8 department of health for the purposes of this Act.
 
 9                              PART V
 
10                   HAWAII CHILDREN'S TRUST FUND
 
11      SECTION 16.  The Hawaii children's trust fund, chapter 350B,
 
12 Hawaii Revised Statutes, was established in 1993 to serve as a
 
13 medium for a public-private partnership for family strengthening
 
14 to prevent child abuse and neglect.  The fund makes grants to
 
15 private, nonprofit organizations, public agencies, or qualified
 
16 persons in order to provide community-based services and
 
17 education designed to strengthen families and prevent child abuse
 
18 and neglect.  The fund also serves as a mechanism to maximize
 
19 financial resources for this endeavor by serving as a repository
 
20 for federal and state funds, as well as private contributions
 
21 from corporations and other businesses, foundations, individuals,
 
22 and other interested parties.
 
23      The purpose of this part is to appropriate funds to the
 

 
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 1 Hawaii children's trust fund for child abuse and neglect
 
 2 prevention services.
 
 3      SECTION 17.  There is appropriated out of the general
 
 4 revenues of the State of Hawaii the sum of $         , or so much
 
 5 thereof as may be necessary for fiscal year 1999-2000, and
 
 6 $         , or so much thereof as may be necessary for fiscal
 
 7 year 2000-2001, for the Hawaii children's trust fund, established
 
 8 under section 350B-2, Hawaii Revised Statutes.
 
 9      SECTION 18.  The sums appropriated shall be expended by the
 
10 department of health for the purposes of this Act.
 
11                              PART VI
 
12                           HEALTHY START
 
13      SECTION 19.  The legislature finds that the prevention of
 
14 child abuse and neglect of young children during their formative
 
15 years is imperative as research on early brain development
 
16 indicates that "by age three, a child who has been seriously
 
17 abused or neglected bears scars that are difficult, it not
 
18 impossible, to erase."
 
19      The legislature further finds that the Healthy Start program
 
20 has been an integral factor in mitigating the number of child
 
21 abuse cases in the State by providing intensive support to
 
22 at-risk families from the onset.  In fact, the rate of children
 
23 hospitalized for abuse and neglect on Oahu is four times higher
 

 
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 1 per thousand, among families who do not receive support from
 
 2 Healthy Start.  However, the legislature also finds that funding
 
 3 for Healthy Start has been reduced by thirty per cent, and a
 
 4 "sister program," Mother Infant Support Team, was cut entirely.
 
 5      The legislature recognizes the importance of funding such
 
 6 programs that provide necessary services to children and their
 
 7 families.  Although hospital-based risk screening is proposed to
 
 8 be increased to reach all families of newborns, as part of the
 
 9 Felix consent decree, there is no provision for funds for
 
10 services for families identified as at-risk through this process.
 
11      The purpose of this part is to appropriate funds for
 
12 services for families identified as "at risk".
 
13      SECTION 20.  There is appropriated out of the general
 
14 revenues of the State of Hawaii the sum of $         , or so much
 
15 thereof as may be necessary for fiscal year 1999-2000, and
 
16 $         , or so much thereof as may be necessary for fiscal
 
17 year 2000-2001, for the Healthy Start program for services for
 
18 families identified as "at-risk".
 
19      SECTION 21.  The sums appropriated shall be expended by the
 
20 department of health for the purposes of this Act.
 
21                             PART VII
 
22                SUBSTANCE ABUSE TREATMENT SERVICES
 
23        FOR PREGNANT AND PARENTING WOMEN AND THEIR FAMILIES
 

 
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 1      SECTION 22.  The legislature finds that families are the
 
 2 foundation upon which our society is built.  Mothers, in
 
 3 particular, have a profound influence as the ones responsible in
 
 4 large part for the development and growth of their children.
 
 5      Substance abuse can have a devastating effect on families,
 
 6 especially if the mother has a substance abuse problem.  A
 
 7 substance-abusing mother would not be able to discern whether a
 
 8 child is in need of protection from harm or abuse.  In fact, a
 
 9 substance-abusing mother may not even be aware that she is the
 
10 one responsible for harming her own child.
 
11      The purpose of this part is to increase funding for
 
12 substance abuse treatment services to assist pregnant women,
 
13 mothers, and their families involved in the child protective
 
14 services system.
 
15      SECTION 23.  The purpose of this section is to ensure the
 
16 availability of substance abuse treatment for pregnant and
 
17 parenting women and their families through department of human
 
18 services functions and services.  Implementation of section 22 of
 
19 this Act during each fiscal year in the 1999-2001 fiscal
 
20 biennium, shall be funded from the appropriation authorized under
 
21 this section, and shall provide the following services:
 
22      (1)  Comprehensive substance abuse
 
23           treatment services, including six certified
 

 
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 1           substance abuse counselors and training
 
 2           for program staff                              $       
 
 3      (2)  Assessments                                            
 
 4      There is appropriated out of the general revenues of the
 
 5 State of Hawaii the sum of $       , or so much thereof as may be
 
 6 necessary for fiscal year 1999-2000, and the sum of $       , or
 
 7 so much thereof as may be necessary for fiscal year 2000-2001, to
 
 8 provide substance abuse treatment services for pregnant and
 
 9 parenting women and their families.
 
10      SECTION 24.  The sums appropriated shall be expended by the
 
11 department of human services for the purposes of this Act.
 
12      SECTION 25.  The purpose of this section is to ensure the
 
13 availability of substance abuse treatment for pregnant and
 
14 parenting women and their families through department of health
 
15 functions and services.  Implementation of this section during
 
16 each fiscal year in the 1999-2001 fiscal biennium, shall be
 
17 funded from the appropriation authorized under this section, and
 
18 shall provide the following services:
 
19      (1)  Babysafe                                       $       
 
20      (2)  Early intervention                                     
 
21      (3)  Treatment services, including
 
22           therapeutic living and intensive
 
23           outpatient treatment                                   
 

 
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 1      (4)  Special residential treatment
 
 2           facility                                               
 
 3      (5)  Unfunded beds                                          
 
 4      (6)  Maui intensive outpatient treatment
 
 5           programs                                               
 
 6      (7)  Oahu intensive outpatient treatment
 
 7           programs                                               
 
 8      There is appropriated out of the general revenues of the
 
 9 State of Hawaii the sum of $         , or so much thereof as may
 
10 be necessary for fiscal year 1999-2000, and the sum of
 
11 $         , or so much thereof as may be necessary for fiscal
 
12 year 2000-2001, to provide substance abuse treatment services for
 
13 pregnant and parenting women and their families.
 
14      SECTION 26.  The sums appropriated shall be expended by the
 
15 department of health for the purposes of this Act.
 
16                             PART VIII
 
17                       BLUEPRINT FOR CHANGE
 
18      SECTION 27.  The legislature finds that one of the
 
19 recommendations of a 1994-1996 task force on child protective
 
20 services reform was to implement a community partnership for
 
21 child protection.  A major component of this partnership was to
 
22 be the establishment of the neighborhood place to deliver
 
23 diversion services and child protective services to targeted
 

 
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 1 families.
 
 2      The neighborhood place provides a community-based center for
 
 3 services and community support for abused or neglected children
 
 4 and their families as well as for families at-risk of child
 
 5 abuse.  Each neighborhood place has been patterned around the
 
 6 needs of the specific community and has included a physical site
 
 7 for these families to work with private and public service
 
 8 providers.  A wide range of services and resources are available
 
 9 from early response to continued services for families already
 
10 facing problems.
 
11      Limited start-up funding for neighborhood place sites in
 
12 West Hawaii and Waipahu were obtained through local foundation
 
13 grants and federal Title IVB moneys.  However, without continued
 
14 funding for the pilot period, the neighborhood places will not be
 
15 able to model the system reform that the task force and the
 
16 legislature recommended.
 
17      The purpose of this part is to appropriate funds to
 
18 establish additional neighborhood places.
 
19      SECTION 28.  There is appropriated out of the general
 
20 revenues of the State of Hawaii the sum of $       , or so much
 
21 thereof as may be necessary for fiscal year 1999-2000, and the
 
22 sum of $       , or so much thereof as may be necessary for
 
23 fiscal year 2000-2001, for staffing and services for the
 

 
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 1 neighborhood places.
 
 2      SECTION 29.  The sums appropriated shall be expended by the
 
 3 department of human services for the purposes of this Act.
 
 4                              PART IX
 
 5                          FOSTER PARENTS
 
 6      SECTION 30.  The department of human services is responsible
 
 7 for ensuring that prospective foster and adoptive parents are
 
 8 prepared for their new roles.  As such, the department is
 
 9 responsible for administering a training program for all foster
 
10 parents and adoptive parents seeking general certification or
 
11 approval as parents.
 
12      The legislature finds that the Foster PRIDE/Adopt PRIDE
 
13 program is a competency-based, comprehensive pre-service training
 
14 and assessment program for prospective foster and adoptive
 
15 parents, which has been recognized by the department of human
 
16 services.  This program can provide the basis for a training
 
17 program for prospective foster and adoptive parents in the State.
 
18      The purpose of this part is to allow the department of human
 
19 services to contract with a provider to:
 
20      (1)  Increase the pool of foster homes and adoptive homes
 
21           for better matching of children in need of out-of-home
 
22           care; and
 
23      (2)  Strengthen the quality of family foster care and
 

 
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 1           adoptive services by providing a standardized,
 
 2           consistent framework for the competency-based training,
 
 3           preparation, and selection of foster parents and
 
 4           adoptive parents.
 
 5      SECTION 31.  There is appropriated out of the general
 
 6 revenues of the State of Hawaii the sum of $          , or so
 
 7 much thereof as may be necessary for fiscal year 1999-2000, and
 
 8 the sum of $           , or so much thereof as may be necessary
 
 9 for fiscal year 2000-2001, for:
 
10      (1)  Foster parent training for foster parents of licensed
 
11           foster homes;
 
12      (2)  Foster parent training for relative foster parents of
 
13           special licensed foster homes; and
 
14      (3)  Follow-up foster parent training for foster parents of
 
15           licensed foster homes.
 
16      SECTION 32.  There is appropriated out of the general
 
17 revenues of the State of Hawaii the sum of $           , or so
 
18 much thereof as may be necessary for fiscal year 1999-2000, and
 
19 the sum of $          , or so much thereof as may be necessary
 
20 for fiscal year 2000-2001, to increase foster board payments for
 
21 children with special needs.
 
22      SECTION 33.  The sums appropriated shall be expended by the
 
23 department of human services for the purposes of this Act.
 

 
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 1                              PART X
 
 2                   PSYCHOSOCIAL SUPPORT SERVICES
 
 3      SECTION 34.  The legislature finds that intervention
 
 4 services is a key factor in preventing stressful situations in
 
 5 the home from escalating to unmanagable proportions.  The
 
 6 legislature finds that two programs--the parent line and home
 
 7 reach--have been successful in providing a healthy outlet for
 
 8 families to express their concerns and anger with regard to child
 
 9 management, development, and behavior.  Both programs have been
 
10 successful in giving much-needed support and respite to families.
 
11      The parent line provides counseling, support, and community
 
12 referrals to over four thousand parents and caregivers that have
 
13 questions regarding their childrens' development and behavior.
 
14 Home Reach provides short-term home visitation to four hundred
 
15 families identified through the parent line as being at risk for
 
16 social, emotional, or behavioral programs.  Those persons using
 
17 the services of the home reach program require family
 
18 intervention beyond a phone call to resolve a family parenting
 
19 concern or crisis.
 
20      The legislature finds that the parent line and home reach
 
21 are overburdened due to the increase in the number of clients
 
22 requiring their services.
 
23      The purpose of this part is to appropriate the necessary
 

 
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 1 funds to broaden the scope of the parent line and home reach to
 
 2 properly service the needs of the community.
 
 3      SECTION 35.  There is appropriated out of the general
 
 4 revenues of the State of Hawaii the sum of $       , or so much
 
 5 thereof as may be necessary for fiscal year 1999-2000, and the
 
 6 sum of $       , or so much thereof as may be necessary for
 
 7 fiscal year 2000-2001, in increase the capacity of the parent
 
 8 line and home reach services to properly service the needs of the
 
 9 community.
 
10      SECTION 36.  The sums appropriated shall be expended by the
 
11 department of health for the purposes of this Act.
 
12      SECTION 37.  All specified sums in this Act shall be in
 
13 addition to the respective departmental budgets.
 
14      SECTION 38.  This Act shall take effect on July 1, 1999.