REPORT TITLE:
School/Adolescent Health Care


DESCRIPTION:
Requires the director of health, with the assistance of the
superintendent of education, to establish and operate fewer than
one school-based health center in each of the seven department
school districts.  Provides different types of health services
based on a student's ability to pay for these services.  Requires
that a student produce a signed parental consent form to be
eligible to receive most services.  Prohibits the performance of
abortions at a center and the referral of students to abortion
services.  Holds a student financially responsible for services
provided by a center without parental consent. (HB264 HD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        264
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

RELATING TO SCHOOL-BASED HEALTH CARE FOR ADOLESCENTS.



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

 1      SECTION 1.  Definitions.  As used in this Act, unless the
 
 2 context otherwise requires:
 
 3      "Parent" includes a parent, custodian, or guardian.
 
 4      "Records" include the results of laboratory screenings and
 
 5 tests.
 
 6      "Student" means a person enrolled at either a three-year
 
 7 (grades ten through twelve) public high school or a four-year
 
 8 (grades nine through twelve) public high school.
 
 9      SECTION 2.  School-based health centers; establishment.(a)
 
10 The director of health, with the assistance of the superintendent
 
11 of education, shall establish and operate no fewer than one
 
12 school-based health center in each of the seven departmental
 
13 school districts established in section 13-1(d), Hawaii Revised
 
14 Statutes.
 
15      (b)  Each center shall consider rendering the provisions of
 
16 the following types of health services to eligible students:
 
17      (1)  Physical examinations for athletic activities;
 
18      (2)  Laboratory screening (e.g., throat cultures,
 
19           mononucleosis, diabetes, urinalysis, hematocrit, Pap
 
20           smears, and sickle cell anemia);
 

 
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                                     H.B. NO.           H.D. 1
                                            
                                                        


 1      (3)  Sexually transmitted disease testing;
 
 2      (4)  Immunization (e.g., mumps, measles, rubella, polio, and
 
 3           DPT);
 
 4      (5)  Nutrition counseling;
 
 5      (6)  Drug and substance abuse counseling;
 
 6      (7)  Family counseling;
 
 7      (8)  Individual counseling about sexuality;
 
 8      (9)  Pregnancy testing;
 
 9     (10)  Prenatal care;
 
10     (11)  Mental health screening and referrals; and
 
11     (12)  Referrals to other agencies.
 
12      (c)  Nothing in this section shall be construed to limit the
 
13 types of health services that may be provided by a center, except
 
14 that the performance of abortions at a center and the referral of
 
15 students to abortion services by center personnel shall be
 
16 expressly prohibited.
 
17      (d)  Immediately after the establishment but prior to the
 
18 operation of a center, the principal of each school shall appoint
 
19 a nine-member board of directors, which shall be responsible for
 
20 making policy decisions related to the operation of and services
 
21 to be offered by the center.  The board shall consist of not less
 
22 than two parents of students enrolled at the school, two students
 
23 enrolled at the school, one teacher assigned to the school, one
 

 
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                                     H.B. NO.           H.D. 1
                                            
                                                        


 1 administrator assigned to the school, one member from the
 
 2 community served by the school, and one health professional.
 
 3      SECTION 3.  Eligibility; consent of parent required;
 
 4 exceptions.(a)  Except as provided by section 577A-2, Hawaii
 
 5 Revised Statutes, no student shall be eligible to receive
 
 6 services unless a center receives a consent form signed by the
 
 7 student and the student's parent.
 
 8      (b)  Notwithstanding subsection (a), a student who has
 
 9 reached the age of majority shall not be required to obtain the
 
10 permission of a parent to be eligible to receive services.
 
11      SECTION 4.  Provision of health services; ability to pay.
 
12 (a)  The director of health, with the assistance of the director
 
13 of human services, shall look for all possibilities of
 
14 reimbursement, including but not limited to federal or private
 
15 foundation funds, for all services provided by a center.
 
16      (b)  Notwithstanding subsection (a), no eligible student
 
17 shall be denied the right to receive requested services for lack
 
18 of the ability to pay for these services.
 
19      SECTION 5.  Confidentiality of records.  Except as otherwise
 
20 provided by law, all student-medical records shall be considered
 
21 confidential information.
 
22      SECTION 6.  Financial responsibility.  If a student receives
 
23 services for the diagnosis, examination, or administration of
 

 
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                                     H.B. NO.           H.D. 1
                                            
                                                        


 1 medication in the treatment of venereal diseases, pregnancy, or
 
 2 family planning services without the consent of a parent, then
 
 3 the parent of the student shall not be liable for the legal
 
 4 obligations resulting from the furnishing of these services by a
 
 5 center.  A student who receives these services from a center
 
 6 shall assume financial responsibility for the cost of the
 
 7 services.  Notwithstanding any other law to the contrary, no
 
 8 spouse or parent whose consent has not been obtained for these
 
 9 services shall be liable for the cost of services incurred by the
 
10 student.
 
11      SECTION 7.  Limitation of actions.  Notwithstanding any
 
12 other law to the contrary, an action to recover any debt founded
 
13 upon any contract, obligation, or liability made pursuant to this
 
14 Act shall not commence until a student has reached the age of
 
15 majority; provided that the action shall commence not more than
 
16 two years after the date a student reaches the age of majority.
 
17      SECTION 8.  Personnel.  The director of health shall appoint
 
18 and remove without regard to chapters 76 and 77, physicians,
 
19 nurse-practitioners nurses, counselors, social workers, and any
 
20 other persons as the department of health may employ to implement
 
21 to this Act.
 
22      SECTION 9.  Reports to the legislature.  The director of
 
23 health shall report to the legislature on the experience of each
 

 
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                                     H.B. NO.           H.D. 1
                                            
                                                        


 1 school-based health center not less than thirty days prior to the
 
 2 convening of each regular session.  The report shall include but
 
 3 not be limited to:
 
 4      (1)  The number of students served and the types of health
 
 5           services provided;
 
 6      (2)  The operating cost, including income collected through
 
 7           fees, monetary donations, private grants-in-aid, and
 
 8           in-kind services;
 
 9      (3)  Quantifiable changes in high-risk behaviors among
 
10           students receiving services through the center;
 
11      (4)  Recommended changes to improve the center; and
 
12      (5)  Any other information that the department of health may
 
13           determine to be necessary to assist the legislature in
 
14           evaluating the efficacy, cost-effectiveness, and
 
15           intangible merits of the center.
 
16      SECTION 10.  There is appropriated out of the general
 
17 revenues of the State of Hawaii the sum of $           or so much
 
18 thereof as may be necessary for fiscal year 1999-2000 and the
 
19 same sum or so much thereof as may be necessary for fiscal year
 
20 2000-2001 for the department of health to carry out the purposes
 
21 of this Act, including the hiring of necessary staff.
 
22      The sums appropriated shall be expended by the department of
 
23 health.
 

 
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                                     H.B. NO.           H.D. 1
                                            
                                                        


 1      SECTION 11.  There is appropriated out of the general
 
 2 revenues of the State of Hawaii the sum of $           or so much
 
 3 thereof as may be necessary for fiscal year 1999-2000 and the
 
 4 same sum or so much thereof as may be necessary for fiscal year
 
 5 2000-2001 for the department of education to carry out the
 
 6 purposes of this Act.
 
 7      The sum appropriated shall be expended by the department of
 
 8 education.
 
 9      SECTION 12.  This Act shall take effect upon its approval,
 
10 except that sections 10 and 11 shall take effect on July 1, 1999.