REPORT TITLE:
Approp.; Child Protection


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

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        
THE SENATE                              S.B. NO.           175
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

MAKING AN APPROPRIATION 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 Statues, 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 the provisions of chapters 76 and 77 to
 

 
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 1 carry out the purposes of section 321-341, Hawaii Revised
 
 2 Statutes.
 
 3      SECTION 4.  There is appropriated out of the general
 
 4 revenues of the State of Hawaii the sum of $100,000 or so much
 
 5 thereof as may be necessary for fiscal year 1999-2000 and the sum
 
 6 of $100,000 or so much thereof as may be necessary for fiscal
 
 7 year 2000-2001 for the establishment of one and one-half full
 
 8 time equivalent (1.5 FTE) positions and operating expenses to
 
 9 assure continuous implementation of the child death review teams.
 
10      SECTION 5.  The sums appropriated shall be expended by the
 
11 department of health for the purposes of this Act.
 
12                             PART III
 
13  DEPARTMENT OF THE ATTORNEY GENERAL ADMINISTRATIVE EXPENDITURES
 
14      SECTION 6.  The legislature finds that the department of the
 
15 attorney general lacks the sufficient number of staff to
 
16 adequately carry out its functions relating to chapter 587,
 
17 Hawaii Revised Statutes.
 
18      The purpose of this part is to appropriate funds to
 
19 establish and fill three permanent deputy attorney general
 
20 positions to carry out the purposes of chapter 587, Hawaii
 
21 Revised Statutes.
 
22      SECTION 7.  The department of the attorney general is
 
23 authorized to establish and fill three permanent deputy attorney
 

 
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 1 general positions exempt from the provisions of chapters 76 and
 
 2 77 to carry out the purposes of chapter 587, Hawaii Revised
 
 3 Statutes.
 
 4      SECTION 8.  There is appropriated out of the general
 
 5 revenues of the State of Hawaii the sum of $198,000 or so much
 
 6 thereof as may be necessary for fiscal year 1999-2000 and the sum
 
 7 of $198,000 or so much thereof as may be necessary for fiscal
 
 8 year 2000-2001 for the establishment of three full-time
 
 9 equivalent (3.00 FTE) permanent deputy attorney general
 
10 positions, and support staff for the family law division of the
 
11 department of the attorney general; provided that the department
 
12 of human services shall annually reimburse the department of the
 
13 attorney general $60,000, or thirty-three and one-third per cent
 
14 of the total appropriation, from federal funds.
 
15      SECTION 9.  The sums appropriated shall be expended by the
 
16 department of the attorney general for the purposes of this Act.
 
17                              PART IV
 
18               MEDICAL/HEALTH CASE MANAGEMENT SYSTEM
 
19      SECTION 10.  The legislature finds that medical management
 
20 of child protective services children is complicated and has been
 
21 wholly dependent on the individual social worker's priority
 
22 assignments.  Problems already exist in the medical management of
 
23 these children, including:
 

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

 
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 1 to ensure that mandated health exams occur, or that communication
 
 2 and follow-up are enhanced.
 
 3      The purpose of this part is to appropriate funds to
 
 4 establish a medical/health case management system.
 
 5      SECTION 11.  The department of human services is authorized
 
 6 to establish and fill one half-time equivalent (0.5 FTE)
 
 7 permanent physician position exempt from the provisions of
 
 8 chapters 76 and 77 to carry out the purposes of section 587-   ,
 
 9 Hawaii Revised Statutes.
 
10      SECTION 12.  There is appropriated out the general funds of
 
11 the State of Hawaii the sum of $70,000 or so much thereof as may
 
12 be necessary for fiscal year 1999-2000 and $70,000 or so much
 
13 there of as may be necessary for fiscal year 2000-2001 for the
 
14 establishment of one half-time equivalent (0.5 FTE) permanent
 
15 physician position for ongoing consultation and forensic review
 
16 of cases to prevent further child abuse and neglect; provided
 
17 that funds be designated to a child protection multidisciplinary
 
18 team for the implementation of the medical/health case management
 
19 system.
 
20      SECTION 13.  The sums appropriated shall be expended by the
 
21 department of human services for the purpose of this Act.
 
22      SECTION 14.  There is appropriated out of the general funds
 
23 of the State of Hawaii the sum of $746,624 or so much thereof as
 

 
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 1 may be necessary for fiscal year 1999-2000 and $746,624 or so
 
 2 much thereof as may be necessary for fiscal year 2000-2001 to
 
 3 fill eleven vacant public health nursing positions within the
 
 4 department of health for the implementation of the medical/health
 
 5 case management system.
 
 6      SECTION 15.  The sums appropriated shall be expended by the
 
 7 department of health for the purposes of this Act.
 
 8                              PART V
 
 9                   HAWAII CHILDREN'S TRUST FUND
 
10      SECTION 16.  The Hawaii children's trust fund was
 
11 established in 1993 to serve as a medium for a public-private
 
12 partnership for family strengthening to prevent child abuse and
 
13 neglect.  The fund makes grants to private, nonprofit
 
14 organizations, public agencies, or qualified persons in order to
 
15 provide community-based services and education designed to
 
16 strengthen families and prevent child abuse and neglect.  The
 
17 fund also serves as a mechanism to maximize financial resources
 
18 for this endeavor by serving as a repository for federal and
 
19 state funds, as well as private contributions from corporations
 
20 and other businesses, foundations, individuals, and other
 
21 interested parties.
 
22      The purpose of this part is to appropriate funds to the
 
23 Hawaii children's trust fund for child abuse and neglect
 
24 prevention services.
 

 
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 1      SECTION 17.  There is appropriated out of the general
 
 2 revenues of the State of Hawaii the sum of $5,000,000 or so much
 
 3 thereof as may be necessary for fiscal year 1999-2000 and
 
 4 $5,000,000 or so much thereof as may be necessary for fiscal year
 
 5 2000-2001 for the Hawaii children's trust fund; provided that the
 
 6 interest earned from the Hawaii children's trust fund shall be
 
 7 used for child abuse and neglect prevention services.
 
 8      SECTION 18.  The sums appropriated shall be expended by the
 
 9 department of health for the purposes of this Act.
 
10                              PART VI
 
11                           HEALTHY START
 
12      SECTION 19.  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, it
 
17 not impossible, to erase."
 
18      The legislature further finds that the Healthy Start program
 
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
 

 
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 1 Healthy Start.  However, the legislature also finds that funding
 
 2 for Healthy Start has been reduced by thirty per cent, and a
 
 3 "sister program," Mother Infant Support Team, was 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 20.  There is appropriated out of the general
 
13 revenues of the State of Hawaii the sum of $5,275,000 or so much
 
14 thereof as may be necessary for fiscal year 1999-2000 and
 
15 $8,357,050 or so much thereof as may be necessary for fiscal year
 
16 2000-2001 for the healthy start program for services for families
 
17 identified as "at-risk".
 
18      SECTION 21.  The sums appropriated shall be expended by the
 
19 department of health for the purposes of this Act.
 
20                             PART VII
 
21                SUBSTANCE ABUSE TREATMENT SERVICES
 
22        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      The purpose of this section of this Act 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
 
19 during each fiscal year in the 1999-2001 fiscal biennium, to be
 
20 funded from the appropriation authorized in section 23, shall
 
21 provide the following services:
 

 
 
 
 
 
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 1      (1)  Comprehensive substance abuse
 
 2           treatment services, including six certified
 
 3           substance abuse counselors and training
 
 4           for program staff                              $400,000
 
 5      (2)  Assessments                                     375,000
 
 6      SECTION 23.  There is appropriated out of the general
 
 7 revenues of the State of Hawaii the sum of $775,000 or so much
 
 8 thereof as may be necessary for fiscal year 1999-2000 and the sum
 
 9 of $775,000 or so much thereof as may be necessary for fiscal
 
10 year 2000-2001 to provide substance abuse treatment services for
 
11 pregnant and parenting women and their families.
 
12      SECTION 24.  The sums appropriated shall be expended by the
 
13 department of human services for the purposes of this Act.
 
14      SECTION 25.  The purpose of this section of this Act is to
 
15 ensure the availability of substance abuse treatment for pregnant
 
16 and parenting women and their families through department of
 
17 health functions and services.  Implementation of section 25
 
18 during each fiscal year in the 1999-2001 fiscal biennium, to be
 
19 funded from the appropriation authorized in section 26, shall
 
20 provide the following services:
 
21      (1)  Babysafe                                       $700,000
 
22      (2)  Early Intervention                              900,000
 

 
 
 
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 1      (3)  Treatment services, including
 
 2           therapeutic living and intensive
 
 3           outpatient treatment                          1,097,760
 
 4      (4)  Special residential treatment
 
 5           facility                                        280,000
 
 6      (5)  Unfunded beds                                    90,000
 
 7      (6)  Maui intensive outpatient treatment
 
 8           programs                                         55,440
 
 9      (7)  Oahu intensive outpatient treatment
 
10           programs                                        144,144
 
11      SECTION 26.  There is appropriated out of the general
 
12 revenues of the State of Hawaii the sum of $4,042,344 or so much
 
13 thereof as may be necessary for fiscal year 1999-2000 and the sum
 
14 of $4,042,344 or so much thereof as may be necessary for fiscal
 
15 year 2000-2001 to provide substance abuse treatment services for
 
16 pregnant and parenting women and their families.
 
17      SECTION 27.  The sums appropriated shall be expended by the
 
18 department of health for the purposes of this Act.
 
19                             PART VIII
 
20                       BLUEPRINT FOR CHANGE
 
21      SECTION 28.  The legislature finds that one of the
 
22 recommendations of a 1994-1996 task force on child protective
 
23 services reform was to implement a community partnership for
 

 
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 1 child protection.  A major component of this partnership was to
 
 2 be the establishment of the neighborhood place to deliver
 
 3 diversion services and child protective services to targeted
 
 4 families.
 
 5      The neighborhood place provides a community-based center for
 
 6 services and community support for abused or neglected children
 
 7 and their families as well as for families at-risk of child
 
 8 abuse.  Each neighborhood place has been patterned around the
 
 9 needs of the specific community and has included a physical site
 
10 for these families to work with private and public service
 
11 providers.  A wide range of services and resources are available
 
12 from early response to continued services for families already
 
13 facing problems.
 
14      Limited start-up funding for neighborhood place sites in
 
15 West Hawaii and Waipahu were obtained through local foundation
 
16 grants and Federal Title IVB monies.  However, without continued
 
17 funding for the pilot period, the neighborhood places will not be
 
18 able to model the system reform that the task force and the
 
19 legislature recommended.
 
20      The purpose of this part is to appropriate funds to
 
21 establish additional neighborhood places.
 
22      SECTION 29.  There is appropriated out of the general
 
23 revenues of the State of Hawaii the sum of $320,000 or so much
 

 
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 1 thereof as may be necessary for fiscal year 1999-2000 and the sum
 
 2 of $320,000 or so much thereof as may be necessary for fiscal
 
 3 year 2000-2001 for staffing and services for the neighborhood
 
 4 places.
 
 5      SECTION 30.  The sums appropriated shall be expended by the
 
 6 department of human services for the purposes of this Act.
 
 7                              PART IX
 
 8                          FOSTER PARENTS
 
 9      SECTION 31.  The department of human services is responsible
 
10 for ensuring that prospective foster and adoptive parents are
 
11 prepared for their new roles.  As such, the department is
 
12 responsible for administering a training program for all foster
 
13 parents and adoptive parents seeking general certification or
 
14 approval as parents.
 
15      The legislature finds that the Foster PRIDE/Adopt PRIDE
 
16 program is a competency-based, comprehensive pre-service training
 
17 and assessment program for prospective foster and adoptive
 
18 parents, which has been recognized by the department of human
 
19 services.  This program can provide the basis for a training
 
20 program for prospective foster and adoptive parents in the State.
 
21      The purpose of this part is to allow the department of human
 
22 services to contract with a provider 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 32.  There is appropriated out of the general
 
10 revenues of the State of Hawaii the sum of $     or so much
 
11 thereof as may be necessary for fiscal year 1999-2000 and the sum
 
12 of $    or so much thereof as may be necessary for fiscal year
 
13 2000-2001 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 33.  There is appropriated out of the general
 
21 revenues of the State of Hawaii the sum of $     or so much
 
22 thereof as may be necessary for fiscal year 1999-2000 and the sum
 
23 of $    or so much thereof as may be necessary for fiscal year
 

 
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 1 2000-2001 to increase foster board payments for children with
 
 2 special needs.
 
 3      SECTION 34.  The sums appropriated shall be expended by the
 
 4 department of human services for the purposes of this Act.
 
 5                              PART X
 
 6                   PSYCHOSOCIAL SUPPORT SERVICES
 
 7      SECTION 35.  The legislature finds that intervention
 
 8 services is a key factor in preventing stressful situations in
 
 9 the home from escalating to unmanagable proportions.  The
 
10 legislature finds that two programs--The Parent Line and Home
 
11 Reach--have been successful in providing a healthy outlet for
 
12 families to express their concerns and anger with regard to child
 
13 management, development, and behavior.  Both programs have been
 
14 successful in giving much-needed support and respite to families.
 
15      The Parent Line provides counseling, support, and community
 
16 referrals to over four thousand parents and caregivers that have
 
17 questions regarding their childrens' development and behavior.
 
18 Home Reach provides short-term home visitation to four hundred
 
19 families identified through The Parent Line as being at risk for
 
20 social, emotional, or behavioral programs.  Those persons using
 
21 the services of the Home Reach program require family
 
22 intervention beyond a phone call to resolve a family parenting
 
23 concern or crisis.
 

 
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 1      The legislature finds that The Parent Line and Home Reach
 
 2 are overburdened due to the increase in the number of clients
 
 3 requiring their services.
 
 4      The purpose of this part is to appropriate the necessary
 
 5 funds to broaden the scope of The Parent Line and Home Reach to
 
 6 properly service the needs of the community.
 
 7      SECTION 36.  There is appropriated out of the general
 
 8 revenues of the State of Hawaii the sum of $225,000 or so much
 
 9 thereof as may be necessary for fiscal year 1999-2000 and the sum
 
10 of $225,000 or so much thereof as may be necessary for fiscal
 
11 year 2000-2001 in increase the capacity of the parent line and
 
12 home reach services to properly service the needs of the
 
13 community.
 
14      SECTION 37.  The sums appropriated shall be expended by the
 
15 department of health for the purposes of this Act.
 
16      SECTION 38.  All specified sums in this Act shall be in
 
17 addition to the respective departmental budgets.
 
18      SECTION 39.  This Act shall take effect on July 1, 1999.
 
19 
 
20                           INTRODUCED BY:  _______________________