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.           2446
TWENTIETH LEGISLATURE, 2000                                
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 nonprofit 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
 
 5 much thereof as may be necessary for fiscal year 2000-2001, for
 
 6 the establishment of one and one-half full time equivalent (1.5
 
 7 FTE) positions and operating expenses to assure continuous
 
 8 implementation of the child death review teams.
 
 9      SECTION 5.  The sum appropriated shall be expended by the
 
10 department of health for the purposes of this Act.
 
11                             PART III
 
12  DEPARTMENT OF THE ATTORNEY GENERAL ADMINISTRATIVE EXPENDITURES
 
13      SECTION 6.  The legislature finds that the department of the
 
14 attorney general lacks the sufficient number of staff to
 
15 adequately carry out its functions relating to chapter 587,
 
16 Hawaii Revised Statutes.
 
17      The purpose of this Part is to appropriate funds to
 
18 establish and fill three permanent deputy attorney general
 
19 positions to carry out the purposes of chapter 587, Hawaii
 
20 Revised Statutes.
 
21      SECTION 7.  The department of the attorney general is
 
22 authorized to establish and fill three permanent deputy attorney
 
23 general positions exempt from chapters 76 and 77, Hawaii Revised
 

 
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 1 Statutes, to carry out the purposes of chapter 587, Hawaii
 
 2 Revised Statutes.
 
 3      SECTION 8.  There is appropriated out of the general
 
 4 revenues of the State of Hawaii the sum of $          , or so
 
 5 much thereof as may be necessary for fiscal year 2000-2001, for
 
 6 the establishment of three full-time equivalent (3.00 FTE)
 
 7 permanent deputy attorney general positions and support staff for
 
 8 the family law division of the department of the attorney
 
 9 general; provided that the department of human services shall
 
10 annually reimburse the department of the attorney general
 
11 $60,000, or thirty-three and one-third per cent of the total
 
12 appropriation, from federal funds.
 
13      SECTION 9.  The sum appropriated shall be expended by the
 
14 department of the attorney general for the purposes of this Act.
 
15                              PART IV
 
16               MEDICAL/HEALTH CASE MANAGEMENT SYSTEM
 
17      SECTION 10.  The legislature finds that medical management
 
18 of child protective services children is complicated and has been
 
19 wholly dependent on the individual social worker's priority
 
20 assignments.  Problems already exist in the medical management of
 
21 these children, including:
 
22      (1)  When a child protective services child is assigned a
 
23           new physician, the physician is not informed until the
 

 
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 1           child comes in for an office visit, and the child
 
 2           usually has little to no medical information at the
 
 3           time of the visit;
 
 4      (2)  The physician often has little or no communication with
 
 5           the child protective services social worker or foster
 
 6           parent because children are often transported to
 
 7           appointments by a transport worker;
 
 8      (3)  When a child is discharged from the hospital with a
 
 9           diagnosis of child abuse, follow-up with the child's
 
10           doctor and other specialists is almost always needed.
 
11           There is no system in place to ensure this gets done.
 
12           Furthermore, these follow-ups are sometimes overlooked;
 
13           and
 
14      (4)  When a multidisciplinary team meeting is held, there
 
15           are often medical problems identified that need to be
 
16           addressed.  There is no system in place to ensure that
 
17           these problems are followed up.
 
18      While child welfare services has amended its procedures to
 
19 comply with Act 134, Session Laws of Hawaii 1998, and Acts 153
 
20 and 271, Session Laws of Hawaii 1999, of even more concern is the
 
21 complex medical management that is expected of the social worker.
 
22 The legislature finds that more needs to be done to ensure that
 
23 mandated health exams occur, or that communication and follow-up
 

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

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

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

 
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 1 programs that provide necessary services to children and their
 
 2 families.  Although hospital-based risk screening is proposed to
 
 3 be increased to reach all families of newborns, as part of the
 
 4 Felix consent decree, there is no provision for funds for
 
 5 services for families identified as at-risk through this process.
 
 6      The purpose of this Part is to appropriate funds for
 
 7 services for families identified as "at risk".
 
 8      SECTION 20.  There is appropriated out of the general
 
 9 revenues of the State of Hawaii the sum of $         , or so much
 
10 thereof as may be necessary for fiscal year 2000-2001, for the
 
11 Healthy Start program for services for families identified as
 
12 "at-risk".
 
13      SECTION 21.  The sum appropriated shall be expended by the
 
14 department of health for the purposes of this Act.
 
15                             PART VII
 
16                SUBSTANCE ABUSE TREATMENT SERVICES
 
17        FOR PREGNANT AND PARENTING WOMEN AND THEIR FAMILIES
 
18      SECTION 22.  The legislature finds that families are the
 
19 foundation upon which our society is built.  Mothers, in
 
20 particular, have a profound influence as the ones responsible in
 
21 large part for the development and growth of their children.
 
22      Substance abuse can have a devastating effect on families,
 
23 especially if the mother has a substance abuse problem.  A
 

 
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 1 substance-abusing mother would not be able to discern whether a
 
 2 child is in need of protection from harm or abuse.  In fact, a
 
 3 substance-abusing mother may not even be aware that she is the
 
 4 one responsible for harming her own child.
 
 5      The purpose of this Part is to increase funding for
 
 6 substance abuse treatment services to assist pregnant women,
 
 7 mothers, and their families involved in the child protective
 
 8 services system.
 
 9      SECTION 23.  The purpose of this section is to ensure the
 
10 availability of substance abuse treatment for pregnant and
 
11 parenting women and their families through department of human
 
12 services functions and services.  Implementation of section 22 of
 
13 this Act during the fiscal year 2000-2001 shall be funded from
 
14 the appropriation authorized under this section, and shall
 
15 provide the following services:
 
16      (1)  Comprehensive substance abuse treatment
 
17           services, including six certified
 
18           substance abuse counselors and training
 
19           for program staff                              $       
 
20      (2)  Assessments
 
21      There is appropriated out of the general revenues of the
 
22 State of Hawaii the sum of $       , or so much thereof as may be
 
23 necessary for fiscal year 2000-2001, to provide substance abuse
 

 
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 1 treatment services for pregnant and parenting women and their
 
 2 families.
 
 3      SECTION 24.  The sum appropriated shall be expended by the
 
 4 department of human services for the purposes of this Act.
 
 5      SECTION 25.  The purpose of this section is to ensure the
 
 6 availability of substance abuse treatment for pregnant and
 
 7 parenting women and their families through department of health
 
 8 functions and services.  Implementation of this section during
 
 9 the fiscal year 2000-2001, shall be funded from the appropriation
 
10 authorized under this section, and shall provide the following
 
11 services:
 
12      (1)  Babysafe                                    $          
 
13      (2)  Early intervention
 
14      (3)  Treatment services, including
 
15           therapeutic living and intensive
 
16           outpatient treatment
 
17      (4)  Special residential treatment facility
 
18      (5)  Unfunded beds
 
19      (6)  Maui intensive outpatient treatment
 
20           programs
 
21      (7)  Oahu intensive outpatient treatment
 
22           programs
 
23      There is appropriated out of the general revenues of the
 

 
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 1 State of Hawaii the sum of $         , or so much thereof as may
 
 2 be necessary for fiscal year 2000-2001, to provide substance
 
 3 abuse treatment services for pregnant and parenting women and
 
 4 their families.
 
 5      SECTION 26.  The sum appropriated shall be expended by the
 
 6 department of health for the purposes of this Act.
 
 7                             PART VIII
 
 8                       BLUEPRINT FOR CHANGE
 
 9      SECTION 27.  The legislature finds that one of the
 
10 recommendations of a 1994-1996 task force on child protective
 
11 services reform was to implement a community partnership for
 
12 child protection.  A major component of this partnership was to
 
13 be the establishment of the neighborhood place to deliver
 
14 diversion services and child protective services to targeted
 
15 families.
 
16      The neighborhood place provides a community-based center for
 
17 services and community support for abused or neglected children
 
18 and their families as well as for families at-risk of child
 
19 abuse.  Each neighborhood place has been patterned around the
 
20 needs of the specific community and has included a physical site
 
21 for these families to work with private and public service
 
22 providers.  A wide range of services and resources are available
 
23 from early response to continued services for families already
 

 
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 1 facing problems.
 
 2      Limited start-up funding for neighborhood place sites in
 
 3 West Hawaii and Waipahu were obtained through local foundation
 
 4 grants and federal Title IVB moneys.  However, without continued
 
 5 funding for the pilot period, the neighborhood places will not be
 
 6 able to model the system reform that the task force and the
 
 7 legislature recommended.
 
 8      The purpose of this Part is to appropriate funds to
 
 9 establish additional neighborhood places.
 
10      SECTION 28.  There is appropriated out of the general
 
11 revenues of the State of Hawaii the sum of $          , or so
 
12 much thereof as may be necessary for fiscal year 2000-2001, for
 
13 staffing and services for the neighborhood places.
 
14      SECTION 29.  The sum appropriated shall be expended by the
 
15 department of human services for the purposes of this Act.
 
16                              PART IX
 
17                          FOSTER PARENTS
 
18      SECTION 30.  The department of human services is responsible
 
19 for ensuring that prospective foster and adoptive parents are
 
20 prepared for their new roles.  As such, the department is
 
21 responsible for administering a training program for all foster
 
22 parents and adoptive parents seeking general certification or
 
23 approval as parents.
 

 
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 1      The legislature finds that the Foster PRIDE/Adopt PRIDE
 
 2 program is a competency-based, comprehensive pre-service training
 
 3 and assessment program for prospective foster and adoptive
 
 4 parents, which has been recognized by the department of human
 
 5 services.  This program can provide the basis for a training
 
 6 program for prospective foster and adoptive parents in the State.
 
 7      The purposes of this Part are to allow the department of
 
 8 human services to contract with a provider to:
 
 9      (1)  Increase the pool of foster homes and adoptive homes
 
10           for better matching of children in need of out-of-home
 
11           care; and
 
12      (2)  Strengthen the quality of family foster care and
 
13           adoptive services by providing a standardized,
 
14           consistent framework for the competency-based training,
 
15           preparation, and selection of foster parents and
 
16           adoptive parents.
 
17      SECTION 31.  There is appropriated out of the general
 
18 revenues of the State of Hawaii the sum of $          , or so
 
19 much thereof as may be necessary for fiscal year 2000-2001, for:
 
20      (1)  Foster parent training for foster parents of licensed
 
21           foster homes;
 
22      (2)  Foster parent training for relative foster parents of
 
23           special licensed foster homes; and
 

 
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 1      (3)  Follow-up foster parent training for foster parents of
 
 2           licensed foster homes.
 
 3      SECTION 32.  There is appropriated out of the general
 
 4 revenues of the State of Hawaii the sum of $          , or so
 
 5 much thereof as may be necessary for fiscal year 2000-2001, to
 
 6 increase foster board payments for children with special needs.
 
 7      SECTION 33.  The sum appropriated shall be expended by the
 
 8 department of human services for the purposes of this Act.
 
 9                              PART X
 
10                   PSYCHOSOCIAL SUPPORT SERVICES
 
11      SECTION 34.  The legislature finds that intervention
 
12 services is a key factor in preventing stressful situations in
 
13 the home from escalating to unmanageable proportions.  The
 
14 legislature finds that two programs--the parent line and home
 
15 reach--have been successful in providing a healthy outlet for
 
16 families to express their concerns and anger with regard to child
 
17 management, development, and behavior.  Both programs have been
 
18 successful in giving much-needed support and respite to families.
 
19      The parent line provides counseling, support, and community
 
20 referrals to over four thousand parents and caregivers that have
 
21 questions regarding their childrens' development and behavior.
 
22 Home Reach provides short-term home visitation to four hundred
 
23 families identified through the parent line as being at risk for
 

 
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 1 social, emotional, or behavioral programs.  Those persons using
 
 2 the services of the home reach program require family
 
 3 intervention beyond a phone call to resolve a family parenting
 
 4 concern or crisis.
 
 5      The legislature finds that the parent line and home reach
 
 6 are overburdened due to the increase in the number of clients
 
 7 requiring their services.
 
 8      The purpose of this Part is to appropriate the necessary
 
 9 funds to broaden the scope of the parent line and home reach to
 
10 properly service the needs of the community.
 
11      SECTION 35.  There is appropriated out of the general
 
12 revenues of the State of Hawaii the sum of $          , or so
 
13 much thereof as may be necessary for fiscal year 2000-2001, to
 
14 increase the capacity of the parent line and home reach services
 
15 to properly service the needs of the community.
 
16      SECTION 36.  The sum appropriated shall be expended by the
 
17 department of health for the purposes of this Act.
 
18      SECTION 37.  All specified sums in this Act shall be in
 
19 addition to the respective departmental budgets.
 
20      SECTION 38.  This Act shall take effect on July 1, 2000.
 
21 
 
22                           INTRODUCED BY:  _______________________