STAND. COM. REP. NO. 274-00

                                 Honolulu, Hawaii
                                                   , 2000

                                 RE: H.B. No. 2541
                                     




Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 2000
State of Hawaii

Sir:

     Your Committee on Health, to which was referred H.B. No.
2541 entitled: 

     "A BILL FOR AN ACT RELATING TO COMMUNITY WATER
     FLUORIDATION,"

begs leave to report as follows:

     The purpose of this bill is to prevent tooth decay by
fluoridating Hawaii's water supply.

     The Department of Health (DOH), the State Health Planning
and Development Agency (SHPDA), the Hawaii Statewide Health
Coordinating Council, the SHPDA Plan Development Committee, the
State Certificate of Need Review Panel, the Kauai County Subarea
Health Planning Council, the Tri-Isle Subarea Health Planning
Council, the Hawaii County Subarea Health Planning Council, the
Honolulu Subarea Health Planning Council, the West Oahu Subarea
Health Planning Council, the Windward Oahu Subarea Health
Planning Council, the Hawaii Medical Service Association, the
Hawaii Medical Association, and the Waianae Coast Comprehensive
Health Center testified in support of this measure.

     The Hawaii Dietetic Association, the Hawaii Public Health
Association, the Hawaii State Primary Care Association, the
Hawaii Dental Association, the Hawaii Dental Hygienists'
Association, Kokua Kalihi Valley Comprehensive Family Services,
Ke Ola Mamo Native Hawaiian Health Care System of Oahu, the Kauai
Rural Health Association, the Honolulu County Dental Society, the
Policy Advisory Board for Elder Affairs, the Hawaiian Health

 
 
                                 STAND. COM. REP. NO. 274-00
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Committee of Wilcox Health System, the Kauai Dental Health Task
Force, the Hawaii Academy of Pediatric Dentistry, the Chamber of
Commerce of Hawaii, the Hawaii Chapter of the American Academy of
Pediatrics, and numerous individuals also testified in support of
this measure.

     The Hawaii County Department of Water Supply, the Hawaii
Citizen's for Health, and numerous individuals opposed this
measure.  The Kauai County Department of Water, the Maui Board of
Water Supply, and an individual submitted comments.

     Your Committee heard compelling testimony both for and
against fluoridating Hawaii's water supply, and acknowledges that
this is a highly emotional and complex issue.  Your Committee
recommends that this measure be passed out of committee for
further review, but has the following concerns requiring further
discussion:

     (1)  The appropriateness of using the Hawaii Tobacco
          Settlement Special Fund as the funding source to
          fluoridate the water supply;

     (2)  The abolishment of DOH's Dental Hygiene Program
          (Program).  Your Committee believes that the Program is
          a significant component of a comprehensive system to
          ensure healthy oral hygiene, and is concerned about its
          possible termination; and

     (3)  The evaluation component to test the effectiveness of
          fluoridation.  Your Committee believes that benchmarks
          and outcome indicators are necessary and should be used
          to hold DOH accountable for its outcomes.

     As affirmed by the record of votes of the members of your
Committee on Health that is attached to this report, your
Committee is in accord with the intent and purpose of H.B. No.
2541 and recommends that it pass Second Reading and be referred
to the Committee on Finance.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health,



                                   ______________________________
                                   ALEXANDER C. SANTIAGO, Chair