STAND. COM. REP. NO. 622

                                 Honolulu, Hawaii
                                                   , 1999

                                 RE: H.B. No. 264
                                     H.D. 2




Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committee on Education, to which was referred H.B. No.
264, H.D. 1, entitled: 

     "A BILL FOR AN ACT RELATING TO SCHOOL-BASED HEALTH CARE FOR
     ADOLESCENTS,"

begs leave to report as follows:

     The purpose of this bill is to promote access to health care
to adolescents by requiring the Director of Health to establish
at least one school-based health center in each departmental
school district of the Department of Education.

     Testimony in support of the bill was received from the
Healthy Mothers Healthy Babies Coalition of Hawaii, the Hawaii
Nurses Association, the project director of the school health
service center at Kapaa High School, three students at Kahuku
High School, and two individuals.

     The Department of Health testified in support of the intent
of the bill.  The Department of Education testified that it would
welcome support for school-based centers.

     The Office of Information Practices testified that a
potential problem exists because the language used to provide for
the confidentiality of student medical records may be construed
to prohibit students, as well as their parents, from obtaining
access to these records.

     Your Committee finds that access to health care for many
adolescents can be significantly improved with the establishment
of school-based health centers.  The school-based health center

 
                                 STAND. COM. REP. NO. 622
                                 Page 2

 
model has been shown to be an effective intervention among
adolescents on critical wellness issues.  Teens who are healthy
learn better and are better prepared to become productive
citizens.

     Moreover, since a broad array of health care services is
typically provided at a school-based health center, students who
utilize certain services that would otherwise be stigmatizing are
not stigmatized.  The potential for providing services to satisfy
the Felix v. Cayetano consent decree is particularly encouraging.

     Your Committee has addressed the concern expressed by the
Office of Information Practices in amending the bill as follows:

     (1)  Added a purpose section;

     (2)  Specified the types of referrals that may be considered
          for a center;

     (3)  Required the principal of the school and its
          school/community-based management council, in
          consultation with at least one health care
          professional, rather than a board appointed by the
          principal, to determine the services to be offered by
          the center and the policies to be established for its
          operation;

     (4)  Clarified that the approval of the student's parent is
          required for the student's medical records to be
          considered confidential; and

     (5)  Made technical, nonsubstantive revisions for purposes
          of style and clarity.

     As affirmed by the record of votes of the members of your
Committee on Education that is attached to this report, your
Committee is in accord with the intent and purpose of H.B. No.
264, H.D. 1, as amended herein, and recommends that it be
referred to the Committee on Finance in the form attached hereto
as H.B. No. 264, H.D. 2.

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



                                   ______________________________
                                   KEN ITO, Chair