HB2138.DOC

SECTION 1. Hawaii has long been a leader in early childhood services, reflecting an understanding of the importance of early childhood development and proactive legislation to ensure the safety and well-being of infants, toddlers, and pre-schoolers. As a result, over the past twenty-five years, many early childhood programs, services, and concepts have been developed and expanded, including the healthy start program, the zero to three program, the early learning council, good beginnings alliance, the concept of universal pre-school for four year olds, baby safe, keiki play mornings, the parenting hotline, and the family center.

A recent renaissance in research and national-level policy on early childhood underscores the foresight of these actions. For example, the National Scientific Council on the Developing Child published The Science of Early Childhood Development: Closing the Gap Between What We Know and What We Do (Harvard University, 2007). Comprised of leading neuroscientists, pediatricians, developmental psychologists, and economists, the National Scientific Council on the Developing Child reviewed all current research and literature on early childhood development. Based on this research, the publication presents the following core concepts of development and considers their implications for policy and practice:

(1) Child development is the foundation for community development and economic development; capable children become the foundation for a prosperous, sustainable society;

(2) Brain architecture is built from the bottom up, with simple circuits and skills providing the scaffolding for more advanced circuits and skill over time;

(3) Toxic stress in early childhood is associated with persistent effects on the nervous system and stress hormonal systems that can damage developing brain architecture and lead to lifelong problems in learning, behavior, and mental and physical health;

(4) Policy initiatives that promote supportive relationships and rich learning opportunities for children create a strong foundation for high achievement in school followed by greater productivity in the workplace and solid citizenship in the community;

(5) Substantial progress in proper child development can be achieved by assuring growth-promoting experiences through a range of parent education, family support, early childhood education, and early intervention programs;

(6) Later remediation for highly vulnerable children will produce less favorable outcomes and cost more than appropriate early interventions, beginning in the earliest year of life; and

(7) Responsible investment is needed to produce results; it is not profitable to utilize intervention that may be less costly but fails to produce needed results.

Given the foregoing realities, the legislature finds it prudent to move as soon as possible to reinstate early childhood services and continue the work of the early learning council to develop a comprehensive continuum of services, with emphasis and priority given to the most vulnerable children. Abuse and neglect often start early in a child's life. Perinatal child abuse prevention and home visiting services with high-risk families should be re-established on a permanent basis, as it is critical to avert or minimize toxic stresses that cause long-term damage to children.

As recent events exemplify, in tight economic times, the safety net for vulnerable families is the first to be dismantled. In the longer term, this will increase the cost of services which already are very costly, such as special education, mental health services, drug treatment services, and prison construction. The State will also lose the potential productivity which these affected children should have as adults.

The strategy of establishing permanent services to ensure the safety and optimal development of our children in their earliest years is humane and economically strategic.

The purpose of this Act is to exempt the healthy start program from the state budget allotment system and to establish the healthy start program in statute.

SECTION 2. Chapter 37, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§37‑A Programs exempt from allotment system. The healthy start program of the department of health under section 321‑A shall be exempt from sections 37-32, 37-34, and 37-37, to the extent that services provided by or contracted by the department of health for the healthy start program shall not be diminished or eliminated due to budgetary shortfalls. This exemption shall apply to personnel positions for the healthy start program within the department of health."

SECTION 3. Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§321‑A Healthy start program; established. (a) There is established the healthy start program, to be placed under the department of health for administrative purposes. The healthy start program shall provide support services within a family's natural environment to reduce the likelihood of child maltreatment by reducing parental or environmental stressors; provide linkages with community resources including health and mental health services, early childhood education, childcare, family literacy, employment, social services, developmental screening and appropriate child development education and interventions, service coordination, and advocacy for families; and provide parents with knowledge of child development, child health, and positive parenting skills and problem-solving techniques.

The healthy start program shall include a home visitation program to foster family functioning, promote child health development, and enhance positive parenting skills for families in order to reduce the risk of child maltreatment by addressing malleable environmental risk factors via information, support, and linkages to needed community resources. The home visitation program shall:

(1) Include proactive universal screening and assessment to enroll families at birth or prenatally before any child welfare reports are made;

(2) Make home visit services available for families assessed to be at-risk, with the highest priority given to those with scores of forty and above on the family stress checklist or parent survey;

(3) Maintain critical elements, especially related to caseloads, staff ratios, and training, developed by the Healthy Families America Program;

(4) Focus on a relational approach with families, mother-infant dyads, and supervisor and family support worker relationships;

(5) Focus strongly on caregiver and infant attachment and social and emotional development;

(6) Conduct interventions to strengthen protective factors and reduce risk;

(7) Integrate emerging evidence-based practice, as feasible and appropriate;

(8) Ensure continuous quality improvement by engaging program staff; and

(9) Evaluate outcomes related to child development, risk reduction, and confirmed cases of abuse, neglect, and family resilience.

Acceptance of services by the family shall be voluntary. Services shall continue until the child reaches three years of age, or until the child reaches five years of age if there is a younger sibling.

(b) In addition to public moneys from appropriations, the department of health may receive federal grants and accept private donations for purposes of funding the healthy start program.

(c) As provided in section 37-A, the healthy start program shall not be subject to budget reductions made under the allotment system."

SECTION 4. In codifying the new sections added by sections 2 and 3 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

SECTION 5. New statutory material is underscored.

SECTION 6. This Act, upon its approval, shall take effect retroactive to .

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	2138
TWENTY-FIFTH LEGISLATURE, 2010
STATE OF HAWAII