HB398 SD2.DOC

PART I

SECTION 1. The legislature finds that sudden unexpected infant death is a broad term that refers to the sudden death of an infant less than one year of age where the specific cause of death is not immediately obvious prior to investigation. According to the Centers for Disease Control and Prevention, more than four thousand five hundred sudden unexpected infant deaths occur in the United States every year. The specific cause of death may include but not be limited to sudden infant death syndrome, infection, accidental suffocation, poisoning or overdose, or metabolic disorders. Sudden infant death syndrome, the sudden death of an infant less than one year of age where the death cannot be explained even after a thorough investigation is conducted, accounts for half of the sudden unexpected infant deaths that occur in the United States every year and is the leading cause of death among infants less than one year of age. According to a Mayo Clinic web article, "[T]he exact cause is unknown, but sudden infant death syndrome may be associated with abnormalities in the portion of an infant's brain that controls breathing and arousal from sleep. Although all babies are vulnerable, certain sleep environments have been linked to increased risk. Perhaps the most important way to reduce the risk of sudden infant death syndrome is to place your baby on his or her back to sleep, on a firm crib mattress covered by a fitted sheet. Nothing else should go in the crib with your baby — no blanket, pillow, bumper pads or toys." The Centers for Disease Control and Prevention, Division of Reproductive Health, recognizes sudden infant death syndrome and sudden unexpected infant deaths as a public health issue and has established the Sudden Unexpected Infant Death Initiative to address the problem by improving investigation and reporting practices of sudden infant death syndrome and sudden unexpected infant deaths. The Initiative includes improving data collection and reporting regarding sudden unexpected infant deaths, using improved data to identify those at risk of sudden unexpected infant death, and training professionals to conduct comprehensive infant death investigations, with the hope that better data and the consistent classification of causes of death will result in a greater ability to prevent these types of deaths.

The legislature also finds that sudden unexpected infant deaths and sudden infant death syndrome are preventable through safe sleep policies that address causes of death that are associated with sudden unexpected infant deaths, such as accidental suffocation, and incorporate elements of the Sudden Unexpected Infant Death Initiative. However, Hawaii is one of nine states that do not regulate the proper sleep positions of infants and toddlers under the care of child care centers or family care homes.

The purpose of this part is to require child care facilities, which include family child care homes, group child care centers, group child care homes, and infant and toddler child care centers, that care for children less than one year of age to implement safe sleep policies to prevent the occurrence of sudden unexpected infant deaths and sudden infant death syndrome.

SECTION 2. Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to part VIII to be appropriately designated and to read as follows:

"§346‑ Safe sleep policy. (a) All child care facilities, which include family child care homes, group child care centers, and group child care homes, as those terms are defined in section 346-151, and infant and toddler child care centers, that are registered or licensed by the department to provide care for children less than one year of age shall develop, maintain, and implement a written safe sleep policy in accordance with rules adopted by the department in accordance with the law. The purpose of the safe sleep policy shall be to maintain a safe sleep environment that prevents the occurrence of sudden infant death syndrome and sudden unexpected infant deaths in children less than one year of age.

(b) As used in this section:

"Sudden infant death syndrome" means the sudden death of an infant less than one year of age that cannot be explained after a thorough investigation has been conducted, including a complete autopsy, an examination of the death scene, and a review of the clinical history.

"Sudden unexpected infant death" means the sudden and unexpected death of an infant less than one year of age in which the manner and cause of death are not immediately obvious prior to investigation. Causes of sudden unexpected infant death include but are not limited to metabolic disorders, hypothermia or hyperthermia, neglect or homicide, poisoning, and accidental suffocation."

PART II

SECTION 3. (a) There is established a working group to review issues relating to the transition of oversight of home and community-based facilities from the department of human services to the department of health, including services offered by or issues related to:

(1) Community care foster family homes;

(2) Adult residential care homes;

(3) Adult day care centers;

(4) Caregivers of persons with developmental or intellectual disabilities;

(5) Adult foster homes;

(6) Licensed case management agencies; and

(7) Fees, rules, and regulations that affect all of these care setting providers.

(b) The working group shall be convened by the chairs of the house and senate committees on human services. The working group shall consist of:

(1) The chairs of the house and senate committees on human services, who shall serve as co-chairs;

(2) One representative from the department of human services;

(3) One representative from the department of health;

(4) representatives of community care foster family homes;

(5) representatives of adult residential care homes;

(6) representatives from adult day care centers;

(7) representatives of developmental disabilities domiciliary homes;

(8) representatives of adult foster homes; and

(9) representatives of licensed case management agencies.

(c) Members shall serve without compensation and shall not be considered state employees based solely upon their participation in the working group.

(d) The working group shall submit a written report of its findings and recommendations, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2014.

(e) The working group shall terminate on June 30, 2014.

PART III

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect on July 1, 2020.

HOUSE OF REPRESENTATIVES	H.B. NO.	398
TWENTY-SEVENTH LEGISLATURE, 2013		H.D. 1
STATE OF HAWAII		S.D. 2