THE SENATE

S.B. NO.

318

THIRTY-SECOND LEGISLATURE, 2023

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO FETAL ALCOHOL SPECTRUM DISORDERS.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


     SECTION 1.  The legislature finds that fetal alcohol spectrum disorders (FASDs) are lifelong physical, developmental, behavioral, and intellectual conditions caused by prenatal exposure to alcohol.  According to the Centers for Disease Control and Prevention, up to one in five school children in the United States may have a FASD.  FASDs are more prevalent than autism disorders, spina bifida, cerebral palsy, and Down syndrome combined.

     The legislature recognizes that individuals with FASDs face unique challenges.  For example, while children with autism spectrum disorders share many of the same behavioral characteristics and related mental health diagnoses of children with FASDs, the latter tend to also struggle with feelings of being different from others, difficulties following through with instructions, emotional dysregulation, sleep disturbance, indiscriminate affection with strangers, lying, learning difficulties, and difficulties in understanding the causes and consequences of behaviors.  Further, due to diffuse brain damage, children with FASDs may also exhibit startled responses; suffer from depression, often in teenage years; fail to take initiative; fail to manage or comprehend time; lose one's temper; tend to argue with those in authority; and appear defiant.  Although many of these behaviors may appear to resemble typical teenage behaviors, many individuals with FASDs retain these behaviors through adulthood.

     The legislature also finds that FASDs may impact an estimated seventy thousand eight hundred people living in Hawaii.  Of the nearly seventeen thousand babies born annually in the State, as many as eight hundred forty are estimated to have FASDs.  However, few children in Hawaii are diagnosed using best practices.  Within foster care and adoptive families, eighty-five per cent of children are not diagnosed, or are misdiagnosed.  Raising a child with a FASD costs thirty times more than the cost of successful prevention efforts, and FASDs cost the State an estimated $876,000,000 annually. 

     Of the 174,000 students in Hawaii schools, as many as eight thousand seven hundred may have FASDs, yet far fewer are diagnosed.  Many individuals with FASDs have normal intelligence quotient scores but function below their chronological age, and many students with FASDs do not qualify for services dedicated to those with developmental disabilities, even when the students are correctly diagnosed.  FASDs are not tracked in special education, and most schools lack trained staff and the ability to support students with FASDs.  By age thirteen, more than sixty per cent of students with FASDs may experience trouble with law enforcement, and individuals with FASDs, with or without a diagnosis, face high rates of incarceration and recidivism.  A high proportion of older youths and adults with FASDs struggle with independent living and unemployment.  More than ninety per cent of individuals with FASDs will develop co‑morbid mental health conditions.

     The legislature further finds that Canada has adopted diagnostic guidelines for FASDs.  The creation of a task force to develop similar guidelines and a screening tool will be helpful in preparing proposed legislation to assist the legislature in providing the best possible support for individuals with FASDs.

     Accordingly, the purpose of this Act is to:

     (1)  Establish within the department of health a fetal alcohol spectrum disorders task force that shall develop guidelines, recommendations, teaching protocols, and a screening tool relating to fetal alcohol spectrum disorders and report to the legislature thereon; and

     (2)  Appropriate moneys to the department of health to establish and support the fetal alcohol spectrum disorders task force.

     SECTION 2.  (a)  There is established a fetal alcohol spectrum disorders task force to be placed in the department of health for administrative purposes.

     (b)  The following individuals, or the individuals' designees, shall serve as members of the fetal alcohol spectrum disorders task force:

     (1)  The director of health, who shall serve as chair of the task force;

     (2)  The chief justice of the supreme court;

     (3)  The president of the senate;

     (4)  The speaker of the house of representatives;

     (5)  The director of human services;

     (6)  The superintendent of education;

     (7)  The insurance commissioner; and

     (8)  The executive director of the Hawaii Disability Rights Center.

     (c)  The chair of the task force shall invite the following individuals to serve as members of the task force:

     (1)  An expert in fetal alcohol spectrum disorders;

     (2)  An individual with a fetal alcohol spectrum disorder, or the individual's guardian; and

     (3)  Any other individuals with experience relevant to the work of the task force.

     (d)  The fetal alcohol spectrum disorders task force shall develop:

     (1)  Guidelines and recommendations for governmental support of individuals with fetal alcohol spectrum disorders, including outreach, treatment, and resource identification guidelines and recommendations;

     (2)  Teaching protocols relating to fetal alcohol spectrum disorders, with assistance from the department of education;

     (3)  A fetal alcohol spectrum disorders screening tool in accordance with the Canada Fetal Alcohol Spectrum Disorder Research Network's diagnostic guidelines;

     (4)  Pathways for state departments to implement policies and procedures relating to paragraphs (1) through (3); and

     (5)  A proposed time frame for the complete implementation of paragraphs (1) through (3).

     (e)  The fetal alcohol spectrum disorders task force shall submit a 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 2024.

     (f)  The fetal alcohol spectrum disorders task force shall dissolve on July 1, 2024.

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2023-2024 and the same sum or so much thereof as may be necessary for fiscal year 2024-2025 for the establishment of the fetal alcohol spectrum disorders task force and procurement of any services required for the task force to carry out its duties.

     The sums appropriated shall be expended by the department of health for the purposes of this Act; provided that the department may contract with a third party to provide any necessary services to assist the task force.

     SECTION 4.  This Act shall take effect on July 1, 2023.

 

INTRODUCED BY:

_____________________________

 

 


 


 

Report Title:

Fetal Alcohol Spectrum Disorders; Task Force; Department of Health; Appropriation

 

Description:

Establishes the Fetal Alcohol Spectrum Disorders Task Force within the Department of Health.  Requires a report to the Legislature.  Dissolves the task force on 7/1/2024.  Appropriates moneys to the Department of Health to establish and support the work of the task force.  Authorizes the Department of Health to contract with a third party to assist the task force.

 

 

 

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