Honolulu, Hawaii
                                                   , 1999

                                 RE: H.B. No. 264
                                     H.D. 1

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


     Your Committee on Health, to which was referred H.B. No. 264


begs leave to report as follows:

     The purpose of this bill is to provide students access to
health care by requiring the Director of Health, with assistance
of the Superintendent of Education, to establish and operate as a
demonstration project, not less than one school-based health
clinic in each of the seven department school districts.

     The G.N. Wilcox Health Services Corporation of Wilcox
Memorial Hospital, the School Health Service Centers at Kapaa and
Kahuku High Schools, the Hawaii Nurses' Association, Healthy
Mothers Healthy Babies Coalition of Hawaii, and several concerned
students submitted testimony in support of this measure.  The
Departments of Health and Education submitted testimony in
support of the intent of this measure.

     The Hawaii Chapter of the American Academy of Pediatrics
submitted testimony expressing significant reservations, and the
Hawaii Medical Association submitted testimony opposing this
measure.  The Office of Information Practices submitted comments
on the provision regarding the confidentiality of student-medical

                                 STAND. COM. REP. NO. 39
                                 Page 2

     Your Committee finds that this measure encourages
collaboration and ensures access to health care for adolescent
populations who would otherwise have difficulty accessing timely
and appropriate care.

     Your Committee further believes that school-based health
centers would reduce costs for mental health services, and
encourages that mental health services be pursued at these
centers to address the Felix Consent Decree.

     Your Committee has amended this measure by:

     (1)  Replacing the term "clinic" with "center" to more
          accurately describe the concept;

     (2)  Deleting references to a demonstration project;

     (3)  Authorizing instead of requiring the centers to provide
          its list of health services;

     (4)  Requiring the Directors of Health and Human Services to
          look for all possibilities for reimbursement, including
          federal and private foundation funds, for services
          provided at a center; and

     (5)  Making technical, nonsubstantive amendments for
          purposes of clarity and style.

     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.
264, as amended herein, and recommends that it pass Second
Reading in the form attached hereto as H.B. No. 264, H.D. 1, and
be referred to the Committee on Education.

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

                                   ALEXANDER C. SANTIAGO, Chair