School-based Student Health Services Program
Establishes a school-based student health services program that promotes a comprehensive approach to healthy development of all students through an student health system that is integrated with and complements school and community programs and resources. Convenes a joint planning committee to develop and plan for the implementation of the program. (HB1894 HD2)
HOUSE OF REPRESENTATIVES
TWENTY-SECOND LEGISLATURE, 2004
STATE OF HAWAII
A BILL FOR AN ACT
relating to student health.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Children and adolescents are usually dependent on parents and caregivers for access to health care to maintain good health. Although most children and adolescents have access to a health care professional or service when they become sick or are injured, many of them, particularly those from poor families or in rural or isolated communities, are at risk for multiple health problems because they lack health insurance or access to a primary care provider.
Indigent children may experience two to three times the usual incidence of certain medical conditions, many of which are preventable. Even adolescents who have health insurance and a primary care provider do not readily seek medical care, and their parents or caregivers find it difficult to maintain their teenagers' regular visits to the doctor.
The most common health problems affecting children and adolescents today include injuries, chronic illnesses such as asthma, and mental health problems. In addition, adolescents and pre—adolescents are now engaging more frequently in risky behaviors and unhealthy lifestyles that may lead to more health problems as adults, including smoking, drinking alcohol, unsafe sex, and the abuse of illegal drugs, such as crystal methamphetamine, otherwise known as "ice."
Since all children and adolescents are required to attend school, school-based health services would encourage students, especially adolescents, to access care or information because these services would be readily available at little or no cost, and an adult would not have to "hold their hand." School-based student health services would also encourage students to seek mental health services, and alcohol and substance abuse counseling because they would be provided in a nonthreatening, "nonlabeling," and nonstigmatizing venue, as part of an array of services. As such, school-based student health services can play a strategic role in the delivery of school-based mental health assessments, day treatment, and mental health services required under the Felix v. Cayetano consent decree.
The legislature finds that school-based or school-linked health services enhanced and supported by services provided by community agencies are an important component of the comprehensive, multifaceted, integrated approach necessary to prevent and treat adolescent health problems. However, the legislature recognizes that an integrated approach requires more than outreach services that link youth to community resources, the coordination of school-based services, and the establishment of family resource centers and full-service schools. To meet the needs of all students, community input and investment are also required to identify and develop an array of school and community programs that reflect the needs and values of the community. Collaboration, communication, and cooperation between the school, parents, students, community agencies, and organizations are essential to successfully establish school-based student health services and ensure a seamless system of prevention, early intervention, treatment, and follow-up.
The purpose of this Act is to provide children and adolescents access to quality, affordable health care in an environment that is convenient, nonthreatening, and encouraging, by establishing a school-based student health services program.
SECTION 2. (a) The department of health, in collaboration with the department of education and department of human services, shall establish a school-based student health services program to complement the department of education's comprehensive school support services program. Within five years of the effective date of this Act, at least one student health services project shall be established in each school district, with no fewer than one student health services project in each of the departmental school complexes.
(b) In establishing the student health services program, the director of health, director of human services, and superintendent of education shall draft and sign a memorandum of agreement to establish and operate a school-based student health services program that complements the comprehensive school support services program. The school-based student health services program shall:
(1) Be student-centered;
(2) Fully integrate health-related services with other program components designed to:
(A) Facilitate development and learning; and
(B) Maximize and manage resources;
(3) Integrate school—centered resources;
(4) Integrate school and community resources; and
(5) Use to the fullest extent, available funding sources including:
(A) Medicaid, the medicaid early and periodic screening, diagnostic, and treatment program, and QUEST;
(B) Special education and the child and adolescent mental health division of the department of health;
(C) General funds; and
(D) Community resources, including agencies, foundations, grants, donations, and volunteers.
(c) The comprehensive student health services project may include the following components:
(1) Health education, including medically accurate, factually based sex education;
(2) Physical education and physical fitness;
(3) Health services;
(4) Nutrition services;
(5) Counseling, psychological, and social services;
(6) Substance and alcohol abuse counseling;
(7) Healthy school environment;
(8) Health promotion for staff;
(9) Parent and community involvement; and
(10) Mental health assessments and services.
The school-based student health services project shall not promote, provide referrals to, or provide abortions or abortion-related services on site.
(d) Prior to the establishment and operation of a student health services project, the superintendent of education and the school and community—based management council, in consultation with at least one hospital, community health center, or health care professional with a practice in the community, shall establish policies for the operation of the project, including:
(1) Procedures for obtaining the consent of a parent or guardian;
(2) Application of the program to persons needing financial assistance;
(3) Confidentiality of records;
(4) Financial responsibility;
(5) Limitation of liability; and
SECTION 3. (a) The department of health, in collaboration with the department of education and the department of human services' office of youth services, shall convene a joint planning committee to plan and coordinate the provisions for school-based student health services that will complement the department of education's comprehensive school support services program.
(b) The director of health, director of human services, and superintendent of education shall designate members of their respective departments to sit on the joint planning committee to carry out the purposes of this Act. The planning committee may also include representatives of the following:
(1) The legislature;
(2) The board of education;
(5) Public employee labor unions;
(6) The Hawaii State Parent Teacher Student Association;
(7) Community health centers;
(8) The American Pediatric Society;
(9) Mental health providers;
(10) Medical providers;
(11) Dental services providers, including dental hygienists; and
(12) Public health nurses.
SECTION 4. (a) The joint planning committee shall report its plan for the establishment and implementation of a school-based student health services program that complements the comprehensive school services program and other student support programs and services, to the legislature no later than twenty days prior to the convening of the regular session of 2005.
(b) The director of health, in collaboration with the director of human services and superintendent of education, shall report to the legislature on the experience of each comprehensive school-based student health services project no later than twenty days prior to the convening of the regular session of 2006. The report shall include:
(1) The policies of each comprehensive student health services project;
(2) The number of students served and the types of health services provided;
(3) The operating cost, including income collected through fees, monetary donations, private grants, and in—kind services;
(4) Quantifiable changes in high—risk behaviors among students receiving services;
(5) Benchmarks for physical and mental health and increases in positive outcomes for children and adolescents;
(6) The number of uninsured students served;
(7) The number of students who are referred for alcohol and substance abuse treatment or counseling;
(8) The number of students referred to their physicians or other specialists;
(9) Recommended changes to improve the program; and
(10) Any other information that the departments of health, human services, and education may determine to be necessary to assist the legislature in evaluating the efficacy and cost-effectiveness of the program.
SECTION 5. 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 2004—2005 for comprehensive student health services. The funds shall be allocated as follows:
(1) $ for planning and start-up of school-based student health services projects, at least at one school in each school district, up to one school in each of the departmental school complexes; and
(2) $ for evaluation of the cost and effectiveness of providing student health services based at school sites, to be submitted to the legislature no later than twenty days prior to the start of the 2006 legislature.
The sum appropriated shall be expended by the department of health for the purposes of this Act.
SECTION 6. This Act shall take effect on July 1, 2010, and shall be repealed on June 30, 2015.