THE SENATE

S.B. NO.

714

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 are lifelong physical, developmental, behavioral, and intellectual disabilities caused by brain damage due to prenatal alcohol exposure. According to the federal Centers for Disease Control and Prevention, these disorders impact as many as one in twenty first graders in the United States, and are more prevalent than autism disorders, spina bifida, cerebral palsy, and Down syndrome combined.

The legislature recognizes that individuals who have fetal alcohol spectrum disorders face unique challenges. For example, while children who have autism spectrum disorders share many of the same behavioral characteristics and related mental health diagnoses of children who have fetal alcohol spectrum disorders, the latter also tend to struggle with distractions, feelings of being different from other people, difficulties following through with instructions, emotional dysregulation, hyperactivity, sleep disturbance, indiscriminate affection with strangers, lying, difficulties in learning, and difficulties in understanding the causes and consequences of behavior. Furthermore, due to diffuse brain damage, children who have fetal alcohol spectrum disorders may also exhibit startled responses; suffer from depression, often in teenage years; fail to take initiative; fail to manage or comprehend time; lose their 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 who have fetal alcohol spectrum disorders do not grow out of these behaviors when they become adults.

The legislature also finds that an estimated seventy thousand eight hundred people living in Hawaii could be impacted by fetal alcohol spectrum disorders. Of the nearly seventeen thousand babies born annually in the State, as many as eight hundred forty are estimated to have a fetal alcohol spectrum disorder. Raising a child who has a fetal alcohol spectrum disorder costs thirty times more than the cost of successful prevention efforts. The impact of these disorders costs the State an estimated $876,000,000 annually. Few children in Hawaii are diagnosed using best practices. Eighty-five per cent of children in foster care or adopted families are either not diagnosed or are misdiagnosed.

Of the one hundred seventy-four thousand students in Hawaii schools, as many as eight thousand seven hundred may have fetal alcohol spectrum disorders, yet far fewer are diagnosed. The disorders are not tracked in special education, and most schools lack trained staff and the ability to support students who have the disorders. By age twelve, sixty-one per cent of individuals who have the disorders may be expelled, suspended, or drop out of school. By age thirteen, more than sixty per cent of students who have the disorders may experience trouble with law enforcement. Many students who have the disorders will not qualify for services for those who have developmental disabilities, even when they are correctly diagnosed. Many individuals who have the disorders have normal intelligence quotient scores, but function below their chronological age, and are sometimes precluded from receiving needed services. A high proportion of older youths and adults who have the disorders struggle with independent living and unemployment. Individuals who have the disorders, with or without a diagnosis, face high rates of incarceration and recidivism. More than ninety per cent of individuals who have the disorders will develop co‑morbid mental health conditions.

The legislature also recognizes that in 2021, members of Congress introduced H.R. 4151 and S. 2238, which are identical bills, each given the alternative titles of the "Advancing FASD [fetal alcohol spectrum disorder] Research, Services, and Prevention Act" and the "FASD Respect Act". The bills address the issues surrounding support services, prevention public health, and research programs relating to the disorders. The bills enhance programs and funding for research relating to prevention of the disorders, screening, identification, and research and services by federal, state, local, and private stakeholders. The legislature believes that the State should be ready to properly hold and administer federal moneys if this federal legislation becomes law.

Accordingly, the purpose of the Act is to establish:

(1) The fetal alcohol spectrum disorders special fund, to be administered by the department of human services, and which will consist only of federal moneys relating to fetal alcohol spectrum disorders, and interest earned on those moneys; and

(2) A fetal alcohol spectrum disorders task force, which shall develop and report to the legislature regarding guidelines, recommendations, and teaching protocols relating to fetal alcohol spectrum disorders.

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

"346-    Fetal alcohol spectrum disorders special fund; established. (a) There is established within the state treasury a special fund to be known as the fetal alcohol spectrum disorders special fund to be administered and expended by the department.

(b) The fund shall consist of:

(1) Federal funds granted by Congress or presidential executive order for the purpose of assisting individuals who have fetal alcohol spectrum disorders; and

(2) Interest accrued to the moneys in the special fund.

(c) The moneys in the fetal alcohol spectrum disorders special fund shall be used by the department to provide assistance to individuals who have fetal alcohol spectrum disorders, in a manner that complies with federal law or presidential executive orders, as applicable."

SECTION 3. (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 their 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 president 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 who has a fetal alcohol spectrum disorder, or the individual's guardian; and

(3) Any other individuals with relevant experience relating 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 who have fetal alcohol spectrum disorders, including guidelines and recommendations for outreach, treatment, and resource identification;

(2) Teaching protocols, with assistance from the department of education;

(3) Pathways by which state departments may implement policies and procedures relating to these guidelines, recommendations, and teaching protocols; and

(4) A proposed timeframe for the full implementation of these guidelines, recommendations, and teaching protocols.

(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 4. New statutory material is underscored.

SECTION 5. This Act shall take effect upon its approval.

 

INTRODUCED BY:

_____________________________

 

 


 


 

Report Title:

Fetal Alcohol Spectrum Disorder; Department of Health; Department of Human Services; Special Fund; Task Force

 

Description:

Establishes the fetal alcohol spectrum disorders special fund, to be administered by the department of human services, and which shall consist of federal funds and interest earned on those funds. Establishes a temporary fetal alcohol spectrum disorders task force within the department of health for administrative purposes. Requires a report to the legislature.

 

 

 

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