REPORT TITLE:
School health system


DESCRIPTION:
Establishes a comprehensive school health system that promotes
the healthy development of all students and a comprehensive
school health demonstration program.  Convenes a joint planning
committee to coordinate a phased implementation of the
demonstration program.  (SD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        1917
HOUSE OF REPRESENTATIVES                H.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 2000                    
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

RELATING TO SCHOOL HEALTH.



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

 1      SECTION 1.  Children require access to health care to
 
 2 maintain good health.  When they become sick or are injured, most
 
 3 children have access to a health care professional.  However, too
 
 4 many children in the United States, particularly those from poor
 
 5 families, are at risk for multiple health problems.  Indigent
 
 6 children may experience two to three times the usual incidence of
 
 7 certain medical conditions, many of which are preventable.  The
 
 8 most common health problems affecting children today include
 
 9 injuries, chronic illnesses such as asthma, and mental health
 
10 problems.  In addition, children are now engaging more frequently
 
11 in risky behaviors that may lead to health problems, including
 
12 smoking, binge drinking, and unsafe sex.
 
13      The number of children at risk for poor health has increased
 
14 as children have lost access to care because their parents have
 
15 lost their health insurance.  Currently, about sixteen per cent,
 
16 or eleven million, of America's children are uninsured.  Even for
 
17 children who do have health insurance, barriers to health care
 
18 exist.  For example, parents may be unable to leave work to take
 
19 their child to see a doctor.  And in many low-income communities,
 

 
Page 2                                                     1917
                                     H.B. NO.           S.D. 1
                                                        
                                                        

 
 1 health care facilities are few and often inadequate.
 
 2      The legislature finds that the concept of school-linked
 
 3 services, and the idea of community agencies locating services on
 
 4 a school site, will facilitate school and community reforms to
 
 5 adopt a comprehensive, multi-faceted, and integrated approach
 
 6 necessary to prevent health problems.  However, the legislature
 
 7 understands that developing a comprehensive, integrated approach
 
 8 requires more than outreach to link community resources, more
 
 9 than coordination of school-owned services, more than
 
10 coordination of school and community services, and more than
 
11 family resource centers and full service schools.  The design
 
12 meeting the needs of all students also requires a continuum of
 
13 school and community programs and services that ensures the use
 
14 of minimal interventions.  Systemic collaboration is essential to
 
15 establish interprogram connections on a daily basis, and over
 
16 time to ensure seamless intervention within each system and among
 
17 systems of prevention, systems of early intervention, and systems
 
18 of care.
 
19      The purpose of this Act is to establish:
 
20      (1)  A comprehensive school health system that promotes the
 
21           healthy development of all students;
 
22      (2)  A comprehensive school health demonstration program;
 
23           and
 

 
Page 3                                                     1917
                                     H.B. NO.           S.D. 1
                                                        
                                                        

 
 1      (3)  A joint planning committee to coordinate a phased
 
 2           implementation of the comprehensive school health
 
 3           demonstration program.
 
 4      SECTION 2.  The departments of education and health shall
 
 5 jointly establish a comprehensive school health system.  The
 
 6 system shall:
 
 7      (1)  Ensure a full integration of enabling programs and
 
 8           services with components designed to:
 
 9           (A)  Facilitate development and learning; and
 
10           (B)  Govern and manage resources;
 
11      (2)  Weave together school-owned resources;
 
12      (3)  Enhance programs by integrating school and community
 
13           resources, including increasing access to community
 
14           programs and services by integrating as many as
 
15           feasible with the school to fill gaps in programs and
 
16           services; and
 
17      (4)  Blend funds from, but not be limited to:
 
18           (A)  Compensatory education;
 
19           (B)  Special education;
 
20           (C)  General funds; and
 
21           (D)  Community resources, including agencies, grants,
 
22                donations, and volunteers.
 
23      For purposes of this section, "enabling programs and
 

 
Page 4                                                     1917
                                     H.B. NO.           S.D. 1
                                                        
                                                        

 
 1 services" means clusters of programmatic activity that address
 
 2 barriers to learning and enhance healthy development.  The
 
 3 function of enabling programs and services are designed to:
 
 4      (1)  Enhance classroom-based efforts to enable learning;
 
 5      (2)  Provide prescribed student and family assistance;
 
 6      (3)  Respond to and prevent crises;
 
 7      (4)  Support transitions;
 
 8      (5)  Increase home involvement in schooling; and
 
 9      (6)  Outreach for greater community involvement and support,
 
10           including recruitment of volunteers.
 
11      SECTION 3.  (a)  The director of health, with the assistance
 
12 of the superintendent of education, shall establish and operate
 
13 as a demonstration project, not less than one comprehensive
 
14 school health program in each of the seven departmental school
 
15 districts established in section 13-1(d), Hawaii Revised
 
16 Statutes.
 
17      (b)  Prior to the establishment and operation of a
 
18 comprehensive school health demonstration program, the principal
 
19 of the school and the school and community-based management
 
20 council, in consultation with at least one health care
 
21 professional and the joint department of health and department of
 
22 education planning committee, shall establish policy decisions
 
23 related to the operation of the demonstration program, including
 

 
Page 5                                                     1917
                                     H.B. NO.           S.D. 1
                                                        
                                                        

 
 1 but not limited to:
 
 2      (1)  Consent of parent required;
 
 3      (2)  Ability to pay;
 
 4      (3)  Confidentiality of records;
 
 5      (4)  Financial responsibility;
 
 6      (5)  Limitation of actions; and
 
 7      (6)  Personnel.
 
 8      (c)  The comprehensive school health demonstration program
 
 9 shall be student-centered and include the following components:
 
10      (1)  Health education;
 
11      (2)  Physical education;
 
12      (3)  Health services;
 
13      (4)  Nutrition services;
 
14      (5)  Dental hygiene services;
 
15      (6)  Counseling, psychological, and social services;
 
16      (7)  Healthy school environment;
 
17      (8)  Health promotion for staff; and
 
18      (9)  Parent and community involvement.
 
19      (d)  The comprehensive school health demonstration program
 
20 shall be designed using the comprehensive school health system
 
21 established in section 2 of this Act.
 
22      SECTION 4.  There is established a joint department of
 
23 health and department of education planning committee to:
 

 
Page 6                                                     1917
                                     H.B. NO.           S.D. 1
                                                        
                                                        

 
 1      (1)  Plan and coordinate a phased implementation of a
 
 2           comprehensive school health system and comprehensive
 
 3           school health demonstration program; and
 
 4      (2)  Study the staturorily required work day of six and one-
 
 5           half hours for school health aides under section 321-
 
 6           245, Hawaii Revised Statutes, and for other department
 
 7           of health personnel working in schools.
 
 8      The director of health and superintendent of education shall
 
 9 designate members of their respective departments, and the
 
10 appropriate collective bargaining representative shall designate
 
11 from the department of health at least one registered
 
12 professional nurse and at least one health aide, to sit on the
 
13 joint planning committee to carry out the purposes of this Act.  
 
14      SECTION 5.  (a)  The joint planning committee shall report:
 
15      (1)  Its plan and coordination for a phased implementation
 
16           of a comprehensive school health system and
 
17           comprehensive school health demonstration program; and
 
18      (2)  Its findings and recommendations on the work day of
 
19           school health aides and other department of health
 
20           personnel working in schools,
 
21 to the legislature no later than twenty days prior to the
 
22 convening of the regular session of 2001.
 
23      (b)  The director of health shall report to the legislature
 

 
Page 7                                                     1917
                                     H.B. NO.           S.D. 1
                                                        
                                                        

 
 1 on the experience of each comprehensive school health
 
 2 demonstration program not less than twenty days prior to the
 
 3 convening of the regular sessions of 2002 and 2003.  The report
 
 4 shall include:
 
 5      (1)  The policies of each comprehensive school health
 
 6           demonstration program;
 
 7      (2)  The number of students served and the types of health
 
 8           services provided;
 
 9      (3)  The operating cost, including income collected through
 
10           fees, monetary donations, private grants, and in-kind
 
11           services;
 
12      (4)  Quantifiable changes in high-risk behaviors among
 
13           students receiving services;
 
14      (5)  Recommended changes to improve the demonstration
 
15           program; and
 
16      (6)  Any other information that the departments of health
 
17           and education may determine to be necessary to assist
 
18           the legislature in evaluating the efficacy, cost-
 
19           effectiveness, and intangible merits of the
 
20           demonstration program.
 
21      SECTION 6.  There is appropriated out of the general
 
22 revenues of the State of Hawaii the sum of $     or so much
 
23 thereof as may be necessary for fiscal year 2000-2001 for
 

 
Page 8                                                     1917
                                     H.B. NO.           S.D. 1
                                                        
                                                        

 
 1 comprehensive school health demonstration programs.
 
 2      The sum appropriated shall be expended by the department of
 
 3 health for the purposes of this Act.
 
 4      SECTION 7.  There is appropriated out of the general
 
 5 revenues of the State of Hawaii the sum of $     or so much
 
 6 thereof as may be necessary for fiscal year 2000-2001 for
 
 7 comprehensive school health demonstration programs.
 
 8      The sum appropriated shall be expended by the department of
 
 9 education for the purposes of this Act.
 
10      SECTION 8.  This Act shall take effect upon its approval;
 
11 provided that:
 
12      (1)  Sections 6 and 7 shall take effect on July 1, 2000; and
 
13      (2)  This Act shall be repealed on June 30, 2003.