STAND. COM. REP. NO. 480

Honolulu, Hawaii

RE: S.B. No. 318

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Second State Legislature

Regular Session of 2023

State of Hawaii

Sir:

Your Committee on Health and Human Services, to which was referred S.B. No. 318 entitled:

"A BILL FOR AN ACT RELATING TO FETAL ALCOHOL SPECTRUM DISORDERS,"

begs leave to report as follows:

The purpose and intent of this measure is to establish and appropriate funds for a Fetal Alcohol Spectrum Disorders Task Force within the Department of Health.

Your Committee received testimony in support of this measure from the State Council on Developmental Disabilities, Hawaii Disability Rights Center, Hawaii Fetal Alcohol Spectrum Disorders Action Group, Hawaii Substance Abuse Coalition, and four individuals. Your Committee received comments on this measure from the Department of Human Services and Department of Health.

Your Committee finds that fetal alcohol spectrum disorders (FASDs) are lifelong physical, developmental, behavioral, and intellectual conditions caused by prenatal exposure to alcohol. FASDs may impact as many as seventy thousand eight hundred people living in the State. Despite the prevalence of FASDs, few children in the State are diagnosed even by using best practices, especially within foster care and adoptive families, and many students with FASDs receive no additional support in the classroom. This measure would establish a task force to develop guidelines, recommendations, teaching protocols, and a screening tool relating to FASDs to assist the Legislature in determining the most effective way to support individuals with FASDs.

Your Committee notes the concerns raised by the Department of Health that the State's model of care lacks the appropriate multidisciplinary organization to assess and diagnose FASD cases. Seeking recommendations for legislative support is premature until a more reliable prevalence rate can be established. In lieu of a task force, a pilot project to implement a co-management system for primary care providers, behavioral health providers, and FASDs specialists would be more appropriate at this time. Amendments to this measure are therefore necessary to address these concerns.

Accordingly, your Committee has amended this measure by:

(1) Deleting language that would have:

(A) Established a Fetal Alcohol Spectrum Disorders Task Force within the Department of Health;

(B) Designated the membership composition of the Task Force;

(C) Required the Task Force to develop guidelines, recommendations, teaching protocols, and a screening tool relating to FASDs;

(D) Required the Task Force to submit a report to the Legislature; and

(E) Dissolved the Task Force on July 1, 2024;

(2) Inserting language that:

(A) Requires the Department of Health to establish and administer a five-year pilot program to implement a co-management system of care for the diagnosis and treatment of FASDs; and

(B) Specifies the operational procedures of the co-management system of care, including the responsibilities of the primary care provider, FASDs specialist, and behavioral health provider;

(3) Clarifying that the funds appropriated to the Department of Health shall be for the establishment and administration of the five-year pilot program to implement a co-management system of care for the diagnosis and treatment of individuals with FASDs;

(4) Amending section 1 to reflect its amended purpose; and

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

As affirmed by the record of votes of the members of your Committee on Health and Human Services that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 318, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 318, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committee on Health and Human Services,

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JOY A. SAN BUENAVENTURA, Chair