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HOUSE OF REPRESENTATIVES             H.C.R. NO.            
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
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                     HOUSE  CONCURRENT
                        RESOLUTION
  REQUESTING THE STATE AUDITOR TO CONDUCT A PROGRAM AND FINANCIAL
    AUDIT OF THE DEPARTMENT OF HEALTH'S ADULT MENTAL HEALTH
    DIVISION.



 1        WHEREAS, there are an estimated 24,000 persons in Hawaii
 2   with serious mental illness; and
 3   
 4        WHEREAS, care and compassion for people with mental
 5   illness is a hallmark of a civilized and humane society; and
 6   
 7        WHEREAS, in 1991, the State of Hawaii and the United
 8   States government entered into a settlement agreement to
 9   correct deficiencies at the Hawaii State Hospital, the only
10   facility in Hawaii dedicated and designed to treat the severely
11   mentally ill; and in 1995, the U.S. District Court found the
12   State in contempt of court for not fulfilling certain
13   conditions of the settlement agreement; and
14   
15        WHEREAS, at a status conference in February 1999, the U.S.
16   District Court further found the Hawaii State Hospital to be
17   out of compliance with significant requirements of the court
18   orders; and
19   
20        WHEREAS, the Court convened a panel of Hawaii and U.S.
21   Department of Justice officials to review the issues and
22   problems facing the Hawaii State Hospital and to develop a plan
23   to bring the State into compliance; and as part of its plan to
24   comply, the Department of Health proposed that the 1999
25   Legislature reduce the number of State Hospital beds by
26   transferring clients to community-based services; and
27   
28        WHEREAS, the Department of Health requested an additional
29   $16,000,000 from the 1999 Legislature, for a total
30   authorization of $46,000,000, to implement its compliance plan;
31   and
32   
33        WHEREAS, however, the 1999 Legislature withheld
34   appropriation of the additional funds pending the receipt of
35   details regarding the bed closure proposal, with specific
36   details regarding the location of patient community placement;
37   and
38   

 
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                                  H.C.R. NO.            
                                                        
                                                        

 
 1        WHEREAS, although the national average is twenty-two
 2   mental health hospital beds per 100,000 residents, Hawaii
 3   currently only has twelve beds per 100,000 residents; and the
 4   Department of Health plans to further reduce the total number
 5   of state beds to 108, resulting in a ratio of only nine beds
 6   per 100,000 residents -- by far the fewest number of beds per
 7   capita for the mentally ill of any state; and
 8   
 9        WHEREAS, it is alleged that, under the authority of the
10   Director of Health, persons who need hospital treatment have
11   been diverted from the State Hospital to correctional
12   facilities where they may not receive appropriate treatment;
13   and
14   
15        WHEREAS, it is alleged that the reduction in the number of
16   State Hospital beds has forced individuals who required
17   hospitalization to be denied the necessary treatment; and
18   
19        WHEREAS, the U.S. Department of Justice December 1999
20   Hawaii State Hospital Status Report states that "downsizing of
21   the hospital is resulting in patients being prematurely or
22   inappropriately discharged from the hospital"; and
23   
24        WHEREAS, the 1999 Status Report expresses concerns that
25   the Department of Health has not developed an adequate plan
26   that integrates hospital-based and community-based services in
27   a way that addresses both the clinical needs of persons with
28   serious mental illnesses and public safety concerns; and
29   
30        WHEREAS, the Governor has requested the 2000 Legislature
31   to appropriate over $14,000,000 in emergency funding for the
32   Adult Mental Health Division's fiscal year 1999-2000 budget;
33   and
34   
35        WHEREAS, the Governor also has requested an additional
36   $23,300,000 in fiscal year 2000-2001 supplemental funding for
37   adult mental health services; and
38   
39        WHEREAS, the Legislature remains concerned that, while it
40   is being asked to appropriate millions of additional dollars
41   for adult mental health services, it has not seen a firm plan
42   of action to address the court orders; and
43   
44        WHEREAS, the Legislature also is still very much concerned
45   about the millions of dollars it is required to appropriate for
46   another Department of Health program for children and
47   adolescent mental health, pursuant to yet another consent
48   decree; and
49   

 
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                                  H.C.R. NO.            
                                                        
                                                        

 
 1        WHEREAS, as the funding authority for the State, it is
 2   appropriate that the Legislature, in complying with its
 3   fiduciary responsibility, have available as much information as
 4   possible before making funding decisions; now, therefore,
 5   
 6        BE IT RESOLVED by the House of Representatives of the
 7   Twentieth Legislature of the State of Hawaii, Regular Session
 8   of 2000, the Senate concurring, that the State Auditor is
 9   requested to conduct a program and financial audit of the
10   Department of Health's Adult Mental Health Division; and
11   
12        BE IT FURTHER RESOLVED that the State Auditor's review is
13   requested to include, but not be limited to, the operations of
14   Hawaii State Hospital, the Department of Health's plans to
15   comply with court orders applicable to the Hawaii State
16   Hospital, the availability of appropriate community-based
17   services for the severely mentally ill, and the legislative
18   appropriations for the Adult Mental Health Division; and
19   
20        BE IT FURTHER RESOLVED that the State Auditor is requested
21   to submit the findings of this program and financial audit no
22   later than twenty days prior to the convening of the Regular
23   Session of 2001; and
24   
25        BE IT FURTHER RESOLVED that certified copies of this
26   Concurrent Resolution be transmitted to the Governor, the
27   Director of Health, and the State Auditor; and
28 
29 
30 
31                           OFFERED BY: ___________________________