Wednesday, February 3, 1999
THE state administration is under fire for its handling of two separate but related programs: the mental health system and Child Protective Services. Although administered by different departments -- the Health Department and the Department of Human Services -- both deal with aberrant behavior.
State must improve
The defects cited did not originate with the Cayetano administration. They go back many years. However, the current administration has had four years to correct them and should -- not only because there are legal consequences of failure to act but also because people need and deserve better treatment.
Federal District Judge David Ezra, citing the state's failure to bring the state mental health system into compliance with federal law, has given the Cayetano administration until June 15 to correct problems at the Hawaii State Hospital. If it does not do so, he will appoint a special master to oversee the system.
"Unless the state wants to lose control of an essential and important control of government, running a mental health system, it needs to move forward," the judge declared.
Problem areas cited by the federal government include lack of appropriate treatment plans for patients and failure to carry them out, failure to evaluate the effectiveness of plans and failure to coordinate services with other state agencies.
Officials from the federal Department of Justice surveyed the state hospital and other mental health facilities last month and noted that improvements have been made -- but not sufficient to eliminate the problems.
Ezra ordered that the state and the Justice Department establish a team to produce a plan to address the issues by the end of February. By June 15 the state must have programs in place to address each of the issues identified by the compliance team. The court will hold a hearing Dec. 20 to determine whether the state is in compliance.
EARLIER State Auditor Marion Higa criticized the Department of Human Services for failing to ensure that all child abuse and neglect reports are investigated. The auditor's report termed supervisory review at key decision-making points insufficient. It said staff members failed to follow procedures to assess the risk of harm in investigating reports of suspected abuse and neglect.
The auditor found ineffective the department's communication within the Child Welfare Services branch and with the police and the Family Court. "As a result," the report said, "DHS has not ensured that decision makers have access to necessary information, that criminal proceedings begin when warranted, or that Family Court jurisdiction is sought when required."
During the month of June 1998, the auditor said, nearly half of the child abuse and neglect cases reported statewide were not registered in the Child Protective Services System, the central registry of abuse and neglect reports. The report said that in a one-month period under review the department failed to refer to the police about 40 percent of the reports of child sexual assault it had received. Moreover, the police do not consistently inform the department of all child abuse and neglect cases reported to them, it added.
Child abuse is an appalling fact that society must confront. Child Protective Services, the program primarily charged with dealing with the problem, has a tremendously difficult task. But its deficiencies can have tragic results and every effort must be made to correct them. Similarly, the treatment of mental illness must be held to high standards.
IT'S a relief that companies that pulled out of the homeowners insurance market in Hawaii after Hurricane Iniki devastated Kauai in 1992 have re-entered the market. The state, which established a hurricane insurance fund to fill the gap left by the private insurers, should leave the field when the private sector takes over. However, the state should make sure that it is not acting prematurely in abolishing the Hawaii Hurricane Relief Fund.
Rep. Robert Herkes, chairman of the House Economic Development Committee, is drafting legislation that would phase out the fund. The Cayetano administration also proposes to phase out the hurricane fund, and Herkes is preparing legislation that combines the administration proposal with his. The fund is financed by a fee on mortgages recorded in the state, premiums from the fund's insurance policies and an annual assessment on private insurance companies.
Herkes said he'll follow the administration's recommendation that 99 percent of the fund's remaining $130 million be placed in an emergency natural disaster relief fund; 1 percent would go to a natural disaster loss mitigation fund, which would be used for prevention efforts. However, Herkes wants the phase out to be completed in two years while the administration proposed three years.
The state should not remain in the home insurance business any longer than necessary. But the concerns of the private companies should be considered. The Hawaii Insurers Council, the trade group representing property and casualty insurance companies, opposes the shutdown.
Paul Ables, the council's legislative chairman, told the committee, "If the fund is terminated, there will again be some difficulty for consumers in buying homeowners insurance as insurance companies find their surplus overexposed and seek to limit the number of policies written in Hawaii." Herkes' responded that "Naturally insurance companies don't want HHRF to go away. Their losses are capped (under the fund)."
It's true that the hurricane fund was intended to be nothing more than a temporary solution to the lack of availability of hurricane insurance, but the Legislature should weigh the validity of the private companies' objections before deciding whether to abolish it. Nobody wants to repeat the experience of 1992, when thousands of homeowners had the scary experience of being deprived of insurance coverage.
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