Health services face crisis
By Alice Keesing
Advertiser Education Writer
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As the House Finance Committee continues to defer approval of the emergency money that the department says it needs, the department exhausted its special-education fund a week ago. It is now paying for services with money earmarked for staff pay and will soon have to raid its fund for emergency ambulance services.
"This is past the point of being critical," said Health Director Anderson. "We are drawing down funds, which will result in catastrophic problems if we are not reimbursed by the end of this session."
The Department of Health, along with the Department of Education, is under a federal court order, the Felix consent decree, to improve services for Hawai'i's more than 20,000 special-needs children. At the beginning of this legislative session, the departments asked for a total of $158 million in emergency money to pay for special-education services for the rest of this fiscal year.
At the Department of Education, which bears the brunt of the Felix requirements, Schools chief Paul LeMahieu also is watching the money dwindle. He estimates that the DOE's special-education account will run dry in about six weeks but is refusing to take money from regular education as suggested by lawmakers.
As for the Health Department if it does not get the emergency money needed for the rest of this year, Anderson said he will have no choice but to stop services to the children his department serves — those with severe mental illnesses.
"Kids not getting services would certainly not improve, and possibly we would see some regression as they fall back into old habits and behaviors," Anderson said. "There may be more serious consequences, of course, with not being able to continue residential services for some children, and they would be essentially on the street."
Not getting the money also could mean Anderson will be unable to pay his staff or the emergency ambulance services, which the department has borrowed against.
What's more, the disruption of services to special-needs children would open up the state to a contempt ruling from the federal court.
The crisis at the Health Department is part of the maelstrom created by the Felix consent decree, a federal court order issued by U.S. District Judge David Ezra that resulted from the state's woeful treatment of children with disabilities.
After finding the state in contempt in May, Ezra has imposed a December deadline to show improved services. Already this year, he has warned of dire consequences if lawmakers do not provide the money needed to get the job done.
He threatened to divest the state of control, and could use his sweeping powers to take over the special-education system and divert state money to pay for it.
But House legislators, alarmed at the hundreds of millions of dollars being poured into special education, say they want to be sure the money is being spent wisely before they sign off on this year's emergency requests.
Lawmakers speak of the $1.35 billion that has been spent on special education since 1995. They speak of the threat to the money for other state programs.
And they speak of reports that expenses have been inflated because too many children are being identified as having the special needs that the Felix decree addresses.
With Ezra indicating he has run out of patience and options, both Anderson and LeMahieu are warning that, despite significant progress in improving services, the state is on the verge of huge upheaval.
If Ezra steps in, his oversight could last for years, and he could appoint a special master to run the education system.
"As I understand it, (Ezra) would have jurisdiction and authority over all of the state's assets, which means he could dispose of them as he sees fit," LeMahieu said.
"I say this only for dramatic effect, but he could sell 'Iolani Palace," he added.
House Finance Chairman Dwight Takamine said lawmakers are aware of the situation.
"I don't think we want to do anything to aggravate the situation with the judge," said Takamine, D-1st (North Kohala, Hamakua). "But I think we still have our responsibility that we have to live up to, which is to ensure that ... the Felix kids are the ones actually receiving the benefit and that it be done in a cost-effective manner that protects the taxpayers' interests."
Takamine pointed out that, over the course of this session's scrutiny, both the DOE and the Health Department have lowered the amounts they are asking for. Some of that is from items that should not have been in an emergency request in the first place, he said.
At the start of the session the Department of Health was asking for $56 million and it now needs $44.6 million. The Department of Education originally asked for $46 million and is now at $28 million.
LeMahieu said he knew that lowering the request would be tantamount to walking into a political trap.
"The retort is, 'So, what are you? A liar or incompetent? You either couldn't do it right, or you could do it right and you were lying to us.'
"But they were honest numbers when we first came out with them, and they're honest numbers today," he said.
"But, yes, they are numbers that change."
The DOE has been able to reduce its emergency appropriation request because it has not recruited as many special-education teachers as it needs, which means new programs have not come on line, LeMahieu said.
Health Department savings have come in part from new practices that help children with less invasive, and less costly, services, Anderson said.
But every time the amount has changed, the House Finance Committee's decision on how much to approve has been pushed back while lawmakers go over the new numbers, Takamine said.
"Sometimes it's a lot of boring detail, but if we do not do the work then we are failing to ensure accountability in the process."
The committee has tried to provide the DOE with money through a measure that would allow it to take money from its regular education account to pay for special education.
"It was attempting to provide the department with a tool in case there was this period that they have to get by while we were considering the emergency request and what would be the appropriate level (so) that they did not run into a crisis situation where all funds were exhausted," Takamine said.
But in the increasingly stormy environment surrounding Felix, LeMahieu describes the move as "sinister."
"Someone is going to have to force me to (take money from regular education) because I won't do it," LeMahieu said. "I think the divisiveness, the harm and the damage done to a whole other constituency — which is to say, the majority of children — would be so great that it would not be even to the benefit of special-ed kids even in the long run."
In addition, LeMahieu said, regular education already has less money than it needs, and the loss of more money would be a "fatal blow" to school staff, where Felix already has created havoc as they rush toward the December deadline.
If the DOE runs out of special-education money before the House approves the emergency appropriation, LeMahieu said the department will stop spending on special education "and then there'll be trouble." That "trouble" could be far-reaching.
