Social-service providers hope Gov. Linda Lingle will release money state lawmakers put in the budget to salvage Healthy Start, a child-abuse prevention program the governor wanted to abolish to save money during the recession.

Ending Healthy Start would have saved the state $23.2 million over two years, but lawmakers, moved by advocates who believe the program deters child abuse, found money to keep it alive. Specifically, they allocated $4.5 million in tobacco settlement fund and federal welfare money for fiscal year 2010 and $3 million in tobacco settlement money for fiscal year 2011.

Providers will also ask the state to divert additional federal welfare money so Healthy Start would receive at least $6 million a year for a "bare bones" program.

Under the voluntary program, providers try to screen every woman who gives birth in the state for risk factors of child abuse. Women who appear vulnerable are offered home visits to help with parenting for up to three years.

With the reduced level of funding, the program would probably not be able to screen as many women and would likely concentrate on new mothers from low-income families. Providers may also have to curtail the frequency of home visits or prioritize home visits by risk.

"Healthy Start has been very successful at working with families of newborns that are experiencing tremendous challenges and stresses," said Gail Breakey, the executive director of the Hawai'i Family Support Institute and an originator of the program back in 1985. "The bottom line is that the children are not abused and neglected. Their parents may have been on drugs, may have not experienced good childhoods themselves and may not know how to raise a child, how to bond with it, how to do the day in, day out care of a child.

"These families, for the most part, are functioning better. They're understanding their parenting role. They're attached to their child so there is the emotional bond that creates good parenting."

MODEL PROGRAM

Healthy Start is administered by the state Department of Health. Screening and home visits are contracted to social-service providers such as Catholic Charities Hawai'i, Child and Family Service, Parents and Children Together, and Maui Family Support Services. Enrollment is about 4,100 families and 4,400 children.

(A separate program, Enhanced Healthy Start, is administered by the state Department of Human Services and serves about 325 families. Women in Enhanced Healthy Start are referred to the program by child welfare services after engaging in risky behavior such as drug or alcohol abuse.)

Under Healthy Start, about 78 percent of all new mothers are screened and about 10 percent agree to home visits. About half of the women leave the program within the first year, according to the state, and only about 20 percent stay longer than two years.

Healthy Start has been used as a model for similar child-abuse prevention programs nationally.

Janice Okubo, a spokeswoman for the state Department of Health, said it is premature to comment on the future of Healthy Start because the budget has yet to become law. Lingle has until July to decide whether to sign, veto or allow the budget to become law without her signature.

Howard Garval, the president and chief executive officer of Child and Family Service, said there are promising indications the Lingle administration will support the scaled-back funding lawmakers provided. He said the department had invited providers to come up with a Healthy Start model at a reduced spending level.

Garval said providers are scheduled to meet with department officials to discuss the model options.

"We're encouraged by the fact that they're actually meeting with providers to do that, so we feel that there will be a program into next fiscal year and there will be a new model," he said. "Our biggest concern is the risk level of the families and whether the home visiting intensity is adequate."

MORE CUTS COMING

Healthy Start was one of two programs Lingle suggested for elimination in her initial budget proposal last December. The other program — adult dental services — also received money in the budget after lawmakers determined it was worth saving.

The lower forecast by the state Council on Revenues on Thursday will force Lingle to make additional general-fund spending cuts. The fact lawmakers used tobacco settlement fund and federal welfare money for Healthy Start, instead of general-fund money, may work in the program's favor as the administration looks to restrict spending.

State Sen. Suzanne Chun Oakland, D-13th (Kalihi, Nu'uanu), the chairwoman of the Senate Human Services Committee, said it is essential to preserve Healthy Start and identify families at risk of maltreating children. She said she would ask Lillian Koller, the director of the state Department of Human Services, to agree to use more federal welfare money to raise spending levels for the program to at least $6 million a year.

"This is our basic child abuse and neglect prevention program," she said.