emergency care in every public school in the State. The program also offers diagnostic evaluations for three- to ten-year-olds with learning disabilities.
The services provided by the Crippled Children Services Branch include: diagnosis, medical and surgical treatment, general counseling, occupational and physical therapy, speech therapy, social work, and nursing services. Diagnostic evaluations are provided without charge to all medically-eligible children. Treatment services are also free to families in financial need. The Federal Government also provides funds for specific programs in the family health area. 159/ The U.S. Department of Health and Human Services supports:
- A program at the State Department of Health to support services to children with special needs;
- A special State project for mentally-retarded children; and
- A medical genetics screening program at the State Department of Health.
In addition, the School of Public Health at the University of Hawaii is the recipient of $301,000 in Federal funding to support a maternal and child health program directed to help young mothers during the pre- and postnatal periods.
F. COMMUNICABLE DISEASES
The Epidemiology Branch of the Hawaii State Department of Health operates the one venereal disease clinic in the State. Other programs include school immunization programs, an influenza vaccine program, and research on fish poisoning, salmonellosis, and leptospirosis. It is feared that the latter may be an occupational hazard of the growing aquaculture industry, and surveillanc activities to monitor the situation are to be intensified.
The Tuberculosis Program offers detection services and preventive treatment. Tuberculosis remains a problem in Hawaii because of immigration, particularly of Indo- Chinese refugees.
The other major program in the communicable diseases category is the Leprosy Program. At the end of December 1979, there were 458 cases of leprosy on the state register. Of these cases, 328 were outpatients, 12' were residents of Kalaupapa on Molokai, 160/ and six resided at the South Trotter Wing at Leahi Hospital on Oahu. The Communicable Disease Division reports that, over the past ten years, there have been an average of 40 new leprosy cases each year. Of these cases, about 80 percent involve people who were born in Samoa or the Philippines. The Leprosy Program does not collect ethnic data on patients, but has informed the Commission that the distribution of the small numbers of locally-born cases appear to be indicative of the ethnic population distribution in Hawaii. 161/
Since 1974, the policy of the State has been to place all new leprosy cases under outpatient treatment, unless there are severe reactions or complications. Only three percent of the leprosy program budget was allocated to outpatient care in 1979-1980, while inpatient care accounted for the balance. The majority of the inpatients, as noted above, live in Kalaupapa, and their care is made more expensive by their advancing age (their average age in 1979 was 61). By law, the residents of Kalaupapa may live out the rest of their natural lives there.
In December 1980 (in the same public law that created the Native Hawaiians Study Commission), the U.S. Congress established the Kalaupapa National Historic Park. However, the