SB13

SECTION 1. The legislature finds that the Hawaii's public elementary school children have tooth decay rates that nearly double those documented in all of the other states. For Native Hawaiian and Filipino children, the rate of tooth decay is even higher. Poor oral health among children and vulnerable adult populations is among the most widespread and pressing challenges identified in Hawaii. Dental disease, including tooth decay, is Hawaii’s silent epidemic. It causes pain, suffering, loss of productivity at school and work, and becomes more expensive to treat the longer the decay or disease is left untreated. In addition to negatively affecting one's quality of life, dental disease and tooth decay are also catalysts to other life-threatening systemic diseases and infections.

There is a dramatic documented variance in Hawaii between children attending military base schools whose water is fluoridated and children in non-military base schools. While many factors affect dental health, the fact that Hawaii’s military base water systems are optimally fluoridated is considered the major factor contributing to the superior oral health found among military base elementary school children. When dental health statistics from Hawaii’s military bases are not used in the calculations, Hawaii ranks last in oral health in the United States.

Over four hundred million people in over sixty countries presently receive the benefits of optimally fluoridated drinking water. This figure includes more than one hundred seventy million people in the United States in thousands of communities, and approximately sixty-five per cent of the total United States population. Every recent United States surgeon general has recommended optimally fluoridating water. More than one hundred health organizations, including the American Medical Association and the World Health Organization, support water fluoridation. Between 2000 and 2004, more than one hundred twenty-five United States communities in thirty six states have voted to adopt fluoridation programs. The Centers for Disease Control and Prevention has proclaimed community water fluoridation as one of the ten great public health achievements of the 20th century.

Fluoridation is safe and cost effective. Community water fluoridation in the United States has a record of safety and effectiveness dating back over fifty years. Despite claims to the contrary, years of critical scientific research has not demonstrated an association between fluoridation and acute or long-term health problems. It is considered among the most socially equitable and cost-effective public health measures ever implemented. The benefits of fluoridated drinking water include a sixty to sixty-five per cent reduction in tooth decay. Our communities would further benefit from this substantial reduction in tooth decay by lower private and public health care costs and dental insurance premiums. Those in greatest need in our community will benefit the most. The United States Centers for Disease Control and Prevention estimates that the lifetime cost: benefit ratio of community water fluoridation is 1:80; every dollar spent on fluoridation will save eighty dollars in health care costs. The average annual cost of community water fluoridation is estimated to be about one dollar per person per year. The lifetime cost per person is less than a single dental filling.

All drinking water systems in Hawaii contain a low level of naturally occurring fluoride. The adjusted concentration recommended to effectively improve oral health is 0.7 parts per million. In relative terms, this minute amount may be viewed as equivalent in length to 1 inch in 20.8 miles, in time, to 1 minute in 2.6 years, in money, to 1 penny in $13,000, and in per cent, to 1/13,000th of 1 per cent.

The purpose of this Act is to promote oral health in our communities by adjusting the amount of naturally occurring fluoride in the water to the optimum level that will benefit oral health.

SECTION 2. Chapter 340E, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§340E- Water fluoridation pilot program. (a) There is established a water fluoridation pilot program to be administered by the director in the geographic areas of Waimanalo, Kalihi, and the Waianae coast. The director shall administer the program to all other communities at the option and request of each requesting community.

(b) At any time, the fluoride content of water served by the public water system in an area specified under subsection (a) is less than 0.7 parts per million of fluoride, the department shall add a measured amount of fluoride to the water so as to maintain a fluoride content that is in accordance with the water fluoridation guidelines issued by the United States Centers for Disease Control and Prevention.

SECTION 3. The department of health shall submit a report to the legislature evaluating the efficacy of the water fluoridation pilot program no later than twenty days prior to the convening of each regular legislative session in which the program is administered.

SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $ , or so much thereof as may be necessary for fiscal year 2007-2008, and the same sum, or so much thereof as may be necessary for fiscal year 2008-2009, for the establishment and administration of the water fluoridation pilot program.

The sums appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 5. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval; provided that section 4 shall take effect on July 1, 2007; and

provided further that this Act shall be repealed on July 1, 2012.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	13
TWENTY-FOURTH LEGISLATURE, 2007
STATE OF HAWAII