State officials plan to slash funding for Healthy Start, a nationally recognized child-abuse prevention program that serves thousands of children in the Islands, limiting services to East Hawai'i and Leeward O'ahu, and forcing the layoffs of dozens at nonprofits with Healthy Start programs.

The state Health Department told Healthy Start providers Monday that about $3 million from the tobacco settlement fund would be redirected from Healthy Start to help meet the state's growing budget shortfall and that without the money, Healthy Start couldn't be offered statewide.

Healthy Start serves about 4,000 young children in the Islands, linking up with at-risk families after the birth of a child to offer home visits, lessons on parenting and other services in order to prevent child abuse.

It's unclear how many Healthy Start workers will be laid off, but officials say probably more than 100.

Health Department spokeswoman Janice Okubo said the tobacco money is needed because of continued uncertainty about the state budget, given ongoing collective bargaining with state workers.

In an e-mail to seven providers, the department said Healthy Start would remain in only two small pockets of the state to target at-risk families in the greatest need of intervention services. Programs that don't offer services in those areas were asked to lay off their employees and close their doors in 30 days.

"It is with deep regret that I must inform you that the word is officially to shut down Healthy Start," Loretta Fuddy, chief of the Family Health Services Division at the Health Department, said in an e-mail on Monday to Healthy Start providers. She added, "Healthy Start has positively impacted a generation."

BAD TIMING

Child-welfare advocates say the cut all but dismantles Healthy Start at a time when many families with young children are in need of services and under increased stress because of the economic downturn.

"We're concerned about more and more families being at risk," said Howard Garval, president and CEO of Child and Family Service, which manages four Healthy Start programs statewide.

The two remaining Healthy Start programs will get about $1.3 million in federal Temporary Assistance for Needy Families, or TANF, money, which was originally supposed to be added to the tobacco settlement funds and divvied up statewide to Healthy Start providers.

Though the $4.3 million was far less than providers were hoping for, they say it could have kept the program alive at a "bare bones" level.

The decision to close Healthy Start programs across much of the state comes eight years after the program went statewide — and boasted appropriations of upward of $15 million a year.

In fiscal year 2008, which ended June 30, 2008, Healthy Start got about $15.6 million. Last fiscal year, the program got about $10.8 million.

That figure was reduced several times throughout the year as state government finances worsened.

The funding followed years of research that showed Healthy Start was making progress in preventing child abuse in at-risk families.

The state's Healthy Start model, which began as a pilot project in 1985, has also gotten national attention, and more than 30 other states now have similar abuse prevention initiatives.

Under the voluntary program, women who give birth in the Islands are screened for child-abuse risk factors. Those with multiple risk factors are offered support services and home visits until their child turns 3.

During home visits, providers are trained to spot other risk factors and offer suggestions about parenting, along with reminders on immunizations and education. The state has said that about 50 percent of mothers drop out of Healthy Start within their first year of the program.

But providers point out that of those who stay in the program longer than a year, 99 percent have no reports of child abuse.

(Enhanced Healthy Start, administered by the state Department of Human Services, is a separate program that helps mothers of young children referred after engaging in risky behavior, such as alcohol or drug abuse. Funding for Enhanced Healthy Start has not been affected by the Health Department decision.)

WIDELY EMULATED

Barbara Naki, director of prevention and education at The Institute for Family Enrichment, which is contracted with the Health Department to offer Healthy Start training and technical assistance, said the program has proven successful.

"We're the prototype. States all over the nation adopted the Healthy Start model," Naki said.

She added that though she understands money is tight, she doesn't understand why the program is being targeted and why it can't be saved. "We're putting our children at risk," she said.

Healthy Start providers statewide have watched their appropriations dwindle significantly over the last two years as the economy has deteriorated.

And in the last legislative session, they came out in force after the governor proposed abolishing the program to save money. In a last-ditch effort to save Healthy Start, they proposed funding the program at $6 million to preserve it until more money was available.

In response, legislators secured $4.5 million in tobacco settlement and TANF money for Healthy Start, and had hoped to seek more TANF funding later this year. State Sen. Suzanne Chun Oakland, D-13th (Kalihi, Nu'uanu), chairwoman of the Senate Human Services Committee, said she doesn't understand why the state would redirect the tobacco money away from Healthy Start when families are in need.

"This is a real tragedy," Chun Oakland said.

Yesterday, Healthy Start providers were informing employees of layoffs, and so a total accounting on how many people have lost their jobs was not available.

But Parents and Children Together alone is laying off about 20 people, in addition to 27 people who were laid off in March after earlier cuts to the program.

Child and Family Service will lay off 10 to 25 employees, while Catholic Charities Hawaii gave layoff notices to 30 Healthy Start employees in June, anticipating that the tobacco money wouldn't come through.