Medical, Military, Public and Municipal Affairs

Representative Joe E. Brown
Chairman

Mary Denis Cauthen
Director of Research

Zenda Leaks
Research Assistant

Barbara M. Coleman
Executive Secretary

MEDICAL, MILITARY, PUBLIC AND MUNICIPAL AFFAIRS
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This act adds a new exception to the general requirement that children in this state who are eligible for adoption be placed with South Carolina residents. The new exception will allow for out-of-state or non-resident adoption if the child has been legally freed for adoption, has been in foster care for six months, and no South Carolina resident has been identified as a prospective adoptive home.

Nothing in this act changes the requirement that there must be a judicial determination that the child meets the conditions of the exception. The court must include in its order specific findings of fact as to the circumstances allowing the placement of a child with a nonresident or the adoption of a child by a nonresident. In addition, before a child can be placed adoption with nonresidents of South Carolina, compliance with the Interstate Compact on the Placement of Children is required. The Intersta te Compact authorizes DSS to enter into agreements with agencies of other states regarding assistance payments, social services and medical payments for eligible adopted children. These agreements are structured for the protection of adopted children when the adoptive parents move to other states or are residents of other states.

Signed June 12, 1995.

This legislation allows a police chief or sheriff, with the approval of the municipality, to provide compensation for reserve police officers. Reserve officers may be compensated for public activities, such as basketball or football games, just as school districts pay off-duty police officers to be present at such activities. The act also allows reserve officers to carry a weapon, both on duty and off duty, just as any other regular, salaried law enforcement officer.

Signed June 12, 1995.

There are 16 local foster care review boards in South Carolina, one for each judicial circuit. Each board is made up of five members appointed by the governor upon the recommendation of the legislative delegation.

This act prohibits a person from serving on a local foster care review board or being employed by the Division of Foster Care Review if he or she is the subject of an indicated report or affirmative determination of abuse and neglect on DSS's Central Registry.

Additionally, the legislation prohibits a person from serving on a local foster care review board or being employed by the Division of Foster Care Review if the person has been convicted or has pled nolo contendere (no contest) to an `offense against the person'; an `offense against morality or decency'; or contributing to the delinquency of a minor.

Before appointment or reappointment to a board, the Foster Care Review Division in the Governor's office will be required to have DSS to do a Central Registry records check and to get a SLED criminal records check to certify that the nominees qualify. Annually, the Division will obtain a DSS Central Registry check on all persons serving on these boards. Employees of the Division will be required to undergo the same fingerprint and Central Registry checks as those required for board members.

Signed June 12, 1995.

Prior to passage of this act, state law allowed a dental hygienist to apply sealants or to clean children's teeth in a school setting. However, the law specifically stated that the students must be "medically indigent", (i.e., eligible for Medicaid or for free or reduced school lunch programs).

This legislation will allow a dental hygienist to apply a sealant to or clean the teeth of any student with unmet oral needs if the parent or guardian provides written permission. Provision of these services will no longer be restricted just to medically indigent students. The hygienist must receive authorization from a licensed dentist before provision of these services and treatment cannot be authorized for a student who is an active patient of another dentist.

Signed June 12, 1995.

This act requires anyone applying for a license as an operator or to be employed at a child day care facility to undergo a State Law Enforcement Division (SLED) and an FBI fingerprint check for criminal history. Any facility seeking a license, registration or approval will be required, on the first renewal after June 30, 1995, or by June 30, 1996 (whichever is later) to undergo a SLED and an FBI fingerprint check. Employees and caregivers at these facilities also will be required to undergo a SLED and F BI fingerprint check by those dates. These fingerprint reviews will not be required on a subsequent renewal unless the renewal coincides with employment of a new operator, employee, or caregiver. Employees of the day care licensing and child protective services divisions of DSS (Department of Social Services) also will be required to submit to fingerprint reviews prior to employment. SLED is prohibited from charging more than $25 to conduct a check required by this legislation.

DSS will be prohibited from issuing a new or renewed license, registration or approval for any type of child day care facility if the operator has been convicted of a felony or one of the offenses listed in §16-1-10(D). Existing law already prohibited DSS from issuing a license or registration for a facility if the operator had been convicted of an Offense Against the Person; an Offense Against Morality and Decency; or contributing to the delinquency of a minor. A person convicted of one of these c rimes who applies for a license as operator or employment at a child day care facility would be guilty of a misdemeanor, punishable upon conviction by a fine not exceeding $5,000, or imprisonment not exceeding one year, or both. DSS must place a warning about this provision in large, bold type at the top of their day care facility application forms. Similarly, day care facilities will be required to put the same notice in large, bold type at the top of their employment application forms to warn a person applying to work at a facility that if he has been convicted of one of these crimes and applies to work there, he may be fined or imprisoned.

Any time DSS cites a child day care facility for a violation of state law or regulations, the department will have to provide the owner and operator of the facility with a brochure stating, in simple language, the rights and procedures available to the owner or operator for a hearing and the rights and procedures available to appeal the decision.

Signed June 12, 1995.

This act allows the Department of Probation, Parole and Pardon Services to consider film, videotape, or other electronic information when determining a person's parole. The crime victim, the prosecuting solicitor's office, and the person being considered for parole will be allowed to submit electronic information at the parole hearing.

Signed June 7, 1995.

This legislation creates a reserve detention officer program. The director of the detention facility has the authority to appoint the number of reserve detention officers approved by the responsible authority. "Responsible authority" means the sheriff, county administrator, mayor, city manager, or other appropriate official who has legal responsibility for the management of a local detention facility within a particular jurisdiction. The reserve officer must successfully complete a jail pre-s ervice training program approved by the Department of Public Safety and pass a comprehensive test prepared by the S.C. Criminal Justice Academy. The reserve will serve as a jailer or detention officer only on specific orders and directions of the director of the detention facility.

Became law without signature of Governor June 13, 1995.

This act allows a licensed funeral director to be licensed as a life insurance agent only for pre-need funeral contracts. The amount of the insurance policy sold by the funeral director cannot exceed the amount of the pre-need funeral contract as defined in Section ). The funeral director must file a policy to fund a pre-need funeral contract with the S.C. Board of Funeral Service; and before the policy can be marketed in South Carolina, the Board must verify that the policy is consistent with Title 32, Chapter 7. The Board must maintain a list of all funeral directors licensed as life insurance agents, the insurer each director represents, and the policy each director is licensed to sell. Except for a funeral director licensed under §, no insurance agent may sell life insurance for pre-need funeral contracts. Funeral directors licensed as life insurers for pre-need funeral contracts may not solicit or advertise for these insurance policies.

Signed June 12, 1995.

Last year, the General Assembly adopted legislation required by federal law regarding Medicaid estate recovery. This federal law requires states to recover the amount that Medicaid has paid on behalf of two groups of people:

(1) A person of any age, who was an inpatient in a nursing facility, intermediate care facility for the mentally retarded or other medical institution at death, and who was required to pay most of his/her monthly income to the facility for the cost of care; or (2) A person who was 55 or older when he/she received medical services paid by Medicaid.

If a person from one of these two groups has an estate at death, Medicaid will recover from the estate only the amount it paid for the person. No recovery will take place until after the death of the surviving spouse, disabled child or until any minor children of the recipient turn 21.

This act amends the state Medicaid estate recovery statute by further limiting the kinds of medical services that must be repaid for the second group discussed above, the persons 55 or older when they received medical services paid by Medicaid. The legislation that passed last year allowed recovery for the cost of all medical services provided under the state Medicaid plan. This act restricts recovery to only nursing facility services, home and communitybased services, and hospital and prescription drug services provided to individuals in nursing facilities or receiving home and communitybased services.

The second part of the act is prospective. It provides that if the federal requirements for estate recovery are changed to grant states the option to exempt home and community-based services or other noninstitutional Medicaid services from estate recovery, then this act will allow the State Health and Human Services Finance Commission to implement these exemptions without further change in state law.

Signed June 12, 1995.

Prior to passage of this act, the State Health and Human Services Finance Commission (HHSFC) was authorized to contract only with health and human service agencies to determine eligibility of applicants for Medicaid. Currently, HHSFC contracts with DSS for this service.

This act expands HHSFC's authority so that it also may contract with private entities to do Medicaid client eligibility determinations. The legislation was introduced to give HHSFC the flexibility to contract for managed health care options for Medicaid clients.

Signed May 17, 1995.

The Data Oversight Council (DOC) was established to assist the General Assembly and the Budget and Control Board Office of Research and Statistics (R&S) in the formation of health care policy by making recommendations concerning the collection and release of health care data. The DOC is composed of representatives from hospitals, physicians, state agency staff, governor's staff, businesses, long term care providers, and insurance providers.

This act redefines the DOC's enabling legislation to give it more specific authorization regarding the use and release of health carerelated data. In addition, the act addresses patient and health care provider confidentiality issues related to the release of health care data. Before R&S may release provider identifiable data, it must determine that the data to be released is for purposes consistent with agency regulations and the release must be approved by the DOC and Joint Committee on Health Car e Planning and Oversight. The act also deleted much of the statutory detail regarding collection of data since those requirements are now covered in regulations.

The legislation also requires collection of outpatient data on all hospital-based and freestanding ambulatory surgical facilities, hospital emergency rooms, and any health care setting which provides on an outpatient basis radiation therapy, cardiac catherizations, lithotripsy, magnetic resonance imaging, and positron emission therapy. Other providers offering services with equipment requiring a Certificate of Need as well as home health agencies also will be required to provide outpatient information to R&S.

The last part of the act addresses entities that collect health care data or information for a registry, such as the Alzheimer's Disease Registry. These entities will be required to coordinate with R&S to utilize existing data collection formats.

Signed June 12, 1995.

This act creates the Alzheimer's Disease Registry within the University of South Carolina's School of Public Health. The purpose of the registry is to provide a central information data base on individuals with Alzheimer's or related disorders in order to assist in the development of public policy and planning. In gathering its data, the registry will rely upon data from existing sources to the extent possible. For the purpose of gathering additional data and providing information on available public an d private sources, the registry can contact families and physicians of persons reported to the registry.

The School of Public Health will appoint an advisory committee to assist in maintaining the registry. The advisory committee will also assist the registry in: defining the population to be included in the registry; developing procedures and forms for collecting, recording, analyzing, and disseminating data; developing protocols and procedures to be disseminated to and used by health care providers in identifying subjects for the registry; and developing procedures for approving research projects or part icipation in research projects.

No identifying information will be released, except the necessary death information to DHEC's Bureau of Vital Statistics, without the consent of the subject or the subject's legal representative. Follow-up studies done by the registry will be done according to standards for confidentiality, as established by Budget & Control Board Office of Research and Statistics regulations.

Signed June 12, 1995.

SIGNIFICANT PENDING LEGISLATION
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The South Carolina Cemetery Board was allowed to sunset in 1990. This bill would reinstate the Board. The bill, for the most part, tracks the original statute. It includes the same or very similar provisions regarding definition of terms; election of board officers; requirements for licensure; burial depth; ownership transfers; record keeping; trust funds; maintenance; size; signs; construction; and penalties.

The bill does differ significantly from the original statute as pertains to composition of the board; qualifications for general manager of a cemetery; powers of the board to investigate; provisions for trust fund shortages; sale of markers or monuments; and requirements for contract disclosure.

Status: Pending in the House Medical, Military, Public and Municipal Affairs Committee.

The purpose of the Eldercare Trust Fund (ETF) is to award grants to public and private nonprofit agencies and organizations to establish and administer innovative programs and services that assist older persons to remain in their homes and communities with maximum independence and dignity. The ETF is funded through voluntary donations, and current law allows only 75 percent of the funds to be spent in any one fiscal year. The remaining 25 percent is to be held by the trust fund until at least $5 million is accumulated. Due to the low level of contributions, the Treasurer's Office projects that it will take at least 100 years to accumulate $5 million.

This legislation would allow all assets and investment earnings of this trust fund to be spent every year.

Status: Pending in the Senate Medical Affairs Committee.

A continuing care retirement community (CCRC) is a facility licensed by the Department of Consumer Affairs which contracts to provide lodging together with nursing, medical or health-related services. A home health agency (HHA) is an organization licensed by DHEC that provides health services on a visiting basis at the client's home.

Section 1 of this bill provides that if a continuing care retirement community operates a home health agency and a nursing home, then DHEC will do two tasks:

1. allow the home health agency and nursing home to share administration, supervision, and services to the extent that it does not reduce the care, treatment, health, safety, welfare, and comfort of patients served by the home health agency and the nursing home; and

2. coordinate, to the extent feasible, annual licensing inspections.

Section 2 of the bill exempts a home health agency from being required to apply to DHEC for a Certificate of Need (CON) if it is part of a continuing care retirement community that offers to furnish home health services only to residents who reside in living units provided as part of a continuing care contract and if the home health component participates in Medicare. The requirements for Medicare certification are more stringent than conditions required for licensure by DHEC. If at any time the home heal th agency fails to comply with the Medicare conditions of participation, then the home health agency would be required to surrender its license to DHEC. The CCRC would still be required to have a CON for the nursing home portion of the facility.

Status: Pending on the Senate Contested Calendar.

This bill would prohibit body parts that are removed during an autopsy from being used for organ or tissue donation unless authorization was given by the deceased (by prior arrangement) or by another person who is legally authorized to consent to the donation. Before anyone other than the deceased may authorize donation of body parts, the person would be required to receive face-to-face counseling; sign a witnessed statement the counseling was received; and sign a consent form written in plain language th at is separate from the autopsy consent form. In the case of a violent or suspicious death under the jurisdiction of a medical examiner, the bill would require the medical examiner to notify the family or next of kin of any organs or tissue permanently removed in the performance of an autopsy.

The bill also would require the consent form used to authorize a post-mortem examination to be written in plain language understandable by a lay person. This section deals only with the consent for a post-mortem examination. It does not address organ or tissue recovery.

Status: Pending in the House Medical, Military, Public and Municipal Affairs Committee.

This bill is the `Medical Radiation Health and Safety Act'. It would establish minimum standards of education and provide for examination and licensure of persons operating medical and dental X-ray equipment. The bill provides that no person, other than a licensed practitioner (physician, dentist, podiatrist, chiropractor, or osteopath); a radiologic technologist licensed under this chapter; a licensed nurse; or a dental radiographer working under the supervision of a licensed dentist, may use X-ray equ ipment on humans for diagnostic or therapeutic purposes.

The bill also would create the South Carolina Radiologic Technologists Board of Examiners to consist of seven members appointed by the Governor. An applicant for licensure must pass a licensure examination which covers radiologic technology, skills, and techniques. In lieu of this exam, the board may accept a current certificate by a recognized national voluntary credentialing body or a current certificate, registration, or license as a radiologic technologist issued by another state. In addition, the bill would grandfather current radiographers; radiation therapists, and nuclear medicine technologists who pass a proficiency test.

Status: Referred to the House Medical, Military, Public and Municipal Affairs Committee.

This bill would allow a refill prescription, unless it is for a controlled substance, to be transferred to another pharmacy in South Carolina. The pharmacist receiving the transferred prescription could dispense only one refill. The transferring pharmacist would retain the original prescription and could continue to dispense refills up to the amount and for the period authorized less one refill allocated to the receiving pharmacist. All records on these transfers would have to be readily retrievable by both pharmacists.

The Board of Pharmacy would be required to promulgate regulations governing these prescription transfers. The regulations would have to require the transferring pharmacist to communicate directly with the other pharmacist and to record the name and address of the other pharmacist and pharmacy along with the date of transfer and authorization to dispense one refill. The transferring pharmacist also would have to reduce any remaining refills on the prescription by one to account for the amount dispensed b y the other pharmacist.

The other pharmacist would have to record the word `transfer' on the face of the transferred prescription along with any information required to be on a prescription including the date of issuance of the original prescription; the date and time of transfer; the pharmacy's name, address, and original prescription number from which the prescription information was transferred; the name of transferring pharmacist; the manufacturer or brand of drug dispensed; and a statement that the receiving pharmacist may dispense only one refill based on the transferring pharmacist's certification.

Status: Pending in the Senate Medical Affairs Committee.

Currently, masseurs and masseuses in South Carolina are not licensed. Instead, any establishment that employs a masseur or masseuse must post prices inside the entrance and a masseur or masseuse must obtain a health certificate from the county health department prior to starting work. The health certificate must be renewed every six months. In addition, there are statutory restrictions on the hours of operation and the age of masseurs and masseuses and their patrons.

This bill would create an administrative panel and a disciplinary panel for massage/bodywork within the Department of Labor, Licensing and Regulation (LLR). These bodies would be appointed by the Governor like a regular licensure board but would require less administrative operating costs for LLR.

The bill also would establish minimum requirements for licensure as a massage/bodywork therapist and include a grandfathering provision for persons who currently practice massage/bodywork. In addition, the bill would establish grounds for disciplinary actions, fines, reprimands and license revocation.

Status: Pending on the Senate Contested Calendar.

This bill would make it illegal for a person under the age of 15 to stand or sit in the open bed of a pickup truck or trailer while traveling over 25 miles per hour, except when the vehicle is being:

1. used for hunting;
2. operated in an agricultural enterprise; or
3. operated in an organized hay ride or parade.

The driver of the vehicle could be charged with a misdemeanor and, upon conviction, be fined not more than $2,500 or imprisoned not more than 30 days, or both.

Status: Pending on the House Contested Calendar.

This bill would require sheriffs and police chiefs to provide police escorts for funeral processions upon request of funeral home directors.

Status: Pending in the House Medical, Military, Public, and Municipal Affairs Committee.