South Carolina General Assembly
115th Session, 2003-2004

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H. 3371

STATUS INFORMATION

General Bill
Sponsors: Reps. Rice, McGee and Cotty
Document Path: l:\council\bills\dka\3151sd03.doc

Introduced in the House on January 21, 2003
Currently residing in the House Committee on Ways and Means

Summary: South Carolina Health, Human, and Medicaid Services Reorganization and Accountability Act of 2003/Cigarette Tax

HISTORY OF LEGISLATIVE ACTIONS

     Date      Body   Action Description with journal page number
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   1/21/2003  House   Introduced and read first time HJ-18
   1/21/2003  House   Referred to Committee on Ways and Means HJ-18
    2/4/2003  House   Member(s) request name added as sponsor: Cotty

View the latest legislative information at the LPITS web site

VERSIONS OF THIS BILL

1/21/2003

(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A BILL

TO ENACT THE "SOUTH CAROLINA HEALTH, HUMAN, AND MEDICAID SERVICES REORGANIZATION AND ACCOUNTABILITY ACT OF 2003"; TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 1-30-125 SO AS TO CREATE THE DEPARTMENT OF HEALTH, HUMAN, AND MEDICAID SERVICES TO BE HEADED BY A SECRETARY TO BE APPOINTED BY THE GOVERNOR UPON THE ADVICE AND CONSENT OF THE SENATE WHICH IS THE SINGLE STATE AGENCY RESPONSIBLE FOR OVERSEEING ALL OTHER STATE HEALTH AND HUMAN SERVICE AGENCIES AND FOR THE DELIVER OF HEALTH, HUMAN, AND MEDICAID SERVICES TO THE CITIZENS OF THIS STATE, AND TO PROVIDE THAT EXISTING SPECIFIED AGENCIES AND DEPARTMENTS OF THIS STATE MUST BECOME PART OF THIS NEWLY CREATED DEPARTMENT; BY ADDING CHAPTER 64 TO TITLE 2 SO AS TO ESTABLISH A JOINT LEGISLATIVE COMMITTEE ON HEALTH, HUMAN, AND MEDICAID SERVICES AND TO PROVIDE FOR ITS MEMBERSHIP, FUNCTIONS, DUTIES, AND RESPONSIBILITIES; BY ADDING CHAPTER 8 TO TITLE 44 SO AS TO PROVIDE FOR A MEDICAID COST CONTAINMENT ACTION PLAN; BY ADDING SECTION 44-8-50 SO AS TO PROVIDE FOR A DEPARTMENT OF HEALTH, HUMAN, AND MEDICAID SERVICES ENTERPRISE INFORMATION TECHNOLOGY SYSTEM; BY ADDING SECTION 2-15-67 SO AS TO PROVIDE THAT THE LEGISLATIVE AUDIT COUNCIL SHALL EMPLOY A SENIOR AUDITOR AND OTHER AUDITORS NECESSARY TO PERFORM REGULAR AUDITS OF THE ENTITIES IN THE DEPARTMENT OF HEALTH, HUMAN, AND MEDICAID SERVICES; BY ADDING SECTION 12-21-625 SO AS TO IMPOSE AN ADDITIONAL LICENSE TAX ON EACH CIGARETTE SUBJECT TO THE LICENSE TAX ON CIGARETTES IN AN AMOUNT EQUAL TO 2.1 CENTS ON EACH CIGARETTE, TO ESTABLISH THE HEALTH, HUMAN, AND MEDICAID SERVICES REORGANIZATION AND ACCOUNTABILITY FUND TO RECEIVE THE REVENUE OF THIS TAX AND PROVIDE FOR THE USE OF THIS FUND FOR REORGANIZATION AND PUBLIC HEALTH PURPOSES, TO CREATE A MEDICAID MATCHING FUND, AND TO PROVIDE FOR THE COLLECTION AND ENFORCEMENT OF THIS ADDITIONAL TAX; AND TO AMEND SECTION 44-6-155, RELATING TO THE MEDICAID EXPANSION FUND, SO AS TO INCLUDE WITHIN THE FUND THE TAX IMPOSED BY SECTION 12-21-625.

Be it enacted by the General Assembly of the State of South Carolina:

Part I

Citation

SECTION    1.    This act may be cited as the "South Carolina Health, Human, and Medicaid Services Reorganization and Accountability Act of 2003".

Part II

Department of Health, Human, and Medicaid Services

SECTION    2.    Chapter 30, Title 1 of the 1976 Code is amended by adding:

"Section 1-30-125.    (A)    A single state agency, known as the Department of Health, Human, and Medicaid Services, is established which is the single state agency responsible for overseeing all other state health and human service agencies.

(B)    The department is headed by a director to be known as the 'Secretary for Health, Human, and Medicaid Services', who is appointed by the Governor upon the advice and consent of the Senate for a term of four years and until his successor is appointed and qualified. A vacancy must be filled in the manner of original appointment. The secretary shall have appropriate experience and qualifications in the health, human, and Medicaid services field.

(C)    This mission of the department is to provide for the effective and cost-efficient delivery of health, human, and Medicaid services to the citizens of this State.

The department is to provide for performance and outcome measures for all programs and services.

At least annually, the department shall report to the General Assembly the strengths, weaknesses, opportunities, and threats to public health of the citizens of this State.

The department shall provide for the consolidation and streamlining of programs and services.

The secretary has full authority for the planning, supervision, organization, financing, budgeting, and administration of all functions, agencies, programs, and services under the department's purview as contained in this section and is authorized to reorganize and consolidate agencies, programs, and services to meet the department's goals upon approval of the General Assembly.

(D)    The department shall include the following existing agencies and departments:

(1)    Department of Alcohol and Other Drug Abuse Services;

(2)    Commission for the Blind;

(3)    Department of Mental Health;

(4)    Department of Disabilities and Special Needs;

(5)    Department of Health and Environmental Control;

(6)    Department of Health and Human Services;

(7)    Department of Social Services;

(8)    Vocational Rehabilitation; and

(9)    Continuum of Care for Emotionally Disturbed Children (formerly in the Governor's Office).

(E)    The governing body of an agency or department referred to in subsection (D), on the effective date of this section, shall serve in an advisory capacity to the secretary.

(F)    Notwithstanding any other provision of law, the department must be organized into the following divisions, each headed by a division director, employed by the secretary:

(1)    Division of Senior and Long Term Care Services to be comprised of:

(a)    Community Long Term Care, formerly within the Department of Health and Human Services;

(b)    State Office of Aging, formerly within the Department of Health and Human Services;

(c)    Adult Protective Services and Homemaker Services, formerly within the Department of Social Services; and

(d)    State Nursing Facilities, formerly operated by the Department of Mental Health.

(2)    Division of Mental Health to be comprised of:

(a)    Office of Alcohol and Other Drug Abuse Services, formerly known as the Department of Alcohol and Other Drug Abuse Services;

(b)    inpatient addiction treatment services, formerly within Vocational Rehabilitation; and

(c)    Continuum of Care for Emotionally Disturbed Children, formerly administered by the Governor's Office.

(3)    Division of Social Services to be comprised of the former Department of Social Services, excluding the Adult Protective Services and Homemaker Services.

(4)    Division of Disabilities and Special Needs to be comprised of all the programs formerly within the Department of Disabilities and Special Needs.

(5)    Division of Vocational Rehabilitation to be comprised of the former Vocational Rehabilitation Department and the Commission for the Blind.

(6)    Division of Medicaid to be comprised of the former Department of Health and Human Services, excluding Community Long Term Care and State Office of Aging."

Part III

Joint Legislative Committee on Health, Human,

and Medicaid Services

SECTION    3.    Title 2 of the 1976 Code is amended by adding:

"CHAPTER 64

Joint Legislative Committee on Health, Human,

and Medicaid Services

Section 2-64-10.    There is established the Joint Legislative Committee on Health, Human, and Medicaid Services composed of six members, three appointed by the Chairman of the Senate Finance Committee from the membership of the Senate and three appointed by the Chairman of the House Ways and Means Committee from the membership of the House.

Section 2-64-20.    The joint committee shall:

(1)    make a detailed and careful study of the State Medicaid Plan, the federal laws pertaining to the program, and all other laws of the State, which have a bearing upon the Medicaid program;

(2)    compare the State Medicaid program with the Medicaid program structures of other states;

(3)    recommend changes in the Medicaid program structure regarding eligibility, type, scope, and duration of services, together with predicted general fund revenue, to the end that the State Medicaid Plan will be more stable and affordable for the taxpayers of the State;

(4)    provide for the revision of state laws and the State Medicaid Plan so as to develop a more easily understood, financially manageable and stable system;

(5)    make recommendations for amendments to the State Medicaid Plan;

(6)    make an annual report to the General Assembly on the overall status and growth of the Medicaid program;

(7)    make recommendations for improving the program and public health by initiative to improve the overall health and personal responsibility of citizens for healthy lifestyles; and

(8)    make recommendations for providing incentives for public and private agencies and organizations that promote public health and the specific initiatives by law relating to 'Health People 2010'.

Section 2-64-30.    The joint committee may:

(1)    hold public hearings;

(2)    receive testimony of employees of the State or any other witness who may assist the joint committee in its duties;

(3)    call for assistance in the performance of its duties from any employee or agency of the State or any of its political subdivisions; and

(4)    employ consultants to assist the committee in accomplishing its duties.

Section 2-64-40.    (A)    The joint committee may adopt by majority vote rules not inconsistent with this chapter that it considers proper with respect to matters relating to the discharge of its duties under this chapter. Professional and clerical services for the committee must be made available from the staffs of the General Assembly, the Budget and Control Board, and the Secretary of the Department of Health, Human, and Medicaid Services.

(B)    Expenses of the joint committee may be paid from appropriated funds of the House of Representatives upon approval of the Speaker of the House and from appropriated funds of the Senate upon approval of the President Pro Tempore of the Senate.

(C)    The joint committee shall make annual reports and recommendations to the General Assembly and the Governor beginning with the 2004 Legislative Session."

Part IV

Medicaid Cost Containment Action Plan

SECTION    4.    Title 44 of the 1976 Code is amended by adding:

"CHAPTER 8

Medicaid Cost Containment Action Plan

Section 44-8-10.    The Secretary for the Department of Health, Human, and Medicaid Services shall submit by November fifteen of each year in writing to each member of the Budget and Control Board, the projected expenditures for the State Medicaid program for the next fiscal year.

This report must be titled 'Medicaid Cost Containment Action Plan' (the action plan).

Section 44-8-20.    If the secretary informs the Budget and Control Board that general fund expenditures that match federal Medicaid dollars are projected to increase over the current fiscal year by a percentage greater than projected percentage growth of the state's total general fund, the following action as required in this chapter. The secretary shall inform the board, in priority order, of the actions to be taken by the department to reduce expenditures in the Medicaid program for the following fiscal year so as to not exceed an amount equal to the percentage growth of the state's general fund revenue for that fiscal year as estimated by the Board of Economic Advisors.

Section 44-8-30.    The action plan must include:

(1)    a description of each action to be taken;

(2)    the number of individuals affected;

(3)    the Medicaid services or programs affected;

(4)    an estimate of the financial impact on the Medicaid program for the fiscal year in question; and

(5)    other information as directed by the board.

Section 44-8-40.    Upon receipt of the report, and if the report calls for actions to reduce projected spending within this limitation, the action plan must be implemented by the secretary. However, the action plan must not be implemented if, by separate legislation, the General Assembly enacts legislation with a two-thirds vote in each body, specifically calling for a suspension of the Medicaid Cost Containment Action Plan that would reduce Medicaid expenditures."

Part V

Department of Health, Human, and

Medicaid Services Enterprise Information Technology System

SECTION    5.    Chapter 8 of Title 44 of the 1976 Code is amended by adding:

"Section 44-8-50.    (A)    The secretary shall provide the leadership for the implementation of a Enterprise Information Technology System.

The goal of the system is to add operational efficiencies, reduce redundant information technology costs, and to enable the divisions and entities of the department to deliver client services in a more focused, efficient, and cost-effective manner. A priority area for the integrated enterprise system is eligibility determination and coordination.

(B)    The secretary is directed to annually report the department's progress towards the goal of this system to the Governor and the Chairmen of the Senate Finance and the House Ways and Means Committees not later than January tenth."

Part VI

Medicaid Auditor

SECTION    6.    Chapter 15, Title 2 of the 1976 Code is amended by adding:

"Section 2-15-67.    The Director of the Legislative Audit Council shall employ a senior auditor and assistant auditors as necessary to perform regular audits of the operations of the divisions and entities in the Department of Health, Human, and Medicaid Services and to determine the performance of these divisions and entities in complying with all applicable provisions of law."

Part VII

Cigarette Tax Increase and Use of Funds

SECTION    7.    Article 5, Chapter 21, Title 12 of the 1976 Code is amended by adding:

"Section 12-21-625.    (A)    There is imposed a surtax on cigarettes subject to the tax imposed pursuant to Section 12-21-620(1) in an amount equal to 2.1 cents on each cigarette.

(B)    Notwithstanding any other provision of law providing for the crediting of the revenues by license or other taxes, the revenue of the surtax imposed by this section must be credited to the Health, Human, and Medicaid Services Reorganization and Accountability Fund established pursuant to subsection (C) and used only for the purposes prescribed in subsection (C).

(C)(1)    There is created the Health, Human, and Medicaid Services Reorganization and Accountability Fund into which must be deposited funds collected pursuant to subsection (A). The fund must be separate and distinct from the general fund and must be used only for the purposes prescribed in this subsection. The funds are supplementary and must not be used to replace general funds appropriated by the General Assembly or other funds used to support Medicaid or other specified programs, operations, initiatives, or activities. The funds, programs, operations, initiatives, and other activities specified in this subsection are exempt from budgetary cuts, reductions, or eliminations caused by the lack of general fund revenues. Earnings on investments from this fund must remain part of the separate fund and must not be deposited in the general fund.

(2)    Monies in the fund must be used as follows:

(a)    the first one million dollars of revenue from the surtax, for funding the Joint Legislative Committee on Health, Human, and Medicaid Services, the Department of Health, Human, and Medicaid Services start-up costs, the Department of Health, Human, and Medicaid Services Enterprise Information Technology System, and additional audit services from the Legislative Audit Council, in the amount of two hundred fifty thousand dollars each;

(b)    five percent of the revenue remaining after the expenditures in subitem (a), for funding of grants dedicated for community agencies and organizations for 'Healthy People 2010', the promotion of public health, and targeted only toward the following objectives:

(i)            increasing the proportion of adults and adolescents participating in exercise;

(ii)        reducing the proportion of obese adults;

(iii)        reducing cigarette use by adults and adolescents;

(iv)        increasing the proportion of adolescents who do not use alcohol or illicit drugs;

(v)        reducing the proportion of adults engaging in the 'binging' use of alcoholic beverages;

(vi)        reducing motor vehicle fatalities;

(vii)        reducing homicides;

(viii)    increasing the proportion of young children who receive vaccinations and immunizations;

(ix)        increasing the proportion of noninstitutionalized adults, sixty-five years of age and older, who receive vaccinations and immunizations;

(x)        increasing the proportion of noninstitutionalized adults, sixty-five years of age and older, who have ever been vaccinated against pneumococcal disease; and

(xi)    increasing the number of pregnant women who begin prenatal care in the first trimester of pregnancy.

(3)    The remaining revenue of the surtax imposed by this section, to be credited to a separate and distinct fund, apart from all other funds, designated as the Medicaid Match Fund. Revenue collected pursuant to this section must be used by the Department of Health, Human, and Medicaid Services as the secretary determines. Expenditures must be reported annually to the General Assembly. Revenues in this fund not expended during a fiscal year are carried forward to the succeeding fiscal year and must be used for the same purposes.

(D)    The Secretary of the Department of Health, Human, and Medicaid Services shall plan, administer, and monitor the use of the monies as prescribed in subsection (C).

(E)    Monies must be transferred by the State Treasurer upon written request and justification from an authorized official for the purposes prescribed in subsection (C).

(F)    Unexpended revenues distributed from the Health, Human, and Medicaid Services Reorganization and Accountability Fund not expended during a fiscal year are carried forward from year to year and must be used for the prescribed purposes.

(G)    For all purposes of reporting, payment, collection, and enforcement, the surtax imposed by this section is deemed to be imposed pursuant to Section 12-21-620(1)."

SECTION    8.    Section 44-6-155(A)(2) of the 1976 Code is amended to read:

"(2)    collected pursuant to Section Sections 12-21-625 and 2-23-810; and"

Part VIII

Time effective

SECTION    9.    Unless otherwise stated, this act takes effect upon approval by the Governor.

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