The Committee on Finance proposed the following amendment (DG\3707C002.NBD.DG21):

Amend the joint resolution, as and if amended, by striking SECTIONS 2 and 3 and inserting:

/ SECTION2. (A) The Executive Budget Office shall establish the COVID-19 Vaccine Reserve account to be maintained by the Executive Budget Office and administered as set forth in this section.

(B) From the Contingency Reserve Fund, there is appropriated $100,000,000 to the COVID-19 Vaccine Reserve account. The Executive Budget Office only may release funds in the account upon receipt of a letter signed by the Director of DHEC. DHEC shall allocate funds to eligible COVID-19 vaccine providers in support of statewide vaccination efforts. DHEC shall reimburse eligible providers only after affirming the recipient is a COVID-19 vaccination provider enrolled and activated by DHEC, that DHEC has determined that the request will assist the State in its effort to achieve statewide vaccination, and that the enrolled and activated provider has the vaccine implementation capacity to justify the request.

(C)(1) From the funds appropriated in this section, the Executive Budget Office shall allocate up to $75,000,000 to hospitals, or a political subdivision of the State partnering with the same, to pay for the costs of administering the COVID-19 vaccine.

(2) From the funds appropriated in this section, the Executive Budget Office shall allocate up to $25,000,000 to other COVID-19 vaccination providers, or a political subdivision of the State partnering with the same, that are enrolled and activated by DHEC, to pay for the costs of administering the COVID-19 vaccine.

(3) For purposes of this section, eligible costs of administering the COVID-19 vaccine include, but are not limited to, those vaccination costs associated with staffing, facility rental, security, traffic control, storage, transportation, mobile health units including the purchase, upfitting, staffing, and operations thereof, and technology that have not been reimbursed by an insurer's administration fee.

(D) In approving expenses, DHEC must give priority to hospitals and other COVID-19 vaccine providers that are enrolled and activated by DHEC that can prove or have proven a high demand for the vaccine and the ability to meet the demand.

(E) Notwithstanding any other provision of this section, the Director of DHEC may not authorize the Executive Budget Office to release any funds from the COVID-19 Vaccine Reserve account to any vaccine provider that is not offering vaccine appointments to the general public.

(F) On the first day of each month, the Executive Budget Office shall provide a detailed accounting of the expenditure of all funds appropriated pursuant to this section. The report shall be transmitted to the Governor, the General Assembly, and made available on the website of the Executive Budget Office. Additionally, any recipient must provide an accounting of the expenditures to DHEC and DHEC must post the accounting on its website.

SECTION3. (A)(1) Where appropriate and feasible, hospitals, medical providers, and other stakeholders receiving distributions pursuant to this joint resolution also shall seek reimbursement from an individual's public or private health insurer.

(B) To maximize the benefit of all funds received by the State, DHEC and MUSC shall work with the Department of Administration to assure that available federal funds are utilized for the purposes of this joint resolution appropriately and minimize the use of state funds where possible.

(C) If hospitals, medical providers, and other stakeholders receive distributions pursuant to this joint resolution also receive reimbursements from insurers or federal funds for the same purposes, then the distributions pursuant to this joint resolution exceeding the actual costs of vaccine administration must be remitted back to the agency or fund that distributed the funds.

(D) The provisions of this joint resolution shall apply to the extent permitted by federal law. /

Amend the joint resolution further, by striking SECTION 5 and inserting:

/ SECTION5. A. (A) Beginning fourteen days after the effective date of this joint resolution, all vaccines received by the state which have not already been set for distribution must be allocated to the four DHEC public health regions in a per-capita manner with considerations taken into account for factors, including but not limited to poverty level, infection rates, age, and high-risk populations. From the funds appropriated in this act or from other COVID-19 related appropriations, MUSC shall coordinate with DHEC and partner with local healthcare providers to ensure that gaps in statewide vaccination delivery are covered, with priority given to rural and underserved areas.

(B) DHEC shall allocate vaccines so that they are distributed in a manner that ensures that each of its four public health regions shall receive a per-capita allocation, as described in subsection (A). In making allocations to specific vaccine providers, DHEC shall consider the recommendations of its COVID-19 Vaccine Regional Advisory Panels, one of which shall be established in each of the four public health regions as follows:

(1) Each panel shall meet weekly initally, but this frequency may be reduced with DHEC's consent.

(2) At its first meeting, each panel shall select a Chairman from among its members, who shall preside over the panel's meetings. This Chairman must have extensive healthcare experience within the panel's designated region. In the event of a future vacancy, the Chair shall be filled in this same manner.

(3) Each panel must include representation from affected stakeholders and vaccine providers within the region, including but not limited to hospitals, primary care practices, pharmacies, rural health clinics, and the South Carolina Primary Care Association and any other Federally Qualified Health Centers.

(4) Based upon the region's vaccine allocation provided by the department, the panel shall adopt a specific recommendation for allocating vaccines to individual providers and review the plan weekly. This recommendation must be transmitted to the department immediately upon initial adoption and upon subsequent revision and must be based upon the following priorities:

(a) Rural and underserved communities must have equitable access to receive the COVID-19 vaccine;

(b) Available vaccines must be administered to South Carolinians as rapidly as possible, to ensure that no doses are permitted to expire, and to position South Carolina favorably in the event that any future federal allocations to states may be based in part upon a state's ability to expeditiously administer the vaccine;

(c) Each panel must consider which providers are best equipped to handle specific manufacturers' forms of the vaccine, such as those requiring ultra-cold storage; and

(d) Panels' recommendations must be informed by their review of the most current and comprehensive data available as to how vaccines have already been administered within their regions, including how the vaccination rate varies by geography, race, age, in come, or other relevant factors.

(C) Notwithstanding any other provision of this joint resolution, DHEC may retain up to five percent of each weekly dose allocation in inventory to maximize its ability to quickly and efficiently respond to changes in need throughout the week.

B. This SECTION terminates and is no longer effective when the Director of the Department of Health and Environmental Control determines that the demands for the vaccine no longer exceed the supply of the vaccine. /