H 3504 Session 109 (1991-1992)
H 3504 General Bill, By C.Y. Waites, R.S. Corning, Glover, Haskins, Meacham,
Quinn, J. Rama, T.F. Rogers, J.W. Tucker, Vaughn, L.S. Whipper, J.B. Wilder and
D.A. Wright
A Bill to amend Act 114 of 1989 and Article 21, Chapter 7, Title 44, Code of
Laws of South Carolina, 1976, relating to infants and toddlers with
handicapping conditions, so as to revise the legislative findings to conform
to the amendments in this Act and to revise the definitional Section, provide
the purpose of the Article, provide duties of the Department of Health and
Environmental Control, require the comprehensive interagency system to
implement components of the system, to provide certain requirements for the
delivery of early intervention services, to include provisions and
requirements for individualized family service plans, to clarify
confidentiality of information, to require the Department of Health and
Environmental Control to submit an annual report to the Joint Legislative
Committee on Children and to provide for contents of the report, to require
the establishment of local interagency coordinating councils, and to provide
for their membership, functions, and interfacing with the State Interagency
Coordinating Council.
02/13/91 House Introduced and read first time HJ-12
02/13/91 House Referred to Committee on Medical, Military,
Public and Municipal Affairs HJ-13
03/28/91 House Committee report: Favorable with amendment
Medical, Military, Public and Municipal Affairs HJ-5
04/04/91 House Debate adjourned until Wednesday, April 10, 1991 HJ-100
04/10/91 House Debate adjourned until Thursday, April 11, 1991 HJ-24
04/11/91 House Debate adjourned until Tuesday, April 16, 1991 HJ-4
04/16/91 House Tabled HJ-10
Indicates Matter Stricken
Indicates New Matter
COMMITTEE REPORT
March 28, 1991
H. 3504
Introduced by REPS. Waites, Rogers, Haskins, Quinn, Wilder,
Meacham, Corning, Wright, Rama, Glover, Whipper, Tucker and
Vaughn
S. Printed 3/28/91--H.
Read the first time February 13, 1991.
THE COMMITTEE ON MEDICAL,
MILITARY, PUBLIC AND MUNICIPAL
AFFAIRS
To whom was referred a Bill (H. 3504), to amend Act 114 of 1989
and Article 21, Chapter 7, Title 44, Code of Laws of South Carolina,
1976, relating to infants and toddlers with handicapping conditions, etc.,
respectfully
REPORT:
That they have duly and carefully considered the same, and
recommend that the same do pass with amendment:
Amend the bill, as and if amended, Section 44-7-2530, by striking
subsection (B) and inserting:
/(B) To ensure that all eligible infants and toddlers receive
services, pending resolution of any dispute the department shall assign
financial responsibility among agencies providing early intervention
services./
Renumber sections to conform.
Amend title to conform.
DAVE C. WALDROP, JR., for Committee.
STATEMENT OF ESTIMATED FISCAL
IMPACT
1. Estimated Cost to State-First Year $2,315,932
2. Estimated Cost to State-Annually
Thereafter $3,891,234
H. 3504 is a proposed Bill to amend Act 114 of 1989 and Article 21,
Chapter 7, Title 44, Code of Laws of S.C., 1976, relating to infants and
toddlers with handicapping conditions, so as to revise the legislative
findings to conform to the amendments in this act and to revise the
definitional section, provide the purpose of the Article, provide duties
for the Department of Health and Environmental Control, require the
comprehensive interagency system to implement components of the
system, provide for early intervention services, individualized family
service plans, clarify confidentiality of information, annual reporting by
DHEC, establishment of local interagency coordinating councils and
interfacing of such with the State Council.
This proposed legislation is a rewrite of a previously proposed Bill
(S. 521/H. 3689-3/89) that clarifies and redefines some points of the
Bill. Due to the clarifying language and improved population targeting,
this proposed legislation has a higher estimate of cost for the first and
subsequent years. (For purposes of this Bill's fiscal impact, the first and
subsequent year will be fourth phase and fifth phase of the Babynet
Program; additionally the costs estimates will take into consideration
funding presently in place.)
The recent costing and population targeting estimates that, on an
annual basis, 2,400 infants and toddlers will be provided services at a
cost of $4,735/child. Based upon the scenario of services for phase four
of PL99-457, (our first year for fiscal impact), the cost is estimated at
$2,315,932. (Enclosure 1). In phase five, (subsequent year) the
estimated cost for the state is $3,891,234. (Enclosure 2). These
estimates are based upon a delivery of service for one (1) year as shown
at enclosure 3 which was constructed by qualified professionals within
the disciplines indicated. Within enclosure 2 is the existing funding
available in the participating agencies involved in Part H of PL99-457.
Estimates within the targeted population indicate that 50 % of the
children will be eligible for Medicaid sponsorship for the services to be
provided.
Some reduction of cost may occur in the service orientation delivery
(case management) because of the better than expected result of parental
involvement in the process. Less units of service coordination per child
may result as parents become acquainted with the intra-interagency
systems development.
This is a companion Bill to S. 615.
Prepared By: Approved By:
Edward P. Brophy George N. Dorn, Jr.
State Budget Analyst State Budget Division
A BILL
TO AMEND ACT 114 OF 1989 AND ARTICLE 21, CHAPTER 7,
TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976,
RELATING TO INFANTS AND TODDLERS WITH
HANDICAPPING CONDITIONS, SO AS TO REVISE THE
LEGISLATIVE FINDINGS TO CONFORM TO THE AMENDMENTS
IN THIS ACT AND TO REVISE THE DEFINITIONAL SECTION,
PROVIDE THE PURPOSE OF THE ARTICLE, PROVIDE DUTIES
OF THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL
CONTROL, REQUIRE THE COMPREHENSIVE INTERAGENCY
SYSTEM TO IMPLEMENT COMPONENTS OF THE SYSTEM, TO
PROVIDE CERTAIN REQUIREMENTS FOR THE DELIVERY OF
EARLY INTERVENTION SERVICES, TO INCLUDE PROVISIONS
AND REQUIREMENTS FOR INDIVIDUALIZED FAMILY SERVICE
PLANS, TO CLARIFY CONFIDENTIALITY OF INFORMATION, TO
REQUIRE THE DEPARTMENT OF HEALTH AND
ENVIRONMENTAL CONTROL TO SUBMIT AN ANNUAL
REPORT TO THE JOINT LEGISLATIVE COMMITTEE ON
CHILDREN AND TO PROVIDE FOR CONTENTS OF THE REPORT,
TO REQUIRE THE ESTABLISHMENT OF LOCAL INTERAGENCY
COORDINATING COUNCILS, AND TO PROVIDE FOR THEIR
MEMBERSHIP, FUNCTIONS, AND INTERFACING WITH THE
STATE INTERAGENCY COORDINATING COUNCIL.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 1 of Act 114 of 1989 is amended to read:
"Section 1. (A) The General Assembly finds that there is an
urgent and substantial need to:
(1) enhance the development of infants and toddlers with
handicapping conditions disabilities and to minimize
their potential for developmental delay;
(2) reduce the educational costs to our society, including our
schools, by minimizing the need for special education and related
services after infants and toddlers with handicapping conditions
disabilities reach school age;
(3) minimize the likelihood of institutionalization of
individuals with handicapping conditions disabilities
and maximize the potential for their independent living in society;
(4) enhance the capacity of families to meet the special needs
of their infants and toddlers who have handicapping conditions
disabilities.
(B) It is the policy of South Carolina to:
(1) develop and implement a statewide,
comprehensive, coordinated program of early intervention
services for infants and toddlers with handicapping conditions
disabilities and their families;
(2) facilitate the coordination of payment for early
intervention services from federal, state, local, and private sources,
including public and private insurance coverage;
(3) enhance the capacity to provide quality early intervention
services and expand and improve existing early intervention services
being provided to infants and toddlers with handicapping
conditions disabilities and their families."
SECTION 2. Article 21, Chapter 7, Title 44 of the 1976 Code, as
added by Act 114 of 1989, is amended to read:
"Article 21
Infants and Toddlers With
Handicapping Conditions Disabilities
Section 44-7-2510. This article may be cited as the `Infants and
Toddlers with Handicapping Conditions Disabilities
Act'.
Section 44-7-2515. The purpose of this article is to provide early
intervention services to infants and toddlers with disabilities in
accordance with Subchapter VIII, Chapter 33, Title 20, U.S. Code
Annotated, contingent upon appropriation of federal funds for
Subchapter VIII.
Section 44-7-2520. As used in this article unless the context
otherwise requires:
(1) `Department' means the agency designated as lead
agency by the Governor by Executive Order pursuant to Title 20
of the United States Code, Section 1476(b)(9) Subchapter VIII,
Chapter 33, Title 20, U. S. Code Annotated.
(2) `Infants and toddlers with handicapping conditions
disabilities' means children from birth through two years of age
in need of early intervention services due to measurable delays in
cognitive development, physical development, language and speech
development communication, psychosocial development,
or self-help skills, or due to a diagnosed physical or mental condition
which probably will result that has a high probability of
resulting in developmental delay.
(3) `Early intervention services' are services designed to
ameliorate the developmental delays of infants or toddlers with
handicapping conditions meet the developmental needs of
infants and toddlers with disabilities, provided in conformity with an
individualized family service plan under public supervision by qualified
personnel. They include but are not limited to family training,
counseling and home visits, special instruction, speech pathology and
audiology, occupational therapy, physical therapy, psychological
services, case management services service
coordination, medical services only for diagnostic or evaluation
purposes, early identification, screening and assessment services,
and health services necessary to enable the infant or toddler to
benefit from the other early intervention services, and transportation
services.
(4) `Council' means the State Interagency Coordinating Council
which must be established in conformance with federal regulations.
Section 44-7-2530. (A) There is created a State Interagency
Coordinating Council composed of fifteen members appointed by the
Governor for terms of three years. In making appointments to the
council the Governor shall ensure reasonable representation of the
population of the State.
(B) The council must be composed of:
(1) at least three parents of infants or toddlers or children three
through six years of age with disabilities;
(2) at least three public or private providers of early
intervention services;
(3) at least one person involved in training personnel to
provide early intervention services;
(4) one representative of the General Assembly, the State
Mental Retardation Department, the State Health and Human Services
Finance Commission, the State Department of Education, and the
Department of Health and Environmental Control;
(5) other persons as determined by the Governor such as:
(a) adults other than parents responsible for infants, toddlers,
or children with disabilities;
(b) representatives of other agencies involved
in providing or paying for early intervention services to infants or
toddlers with disabilities.
(C) The Governor shall designate a member as chairman for a term
of two years. The chairman may not serve for more than two
consecutive terms. The council shall meet at least quarterly and advise
the department in carrying out its responsibilities under this article. No
member may vote on a matter which would provide him a direct
financial benefit or otherwise appears to be a conflict of interest under
state law. The council shall prepare and submit an annual report to the
Governor and General Assembly on the status of early intervention
programs for infants and toddlers with disabilities and their families in
the State. A copy of the report must be sent to the appropriate federal
and state officials. The department must:
(1) monitor programs and activities to ensure compliance with
federal law and regulations;
(2) identify, facilitate, and coordinate all available resources
within the State from federal, state, local, and private sources;
(3) develop procedures to ensure that services are provided to
infants and toddlers with disabilities and their families in a timely
manner pending the resolution of disputes among public agencies or
service providers;
(4) develop procedures to ensure resolution of intraagency and
interagency disputes;
(5) develop formal interagency agreements that, consistent with
state law, define the financial responsibility of each agency for paying
for early intervention services and procedures for resolving disputes.
(B) To ensure that all eligible infants and toddlers receive services,
the Budget and Control Board shall assign financial responsibility
among the state agencies providing early intervention services.
(C) All publicly funded agencies shall continue to provide all
services within their respective statutory responsibility to eligible infants
and toddlers with disabilities.
Section 44-7-2540. (A) With the advice of the council the
department shall develop and administer either directly or through an
interagency agreement a comprehensive interagency system to provide
early intervention services for infants and toddlers with disabilities and
their families. The services must be provided by qualified personnel
including but not limited to special educators, speech and language
pathologists, audiologists, occupational therapists, physical therapists,
psychologists, social workers, nurses, and nutritionists. The
State Interagency Coordinating Council shall advise and assist the
department in developing a comprehensive interagency system to
provide early intervention services for all eligible infants and toddlers
with disabilities and their families.
(B) The system must include: The comprehensive
interagency system must implement:
(1) a timely, comprehensive, multidisciplinary assessment
of the functioning of each infant and toddler with handicapping
conditions disabilities in the State, including the needs of
their families relating to enhancing the child's development;
(2) a written individualized family service plan for each
eligible infant or toddler with a handicapping condition
disability;
(3) a comprehensive method of identifying infants and toddlers
with handicapping conditions disabilities;
(4) a public awareness program focusing on early identification
of infants and toddlers with handicapping conditions
disabilities;
(5) access to a central directory which includes early
intervention services, resources, and experts available in the State;
(6) a comprehensive system of training personnel
development for those who serve eligible infants and
toddlers with handicapping conditions disabilities;
(7) formal interagency agreements which:
(a) define the responsibility of each agency for providing and
paying for early intervention services;
(b) coordinate programs so as to permit children and their
families to move easily among systems agencies in the
system;
(c) adopt uniform program, health, and safety standards;
(d) establish contain procedures for
resolving disputes;
(8) procedural safeguards as required by federal and state
laws law;
(9) a method for compiling data on the number of infants and
toddlers with handicapping conditions disabilities in the
State in need of early intervention services, the number served, the types
of handicapping conditions disabilities, the types of
services provided, and other information required by the federal
government or needed to deliver services effectively.
(C) Early intervention services must be available through the
comprehensive interagency system and provided by appropriate state
agencies in accordance with time requirements of Subchapter VIII,
Chapter 33, Title 20, U. S. Code Annotated, to effectuate the individual
family service plan for each eligible infant or toddler.
Section 44-7-2550. The department shall promulgate regulations
necessary to carry out the purposes of this article. Through regulation
or interagency agreement when appropriate the department may develop
standards which address addressing the coordination
and provision of early intervention services, including personnel
qualifications and health, safety, and program standards for the facilities
where the services are offered.
Section 44-7-2560. (A) Based on the assessment provided for in
Section 44-7-2540 an individualized family service plan must be
developed by a multidisciplinary team of appropriate qualified
personnel which includes also must include the
parent, guardian, or other adult responsible for the child. The family
also may choose an advocate to be present during the development of
the plan. The plan must be written and explained in easily
understandable language and must contain:
(1) a statement of the present levels of physical, cognitive,
psychosocial, language, speech communication, and
self-help skill development for the infant or toddler with
handicapping conditions disabilities;
(2) a statement of the health status and medical needs of the
child and family to support the highest possible development of the
child, including the names of the health care providers;
(3) with concurrence of the family, a statement of the
family's strengths and needs resources relating to
enhancing the child's development;
(4) a statement of the major outcomes expected to be achieved
for the child and the family and the methods used to measure progress
toward the outcomes;
(5) a statement of specific early intervention services necessary
to meet the needs of the child and family, including the frequency,
intensity, and method of delivering services and payment
arrangement, if any;
(6) the projected dates for initiation of services and the
anticipated duration of services;
(7) the name of the case manager from the profession most
immediately relevant to the needs of the child or family service
coordinator. The case manager service coordinator
is responsible for the implementation of the plan and coordination with
other agencies and persons;
(8) the steps necessary to support transition of the child to
special education and related services for children three years of age
and older other programs, if appropriate.
(B) The individualized family service plan must be developed
within the time established by the department after the child initially
is referred and after the assessment is completed. With the parent's
consent early intervention services may begin before completion of the
assessment or plan, provided an interim plan is developed. The
plan serves as the comprehensive plan for all agencies involved in
providing early intervention services to the child and family. Services
must be provided in a timely manner, as established by the department,
pending resolution of disputes among public agencies or service
providers. The plan must be evaluated at least once a year and reviewed
with the family at six-month three-month intervals or
more frequently if appropriate.
Section 44-7-2570. (A) Families with incomes below the federal
poverty guidelines must not be charged for early intervention services
provided pursuant to this article. The department shall develop a
schedule of sliding fees for families with incomes above the federal
poverty level.
(B) Nothing in this section relieves public or private insurance
programs, or other persons or agencies required by law to provide or pay
for early intervention services, from their financial or legal
responsibilities. As a condition of receiving services under this article,
infants and toddlers with handicapping conditions
disabilities and their families may be required to apply for a
financial or medical assistance program for which they are eligible.
(C) Pursuant to Subchapter VIII, Chapter 33, Title 20, U. S.
Code Annotated, all financial resources from federal, state, local, and
private sources must be coordinated to fund early intervention services.
A joint funding plan must be submitted by the department to the Joint
Legislative Committee on Children on or before August first of each
year. The individual components of the plan as they relate to individual
agencies must be incorporated annually into each affected agency's
budget request.
Section 44-7-2580. (A) During fiscal year 1988-89 the department
shall identify:
(1) all early intervention services currently provided within the
State through federal, state, local, and private programs;
(2) all other financial resources available within the State from
federal, state, local, and private sources for funding the comprehensive
service system provided for in this section.
The department may use these resources to support programs to
demonstrate and evaluate different components of the service system.
(B) By August 1, 1989, the department shall recommend a
comprehensive service system to the State Budget and Control Board
and the General Assembly. The department shall identify components
of the system which can be supported through existing resources and
components for which additional funds are needed.
(C) Using all funds appropriated for this purpose, during fiscal year
1990-91 the department shall implement as much of the comprehensive
service system as possible. The department shall contract with an
independent consultant to evaluate the service system and submit a
written report to the General Assembly by January 1, 1991.
(Reserved)
Section 44-7-2590. All information and reports related to children
and families obtained pursuant to this article are confidential as
provided in Subchapter VIII, Chapter 33, Title 20, U.S. Code
Annotated except that they may be disclosed or made available
to appropriate staff within the comprehensive interagency system for the
purpose of assessment, coordination, and provision of services to
infants, toddlers, and their families or pursuant to a court order for good
cause shown. A person who disseminates or permits the
unauthorized dissemination of the information or reports is guilty of a
misdemeanor and, upon conviction, must be fined not more than one
hundred dollars or imprisoned for not more than thirty days, or both.
Section 44-7-2600. The Joint Legislative Committee on Children
shall receive timely reports from all agencies involved in the
implementation of programs for handicapped infants, toddlers, and
preschool children developed pursuant to Public Law 99-457 and shall
provide consultation and guidance if necessary. By August first
of each year the department shall submit an annual report to the Joint
Legislative Committee on Children regarding the status of the
comprehensive interagency system, including new and existing
resources and gaps in services.
Section 44-7-2610. (A) County or multicounty local
interagency coordinating councils (ICC) representing each county in the
State must be established. Membership on each council must consist of
parents, providers, local agencies, and government agencies.
(B) The function of the local ICC will be to advise and assist the
State Council and the department in planning and implementing a
system of early intervention services at the local community level.
(C) Each local ICC shall report to the State Council on the status of
early intervention services in its county.
(D) With prior approval by the department and the State Council,
local ICC's may enter into local interagency agreements. Local ICC's
may give advice and assistance to local early intervention projects. No
member of a local ICC may vote on a matter which directly would
benefit the member financially or otherwise appear to be a conflict of
interest under state law."
SECTION 3. This act takes effect upon approval by the Governor.
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