Current Status Introducing Body:Senate Bill Number:150 Primary Sponsor:Rose Committee Number:11 Type of Legislation:GB Subject:Perinatal Effects of Alcohol, Drugs, Cigarettes Residing Body:Senate Computer Document Number:NO5/8714AC.93 Introduced Date:19930112 Last History Body:Senate Last History Date:19930126 Last History Type:Referred to Committee Scope of Legislation:Statewide All Sponsors:Rose Type of Legislation:General Bill
Bill Body Date Action Description CMN Leg Involved
____ ______ ____________ ______________________________ ___ ____________
150 Senate 19930126 Referred to Committee 11
150 Senate 19930126 Recalled from Committee 13
150 Senate 19930112 Introduced, read first time, 13
referred to Committee
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TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING CHAPTER 54 TO TITLE 44 SO AS TO ENACT THE "ASSESSMENT OF AND INTERVENTION IN THE PERINATAL EFFECTS OF ALCOHOL, CONTROLLED SUBSTANCES, AND CIGARETTES ACT" SO AS TO REQUIRE THAT PHYSICIANS PROVIDE COUNSELING TO PREGNANT WOMEN ON THESE EFFECTS; TO REQUIRE THE SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL AND THE SOUTH CAROLINA COMMISSION ON ALCOHOL AND DRUG ABUSE TO PROVIDE EDUCATIONAL PROGRAMS AND MATERIALS TO PHYSICIANS PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE; TO DIRECT THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL, THE SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH, AND THE STATE DEPARTMENT OF SOCIAL SERVICES TO ESTABLISH MULTIDISCIPLINARY TEAMS TO ADVISE PHYSICIANS ON THESE ISSUES; TO PROVIDE OPTIONAL REPORTING TO THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL OF FAMILIES WITH CHILDREN EXPOSED TO DRUGS OR ALCOHOL; TO ALLOW THE DEPARTMENT OF SOCIAL SERVICES TO PROVIDE PREVENTION SERVICES; TO REQUIRE REPORTING OF HIGH RISK PREGNANCIES TO THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL AND REQUIRE THE DEPARTMENT TO CONDUCT DRUG PREVALENCE TESTS TO DETERMINE TRENDS IN PREGNANCY SUBSTANCE ABUSE; AND TO AMEND SECTION 59-32-20, RELATING TO COMPREHENSIVE HEALTH EDUCATION INSTRUCTIONAL UNITS FOR SCHOOL DISTRICTS, SO AS TO REQUIRE SCHOOL DISTRICTS TO INCLUDE THE EFFECTS OF PERINATAL SUBSTANCE ABUSE IN THEIR DRUG AND ALCOHOL EDUCATION PROGRAMS.
Be it enacted by the General Assembly of the State of South Carolina: SECTION 1. The 1976 Code is amended by adding:
Section 44-54-10. A physician licensed in South Carolina who provides obstetrical or gynecological care to a patient who is pregnant shall counsel the patient on the perinatal effects of smoking cigarettes, the use of alcohol, and the use of a controlled substance as defined in Section 44-53-110 for nonmedical purposes. The patient shall sign a written statement on a form prepared by the South Carolina Department of Health and Environmental Control certifying that she received this counseling. The signed statement must be maintained as part of that patient's medical file.
Section 44-54-20. The South Carolina Department of Health and Environmental Control, in cooperation with the South Carolina Commission on Alcohol and Drug Abuse, shall develop and provide educational programs and materials to physicians who provide obstetrical and gynecological care which include:
(1) the effects of cigarettes, alcohol, and controlled substances on pregnancy and fetal outcome;
(2) procedures for taking an accurate and complete drug history from a pregnant patient; and
(3) counseling techniques for drug-abusing women to improve referral to and compliance with drug treatment programs.
Section 44-54-30. (A) The South Carolina Department of Health and Environmental Control in cooperation with the State Department of Mental Health and the South Carolina Department of Social Services shall establish local multidisciplinary teams to advise physicians and health care providers and shall include at a minimum a public health nurse, a hospital staff representative, an experienced child protection supervisor, an obstetrician, a neonatologist, a pediatrician or a family practice physician with an interest in perinatal medicine, a medical social worker, a child psychologist, and a drug treatment provider. No compensation may be paid to the members of the multidisciplinary teams. These teams shall report to the commissioner of the Department of Health and Environmental Control. Necessary expenses of teams may be paid from appropriations of the Department of Health and Environmental Control upon approval by the commissioner.
(B) These multidisciplinary teams must be trained in health issues affecting pregnant mothers and their babies, care in the home for medically-complex infants, developmental impairments of drug and alcohol exposed infants, and treatment resources for drug-abusing families. The teams must be trained in intervention in child abuse and neglect cases and in community resources.
Section 44-54-40. (A) A physician or health care provider may refer to the Department of Health and Environmental Control families in which children may have been exposed to a controlled substance as defined in Section 44-53-110 or alcohol as evidenced by:
(1) medical documentation of signs and symptoms consistent with controlled substances or alcohol exposure in the child at birth; or
(2) results of a confirmed toxicology test for controlled substances performed at birth on the mother or the child; and
(3) a written assessment made or approved by a physician, health care provider, or by the Department of Social Services that documents the child as being at risk of abuse or neglect.
(B) Nothing in this section shall preclude a physician or other mandated reporter from reporting abuse or neglect of a child as required pursuant to Section 20-7-510.
(C) Upon notification pursuant to subsection (A), the Department of Health and Environmental Control shall offer service coordination services to the family. The department shall coordinate social services, health care, mental health services and needed education and rehabilitation services. Service coordination services must be initiated within seventy-two hours of notification. The department shall notify the Department of Social Services and the Department of Mental Health within seventy-two hours of initial notification.
(D) A physician or health care provider who in good faith complies with this section is immune from any civil liability that might otherwise result by reason of this compliance.
(E) Referral and associated documentation provided for in this section is confidential and may not be used in any criminal prosecution.
Section 44-54-50. (A) The State Department of Social Services shall provide protective services and may provide preventive services for children that meet the criteria established in Section 44-54-40.
(B) Until the physician or health care provider, or a designee of the physician or health care provider, authorizes the file to be closed, no services may be discontinued for a child exposed to substances as set forth in Section 44-54-40 if a physician or health care provider has made or approved a written assessment documenting the child as being at risk of abuse or neglect.
Section 44-54-60. The South Carolina Department of Health and Environmental Control shall establish and maintain a toll free information line to provide information on resources for substance abuse treatment and to assist with referral for substance-abusing pregnant women.
Section 44-54-70. A pregnant woman referred for substance abuse treatment must receive first priority for use of available treatment. All records and reports regarding the pregnant woman are confidential. The South Carolina Commission on Alcohol and Drug Abuse shall ensure that family oriented substance abuse treatment is available, as appropriations allow. Substance abuse treatment facilities that receive public funds may not refuse to treat a woman solely because she is pregnant.
Section 44-54-80. (A) A physician or health care provider who provides services to pregnant women shall identify those women the physician or health care provider serves who are high risk pregnancies using the regulations developed by the Department of Health and Environmental Control pursuant to this chapter. The physician or health care provider upon identification of a high risk pregnancy shall inform the woman of the availability of services and the option of referral to the Department of Health and Environmental Control.
(B) Upon consent by a woman identified as having a high risk pregnancy, the physician or health care provider shall make a report, within seventy-two hours, to the Department of Health and Environmental Control on forms approved by the department.
(C) A physician or health care provider who in good faith complies with this section is immune from any civil liability that might otherwise result by reason of this compliance.
(D) Referral and associated documentation provided for in this section is confidential and may not be used in any criminal prosecution.
(E) The consent required by subsection (B) is considered a waiver of confidentiality solely for the purpose of making the report pursuant to subsection (B).
Section 44-54-90. The Department of Health and Environmental Control shall conduct periodic and scientifically appropriate drug prevalence tests on a statistically significant sample of women or infants at the time of delivery. Upon request from the department, physicians who provide obstetrical or gynecological care shall obtain test samples from their patients at the time of delivery and send these samples to a central laboratory designated by the department. These samples must be sent to the laboratory with no information identifying the donor. The department, however, may require demographic information necessary to interpret the results. The department shall then conduct studies using data obtained from these samples to determine the extent of use and harmful perinatal effects of cigarettes, alcohol, and controlled substances as defined in Section 44-53-110. Periodic screening results must be compared to those of the preceding series of tests to determine trends in pregnancy substance abuse and to assist in monitoring the effectiveness of this chapter. Prevalence testing during the prenatal period may be conducted in the same manner at the discretion of the department.
Section 44-54-100. (A) The Department of Health and Environmental Control shall promulgate regulations based on a risk assessment profile for substance abuse to be used by physicians and health care providers to identify high risk pregnancies.
(B) Upon notification by a physician or health care provider that a pregnant woman has been identified as having a high risk pregnancy based on these regulations, the Department of Health and Environmental Control shall offer service coordination services to the woman. Service coordination services include a coordination of social services, health care, and mental health services."
SECTION 2. Section 59-32-20 of the 1976 Code is amended by adding a new paragraph at the end of the section which reads:
"All school districts shall develop and include in their drug and alcohol education programs in grades one through twelve, age appropriate drug education curricula concerning the physiological effects and problems before and after birth caused by the use of cigarettes, alcohol, and controlled substances."
SECTION 3. This act takes effect July 1, 1994.