Current Status Bill Number:
119Type of Legislation: General Bill GBIntroducing Body: SenateIntroduced Date: 19950110Primary Sponsor: RoseAll Sponsors: RoseDrafted Document Number: RES9479.MTRResiding Body: HouseDate Tabled: 19960613Date of Last Amendment: 19960613Subject: Drug Impaired Infants Act
Body Date Action Description Com Leg Involved ______ ________ _______________________________________ _______ ____________ House 19960613 Tabled House 19960613 Amended House 19960612 Debate adjourned House 19960612 Reconsidered vote whereby the Bill was continued House 19960530 Continued the Bill House 19960528 Debate adjourned until Wednesday, 19960529 House 19960523 Debate adjourned until Tuesday, 19960528 House 19960515 Committee report: Favorable with 27 H3M amendment, minority unfavorable House 19950412 Introduced, read first time, 27 H3M referred to Committee Senate 19950411 Read third time, sent to House Senate 19950411 Recalled from Committee 06 SF Senate 19950118 Committed to Committee 06 SF Senate 19950112 Read second time, notice of general amendments Senate 19950110 Introduced, read first time, placed on Calendar without reference Senate 19941003 Prefiled, referred to Committee 13 SMAView additional legislative information at the LPITS web site.
Indicates Matter Stricken
Indicates New Matter
AMENDED--NOT PRINTED IN THE HOUSE
Amendment No. 1 (Doc Name P:\amend\PFM\9380AC.96)
June 13, 1996
S. Printed 5/15/96--H.
Read the first time April 12, 1995.
TO AMEND TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING CHAPTER 54 SO AS TO CREATE THE SOUTH CAROLINA DRUG IMPAIRED INFANTS ACT, TO AMEND SECTION 20-7-290, RELATING TO THE RENDERING OF HEALTH SERVICES TO MINORS WITHOUT PARENTAL CONSENT, SO AS TO PROVIDE THAT A PHYSICIAN PROVIDING CARE FOR A NEWBORN CHILD MAY ORDER TESTING FOR ALCOHOL AND OTHER DRUGS WITHOUT THE CONSENT OF PARENTS UNDER CERTAIN CIRCUMSTANCES, TO AMEND SECTION 20-7-510, RELATING TO THE REQUIREMENT THAT CERTAIN PERSONS REPORT INSTANCES OF CHILD ABUSE OR NEGLECT, SO AS TO ADD SUBSECTION (D) TO PROVIDE THE CIRCUMSTANCES UNDER WHICH PERSONS ARE REQUIRED TO REPORT POSITIVE RESULTS OF DRUG OR ALCOHOL TESTING PERFORMED ON A NEWBORN, TO AMEND SECTION 44-7-260, RELATING TO HOSPITALS, ETC. AND REQUIREMENTS FOR LICENSURE, SO AS TO PROVIDE, AMONG OTHER THINGS, THAT NO FACILITY OR SERVICE THAT PROVIDES DIAGNOSTIC TREATMENT OR REHABILITATIVE SERVICES RELATED TO ALCOHOL OR OTHER DRUGS MAY REFUSE TO PROVIDE THESE SERVICES TO A WOMAN SOLELY BECAUSE THE WOMAN IS PREGNANT, TO AMEND SECTION 44-49-40, RELATING TO POWERS AND DUTIES OF THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL CONCERNING NARCOTICS AND CONTROLLED SUBSTANCES, SO AS TO COORDINATE SERVICES OF THE DEPARTMENT RELATING TO PRENATAL SUBSTANCE ABUSE, TO AMEND SECTION 44-53-140, RELATING TO THE ALCOHOL AND DRUG ABUSE COMMITMENT, SO AS TO PROVIDE THAT EVIDENCE OBTAINED IN THE ADMINISTERING OF HEALTH CARE MAY NOT BE USED AGAINST THE PERSON SEEKING TREATMENT IN ANY PROCEEDING EXCEPT PROCEEDINGS INITIATED BY THE DEPARTMENT OF SOCIAL SERVICES, AND TO AMEND SECTIONS 59-32-20 AND 59-32-30, RELATING TO EDUCATION, SO AS TO PROVIDE FOR THE DEVELOPMENT AND INCLUSION OF APPROPRIATE DRUG EDUCATION CURRICULA CONCERNING THE EFFECTS OF ALCOHOL AND DRUG ABUSE.
Amend Title To Conform
Whereas, according to the "1991 South Carolina Prevalence Study of Drug Use Among Women Giving Birth", over fifteen thousand infants, representing approximately twenty-five percent of the births in this State, are born each year in this State to women who used alcohol, illegal drugs, or nonprescribed drugs during the latter stages of pregnancy; and
Whereas, the problem of alcohol and drug use among women giving birth is not limited to any one group of women or one area of the State and the percentage of women using alcohol and drugs varies by type of drug, geographic location, and characteristics of the women; and
Whereas, the use of alcohol and other drugs during pregnancy can have serious consequences on the health of the baby, on the woman, and on society in general; and
Whereas, prenatal exposure to alcohol and other drugs is associated with mental retardation, low birth weight, learning disabilities, drug withdrawal symptoms, cleft palate, and other facial abnormalities among infants; and
Whereas, alcohol and other drug use also is associated with increased risk of premature delivery, increased risk of premature separation of the placenta, and increased risk of miscarriage; and
Whereas, women who use alcohol and other drugs during pregnancy are more likely to have other poor health behaviors, such as smoking cigarettes, poor nutrition, inadequate prenatal care, starting prenatal care later and having no prenatal care at all, and are at a higher risk for hepatitis and sexually transmitted diseases; and
Whereas, the costs of these health problems to society are enormous and result from the increased need for neonatal intensive care due to premature and low weight births, social services, including the foster care system, and special education services; and
Whereas, the excess medical cost of caring for drug-exposed infants can easily exceed fifty thousand dollars an infant in the first year of life and the lifetime economic cost associated with each of the children severely affected by drugs before birth can exceed one million dollars. Now, therefore,
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. This act may be cited as the "South Carolina Drug Impaired Infants Act".
SECTION 2. It is the policy of this State that:
(1) Prevention of harm to the fetus is the primary objective of this State and its subdivisions in formulating programs and policies to address the use of alcohol or other drugs during pregnancy.
(2) Programs and policies to address the use of alcohol or other drugs during pregnancy should concentrate on measures that improve the individual's ability to act responsibly. Punitive or coercive measures should be used only as a last resort.
(3) Prenatal harm can be caused by exposure to various drugs, including alcohol, and is often a result of multiple exposures as well as other influences, such as poor maternal health, malnutrition, and lack of prenatal care. The most effective way to prevent this harm is to improve the overall well-being and the self-esteem of women. Efforts to prevent prenatal harm should utilize innovative strategies aimed at the broad range of factors contributing to harm associated with prenatal substance abuse. New models of service delivery should be developed to increase the utilization of available services, using outreach and community-based services as means for identifying and serving the target population.
(4) The use of alcohol and other drugs by women places them at risk for the development of numerous physical and psychological problems. Women whose physical or psychological health is compromised have diminished capacity to care for themselves and their families as well as to participate meaningfully in the community in which they live. Alcohol and other drug abuse isolates women from the institutions of society which support the building and maintenance of self-respect and healthy relationships. Progress and policies of the State and its subdivisions should seek to promote health-enhancing behaviors in women and to develop treatment programs which improve the capacity of women to function fully within their communities.
(5) Prevention, treatment, rehabilitation, and support services for alcohol and other drug abuse, which reflect the unique needs of pregnant women, should be accessible and available to these women. Public and private funds and resources should be identified to implement model intervention programs. Providers of alcohol or drug treatment services must not discriminate against pregnant women or women of childbearing age in providing these services. Pregnant women should be given priority access to treatment services for alcohol or drug dependency.
(6) Adequate prenatal care, through the public and private sectors, should be available and accessible for every pregnant woman. In order to avoid deterring pregnant substance abusers from obtaining prenatal care at the earliest possible time, the privacy of the physician-patient relationship should be protected.
(7) All men and women of childbearing age should be educated about the physical, emotional, and medical effects of alcohol and other drug use during pregnancy. Appropriate educational materials and programs should be developed for use in schools. Educational efforts should emphasize prevention.
(8) All agencies with functions related to use of alcohol or other drugs by pregnant women, including health, social services, corrections, and law enforcement agencies, shall develop plans and interagency policies for coordination of services and resources. These plans and policies should provide for a continuum of services to prevent harm caused by prenatal exposure to alcohol or other drugs. They should include innovative strategies that take into consideration social conditions likely to affect the success of prevention or treatment initiatives, including housing, child care, transportation, and job training specific to women's needs.
(9) Health, social services, and educational agencies shall develop plans and interagency policies for coordination of services and resources to meet the special needs of children who have been harmed by prenatal exposure to alcohol and other drugs.
(10) Statutes, including statutes defining the authority of state or local agencies or providers of services, must be broadly construed to accomplish the policies set forth in this act.
(11) The policies provided for in this act shall be implemented through the cooperative efforts of state, county, and municipal legislative, judicial, and executive branches, as well as other public and private resources. Where resources are limited, services must be targeted to have the greatest impact on preventing harm associated with prenatal exposure to alcohol or other drugs.
SECTION 3. Title 44 of 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, as well as other risk factors appearing to be present in the patient's life. A physician may fulfill this obligation by causing a nurse, social worker, or other allied health professional to provide the required counseling. A statement evidencing that this counseling has been provided and signed by the patient or by the person giving this counseling must be maintained as part of that patient's medical records.
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 or gynecological care, to other health care providers who provide services for pregnant women, to hospitals, and to other appropriate persons and entities. This information must include, but is not limited to:
(1) the effects of cigarettes, alcohol, and controlled substances on pregnancy and fetal outcome;
(2) how other aspects of a woman's life, such as poor nutrition and domestic violence, interact with substance abuse to affect fetal outcome;
(3) what services are available for addicted or substance-abusing women and their families;
(4) the harm done to fetuses from drug use by the mother; and
(5) the law relating to drug use during pregnancy-including the provisions of this chapter.
Section 44-54-30. The South Carolina Commission on Alcohol and Drug Abuse shall establish and maintain a toll-free information line to provide information on resources for substance abuse and to assist with referral for substance-abusing pregnant women.
Section 44-54-40. 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 44-54-50. (A) A physician or health care provider, upon identification of a woman with a high risk pregnancy due to the abuse of alcohol or a controlled substance or whose newborn child reasonably appears to have been exposed to alcohol or controlled substances in utero, shall inform the woman of the availability of services offered by substance abuse programs and the option of referral to the South Carolina Commission on Alcohol and Drug Abuse Office of Women's Services.
(B) Upon consent by a woman identified in accordance with subsection (A) the physician or health care provider shall within seventy-two hours of making the identification make a referral to the South Carolina Commission on Alcohol and Drug Abuse Office of Women's Services. The commission's toll-free information line and any other reasonable means may be used for this purpose.
(C) Any individual providing a government service to a woman identified in accordance with subsection (A) may refer the woman, with the woman's consent, to the South Carolina Commission on Alcohol and Drug Abuse Office of Women's Services. The commission's toll-free information line and any other reasonable means may be used for this purpose.
(D) The South Carolina Commission on Alcohol and Drug Abuse Office of Women's Services promptly must refer each woman referred in accordance with subsections (B) or (C) to a substance abuse program licensed by the Department of Health and Environmental Control and chosen by the woman, or if the woman does not choose a substance abuse program licensed by the Department of Health and Environmental Control, to the county drug and alcohol abuse authority in the county in which the woman resides. This substance abuse program or county drug and alcohol abuse authority must provide assessment and interdisciplinary treatment to each woman for whom a referral is made in accordance with subsections (B) or (C), and must report to a physician or other health care provider treating the woman the failure of the woman to comply with any reasonable plan of assessment or treatment prescribed by the substance abuse program or the county drug and alcohol abuse authority.
(E) 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. Nothing in this section shall preclude or interfere with voluntary admission to a drug treatment facility or emergency drug treatment pursuant to Chapter 52 of Title 44.
(F) A physician, health care provider, or other individual providing a government service who in good faith substantially complies with this section is immune from any civil liability that otherwise might result by reason of this compliance.
(G) Referral and associated documentation resulting from compliance with this section is confidential and may not be used in any criminal prosecution.
(H) The consent required by subsections (B) and (C) is considered a waiver of confidentiality solely for the purpose of making the report pursuant to subsections (B) and (C)."
SECTION 4. Section 20-7-290 of the 1976 Code is amended to read:
"Section 20-7-290. (A) Health services of any kind may be rendered to minors a minor of any age without the consent of a parent or legal guardian when, in the judgment of a person authorized by law to render a particular health service, such the services are deemed considered necessary unless such involves the services involve an operation which shall may be performed only if such it is essential to the health or life of such child the minor in the opinion of the performing physician and a consultant physician if one is available.
(B) A physician providing care for a newborn child may order testing for alcohol and other drugs without the consent of a parent or legal guardian if the testing is medically necessary to protect the health of the newborn child in the opinion of the performing physician. Consent from the mother should be sought before testing, if practicable.
(C) Information obtained from the drug or alcohol testing performed on a newborn must not be disclosed in a manner that would identify the child or parents to anyone other than the child's parents or guardian, except:
(1) to make a report pursuant to Section 20-7-510 and to cooperate with an investigation pursuant to such report;
(2) to obtain treatment or other services or benefits for the child or the child's family;
(3) as may be permitted by Section 44-53-140 pursuant to Chapter 52 of Title 44; or
(4) upon consent of a custodial parent or legal guardian.
Any person who discloses such information except as authorized in this section is guilty of a misdemeanor and, upon conviction, must be fined not more than five hundred dollars or imprisoned not more than one year, or both."
SECTION 5. Section 20-7-510 of the 1976 Code is amended by adding:
"(D) A person is not required to report based on positive results of drug or alcohol testing performed on a newborn unless the test results combine with one or more other factors, such as the infant's home or family situation or condition, to give the reporter reason to believe that a child's physical or mental health or welfare may be affected adversely by abuse or neglect while in the care of a parent, legal guardian, or custodian."
SECTION 6. Section 44-7-260 of the 1976 Code is amended by adding:
"(F) No facility or service that provides diagnostic, treatment, or rehabilitative services related to the abuse of alcohol or other drugs may refuse to provide these services to a woman solely because the woman is pregnant. Pregnant women must be given priority access to these services. Diagnostic, treatment, or rehabilitative services must be provided in accordance with accepted professional standards applicable to the treatment of abuse of alcohol or other drugs in pregnant women. All treatment providers must ensure that family-oriented substance abuse treatment is available, as resources may allow."
SECTION 7. Section 44-49-40(c) of the 1976 Code is amended by adding:
"(11) Coordinate these matters relating to prenatal substance abuse:
(a) study of issues related to prenatal substance abuse;
(b) development of prevention and treatment strategies;
(c) education of policymakers and other relevant professionals;
(d) identification of grants and other private funding sources and the coordination of efforts to obtain these funds; and
(e) provision of interagency communications and actions relating to the use of alcohol and other drugs during pregnancy."
SECTION 8. Section 44-53-140 of the 1976 Code is amended to read:
"Section 44-53-140. (A) Whenever When a holder of the privilege shall seek seeks counselling, treatment, or therapy for any a drug problem from a confidant, no statement made by such the holder and no observation or conclusion derived by such the confidant shall be is admissible against such the holder in any proceeding. The results of any an examination to determine the existence of illegal or prohibited drugs in a holder's body shall are not be admissible in any proceeding against such the holder. The privilege belongs to the holder and if he the holder waives the right to claim the privilege the communication between the holder of the privilege and the confidant shall be is admissible in evidence in any proceeding. There is no privilege if the services of a confidant are sought to enable the holder of the privilege to commit or plan to commit a crime or a tort.
(B) When a person seeks prenatal care from a licensed health care provider, no statement made by the person and no observation or conclusion of the health care provider is admissible against the person in any proceeding. The results of an examination to determine the existence of alcohol or other drugs in the person's body or in the body of the newborn child of the person are not admissible in any proceeding against the person. However, the provider may release that information necessary to bring about the commitment of the person for alcohol or drug treatment pursuant to Section 44-52-110, where the release is consistent with professional standards of care. The provider also may release information necessary to judicial proceedings that are initiated by the Department of Social Services following a report under Section 20-7-510. The privilege belongs to the person and may be waived by the person."
SECTION 9. Section 59-32-20 of the 1976 Code is amended by adding a new paragraph at the end of the section to read:
"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 10. Section 59-32-30(A) of the 1976 Code is amended by adding at the end:
"(7) Where appropriate to the students' age group, a program of instruction in reproductive health education or substance use or abuse must include instruction concerning the effects of the use and abuse of cigarettes, alcohol, and controlled substances on persons of reproductive age, pregnant women, and fetuses."
SECTION 11. The South Carolina Commission on Alcohol and Drug Abuse shall ensure that a staff position is designated to carry out the functions required by Section 44-49-40(c)(11) of the 1976 Code as added by Section 7 of this act.
SECTION 12. This act takes effect upon approval by the Governor.