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(2) Three members to serve ex officio to represent the public colleges and universities. It shall not be a conflict of interest for any voting ex officio member to vote on matters pertaining to their individual college or university. One member must be serving on the board of trustees of one of the following public senior research institutions: Medical University of South Carolina, Clemson University, and University of South Carolina.

(3) One ex officio member to represent the independent colleges and universities. The individual appointed must be serving as a member of the Advisory Council of Private College Presidents. This member must be appointed for a term of two years, may not serve more than two consecutive terms, and shall serve as a nonvoting member.

(4) One at-large member to serve as chairman. This member shall serve a term of four years and may not succeed himself on the commission.

The Governor, by his appointments, shall assure that various economic interests and minority groups, especially women and blacks, are fairly represented on the commission and shall attempt to assure that the graduates of no one public or private college or technical college are dominant on the commission. Vacancies must be filled in the manner of the original appointment for the unexpired portion of the term. All members of the commission shall serve until their successors are appointed and qualify. The chairman of the commission must be elected annually by the members of the commission and may not serve as chairman for more than four consecutive years. Members recommended by the General Assembly must be residents of the appropriate congressional district. If the boundaries of congressional districts are changed, members serving on the commission continue to serve until the expiration of their terms, but successors to members whose terms expire must be appointed from the

(B) The 1976 Code is amended by adding:

"Section 59-103-45. In addition to the powers, duties, and functions of the Commission on Higher Education as provided by law, the commission, notwithstanding any other provision of law to the contrary, shall have the following additional duties and functions with regard to the various public institutions of higher education:

(1) establish procedures for the transferability of courses at the undergraduate level between two-year and four-year institutions or schools;

(2) coordinate with the State Board of Education in the approval of secondary education courses for the purpose of determining minimal college entrance requirements; and

(3) review undergraduate admissions standards for in-state and out-of-state students."

(C) Section 59-103-60 of the 1976 Code is amended to read:

"Section 59-103-60. The commission shall make such recommendations to the Governor's Office State Budget and Control Board and the General Assembly as to policies, programs, curricula, facilities, administration, and financing of all state-supported institutions of higher learning as may be considered desirable. The House Ways and Means Committee, the Senate Finance Committee, and the State Budget and Control Board may refer to the commission for investigation, study and report any requests of institutions of higher learning for new or additional appropriations for operating and for other purposes and for the establishment of new or expanded programs."

(D) Section 59-103-90 of the 1976 is amended to read:

"Section 59-103-90. An executive director must be appointed by the commission to manage and carry out the duties of the commission as prescribed by law and assigned by the commission. The executive director is not subject to the State Employee Grievance Procedure Act of 1982 and may be dismissed without cause.

A professional staff complement shall be established by the Commission on recommendation of the executive director which who shall insure ensure that there are persons on the staff who have the professional competence and experience to carry out the duties assigned and to insure ensure that there are persons on the staff who are familiar with the problems and capabilities of all of the principal types of state-supported institutions in the State. Provision shall be made for persons of high

(E) A joint legislative committee to study the governance and operation of higher education in South Carolina and the institutional structures of higher education is established as follows:

(1) four members of the committee shall be appointed by the Speaker of the House of Representatives from that body and four members shall be appointed by the President Pro Tempore of the Senate from that body. At least one member of the committee appointed by the Speaker of the House from that body and at least one member of the committee appointed by the President Pro Tempore of the Senate from that body shall be an African-American, and at least one other member of the committee appointed by the Speaker of the House from that body and the President Pro Tempore of the Senate from that body must be a female. Four members of the committee must be appointed by the Governor, two of whom must represent the business community, one of whom must be an institutional trustee elected by the General Assembly, and one who must be a member of the Commission on Higher Education. A chairman shall be elected from among the membership of the committee. The committee shall be convened no later than July 1, 1995.

(2) The committee shall:

(a) conduct a comprehensive review of the current governance structure of higher education including statewide coordinating and oversight measures currently sustained.

(b) examine:

(i) national trends and reform efforts in higher education governance structures, including the advantages and disadvantages of increasing or decreasing the oversight role of state level governance of higher education;

(ii) the lines of authority and the relationship between the respective boards of trustees and the Commission on Higher Education;

(c) investigate how higher education opportunities are currently provided to South Carolina students by examining the structures of higher education institutions at all levels;

(e) solicit topics of inquiry from all public and private institutions in the State and the Commission on Higher Education.

(3) At least one staff person shall be transferred to the committee from the Legislative Audit Council and from the State Reorganization Commission for the duration of the study. The study committee shall use this staff in conjunction with other professional staff. Legislative staff of the committee shall be the lead staff and the staff transferred to the committee from the Legislative Audit Council, and the State Reorganization Commission shall support the lead legislative staff. Upon completion of the workplan of the study and if the committee determines that more staff are needed to ensure a timely report and so requests, one additional professional staff person must be transferred from the Legislative Audit Council and from the State Reorganization Commission. The Commission on Higher Education and the staff of the public institutions of higher education shall cooperate fully with the committee including providing staff support and other in-kind resources as requested by the committee.

(4) The committee shall conclude its work and issue its final report by January 1, 1996, which shall serve as the decennial report of the Commission on Higher Education. The final report shall be submitted to the House Education and Public Works Committee and the Senate Education Committee, and must be considered the first report required by the Decennial section of the commission's Master Assessment plan, and upon submission of its final report, the committee shall be dissolved.

(5) Members of the committee shall receive the usual mileage, subsistence, and per diem paid by law to members of the General Assembly to be paid from approved accounts of both houses.

(F) The terms of the present members of the State Commission on Higher Education shall expire on July 1, 1995, at which time the members of the commission selected in the manner provided by this section shall take office./

Amend sections, totals and title to conform.

Senator SETZLER explained the amendment.

Senator SETZLER moved that the amendment be adopted.

The amendment was adopted.

Senator ROSE proposed the following Amendment No. 200 (3362R304.MTR), which was tabled:

Amend the bill, as and if amended, Part II, on page 601, after line 31, by adding a new section to read:

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,

A. This act may be cited as the "South Carolina Drug Impaired Infants Act".

B. 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.

(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

(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.

C. 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

(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

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