South Carolina General Assembly
115th Session, 2003-2004

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Bill 3768

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COMMITTEE REPORT

March 30, 2004

H. 3768

Introduced by Reps. Rice, Clemmons and Edge

S. Printed 3/30/04--S.

Read the first time March 26, 2003.

            

The Medical Affairs Committee Report Follows the Finance Committee Report.

THE COMMITTEE ON FINANCE

To whom was referred a Bill (H. 3768) to enact the "South Carolina Health and Human Services Reorganization and Accountability Act of 2003"; to amend the Code of Laws of South Carolina, 1976, by adding Article 3, 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, beginning on page 31, by striking PART XI in its entirety and inserting:

/ PART XI

Cigarette Tax and Stamps - Economic Recovery Tax Relief Act

SECTION    24.A.    Article 5, Chapter 21, Title 12 of the 1976 Code is amended by adding:

"Section 12-21-630.    (A)    In addition to the tax imposed pursuant to Section 12-21-620(1), there is levied, assessed, collected, and paid upon all cigarettes made of tobacco or any substitute for tobacco, an additional license tax equal to 2.65 cents on each cigarette made of tobacco or any substitute for tobacco.

(B)    The amount imposed pursuant to subsection (A) must be reported, paid, collected, and enforced in the same manner as the tax imposed pursuant to Section 12-21-620(1).

(C)    There is created in the state treasury the Medicaid Match Fund. The revenue of the tax imposed pursuant to this section must be credited to the Medicaid Match Fund. This fund must be separate and distinct from the general fund of the State. Monies in the fund must be used by the Department of Health and Human Services solely as the state match for federal Medicaid funding. The fund is exempt from any budgetary cuts or reductions caused by the lack of general fund revenues. Earnings on investments of monies in the fund must be credited to the fund and used for the same purposes as other monies in the fund. Any monies in the fund not expended during a fiscal year must be carried forward to the succeeding fiscal year and used for the same purposes."

B.    Article 5, Chapter 21, Title 12 of the 1976 Code is amended by adding:

"Section 12-21-720.    (A)    The license taxes imposed on cigarettes by this article must be paid by affixing stamps to each individual package in the manner and at the time set forth in this article. A stamp evidencing the taxes levied in this article may not be of a denomination of less than one cent and whenever the tax computed at the rate prescribed in this article is a specified amount plus a fractional part of one cent, the package must be stamped for the next full cent.

(B)    The department may authorize wholesale dealers in cigarettes to store cigarettes intended to be sold and shipped out of this State in separate compartments of their business without affixing revenue stamps. However, a wholesale dealer making shipments of cigarettes to locations out of this State shall apply to the department for a license that allows the wholesale dealer to maintain the separate compartments authorized by this subsection. A wholesale dealer in cigarettes violating the rules and regulations permitting the storage of cigarettes without affixing the stamps is liable for the penalties contained in this title.

(C)    The stamps must be affixed to each individual package by wholesalers within seventy-two hours after the products are received by them and by retailers within twenty-four hours of receipt by them of these products. In any event, these goods must be stamped before being sold. If cigarettes are manufactured within the State and sold directly to consumers, they must be stamped by the manufacturer when and as sold.

(D)    Each person or distributor of cigarettes taxable under this article, first receiving untaxed cigarettes for sale or distribution in this State, is subject to the taxes imposed in this article. Each person or distributor required to pay the taxes by affixing stamps must also make a report to the department, in the form the department prescribes, of all cigarettes and cigarette tax stamps in inventory at the beginning and end of the month, all cigarettes and cigarette tax stamps purchased during the month, all cigarettes disposed of in this State during the month, and other information required by law or considered necessary by the department. If the report indicates that the person or distributor did not stamp all cigarettes disposed of, the person or distributor shall pay the additional taxes with the report. The report and taxes, if any additional taxes are due with the report, are due no later than the twentieth day of the month next succeeding the month of the purchase or disposition."

C.        Cigarettes held in inventory on January 1, 2004, by the person or distributor who first received the cigarettes into this State must be stamped as provided in Section 12-21-720 of the 1976 Code as added by this Part. Credit must be allowed for any taxes previously paid on the cigarettes.

D.    Section 12-21-735 of the 1976 Code is repealed.

E.    Notwithstanding the general effective date of this act:

(1)    Subsection A of this section takes effect on the first day of the second month following the month in which this act is approved by the Governor;

(2)    Subsections B, C, and D are effective January 1, 2004.

SECTION 25.A.    Article 5, Chapter 6, Title 12 of the 1976 Code is amended by adding:

"Section 12-6-517.    (A)    This section may be cited as the Economic Recovery Tax Relief Act.

(B)    For purposes of this section:

(1)    'Board of Economic Advisors' means the Board of Economic Advisors of the State Budget and Control Board established pursuant to Section 11-9-820.

(2)    'Board of Economic Advisors revenue estimate' means a Board of Economic Advisors estimate of revenues made by October tenth of each year as required by this section.

(3)    'Individual income tax revenue' means total state individual income tax revenue for a fiscal year.

(4)    'Individual income tax general fund revenue' means individual income tax revenue reduced by amounts required to be deducted and credited to the Trust Fund for Tax Relief pursuant to Section 11-11-150. In determining individual income tax general fund revenue, the amount deducted from individual income tax revenue for credit to the Trust Fund for Tax Relief must be an amount which bears the same ratio to the total Trust Fund for Tax Relief amount for a fiscal year as individual income tax revenue bears to the sum of individual income tax revenue and corporate income tax revenue for the fiscal year.

(5)    'Base revenue' means $2,092,691,000 adjusted upward by one and one-half percent a fiscal year beginning with the fiscal year immediately succeeding the fiscal year in which individual income tax general fund revenue first equals or exceeds $2,092,691,000.

(6)    'Economic recovery revenue' means the amount by which the Board of Economic Advisors revenue estimate for individual income tax general fund revenue exceeds base revenue.

(7)    'Cigarette tax increase' means a state tax on cigarettes in excess of three and one-half mills a cigarette.

(8)    'Cumulative cigarette tax increase' means the sum of state revenues derived from a cigarette tax increase for each completed fiscal year since inception.

(C)    Beginning with fiscal year 2003-2004, the Comptroller General shall certify to the Board of Economic Advisors by October first following the close of the fiscal year:

(1)    base revenue;

(2)    individual income tax revenue for the fiscal year that just ended;

(3)    individual income tax general fund revenue for the fiscal year that just ended; and

(4)    the cumulative cigarette tax increase.

(D)    Beginning with individual income tax liability for taxable years beginning after December 31, 2003, and each taxable year thereafter and continuing until the date provided in subsection (I), there is allowed an Economic Recovery Tax Credit allocated among the individual income taxpayers of South Carolina as provided in subsection (E) of this section. The Economic Recovery Tax Credit is nonrefundable for individual income taxpayers. Except as provided in subsection (G), the total Economic Recovery Tax Credit allowed is an amount equal to eighty percent of the economic recovery revenue for the current fiscal year. There is no Economic Recovery Tax Credit allowed in a fiscal year in which there is no economic recovery revenue. The amount of the Economic Recovery Tax Credit allowed for a specific fiscal year is realized by an individual taxpayer for a taxable year ending on or after December thirty-first during that specific fiscal year.

(E)    The Board of Economic Advisors shall calculate and certify the total amount of the Economic Recovery Tax Credit to the Department of Revenue by October tenth of each year. The Department of Revenue shall establish a method to apply the Economic Recovery Tax Credit to individual income tax returns that meets each of the following criteria:

(1)    The amount of the Economic Recovery Tax Credit realized by an individual taxpayer must be an amount which bears the same ratio to the total amount of the Economic Recovery Tax Credit as the income tax due as shown on the taxpayer's income tax return before taking the Economic Recovery Tax Credit bears to the individual income tax revenue for the fiscal year.

(2)    The Economic Recovery Tax Credit realized by individual taxpayers must be determined by a formula that calculates the Economic Recovery Tax Credit in terms of a percentage reduction to the state income tax liability of each individual.

(3)    The Economic Recovery Tax Credit does not produce a negative income tax liability for individual income taxpayers.

(F)    The individual income tax rates imposed for each income bracket pursuant to Section 12-6-510 are reduced by one-half of a percentage point effective for taxable years beginning on or after the first day of January immediately following the close of the fiscal year in which the Board of Economic Advisors revenue estimate provides that the following conditions are met:

(1)    The sum of the cumulative amount of Economic Recovery Tax Credit allowed pursuant to this section since enactment for completed fiscal years and the Economic Recovery Tax Credit established in October of the current fiscal year equals or exceeds the sum of the cumulative cigarette tax increase and the Board of Economic Advisors revenue estimate of the cigarette tax increase through December thirty-first of the current fiscal year.

(2)    The total Economic Recovery Tax Credit for the current fiscal year is sufficient to offset a one-half percentage point reduction in individual income tax rates for each income bracket during the current calendar year.

(G)    Effective at the beginning of the fiscal year following the income tax rate reductions provided for in section (F), and continuing for succeeding fiscal years until the Economic Recovery Tax Credit is terminated pursuant to subsection (I), the Economic Recovery Tax Credit amount defined in subsection (D) is an amount equal to fifty percent of each fiscal year's economic recovery revenue.

(H)    After the income tax rate reductions and adjustment of the Economic Recovery Tax Credit amount provided in subsections (F) and (G) are implemented, the rates for each income bracket are permanently reduced by one and one-half of a percentage point effective for taxable years beginning on or after the first day of January immediately following the close of the fiscal year in which each of the following conditions are met:

(1)    The current fiscal year Board of Economic Advisors revenue estimate provides that the total Economic Recovery Tax Credit for the current fiscal year is sufficient to offset a one and one-half percentage point reduction in individual income tax rates for each income bracket during the current calendar year.

(2)    In each of the two fiscal years immediately preceding the current fiscal year, the Economic Recovery Tax Credit was sufficient to offset a one and one-half percentage point reduction in state individual income tax rates for each income bracket based upon actual individual income tax revenue as certified by the Comptroller General.

(I)    The Economic Recovery Tax Credit provided by this section terminates effective the first taxable year in which the permanent reduction to individual income tax rates provided by subsection (H) takes effect.

(J)(1)    The Department of Revenue shall apply the income tax rate reductions provided in subsections (F) and (H) to the then applicable rates, and these rates, as reduced, apply in lieu of the former rates.

(2)    After the income tax rate reductions provided for in subsection (F) take effect, the Department of Revenue shall calculate the effective tax rates for each income bracket resulting from the application of the Economic Recovery Tax Credit for each taxable year that the Economic Recovery Tax Credit is allowed. These effective rates must be printed with tax tables and posted on the department's web site."

B.    Notwithstanding the general effective date of this act, Section 12-21-625 of the 1976 Code, as added by this part, is effective January 1, 2004.

SECTION    26.    Reserved. /

Renumber sections to conform.

Amend title to conform.

HUGH K. LEATHERMAN, SR. for Committee.

            

THE COMMITTEE ON MEDICAL AFFAIRS

To whom was referred a Bill (H. 3768) to enact the "South Carolina Health and Human Services Reorganization and Accountability Act of 2003"; to amend the Code of Laws of South Carolina, 1976, by adding Article 3, 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, by striking Parts I through X (page 5, line 19 through page 31, line 27) and Parts XII

through XV (page 35, line 8 through page 36, line 40) and inserting:

/ Part I

Act Citation

SECTION    1.    This act may be cited as the "Health and Human Services Accountability Act of 2004."

Part II

Medicaid Initiatives

SECTION    1.    Chapter 2, Title 12 of the 1976 Code is amended by adding:

"Section 12-2-100.    By July 1, 2006, the Department of Revenue shall implement electronic interface between information systems to enable the Department of Health and Human Services to electronically obtain income and related financial information of residents of the State from the department for the purpose of assisting the Department of Health and Human Services in making eligibility determinations of persons applying for Medicaid coverage."

SECTION 2. Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-110.    The department shall report to the House Ways and Means Committee, the Senate Finance Committee, the House Medical, Military, Public and Municipal Affairs Committee, and the Senate Medical Affairs Committee the following:

(1)    prospectively, any changes to the Medicaid state plan;

(2)    by January 31 of each year, a listing of all co-payments required of Medicaid recipients and the number of recipients and providers impacted by each."

SECTION    3.    Article 1, Chapter 71, Title 38 of the 1976 Code is amended by adding:

"Section 38-71-270.    An insurer, including a health maintenance organization, providing health insurance to residents of this State shall submit the names and other identifying information of its insureds to the Department of Insurance in the manner and time prescribed by the department. The department shall submit this information to the Department of Health and Human Services to be used to identify Medicaid applicants who have other health insurance coverage."

SECTION    4.        A.    This section may be cited as the "South Carolina Medicaid Managed Care Pilot Program."

B.        Article 1, Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-130.    (A)    The department shall develop pilot programs to implement managed and coordinated patient care within the Medicaid program. Each pilot must provide a medical home for Medicaid recipients that will promote continuity of care, emphasize prevention and self-management to improve quality of life, supply evidence-based information and resources to support optimal health management, improve healthcare outcomes, increase access to care, and reduce overall program costs. Each pilot program must consist of one or both of the following:

(1)    managed health care programs employing managed care organizations reimbursed with capitated payments;

(2)    primary care case management programs where a primary care provider is responsible for approving and monitoring the care of enrolled beneficiaries and reimbursement is based on a fee-for-service or capitated basis, or both.

(B)    Each pilot program must operate for a period of three years. If any pilot program fails to demonstrate budget neutrality, the department may end that pilot program prior to the end of the three-year period.

(C)    By June 30, 2006, enrollment in the pilot programs must target a total of at least thirty percent of the total statewide Temporary Assistance to Needy Families, Supplemental Omnibus Budget Reconciliation Act, and Supplemental Security Income Medicaid eligibles. By June 30, 2007, enrollment in the pilot programs must target a total of at least forty percent of the same population. By June 30, 2008, enrollment in the pilot programs must target a total of at least fifty percent of the same population.

(D)    Eligibiles must be given ninety days from their initial Medicaid eligibility determination to elect to participate in one of the pilot programs or in the existing fee-for-service program. If participation in either of the pilot programs is elected, this election must be for a period of not less than one year, subject to all applicable federal laws and regulations. The department may retain an independent enrollment broker or employ such other measures as may be necessary including, but not limited to, auto-enrollment to ensure an appropriate distribution of beneficiaries among the pilot programs.

(E)    Beginning January 31, 2006, and by January 31 of each year thereafter, the department shall submit to the Governor, the Lieutenant Governor, the House Ways and Means Committee, the Senate Finance Committee, the House Medical, Military, Public and Municipal Affairs Committee, and the Senate Medical Affairs Committee an annual evaluation of each pilot program. Each evaluation must include, but is not limited to, the following:

(1)    financial and medical outcomes of each pilot program;

(2)    individual and collective pilot program enrollment totals relative to established targets and explanations of any existing or potential barriers to future targets; and

(3)    the overall effectiveness of each pilot program in managing appropriate emergency room utilization, inpatient hospital admissions, and pharmaceutical utilization while increasing the use of preventive care measures, provider satisfaction, and patient satisfaction.

The department may employ the services of a quality review organization to assist in the evaluation process.

(F)    Each pilot program is subject to all applicable federal laws and regulations.

(G)    To ensure competition, accountability, and the actuarial soundness of each pilot program, the department shall use an independent third-party actuary to develop objective actuarial standards and rates. Updates to rates must be based on actuarially sound business methods and available funding.

(H)    The department shall expeditiously apply for any federal waivers or approvals necessary to implement the pilot programs. If necessary, all implementation and target dates may be delayed to coincide with the effective date of these waivers.

(I)    The department may establish contractual agreements for pilot service providers and may terminate any pilot program, or component of a pilot program, for contractual non-compliance or practices that adversely and dangerously impact patient care.

(J)    Nothing in this section must be construed to limit existing Medicaid programs or to limit the department from establishing other initiatives it considers necessary, in addition to the pilot program, in its administration of the Medicaid program."

C.     This section takes effect June 30, 2005.

SECTION    5.    Article 1, Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-120.    (A)    The department shall explore contracting for external administration of the Medicaid eligibility redetermination process, and if determined to be feasible, upon implementation, the privatized process must be evaluated annually to ensure compliance with all federal and state eligibility determination criteria. If an annual evaluation reveals that the privatized process does not improve efficiency or accuracy in processing Medicaid eligibility redeterminations, the department shall cancel the contract and resume internal processing of Medicaid eligibility redeterminations.

(B)    The department shall develop eligibility determination criteria and processes that:

(1)    provide for face-to-face initial and continued eligibility determinations when feasible and cost-effective;

(2)    prevent the routine initiation of coverage for all recipients except pregnant women until verification of all required eligibility data is complete;

(3)    apply the same standards to eligibility redetermination as applied to the initial eligibility determination process;

(4)    require verification of all unearned income;

(5)    require documented proof of citizenship or legal alien status;

(6)    require applicants' parents, the responsible party, or persons holding a power of attorney for the applicant to sign the application, thereby attesting to the accuracy of the information provided and granting the consent of the applicant for an eligibility search; and

(7)    in accordance with applicable federal laws and regulations, provide for the termination of recipients who have provided false information.

(C)    The department shall require affirmative proof of current income and other eligibility criteria when determining whether a Medicaid recipient is eligible for continued coverage. These reviews must be conducted annually for all income-eligible recipients, provided that such reviews are conducted quarterly for all income-eligible recipients who report that they earn no income.

(D)    The department shall require that all files pertaining to Medicaid eligibility of any agency employee or member of their immediate family be transferred to a central location for processing. The department must not allow an agency employee to participate in processing eligibility determinations for themselves or their immediate family members.

(E)    The department shall conduct regular, random, unannounced audits of eligibility files for completeness and accuracy. These audits must report results that are specific to individual eligibility determination employees and supervisors rather than report statewide results.

(F)    The department shall explore the following eligibility accuracy and efficiency initiatives:

(1)    reducing and streamlining the number of eligibility categories;

(2)    developing a comprehensive eligibility staff training program that must include statewide and on-site training sessions and web-based training and policy dissemination tools;

(3)    piloting online income and asset verification; and

(4)    expanding the number of out-stationed sponsored Medicaid workers.

(G)    Notwithstanding any other provision of law and except as provided below, any promissory note received after July 1, 2004, by a Medicaid applicant or recipient or the spouse of a Medicaid applicant or recipient in exchange for assets, which if retained by the applicant or recipient or his spouse would cause the applicant or recipient to be ineligible for Medicaid benefits are, for Medicaid eligibility purposes, deemed to be fully negotiable under the laws of this State unless the promissory note contains language plainly stating that it is not transferable under any circumstances. To be considered valid for Medicaid eligibility determination purposes, a promissory note must be actuarially sound, require monthly installments that fully amortize it over the life of the loan, and be free of any conditional or self-canceling clauses."

SECTION    6.    There is established a "Task Force on Emergency Room Diversion" to be led by the Department of Health and Environmental Control to develop a plan for community service alternatives, or contract alternatives or both, for persons who currently use emergency rooms inappropriately.

The task force shall submit a plan and budget to reduce inappropriate utilization of the emergency room and to provide more appropriate services. Membership must include, but is not limited to, representatives of the following organizations: South Carolina Medical Association, the South Carolina Academy of Family Physicians, the South Carolina Hospital Association, the Emergency Medical Services Association, the South Carolina Sheriff's Association, Partners in Crisis, the Probate Court Judges Association, and the South Carolina Psychiatric Association. A report and budget must be submitted to the Senate Finance Committee, the Senate Medical Affairs Committee, the House Ways and Means Committee, and the House Medical, Military, Public and Municipal Affairs Committee by January 1, 2006. Upon approval by the committee, the Department of Health and Human Services shall provide support for a pilot project to be administered by the Department of Health and Environmental Control which shall monitor and provide regular evaluations of the pilot project.

SECTION    7.    Article 1, Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-140.    (A)    There is created within the department the South Carolina Medicaid Incentives for Suggesting Expense Reductions program to be known as SC MISER. The department is authorized to establish such regulations as may be necessary for administration of SC MISER.

(B)    SC MISER must be offered to Medicaid Providers and their employees and must feature a monetary award for suggesting a measure that successfully results in saving the Medicaid program money.

(C)    SC MISER suggestions may be made through a form available on the department's website, mailed with provider remittances, or mailed upon request from the department's Public Information Office. Within thirty days of receipt, SC MISER suggestions must be reviewed for merit by department program, fiscal, legal, and program integrity staff. SC MISER suggestions determined to be with merit must be presented to the department director for implementation authorization.

(D)    Twelve months after implementation, the department shall evaluate the savings generated and award the individual who made the suggestions an amount equal to ten percent of the state savings generated, up to five hundred dollars, during that period. Awards must be funded from third party liability collections only and must not exceed twenty thousand dollars annually."

Part III

Seniors Forum

SECTION    1.    Chapter 21, Title 43 of the 1976 Code is amended by adding:

"Section 43-21-15.    (A)    There is created the Office on Aging in the Department of Health and Human Services that must be supported by a Seniors Forum consisting of twenty-one voting members as follows:

(1)    eight members must be appointed by the Governor, six shall represent county Councils on Aging, and two shall represent other local service providers;

(2)    three members must be appointed by the Governor and shall represent area Agencies on Aging or their federally mandated advisory councils;

(3)    four members must be appointed by the Governor, two must be members of the South Carolina Silver Haired Legislature, Inc., and two must be members of American Association of Retired Persons (AARP), whose primary mission includes advocacy of seniors;

(4)    two members must be appointed by the Speaker of the House of Representatives, notwithstanding Section 8-13-770, one must be a member of the House of Representatives, and one must be a consumer;

(5)    two members must be appointed by the President Pro Tempore of the Senate, notwithstanding Section 8-13-770 , one must be a member of the Senate, and one must be a consumer; and

(6)    two members must be consumers appointed by the Governor.

All members shall serve terms coterminous with their respective appointing authorities. A vacancy must be filled in the same manner as the original appointment for the remainder of the unexpired term. The chair must be elected by members of the forum from its members for a term of two years and shall serve until a successor is elected. Members of the forum shall serve without compensation and may not receive mileage, per diem, or subsistence. The Office on Aging shall provide staff for the forum. The Office on Aging must submit an annual draft plan of action for the upcoming fiscal year to the Senior's Forum by December 15 of each year.

(B)    The forum shall:

(1)    meet at least once each quarter and additional meetings may be called at the discretion of the chair. Rules and procedures must be adopted by the forum for the governance of its operations and activities;

(2)    make recommendations regarding:

(a)    the respective responsibilities and appropriate roles of state, regional, and local entities;

(b)    the delivery of services to senior South Carolinians;

(c)    what services should be made available to eligible seniors; and

(d)    the allocation of funds to ensure maximum delivery of services to those seniors who are recipients of services;

(3)    sponsor public forums every four years, one year before the Office on Aging's four-year plan is due;

(4)    respond to the annual draft plan submitted to the forum by the Office on Aging by January 31 of the following year with its comments and recommendations.

(C)    Taking into consideration recommendations developed by the Seniors Forum in accordance with this chapter, the Office on Aging shall develop a service delivery plan for seniors in this State and in developing and implementing this plan, shall maximize the use of state and federal funds for direct service delivery. The office shall review and revise this service delivery plan annually and shall submit a draft plan to the Seniors Forum annually before December 15 and shall submit a final revised plan to the Governor, the Senate Finance Committee, the Senate Medical Affairs Committee, the House Ways and Means Committee, and the House Medical, Military, Public and Municipal Affairs Committee and the Seniors Forum by March 1 of each year."

SECTION 2.    Section 43-21-140 of the 1976 Code, as added by Act 174 of 1987, is amended to read:

"Section 43-21-140.    The council has no authority to direct or require any implementing action from any member agency. The council Seniors Forum shall identify future policy issues in long-term care and may conduct research and demonstration activities related to these issues. Through close coordination of each member agency's planning efforts, the council forum shall develop recommendations for a statewide service delivery system for all health-impaired elderly or disabled persons, regardless of the persons' resources or source of payment. These recommendations must be updated annually as needed and submitted to the Office on Aging. The service delivery system must provide for:

(1)    charges based on ability to pay for persons not eligible for Medicaid;

(2)    coordination of community services;

(3)    access to and receipt of an appropriate mix of long-term care services for all health impaired elderly or disabled persons;

(4)    case management; and

(5)    discharge planning and services.

The council, through its member agencies, forum shall study and make recommendations to the Office on Aging concerning the costs and benefits of: adult day care centers, in-home and institutional respite care, adult foster homes, incentives for families to provide in-home care, such as cash assistance, tax credits or deductions, and home-delivered services to aid families caring for chronically-impaired elderly relatives."

SECTION 3. Members must be appointed to the Seniors Forum, established pursuant to Section 1 of this Part, before December 8, 2004, and the first meeting of the Seniors Forum must be called by the Director of the Office on Aging in the Department of Health and Human Services before January 10, 2005.

Part IV

Prevention of Youth Access to Tobacco

SECTION    1.    This part may be cited as the "Youth Access to Tobacco Prevention Act of 2004."

SECTION    2.    Section 16-17-500 of the 1976 Code, as last amended by Act 445 of 1996, is amended to read:

"Section 16-17-500.    (A)    It shall be is unlawful for any a person to sell, furnish, give, distribute, purchase for, or provide any a minor under the age of eighteen years with cigarettes, tobacco, cigarette paper, or any substitute therefore a tobacco product. Any person violating the provisions of this section, either in person, by agent or in any other way, shall be guilty of a misdemeanor and, upon indictment and conviction, therefor shall be punished as follows:

(1)    for a first offense by a fine not exceeding twenty-five dollars;

(2)    for a second offense, by a fine not exceeding fifty dollars; and

(3)    for a third or subsequent offense, by a fine of not less than one hundred dollars or imprisonment for not more than one year nor less than sixty days, or both.

One-half of any fine imposed shall be paid to the informer of the offense and the other half to the treasurer of the county in which such conviction shall be had.

(B)    It is unlawful for a person to sell a tobacco product to an individual who does not present upon demand proper proof of age. Proof of age is not required from an individual who the person reasonably believes to be over twenty-seven years of age. Failure to require identification to verify a person's age shall be used as evidence to the knowing and intentional violation of this provision unless the person knows the individual is at least eighteen years of age. Proof that is demanded, is shown, and reasonably is relied upon for the individual's proof of age is a defense to an action initiated pursuant to this section. To determine whether a person believes an individual is at least twenty-seven years of age, a court may consider, but is not limited to considering, proof of the individual's general appearance, facial characteristics, behavior, and manners. This subsection does not apply to mail order sales.

(C)    A retail distributor of tobacco products must train its retail sales employees regarding the provisions contained in this section. In lieu of the penalties contained in subsection (F), a retail establishment that fails to comply with this provision must be fined not more than one thousand dollars. A retail establishment that provides proof that it has complied with the provisions contained in this section is not subject to this penalty.

(D)    It is unlawful for an individual less than eighteen years of age to purchase, accept receipt, attempt to purchase, or attempt to accept receipt of a tobacco product, or present or offer to a person proof of age which is false or fraudulent for the purpose of purchasing or possessing a tobacco product. However, a person less than eighteen years of age may be enlisted by local law enforcement agencies to test a community's compliance with this section and to reduce the extent to which tobacco products are sold or distributed to individuals less than eighteen years of age when the testing is under the direct supervision of the law enforcement agency and with the individual's parental consent. In addition, a person less than eighteen years of age may be enlisted by the Office of Alcohol and Other Drug Abuse Services, or a county alcohol and drug abuse authority to test an outlet's compliance with this section, with the permission of the individual's parent or guardian, to collect data for the federally mandated Youth Access to Tobacco Study.

(E)    It is unlawful for an individual less than eighteen years of age to possess a tobacco product. This subsection does not apply to the possession of tobacco products by an individual less than eighteen years of age who delivers tobacco products pursuant to his employment responsibilities.

(F)    Tobacco products may be accessible only in vending machines located in an establishment:

(1)    which is open only to persons who are eighteen years of age or older; or

(2)    where the vending machine is under continuous control by the owner or licensee of the premises, or an employee of the owner or licensee, can be operated only upon activation by the owner, licensee, or employee before each purchase, and is not accessible to the public when the establishment is closed. The owner, licensee, or employee must demand proof of age from a prospective purchaser if he has reasonable grounds to believe the prospective purchaser is less than twenty-seven years of age. Proof that an owner, licensee, or employee demanded, was shown, and reasonably relied upon an individual's proof of age is a defense to any action brought pursuant to this subsection.

Vending machines which distribute tobacco products in establishments must meet the requirements of this section within one hundred-twenty days after the effective date of this section or must be removed.

(G)    A person or individual that intentionally or knowingly violates a provision contained in this section either in person, by agent, or in any other way, is guilty of a misdemeanor and, upon conviction, must be punished as follows:

(1)    for a first offense, by a fine not less than one hundred dollars;

(2)    for a second offense, which occurs within three years of the first offense, by a fine not less than two hundred dollars; and

(3)    for a third or subsequent offense, which occurs within three years of the first offense, by a fine not less than three hundred dollars.

All fines must be placed in the state general fund and distributed in the following manner:

(a)    one-half must be distributed to the treasurer of the county in which the conviction occurred; and

(b)    one-half must be distributed to the county alcohol and drug abuse commission and used for funding youth smoking prevention programs. A violation of this subsection is triable exclusively in either municipal or magistrate court.

A violation of this section is triable exclusively in either municipal or magistrate court.

(H)    In lieu of the penalties contained in subsection (G), a court may require an individual who is less than eighteen years of age who illegally purchases or possesses a tobacco product to perform not less than twenty hours of community service for a first offense and not less than forty hours of community service for a second or subsequent offense.

(I)    As used in this section 'person' means an individual. 'Person' does not mean a firm, partnership, corporation, company, association, club, or commercial entity the person is associated with.

(J)    Notwithstanding any other provision of law, a violation of this section does not violate an establishment's beer and wine permit and is not a ground for revocation or suspension of a beer and wine permit.

(K)    A person who is less than eighteen years of age who is convicted of violating a provision of this section may have his record expunged after his eighteenth birthday if he has paid any fine imposed upon him and successfully completed any court-ordered community service."

SECTION    3.    Section 16-17-501 of the 1976 Code, as added by Act 445 of 1996, is amended to read:

"Section 16-17-501.    As used in this section and Sections 16-17-500, 16-17-502, 16-17-503, and 16-17-504:

(1)    'Distribute' means to sell, furnish, give, or provide tobacco products, including tobacco product samples, cigarette paper, or a substitute for them, to the ultimate consumer.

(2)    'Proof of age' means a driver's license or other documentary or written evidence that the individual is eighteen years of age or older identification card issued by this state, or a United States Armed Services identification card.

(3)    'Sample' means a tobacco product distributed to members of the general public at no cost for the purpose of promoting the products.

(4)    'Sampling' means the distribution of samples to members of the general public in a public place.

(5)    'Tobacco product' means a product that contains tobacco and is intended for human consumption."

Part V

Severability and Savings

SECTION    1.    (A)    If any section, subsection, paragraph, subparagraph, sentence, clause, phrase, or word of this act is for any reason held to be unconstitutional or invalid, such holding shall not affect the constitutionality or validity of the remaining portions of this act, the General Assembly hereby declaring that it would have passed this act, and each and every section, subsection, paragraph, subparagraph, sentence, clause, phrase, and word thereof, irrespective of the fact that any one or more other sections, subsections, paragraphs, subparagraphs, sentences, clauses, phrases, or words hereof may be declared to be unconstitutional, invalid, or otherwise ineffective.

(B)    The repeal or amendment by this act of any law, whether temporary or permanent or civil or criminal, does not affect pending actions, rights, duties, or liabilities founded thereon, or alter, discharge, release or extinguish any penalty, forfeiture, or liability incurred under the repealed or amended law, unless the repealed or amended provision shall so expressly provide. After the effective date of this act, all laws repealed or amended by this act must be taken and treated as remaining in full force and effect for the purpose of sustaining any pending or vested right, civil action, special proceeding, criminal prosecution, or appeal existing as of the effective date of this act, and for the enforcement of rights, duties, penalties, forfeitures, and liabilities as they stood under the repealed or amended laws.

Part VI

Repeals

SECTION    1.    Joint of Resolution 370 of 2002 is repealed. Sections 43-21-10, 43-21-20, 43-21-120, and 43-21-130 of the 1976 Code are repealed.

Part VII

Time Effective

SECTION    1.    Except as otherwise provided for, this act takes effect upon approval by the Governor.

/

Renumber parts and sections to conform.

Amend title to conform.

HARVEY S. PEELER, JR. for Committee.

            

A BILL

TO ENACT THE "SOUTH CAROLINA HEALTH AND HUMAN SERVICES REORGANIZATION AND ACCOUNTABILITY ACT OF 2003"; TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING ARTICLE 3 TO CHAPTER 30, TITLE 1 SO AS TO ESTABLISH THE OFFICE OF CHILDREN'S SERVICES WITHIN THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AND TO TRANSFER TO THIS OFFICE THE CHILDREN'S CASE RESOLUTION SYSTEM, CERTAIN SECTIONS OF THE CONTINUUM OF CARE FOR EMOTIONALLY DISTURBED CHILDREN, CERTAIN SECTIONS OF THE DEPARTMENT OF SOCIAL SERVICES RESPONSIBLE FOR LICENSING AND MONITORING OUT-OF-HOME PLACEMENTS FOR CHILDREN, AND CERTAIN SECTIONS OF THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL RESPONSIBLE FOR LICENSING RESIDENTIAL TREATMENT FACILITIES AND OTHER OUT-OF-HOME PLACEMENT; TO ESTABLISH THE OFFICE OF ALCOHOL AND OTHER DRUG ABUSE SERVICES WITHIN THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AND TO TRANSFER TO THIS OFFICE THE DEPARTMENT OF ALCOHOL AND OTHER DRUG ABUSE SERVICES, INPATIENT ALCOHOL AND DRUG SERVICES FROM THE DEPARTMENT OF MENTAL HEALTH, AND CERTAIN ALCOHOL AND DRUG TREATMENT FACILITIES OPERATED BY THE STATE AGENCY OF VOCATIONAL REHABILITATION UPON APPROVAL OF A PLAN; TO TRANSFER THOSE SECTIONS OF THE CONTINUUM OF CARE FOR EMOTIONALLY DISTURBED CHILDREN RESPONSIBLE FOR CLIENT AND FAMILY SERVICES TO THE DEPARTMENT OF MENTAL HEALTH; TO TRANSFER THE SOUTH CAROLINA COMMISSION FOR THE BLIND TO THE STATE AGENCY OF VOCATIONAL REHABILITATION; TO ABOLISH THE BOARD OF THE COMMISSION FOR THE BLIND AND TO TRANSFER ITS DUTIES TO THE STATE AGENCY FOR VOCATIONAL REHABILITATION; TO ABOLISH THE SOUTH CAROLINA MENTAL HEALTH COMMISSION AND TO TRANSFER ITS DUTIES TO THE DEPARTMENT OF MENTAL HEALTH; AND TO PROVIDE TRANSFER AND TRANSITION PROVISIONS; TO ADD ARTICLE 5 TO CHAPTER 30, TITLE 1 SO AS TO ESTABLISH THE DEPARTMENT OF INFORMATION TECHNOLOGY FOR HEALTH AND HUMAN SERVICES AGENCIES AND TO PROVIDE FOR ITS POWERS AND DUTIES, INCLUDING THE MANAGEMENT AND ADMINISTRATION FOR ALL INFORMATION TECHNOLOGIES ASSOCIATED WITH THESE AGENCIES AND THE APPROVAL OF INFORMATION TECHNOLOGIES EXPENDITURES; TO ADD CHAPTER 64 TO TITLE 2 SO AS TO ESTABLISH THE JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON MEDICAID AND HEALTH CARE AND TO PROVIDE FOR ITS MEMBERSHIP, FUNCTIONS, DUTIES, AND RESPONSIBILITIES INCLUDING, AMONG OTHER THINGS, TO APPROVE REORGANIZATION PLANS AND TO REVIEW THE STATE MEDICAID PLAN; TO ADD ARTICLE 8 TO CHAPTER 6, TITLE 44 SO AS TO ESTABLISH THE STATE OFFICE OF MEDICAID AND HEALTH CARE AUDITS FOR THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, TO PROVIDE THAT THE AUDIT DIRECTOR MUST BE APPOINTED BY AND UNDER THE DIRECTION OF THE JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON MEDICAID AND HEALTH CARE, AND TO FURTHER PROVIDE FOR THE POWERS AND DUTIES OF THE AUDIT DIRECTOR, INCLUDING CONDUCTING AUDITS, PREVENTING WASTE, AND PROMOTING ACCOUNTABILITY; TO ADD SECTION 12-2-100 SO AS TO REQUIRE THE DEPARTMENT OF REVENUE TO PROVIDE THE DEPARTMENT OF HEALTH AND HUMAN SERVICES ELECTRONIC ACCESS TO TAXPAYER INFORMATION TO USE IN DETERMINING MEDICAID ELIGIBILITY; TO ADD SECTION 44-6-105 SO AS TO REQUIRE THE JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON MEDICAID AND HEALTH CARE TO REVIEW CHANGES TO MEDICAID ELIGIBILITY REQUIREMENTS; TO ADD SECTION 44-6-108 SO AS TO REQUIRE THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO REPORT TO THE JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON MEDICAID AND HEALTH CARE ON MEDICAID BENEFICIARIES NOT MAKING REQUIRED PAYMENTS; TO ADD SECTION 38-71-270 SO AS TO REQUIRE HEALTH INSURERS TO PROVIDE NAMES AND IDENTIFYING INFORMATION ON THEIR INSUREDS TO BE USED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES IN DETERMINING MEDICAID ELIGIBILITY; TO ADD SECTION 44-6-75 SO AS TO PROVIDE FOR A MEDICAID COST CONTAINMENT ACTION PLAN FOR THE PROJECTED EXPENDITURES FOR THE STATE MEDICAID PROGRAM FOR THE NEXT FISCAL YEAR AND TO PROVIDE FOR THE CONTENTS OF THE PLAN AND FOR ALTERNATIVE MEASURES WHEN REVENUE IS NOT SUFFICIENT TO ADEQUATELY FUND THE MEDICAID PROGRAM; TO ADD SECTION 44-6-120 SO AS TO ESTABLISH THE SOUTH CAROLINA MEDICAID MANDATORY MANAGED CARE PILOT PROGRAM TO BE IMPLEMENTED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES IN CHARLESTON, FLORENCE, GREENVILLE, HORRY, AND RICHLAND COUNTIES, AND IN ONE RURAL COUNTY TO BE DESIGNATED BY THE DEPARTMENT, FOR FIVE YEARS TO ENROLL MEDICAID RECIPIENTS IN A HEALTH MAINTENANCE ORGANIZATION OR WITH PRIMARY CARE CASE MANAGEMENT PROVIDERS AND TO INCLUDE PROVISIONS TO ENSURE COMPETITION, ACCOUNTABILITY, AND ACTUARIAL SOUNDNESS; TO ADD SECTION 44-6-125 SO AS TO REQUIRE THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO IMPLEMENT A PILOT PROJECT TO EVALUATE THE VIABILITY OF PRIVATIZING THE MEDICAID ELIGIBILITY PROCESS; TO ESTABLISH THE TASK FORCE ON EMERGENCY ROOM DIVERSION TO STUDY INAPPROPRIATE EMERGENCY ROOM USE AND TO MAKE RECOMMENDATIONS TO REDUCE SUCH USE; TO ADD SECTION 44-7-75 SO AS TO REQUIRE THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO CONTRACT FOR THE MANAGEMENT AND OPERATION OF CERTAIN NURSING HOMES FORMERLY UNDER THE DEPARTMENT OF MENTAL HEALTH; TO ADD SECTION 12-21-625 SO AS TO IMPOSE A SURTAX ON CIGARETTES IN AN AMOUNT EQUAL TO 2.1 CENTS PER CIGARETTE, TO CREDIT THIS TAX TO THE MEDICAID SERVICES FUND, TO PROVIDE FOR THE USE OF THESE FUNDS, AND TO FURTHER PROVIDE THAT FIFTY PERCENT OF THESE FUNDS MUST BE USED TO OFFSET REDUCTIONS IN OTHER STATE-IMPOSED TAXES AND FEES INCLUDING, BUT NOT LIMITED TO, OFFSETTING REDUCTIONS IN STATE INDIVIDUAL INCOME TAXES; TO REQUIRE THE DIRECTOR OF THE LEGISLATIVE AUDIT COUNCIL TO EMPLOY AUDITORS NECESSARY TO PERFORM AUDITS ON DEPARTMENTS AFFECTED IN THIS ACT; AND TO ADD SUBARTICLES 2, 3, AND 4 TO ARTICLE 5, CHAPTER 21, TITLE 12 SO AS TO PROVIDE FOR TAX STAMPS ON CIGARETTE PACKAGES AS INDICIA OF TAX PAYMENT, TO PROVIDE FOR ADMINISTRATIVE FINES AND FORFEITURE OF CIGARETTES FOR DEFRAUDING THE STATE OR OTHERWISE FAILING TO COMPLY WITH THE SUBARTICLE, AND TO PROVIDE FOR CRIMINAL PENALTIES INCLUDING FINES, IMPRISONMENT, LICENSE REVOCATION, AND FORFEITURE FOR DEALING IN COUNTERFEIT CIGARETTES; TO PROVIDE PROCEDURES TO PREVENT VIOLATIONS AND ASSIST ENFORCEMENT OF THE TOBACCO ESCROW FUND ACT AND ADD SAFEGUARDS TO THE COMPLIANCE WITH THE MASTER SETTLEMENT AGREEMENT, INCLUDING CERTIFIED REPORTING REQUIREMENTS FOR PARTICIPATING AND NONPARTICIPATING MANUFACTURERS, PRODUCTION OF A WEBSITE FOR PUBLIC ACCESS TO NAMES AND BRAND FAMILIES OF MANUFACTURERS MEETING THE CERTIFICATION CRITERIA, PROHIBITION OF THE APPLICATION OF TAX STAMPS TO A PRODUCT WHOSE BRAND FAMILY DOES NOT APPEAR ON THE LIST, REQUIREMENT OF SALES REPORTS BY BRAND FAMILY, PROVISION OF LICENSE REVOCATION, FINES, INJUNCTIVE RELIEF, AND FORFEITURE FOR NONCOMPLIANCE, AND MAKING NONCOMPLIANCE AN UNFAIR AND DECEPTIVE TRADE PRACTICE; TO REGULATE THE DELIVERY SALES OF CIGARETTES BY PROVIDING AGE VERIFICATION, DISCLOSURE, SHIPPING, REGISTRATION, REPORTING, AND TAX COLLECTION REQUIREMENTS IN CONNECTION WITH A CIGARETTE SALE TO A CONSUMER AS THE RESULT OF A TELECOMMUNICATED ORDER OR DELIVERY BY THE MAILS OR OTHER DELIVERY SERVICE, AND TO PROVIDE FOR FINES AND INJUNCTIVE RELIEF FOR NONCOMPLIANCE; TO AMEND SECTION 12-21-2975, RELATING TO CONFISCATED PRODUCTS DONATED TO THE DEPARTMENT OF MENTAL HEALTH FOR PATIENT USE, SO AS TO DELETE CIGARETTES; TO DESIGNATE SECTIONS 1-30-10 THROUGH 1-30-120 AS ARTICLE 1, CHAPTER 30, TITLE 1 ENTITLED "DEPARTMENTS OF STATE GOVERNMENT" AND TO DESIGNATE SECTIONS 12-21-610 THROUGH 12-21-810 AS SUBARTICLE 1, ARTICLE 5, CHAPTER 21, TITLE 12; AND TO REPEAL SECTION 12-21-2870, RELATING TO CONFISCATION AND SALE OF UNSTAMPED CIGARETTES, AND SECTION 44-9-30, RELATING TO THE SOUTH CAROLINA MENTAL HEALTH COMMISSION.

Be it enacted by the General Assembly of the State of South Carolina:

Part I

Act Citation

SECTION    1.    This act may be cited as the "Health and Human Services Reorganization and Accountability Act of 2003".

Part II

Health and Human Services Agency

Reorganization and Consolidation

SECTION    2.    Chapter 30, Title 1 of the 1976 Code is amended by adding:

"Article 3

Health and Human Services Agencies

Section 1-30-310.    (A)    Notwithstanding any other provision of law, and after approval, pursuant to Section 1-30-330, of plans required by this article to be submitted to the Joint Legislative Oversight Committee on Medicaid and Health Care, the following agencies, boards, and commissions, including all of the allied, advisory, affiliated, or related entities as well as the employees, funds, property, and all contractual rights and obligations associated with these agencies, except for those subdivisions or sections of agencies not specifically transferred to another department, are transferred in accordance with the following:

(1)    There is established within the Department of Health and Human Services the Office for Emotionally Disturbed Children. The director of the department shall employ a director for this office who shall serve at the pleasure of the director of the department. This office is responsible for policy, development, planning, and licensing and monitoring of emotionally disturbed children's services within it's jurisdiction. The Director of the Office for Emotionally Disturbed Children is responsible for licensing, monitoring, and providing technical assistance and training for all providers of public and private group homes for emotionally disturbed children in this State. The director is responsible for providing for an effective and efficient system of services for emotionally disturbed children. The director shall provide for streamlined systems of licensing and monitoring providers while not compromising safety and quality of programs. The director is responsible for a direct billing system between providers and the department for all Medicaid residential, room, and board, and 'WRAP' services for emotionally disturbed children in this State. The following are transferred to the Office for Emotionally Disturbed Children:

(a)    the Governor's Office, Children's Case Resolution System, as provided for in Article 19, Chapter 7, Title 20;

(b)    those sections of the Governor's Office, Continuum of Care For Emotionally Disturbed Children responsible for the program's policy development and oversight;

(c)    those sections of the Department of Social Services responsible for licensing and monitoring group homes and other institutions providing residential care to ten or more children and other out of home placements for children.

(2)    Those sections of the Governor's Office, Continuum of Care for Emotionally Disturbed Children responsible for client and family services are transferred to the Department of Mental Health to be located within the department as determined by the Director of the Department of Mental Health.

(3)    Licensure and regulation of daycare facilities pursuant to Subarticle II, Article 13, Chapter 7, Title 20 must be transferred to the Department of Health and Environmental Control by September 1, 2003.

Funding for Daycare Licensing in the fiscal year 2003-04 general Appropriations Act, Part 1A, Section 13 Department of Social Services, must be transferred to the Department of Health and Environmental Control by September 1, 2003. The amount to be transferred must be $2,458,618 in total funds and $55,204 in general funds. The number of FTE's to be transferred must be 13.00 total funds and 1.17 general funds. The Director of the Office of State Budgets must provide for this transfer after conferring with the directors of state agencies affected by this item. The Department of Health and Environmental Control must consider employees of the Department of Social Services working in childcare licensing for employment with the Department of Health and Environmental Control in a similar capacity.

(4)    There is established within the Department of Health and Human Services the Office of Alcohol and Other Drug Abuse Services. The director of the department shall employ a director for this office who shall serve at the pleasure of the director of the department. The following are transferred to the Office of Alcohol and Other Drug Abuse Services:

(a)    the Department of Alcohol and other Drug Abuse Services, as provided for in Chapter 49, Title 44;

(b)    the inpatient alcohol and drug treatment facility operated by the Department of Mental Health;

(c)    the alcohol and treatment facilities of the South Carolina State Agency of Vocational Rehabilitation upon the Joint Legislative Oversight Committee on Medicaid and Health Care approving a plan pursuant to Section 1-30-330, which must be submitted by the South Carolina State Agency of Vocational Rehabilitation before November 1, 2003. The plan must address the management, operations, and funding realignment of these facilities, including how this transfer would affect the continued receipt of federal funds currently received by these facilities. The transfer provided for in this subitem is not intended to negatively impact federal funds currently received by the South Carolina State Agency of Vocational Rehabilitation for these facilities.

Nothing in this item may be construed to affect the authority, duties, and responsibilities of the boards for the local commissions on alcohol and other drug abuse services.

(B)    The South Carolina Mental Health Commission is abolished and its powers, duties, and responsibilities are transferred to the Department of Mental Health. The Director of the Department of Mental Health must be appointed by the Governor and the director shall serve at the pleasure of the Governor. Directors of mental health facilities and directors of the community mental health centers shall serve at the pleasure of the director.

(C)    Managed Treatment Services within the Department of Social Services shall remain at the department pending approval of a plan to reorganize these services. The department shall submit the plan to the Joint Legislative Oversight Committee on Medicaid and Health Care for approval pursuant to Section 1-30-330.

Section 1-30-320.(A)    The Executive Director of the State Budget and Control Board shall submit an implementation plan for approval pursuant to Section 1-30-330 to the Joint Legislative Oversight Committee on Medicaid and Health Care for the transfer and reorganization of the entities affected by this article and their personnel, funds, property and all other matters of transfer, including the impact of this reorganization on all general funds, federal funds, and other sources of funds of the entities affected by the reorganization. The plan must be submitted before September 1, 2003, and must take effect as soon as practicable, in a manner and on a schedule as prescribed by the State Budget and Control Board, but no later than January 1, 2004.

(B)    The Executive Director of the Budget and Control Board shall provide for the orderly transfer of appropriated funds for the entities affected by this reorganization consistent with the provisions of this article. The executive director, in consultation with the affected agencies, and following approval of the Joint Legislative Oversight Committee on Medicaid and Health Care pursuant to Section 1-30-330, has final decision-making authority regarding the realignment of appropriations to carry out the provisions of this article

(C)    The Executive Director of the State Budget and Control Board and the agencies reporting to the executive director shall assist with the implementation of the reorganization provided for in this article, and the affected agencies shall cooperate with the executive director in the implementation of this reorganization.

Section 1-30-330.    The Joint Legislative Oversight Committee on Medicaid and Health Care may approve or disapprove a plan required to be submitted pursuant to this article either in whole or in part, and the committee may require the entity submitting the plan to revise and resubmit all or a portion of the plan in accordance with changes requested by the committee.

Section 1-30-340.    (A)    The state directors of all health and human service agencies, which include the Department of Social Services, the Department of Health and Human Services, the Department of Disabilities and Special Needs, the Department of Mental Health, the South Carolina State Agency of Vocational Rehabilitation, and the Department of Health and Environmental Control annually shall submit information pertaining to all amounts and sources of funding received by the agency, including general funds, federal funds, and all other sources of funds.

(B)    The state directors of the health and human services agencies may require offices under their respective jurisdiction to:

(1)    locate all or a portion of the agency's employees and programs in the same building as another office or at a location near or adjacent to the location of another health and human services office;

(2)    ensure that the agency's location is accessible to disabled employees and agency clients; and

(3)    consolidate agency support services, including clerical and administrative support services and information resources support services, with support services provided to or by another health and human services office. The state directors of all health and human service agencies are directed to post on the agency's respective web sites, the agency's progress in meeting these objectives.

(C)    The state director of each health and human services agencies shall require the main number of the agency to be answered by an employee during the hours of 8:30 a.m. to 5:30 p.m."

Section 1-30-350.    (A)    It is the intent of the General Assembly in reorganizing and consolidating the health and human services agencies enumerated in Section 1-30-340(A) to improve the communication, coordination, and cooperation of the personnel employed by these agencies in order to provide accessible, quality services. In keeping with this purpose, the state directors of these agencies must be evaluated annually on their leadership and accomplishments including, but not limited to whether they have established and maintained clear lines of authority, the availability, relevance, and effectiveness of staff training, the efficiency and competence of the agency's staff, the, the overall results of staff evaluations, and a cost benefit analysis of all of the agency's programs. This article is not intended to alter the means by which agency heads are evaluated annually.

(B)    It is also the intent of the General Assembly in reorganizing these agencies that:

(1)    minimal disruption of services to the public occurs;

(2)    duplication of operations will be eliminated;

(3)    appropriate services and programs will be consolidated;

(4)    lines of authority will be clearly established;

(5)    cost efficiency will be achieved;

(6)    program application and eligibility determination processes will be integrated to the fullest extent possible;

(7)    state and federal funds must be put to maximum use for direct service delivery, rather than for state and regional administrative overhead.

Part III

Department of Information Technology

SECTION    3.    Chapter 30, Title 1 of the 1976 Code is amended by adding:

"Article 5

Department of Information Technology for

Health and Human Services Agencies

Section 1-30-510.    There is created the Department of Information Technology for Health and Human Services Agencies. The Governor shall appoint the director of the department with the advice and consent of the Senate and the House of Representatives. The director shall have training and experience in the field of information technology planning, administration, and operations.

Section 1-30-520.    (A)    The department is responsible for the management and administration of all information technologies, including information technology appropriations, other funding, and contracting, for the:

(1)    Department of Social Services, including the Office of Child Support Enforcement and Managed Treatment Services;

(2)    Department of Health and Human Services, including the Office of Children's Services and the Office of Alcohol and Other Drug Abuse Services;

(3)    Department of Disabilities and Special Needs;

(4)    Department of Mental Health, including those sections of the Governor's Office, Continuum of Care for Emotionally Disturbed Children responsible for family and client services were transferred to the department pursuant to Section 1-30-310(A)(3);

(5)    South Carolina State Agency of Vocational Rehabilitation, including those programs transferred to the agency pursuant to Section 1-30-310; and

(6)    Department of Health and Environmental Control.

(B)    The director has final approval for all proposed information technologies expenditures of the agencies enumerated in subsection (A). An agency director may appeal a decision of the director concerning information technologies to the Joint Legislative Oversight Committee on Medicaid and Health Care. Decisions of the committee on these matters are final.

(C)    Annually the director shall submit a report to the Joint Legislative Oversight Committee on Medicaid and Health Care containing the proposed information technologies expenditures of the agencies enumerated in subsection (A).

Section 1-30-530.    In carrying out the responsibilities of this article the director shall:

(1)        develop a coordinated strategic plan for information resources management that;

(a)    covers a multi-year period;

(b)    defines objectives for information resources management at each health and human services agency;

(c)    prioritizes information resources projects and implementation of new technology for all health and human services agencies;

(d)    integrates planning and development of each information resources system used by a health and human services agency, including those funded with federal funds or other funds, or both, into a coordinated information resources management planning and development system established by the commission;

(e)    establishes standards for information resources system security and that promotes the ability of information resources systems to operate with each other; and

(f)    achieves economies of scale and related benefits in purchasing for health and human services information resources systems;

(2)    establish information resources management policies, procedures, and technical standards, which must comply with statewide policies, procedures and standards developed by the State Chief Information Officer, and ensure compliance with these policies, procedures, and standards; and

(3)    review and submit to the Joint Legislative Oversight Committee on Medicaid and Health Care for approval, pursuant to Section 1-30-330, the information resources management and operating plans and proposed consolidation of each health and human services agency. Following approval of the committee and no later than December 15 of each year, the director shall post each agency's plan on the department's web site.

Section 1-30-540.    (A)    The director may appoint an information technology advisory committee composed of information resources managers for state agencies and for private employers which may advise the director regarding:

(1)    overall goals and objectives for information resources management for all health and human services agencies;

(2)    coordination of agency information resources management plans;

(3)    development of short-term and long-term strategies for:

(a)    implementing information resources management policies, procedures, and technical standards;

(b)    ensuring compatibility of information resources systems across health and human services agencies as technology changes;

(4)    information resources training and skill development for health and human services agency employees and policies to facilitate recruitment and retention of trained employees;

(5)    standards for determining:

(a)    the circumstances in which obtaining information resources services under contract is appropriate;

(b)    the information resources services functions that must be performed by health and human services agency information resources services employees; and

(c)    the information resources services skills that must be maintained by health and human services agency information resources services employees;

(6)    optimization of the use of information resources technology that is in place at health and human services agencies;

(7)    existing and potential future information resources technologies and practices and the usefulness of those technologies and practices to health and human services agencies.

(B)    The committee shall review and make recommendations to the director concerning the consolidation and improved efficiency of information resources management functions, including:

(a)    cooperative leasing of information resources systems equipment;

(b)    consolidation of data centers;

(c)    improved network operations;

(d)    technical support functions, including help desk services, call centers, and data warehouses;

(e)    administrative applications;

(f)    purchases of standard software;

(g)    joint training efforts;

(h)    recruitment and retention of trained agency employees;

(i)        video conferencing; and

(j)     other related opportunities for improved efficiency.

(C)    The members of the advisory committee appointed pursuant to subsection (A) may not receive mileage, perdiem, subsistence, or any form of compensation for their serviceon the committee."

Part IV

Joint Legislative Oversight Committee on

Medicaid and Health Care

SECTION    4.    Title 2 of the 1976 Code is amended by adding:

"CHAPTER 64

Joint Legislative Oversight Committee on

Medicaid and Health Care

Section 2-64-10.    There is established the Joint Legislative Oversight Committee on Medicaid and Health Care composed of seven members: three of whom must be members of the Senate appointed by the Chairman of the Senate Finance Committee, one of which must be a member of the minority party; three of whom must be members of the House of Representatives appointed by the Chairman of the House Ways and Means Committee, one of which must be a member of the minority party; and one of whom must be the Governor or the Governor's appointee. The committee shall elect a chairman and vice chairman.

Section 2-64-20.    (A)    In carrying out its responsibilities under this chapter, the committee shall:

(1)    make a detailed and careful study of the:

(a)    State Medicaid Plan annually, and the committee must be notified of any amendments to the plan;

(b)    federal laws pertaining to the Medicaid program; and

(c)    laws that have a bearing upon the Medicaid program;

(2)    review the state Medicaid program's compliance with state and federal laws, regulations, and other requirements.

(3)    compare the state Medicaid program with the Medicaid program structures of other states;

(4)    recommend changes, and introduce legislation when appropriate, regarding the structure of Medicaid eligibility, and the type, scope, and duration of services, together with predicted General Fund revenue, to make the State Medicaid Plan more stable and affordable for the taxpayers of this State;

(5)    provide for the revision of state laws and the State Medicaid Plan to develop a more easily understood, financially manageable, and stable system;

(6)    review efforts of the state Medicaid agency such as:

(a)    cost containment measures;

(b)    fiscal and program accountability;

(c)    quality of care;

(d)    effective coordination of all health care providers and payers;

(e)    performance measurement and reporting; and

(f)    detection of fraud and abuse.

(7)    submit reports and recommendations annually to the Governor and the General Assembly for improving state health care policy and financing and other recommendations as may be appropriate.

(B)    In carrying out its responsibilities under this chapter, the committee may:

(1)    hold public hearings;

(2)    receive testimony of any employee of the State or any other witness who may assist the committee in its duties;

(3)    call for assistance in the performance of its duties from any employee or agency of the State or any of its political subdivisions;

(4)    contract with consultants to assist the committee in accomplishing its duties.

(C)    The committee shall review and approve or disapprove, in whole or in part, reorganization plans as provided for in Article 3, Chapter 30, Title 1 and shall perform other such functions as may be provided by law.

Section 2-64-30.    The committee may adopt by majority vote rules not inconsistent with this chapter that it considers proper with respect to matters relating to the discharge of its duties under this section. Professional and clerical services for the committee must be made available from the staffs of the General Assembly, the Budget and Control Board, and the Department of Health and Human Services.

Section 2-64-40.    Expenses of the committee may be paid from appropriated funds of the office of Health Care Audits, established pursuant to Article 8, Chapter 6 of Title 44."

Part V

State Office of Medicaid and Health Care Audits

SECTION    5.    Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Article 8

State Office of Medicaid and Health Care Audits

Section 44-6-1010.    (A)    There is established the State Office of Medicaid and Health Care Audits for the Department of Health and Human Services for the purpose of:

(1)    conducting independent and objective audits, reviews, investigations, and inspections;

(2)    preventing and detecting waste, fraud, and abuse;

(3)    promoting accountability, economy, effectiveness, and efficiency.

(B)    Agencies under the purview of this office are the:

(1)    Department of Social Services;

(2)    Department of Health and Humans Services;

(3)    Department of Disabilities and Special Needs;

(4)    Department of Mental health;

(5)    South Carolina State Agency of Vocational Rehabilitation;

(6)    Department of Health and Environmental Control;

(7)    Department of Information Technology.

(C)    The audit director must be appointed by and is under the direction of the Joint Legislative Oversight Committee on Medicaid and Health Care, established pursuant to Section 2-64-10. The director must be appointed without regard to political affiliation and solely on the basis of integrity, related experience, and demonstrated ability in accounting, auditing, financial analysis, and management analysis. Employees of the office serve at the pleasure of the director.

Section 44-6-1020.    In carrying out the duties of the office the audit director may:

(1)    conduct audits, reviews, analyses, investigations, and inspections relating to the administration and operation of all programs administered by the department;

(2)    conduct audits, reviews, analyses, investigations, and inspections of providers, recipients, and other entities doing business with the department to determine compliance with applicable departmental contracts and regulations and to detect related fraud and abuse, if any;

(3)    receive and investigate complaints concerning possible violations of regulations or law, gross mismanagement, fraud, waste, or abuse. The office may not disclose the identity of an individual submitting a complaint unless the disclosure is unavoidable during the course of an investigation;

(4)    issue evaluation and audit reports in accordance with professional standards;

(5)    have direct access to all systems, records, reports, reviews, files, documents, papers, and similar information related to the programs and operations of the department and entities doing business with the department;

(6)    request information and assistance as necessary from any state, federal, or local agency;

(7)    enter into contracts and make payments for necessary staff and resources to the extent, and in such amounts as provided under this section and the annual general appropriations act;

(8)    instruct the department to collect or withhold amounts related to fraud and abuse findings.

(9)    utilize resources of the Department of Health and Human Services both within and external to the department including, but not limited to, contracting with other entities for the purpose of expanding program integrity efforts and maximizing the ability to detect and eliminate provider fraud.

Section 44-6-1030.    The audit director shall report findings of fraud or abuse to the Director of the Department of Health and Human Services, the State Attorney General, and the Joint Legislative Oversight Committee on Medicaid and Health Care.

Section 44-6-1040.    If the audit director enters into a contract for services to assist the audit director in carrying out his responsibilities under this chapter, the contract must contain a provision authorizing the audit director, or his designee, to obtain records in accordance with applicable federal laws concerning confidentiality and the release of information. The contract must specifically contain a provision that information obtained in the course of the audit must be released to the Joint Legislative Committee when requested by the Chairman of the Committee.

Section 44-6-1050.    At least semi-annually, and more frequently at the request of the Joint Legislative Oversight Committee on Medicaid and Health Care, the audit director shall provide to the committee:

(1)    a description of significant problems, abuses, and deficiencies encountered in the administration and operation of departmental programs and recommendations for corrective action;

(2)    a listing of each audit report issued during the period and estimates for the dollar value of costs questioned in the report;

(3)    a report on each recommendation issued in an audit report over six months old, to which the appropriate entity has not complied;

(4)    a status report on fraud and abuse activity, including case volumes, collections, results of reviews and investigations, and referrals to the Attorney General or other prosecutorial and law enforcement authorities;

(5)    a status report on the annual audit plan that provides progress on current reviews and on known intended reviews and their completion dates;

(6)    other information as requested by the committee.

Section 44-6-1060.    The audit director, in carrying out the duties and responsibilities of this chapter, shall make every attempt to avoid duplication and ensure effective coordination and cooperation. Nothing in this section is intended to duplicate the activity of the State Auditor, the Attorney General's Medicaid Fraud Control Unit, or the Legislative Audit Council.

Section 44-6-1070.    (A)    The audit director shall establish a budget, and seek additional funding sources, to carry out the responsibilities of the office.

(B)    Of the general funds appropriated to the agencies under the purview of this office, as provided for pursuant to Section 44-6-1010, .004 of these funds must be transferred annually by the State Treasurer from the general fund accounts of these agencies to be deposited in a separate and distinct account entitled 'State Office of Medicaid and Health Care Audits'."

Part VI

Medicaid Initiatives

SECTION    6.    Chapter 2, Title 12 of the 1976 Code is amended by adding:

"Section 12-2-100.    By July 1, 2003, the Department of Revenue shall implement electronic interface between information systems to enable the Department of Health and Human Services to electronically obtain income and related financial information of residents of the State from the department for the purpose of assisting the Department of Health and Human Services in making eligibility determinations of persons applying for Medicaid coverage."

SECTION    7.    Chapter 6, Title 44 of the 1976 Code, is amended by adding:

"Section 44-6-105.    Before the Department of Health and Human Services announces, in it's published bulletin or other written communication, a change in eligibility, coverage, duration or scope of services, reimbursement rates of private providers, or any other changes that would affect Medicaid spending, the department shall submit a fiscal impact statement to the Chairman of the Joint Legislative Oversight Committee on Medicaid and Health Care to be distributed to each member of the committee. This fiscal impact statement must identify the providers, services, and sources of funds affected and the method of calculating the fiscal impact."

SECTION    8.    Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-108.    The Department of Health and Human Services annually shall report to the Joint Legislative Oversight Committee on Medicaid Health Care the number of beneficiaries on Medicaid who do not pay for services as required by state law."

SECTION    9.    Article 1, Chapter 71, Title 38 of the 1976 Code is amended by adding:

"Section 38-71-270.    An insurer, including a health maintenance organization, providing health insurance to residents of this State shall submit the names and other identifying information of its insureds to the Department of Insurance in the manner and time prescribed by the department. The department shall submit this information to the Department of Health and Human Services to be used to identify Medicaid applicants who have other health insurance coverage."

SECTION    10.    Article 1, Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-75.    (A) By December 15 of each year, the Director of the Department of Health and Human Services shall submit in writing to each member of the Budget and Control Board, a 'Medicaid Cost Containment Action Plan' on the projected expenditures for the state Medicaid program for the next fiscal year. The action plan must include:

(1)    a description of each action to be taken;

(2)    the number of individuals affected;

(3)    the Medicaid services or programs affected;

(4)    an estimate of the financial impact on the Medicaid program for the fiscal year in question; and

(5)    other information as requested by the board.

(B)    Upon receipt of the report, and if the report calls for actions to reduce projected spending within this limitation, the action plan must be implemented by the director. However, the action plan must not be implemented if, by separate legislation, the General Assembly enacts legislation with a two-thirds vote in each body, specifically calling for a suspension of the Medicaid Cost Containment Action Plan that would reduce Medicaid expenditures.

(C)    If the director informs the Budget and Control Board that general fund expenditures that match federal Medicaid dollars are projected to increase over the current fiscal year by a percentage greater than projected percentage growth of the state's total general fund, the director shall inform the board, in priority order, of the actions to be taken by the department to reduce expenditures in the Medicaid program for the following fiscal year so as to not exceed an amount equal to the percentage growth of the state's general fund revenue for that fiscal year as estimated by the Board of Economic Advisors."

SECTION    11.    A.    This section may be known as the 'South Carolina Medicaid Mandatory Managed Care Pilot Program'.

B.    Article 1, Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-120.    (A)    The Department of Health and Human Services shall implement a mandatory managed care enrollment pilot program in Charleston, Florence, Greenville, Horry, and Richland Counties, and in one rural county to be designated by the department, before January 1, 2004. 'Rural' for purposes of this subsection means a county with a population of less than one hundred thousand persons as of the most recent official United States Census. The pilot program shall operate for a five-year period unless the program fails to demonstrate budget neutrality over the life of the project.

(B)    The department shall provide for a health care delivery system that includes, but is not limited to, Health Maintenance Organizations (HMOs) and Primary Care Case Management (PCCM) Providers who can deliver health care services and provide options to state Medicaid recipients, including all individuals who fall under the Temporary Assistance to Needy Families (TANF) and Supplemental Omnibus Budget Reconciliation Act (SOBRA) categories.

(C)    To ensure competition, accountability, and the actuarial soundness of this pilot program, the Joint Legislative Oversight Committee on Medicaid and Health Care shall require the department to designate a third-party actuary to establish the HMO and PCCM rates effective January 2004, with annual updates based on actuarially sound business methods and projected cost savings to the State. The committee shall evaluate the project and may engage a qualified actuary to evaluate the project annually. The department also shall contract with a third party actuary to conduct project evaluations and for other purposes as the department and this actuary may agree upon. These evaluation must include, but is not limited to, state specific and cross-state analyses of the impact on utilization, cost trends, recipient coverage, public and private expenditures, quality, access, and satisfaction.

(D)    The department shall enroll Medicaid recipients into either a participating HMO fully licensed by the Department of Insurance or the state's Physicians Enhancement Program (PEP) in the designated pilot counties. Recipients in the counties served by the pilot program must be notified by the department about enrollment options and must be given sixty days to choose a medical home through either a HMO or PCCM delivery system. After sixty days, those not responding must be auto-assigned by the department. HMO's participating in the waiver program must meet all network requirements.

(E)    In order to ensure accountability, all HMO and PCCM participants must be held to the same nationally recognized standards, including credentialing, quality improvement, network adequacy, outreach, and education. The South Carolina Department of Insurance, consistent with community standards, shall conduct all network adequacy monitoring, and the department shall rely on the South Carolina Department of Insurance to avoid duplication of oversight cost.

(F)    The department shall provide for a health care delivery system that includes, but is not limited to, Health Maintenance Organizations (HMOs) and Primary Care Case Management (PCCM) Providers who can deliver health care services and provide options to state Medicaid recipients including all individuals who fall under the Temporary Assistance to Needy Families and Supplemental Omnibus Budget Reconciliation Act categories."

SECTION    12.    Article 1, Chapter 6, Title 44 of the 1976 Code is amended by adding:

Section 44-6-125.    (A)    Before November 1, 2003, the Department of Health and Human Services shall implement a pilot project to assess the viability of privatizing the determination and redetermination of Medicaid eligibility. This pilot project must be implemented in at least four major metropolitan areas of the State and may test both partial and total privatization of the eligibility process. The data must be collected and analyzed to evaluate the integrity of a privatized process.

(B)    The department shall explore limiting coverage groups to more essential services rather than a full coverage plan. The department shall continue to improve eligibility determination integrity measures and the accuracy and integrity of the eligibility determination program. Where there is no medical or physical hindrance the eligibility determination measures must:

(1)    require applicants, family members, or third parties to apply in person with an eligibility worker;

(2)    require a face to face re-mail-in application;

(3)    require documented proof of citizenship or legal alien status;

(4)    require a face to fact reapplication every twelve months, except for the elderly and persons with handicapping conditions;

(5)    require applicants parents, the responsible party, or persons holding a power of attorney for the applicant to sign the application, thereby attesting to the accuracy of the information provided and granting the consent of the applicant for an eligibility search;

(6)    provide for the termination of enrollees who have provided false information;

(7)    include an annual report to the General Assembly regarding the implementation of these measures.

(C)    The department shall develop, publish, and implement a plan for improving the eligibility determination process by October 30, 2003. The plan must address:

(1)    auditing and testing measures that are statistically valid;

(2)    recommendations for streamlining the eligibility process;

(3)    automation for efficiency and cost-savings;

(4)    on-line cross checks with the Department of Revenue, the Social Security Administration, and state databases;

(5)    verification of employer sponsored insurance;

(6)    termination of eligibility of employees who fail to provide complete and truthful information;

(7)    annual reporting to the General Assembly of applicants enrollment, utilization, and the statistically valid auditing of the determination program.

Changes to the plan must be submitted the Joint Legislative Oversight Committee on Medicaid and Health Care for approval, pursuant to Section 1-30-330.

(D)    The department shall maximize the use of managed care and explore privatization of the eligibility unit."

SECTION    13.    There is established a 'Task Force on Emergency Room Diversion' to be led by the Department of Health and Environmental Control to develop a plan for community service alternatives, or contract alternatives or both, for persons who currently use emergency rooms inappropriately.

The task force shall submit a plan and budget to reduce inappropriate utilization of the emergency room and to provide more appropriate services. Membership must include, but is not limited to, representatives of the following organizations: South Carolina Medical Association, the South Carolina Academy of Family Physicians, the South Carolina Hospital Association, the Emergency Medical Services Association, the South Carolina Sheriff's Association, Partners in Crisis, the Probate Court Judges Association, and the South Carolina Psychiatric Association. A report and budget must be submitted to the Joint Legislative Oversight Committee on Medicaid Health Care by January 1, 2004. Upon approval by the committee, the Department of Health and Human Services shall provide support for a pilot project to be administered by the department of Health and Environmental Control which shall monitor and provide regular evaluations of the pilot project.

SECTION    14.    Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-112.    The department shall provide a brochure to each Medicaid recipient in easily understood language explaining the benefits a recipient is entitled to receive and those benefits a recipient is not entitled to receive.

SECTION    15.    Article 1, Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-117.    (A)    If a recipient of Medicaid Benefits, or a recipient's agent, reports to the Department of Health and Human Services an error in any Medicaid billing or the commission of fraud in the provision of Medicaid services, the department, upon determination that the error was intentional or that fraud was committed shall pay a reward to the Medicaid recipient, or the recipient's agent, in an amount equal to one-half the state funds recovered due to the error or fraud up to five hundred dollars.

(B)    The department shall print a statement on all billing forms and provider publications in bold print in a size easily read stating:

'You may receive a reward of one-half the state funds recovered up to five hundred dollars if you report an error in Medicaid billing or the commission of fraud in the provision of Medicaid services'."

SECTION    16.    By December 1, 2003, the Department of Transportation must convene a mobility development study committee of health and human services agencies which must submit a statewide plan to the Joint Legislative Committee on Medicaid and Health Care for improving the coordination of public transportation services.

SECTION    17.    Article 1, Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Section 44-6-85.    Notwithstanding any other provision of law, the Department of Health and Human Services may develop a medical management program which may include, but is not limited to, requiring Medicaid beneficiaries to choose a medical home provider.

Part VII

The South Carolina Retirees and Individuals

Pooling Together for Savings Act

(SCRIPTS)

SECTION    18.    Chapter 6, Title 44 of the 1976 Code is amended by adding:

"Article 5

The South Carolina Retirees and Individuals

Pooling Together for Savings Act

Section 44-6-610.    This article may be cited as the 'South Carolina Retirees and Individuals Pooling for Savings Act'.

Section 44-6-620.    For purposes of this article:

(1)    'Department' means the Department of Health and Human Services.

(2)    'Prescription drugs' means outpatient prescription drugs, that have been approved as safe and effective by the United State Food and Drug Administration including insulin syringes, insulin needles, and insulin. 'Prescription drugs' do not include experimental drugs and over the counter pharmaceutical products.

(3)    'Program' means the South Carolina Retirees and Individuals Polling Together for Savings (SCRIPTS) program created pursuant to this article.

Section 44-6-630.    There is created within the Department of Health and Human Services the South Carolina Retirees and Individuals Pooling Together for Savings (SCRIPTS) program. The program must combine the purchasing power of all South Carolina citizens sixty-five years of age and older who enroll in the program to reduce their prescription drug costs. Where possible, without violation of federal law, the department shall combine negotiating power for the program with negotiating power for pharmaceutical pricing and rebates which may exist now or in the future.

Section 44-6-640.    (A)    This program must be administered by the Department of Health and Human Services. The department may designate, or enter into contracts with, other entities including, but not limited to, other states, other governmental purchasing pools, and nonprofit organizations to assist in the administration of this program.

(B)    By December 30, 2003, the department must submit a program implementation and administration plan for review by the Joint Legislative Oversight Committee for Medicaid and Health Care. The plan must include:

(1)    procedures for program enrollment;

(2)    requirements for program participation; and

(3)    annual program enrollment fees that must be calculated to pay all additional costs incurred by the department in the administration of the program.

(C)    Upon review of the Joint Legislative Oversight Committee on Medicaid and Health Care, the program may be implemented as soon as practicable.

(D)    When requested by the department, other state agencies shall provide assistance or information necessary for the administration of this program.

Section 44-6-650.    A person eligible to participate in this program must:

(1)    have attained the age of sixty-five years;

(2)    have resided in South Carolina at least six consecutive months before enrolling in the program; and

(3)    not be eligible for Medicaid prescription benefits.

Section 44-6-660.    (A)    The department shall maintain data to allow evaluation of the cost effectiveness of the program.

(B)    Beginning with the 2005 regular session of the General Assembly, no later than thirty days before the convening of each regular session, the department shall submit an annual report to the Governor and the Joint Legislative Oversight Committee on Medicaid and Health Care summarizing enrollment, financial information, and any other information needed to evaluate the costs and benefits of the program.

Section 44-6-670.    (A)    The department may seek waivers of any federal laws, regulations, or rules necessary to implement this program

(B)    The department may promulgate regulations necessary for the administration of this program.

Section 44-6-680.    The program must be funded entirely from annual enrollment fees collected from program participants."

Part VIII

Seniors Forum

SECTION    19.    Chapter 21, Title 43 of the 1976 code is amended by adding:

"Section 43-21-15.    (A)    The Office on Aging in the South Carolina Department of Human Services must be supported by a Seniors Forum consisting of twenty-one voting members as follows:

(1)    nine members shall represent county Councils on Aging;

(2)    three members shall represent area Agencies on Aging or their federally mandated advisory councils;

(3)    three members must be members of the South Carolina Silver Haired Legislature, Inc.;

(4)    two members must be appointed by the Speaker of the House of Representatives;

(5)    two members must be appointed by the President Pro Tempore of the Senate; and

(6)    two members must be appointed by the Governor.

Members appointed by the Governor, the Speaker, and the President Pro Tempore shall serve terms coterminous with those making the appointments. All other members shall serve four-year terms or until a successor is appointed. A vacancy must be filled in the same manner as the original appointment for the remainder of the unexpired term. The chair must be elected by members of the forum from its members for a term of two years and shall serve until a successor is elected. Members of forum shall serve without compensation and may not receive mileage, per diem, or subsistence. The State Office on Aging shall provide staff for the forum. The Office on Aging must submit an annual draft plan of action for the upcoming fiscal year to the Senior's Forum by December 15 of each year.

(B)    The forum shall:

(1)    meet at least once each quarter and additional meetings may be called at the discretion of the chair. Rules and procedures must be adopted by the forum for the governance of its operations and activities;

(2)    make recommendations regarding:

(a)    the respective responsibilities and appropriate roles of state, regional and local entities;

(b)    the delivery of services to senior South Carolinians;

(c)    what services should be made available to eligible seniors; and

(d)    the allocation of funds to ensure maximum delivery of services to those seniors who are recipients of services;

(3)    sponsor public forums every four years, one year before the Office on Aging's four-year plan is due.

(4)    respond to the annual draft plan submitted to the forum by the Office on Aging by January 31 of the following year with its comments and recommendations.

(C)    The office must submit a revised plan of action to the Governor, the Joint Legislative Committee on Medicaid and Health Care and the Seniors Forum by March 1."

Part IX

Nursing Homes

SECTION    20.    Article 1, Chapter 7, Title 44 of the 1976 Code is amended by adding:

"Section 44-7-75.    The Department of Health and Human Services shall enter into contractual agreements for the management and operation of skilled nursing facilities formerly under the jurisdiction of the Department of Mental Health."

Part X

Prevention of Youth Access to Tobacco

SECTION    21.    This part may be cited as the "Youth Access to Tobacco Prevention Act of 2003".

SECTION    22.    Section 16-17-500 of the 1976 Code, as last amended by Act 445 of 1996, is further amended to read:

"Section 16-17-500.    (A)    It shall be is unlawful for any a person to sell, furnish, give, distribute, purchase for, or provide any a minor under the age of eighteen years with cigarettes, tobacco, cigarette paper, or any substitute therefore a tobacco product. Any person violating the provisions of this section, either in person, by agent or in any other way, shall be guilty of a misdemeanor and, upon indictment and conviction, therefor shall be punished as follows:

(1)    for a first offense by a fine not exceeding twenty-five dollars;

(2)    for a second offense, by a fine not exceeding fifty dollars; and

(3)    for a third or subsequent offense, by a fine of not less than one hundred dollars or imprisonment for not more than one year nor less than sixty days, or both.

One-half of any fine imposed shall be paid to the informer of the offense and the other half to the treasurer of the county in which such conviction shall be had.

(B)    It is unlawful for a person to sell a tobacco product to an individual who does not present upon demand proper proof of age. Proof of age is not required from an individual who the person reasonably believes to be over twenty-seven years of age. Failure to require identification to verify a person's age shall be used as evidence to the knowing and intentional violation of this provision unless the person knows the individual is at least eighteen years of age. Proof that is demanded, is shown, and reasonably is relied upon for the individual's proof of age is a defense to an action initiated pursuant to this section. To determine whether a person believes an individual is at least twenty-seven years of age, a court may consider, but is not limited to considering, proof of the individual's general appearance, facial characteristics, behavior, and manners. This subsection does not apply to mail order sales.

(C)    A retail distributor of tobacco products must train its retail sales employees regarding the provisions contained in this section. In lieu of the penalties contained in subsection (F), a retail establishment that fails to comply with this provision must be fined not more than one thousand dollars. A retail establishment that provides proof that it has complied with the provisions contained in this section is not subject to this penalty.

(D)    It is unlawful for an individual less than eighteen years of age to purchase, accept receipt, attempt to purchase, or attempt to accept receipt of a tobacco product, or present or offer to a person proof of age which is false or fraudulent for the purpose of purchasing or possessing a tobacco product. However, a person less than eighteen years of age may be enlisted by local law enforcement agencies to test a community's compliance with this section and to reduce the extent to which tobacco products are sold or distributed to individuals less than eighteen years of age when the testing is under the direct supervision of the law enforcement agency and with the individual's parental consent. In addition, a person less than eighteen years of age may be enlisted by the Office of Alcohol and Other Drug Abuse Services, or a county alcohol and drug abuse authority to test an outlet's compliance with this section, with the permission of the individual's parent or guardian, to collect data for the federally mandated Youth Access to Tobacco Study.

(E)    It is unlawful for an individual less than eighteen years of age to possess a tobacco product. This subsection does not apply to the possession of tobacco products by an individual less than eighteen years of age who delivers tobacco products pursuant to his employment responsibilities.

(F)    Tobacco products may be accessible only in vending machines located in an establishment:

(1)    which is open only to persons who are eighteen years of age or older; or

(2)    where the vending machine is under continuous control by the owner or licensee of the premises, or an employee of the owner or licensee, can be operated only upon activation by the owner, licensee, or employee before each purchase, and is not accessible to the public when the establishment is closed. The owner, licensee, or employee must demand proof of age from a prospective purchaser if he has reasonable grounds to believe the prospective purchaser is less than twenty-seven years of age. Proof that an owner, licensee, or employee demanded, was shown, and reasonably relied upon an individual's proof of age is a defense to any action brought pursuant to this subsection.

Vending machines which distribute tobacco products in establishments must meet the requirements of this section within one hundred twenty days after the effective date of this section or must be removed.

(G)    A person or individual that intentionally or knowingly violates a provision contained in this section either in person, by agent, or in any other way, is guilty of a misdemeanor and, upon conviction, must be punished as follows:

(1)    for a first offense, by a fine not less than one hundred dollars;

(2)    for a second offense, which occurs within three years of the first offense, by a fine not less than two hundred dollars; and

(3)    for a third or subsequent offense, which occurs within three years of the first offense, by a fine not less than three hundred dollars.

All fines must be placed in the state general fund and distributed in the following manner:

(a)    one-half must be distributed to the treasurer of the county in which the conviction occurred; and

(b)    one-half must be distributed to the county alcohol and drug abuse commission and used for funding youth smoking prevention programs. A violation of this subsection is triable exclusively in either municipal or magistrate court.

A violation of this section is triable exclusively in either municipal or magistrate court.

(H)    In lieu of the penalties contained in subsection (G), a court may require an individual who is less than eighteen years of age who illegally purchases or possesses a tobacco product to perform not less than twenty hours of community service for a first offense and not less than forty hours of community service for a second or subsequent offense.

(I)    As used in this section 'person' means an individual. 'Person' does not mean a firm, partnership, corporation, company, association, club, or commercial entity the person is associated with.

(J)    Notwithstanding any other provision of law, a violation of this section does not violate an establishment's beer and wine permit and is not a ground for revocation or suspension of a beer and wine permit.

(K)    A person who is less than eighteen years of age and who has been convicted of violating a provision of this section may have his record expunged upon becoming eighteen years of age if he has paid any fine imposed upon him and successfully completed any court-ordered community service."

SECTION    23.    Section 16-17-501 of the 1976 Code, as added by Act 445 of 1996, is amended to read:

"Section 16-17-501.    As used in this Section and Sections 16-17-500, 16-17-502, 16-17-503, and 16-17-504:

(1)    'Distribute' means to sell, furnish, give, or provide tobacco products, including tobacco product samples, cigarette paper, or a substitute for them, to the ultimate consumer.

(2)    'Proof of age' means a driver's license or other documentary or written evidence that the individual is eighteen years of age or older identification card issued by this state, or a United States Armed Services identification card.

(3)    'Sample' means a tobacco product distributed to members of the general public at no cost for the purpose of promoting the products.

(4)    'Sampling' means the distribution of samples to members of the general public in a public place.

(5)    'Tobacco product' means a product that contains tobacco and is intended for human consumption."

Part XI

Tobacco Settlement Receipts and Bonds

SECTION    24.    The General Assembly finds that:

(1)    By Act 387 of 2000 (Act 387), the General Assembly established the Tobacco Settlement Revenue Management Authority (the "authority"), and conferred upon the authority certain enumerated powers. Among other things, the authority was given the power to receive, and to issue bonds secured by, the State's tobacco receipts, as defined in Act 387. The factual findings set forth in Act 387 are ratified and confirmed in all respects and are incorporated by reference in this section.

(2)    On March 22, 2001, the authority issued its $200,000,000 Tobacco Settlement Asset-Backed Bonds, Series 2001A (Taxable), and its $734,530,000 Tobacco Settlement Asset-Backed Bonds, Series 2001B (Tax Exempt) (together, the "2001 Bonds"). Act 387 specified the purposes for which the state's tobacco receipts, together with the proceeds of any bonds secured by the state's tobacco receipts, must be applied. The proceeds of the 2001 Bonds were applied for these purposes.

The General Assembly has now determined that it is in the best interests of the State of South Carolina and its residents that additional tobacco receipts be credited to the general fund of the State rather than being deposited as provided in Act 387.

(3)    In addition, the authority has been advised that in order to preserve maximum financial flexibility for the authority in the management of the proceeds of its bonds, Act 387 must be amended to permit the use of tobacco settlement revenues and the proceeds of bonds secured by these revenues to refund or purchase these bonds.

SECTION    25.    Subsections (A) and (B) of Section 11-11-170 of the 1976 Code, as added by Act 387 of 2001, are amended to read:

"(A)    All revenues payable to this State transferred from the authority pursuant to the Master Settlement Agreement as described in Section 11-47-20(e) Section 11-49-130 must be used in the manner specified in this section deposited directly with the Department of Health and Human Services for health care expenditures and for the purpose of achieving the maximum Medicaid match.

(B)    All proceeds of bonds issued pursuant to Section 11-49-70(J)(2) must be deposited as provided in this subsection.

(1)    Seventy-three percent of the revenues must be used for healthcare programs. The revenues, or the funds obtained proceeds of bonds issued pursuant to Chapter 49 of Title 11 Section 11-49-70(J)(2), must be deposited in a fund separate and distinct from the general fund and all other funds, which is hereby established in the State Treasury styled the Healthcare Tobacco Settlement Trust Fund. Earnings on this fund must be credited to the fund. The principal must remain in the fund and only the interest earnings may be appropriated and used for the following purposes:

(a)    for fiscal year 2000-2001 only, the first twenty million dollars available from the principal derived from securitization must be used for hospital base increase RESERVED;

(b)    the South Carolina Seniors' Prescription Drug Program, as provided in Chapter 130 of Title 44;

(c)    home and community-based programs for seniors coordinated by the Department of Health and Human Services;

(d)    youth smoking cessation and prevention programs coordinated by the Department of Health and Environmental Control and the Department of Alcohol and Other Drug Abuse Services;

(e)    newborn infants hearing screening initiatives coordinated by the Department of Health and Environmental Control;

(f)    disease prevention and elimination of health disparities: diabetes, HIV/AIDS, hypertension, and stroke, particularly in minority populations;

(g)    other health related issues as determined by the General Assembly.

(2)    Fifteen percent of the revenues, or the funds obtained proceeds of bonds issued pursuant to Chapter 49 of Title 11 Section 11-49-70(J)(2), must be deposited in a fund separate and distinct from the general fund and all other funds, which is hereby established in the State Treasury styled the Tobacco Community Trust Fund. Earnings on the fund must be credited to the fund. This fund must be used to reimburse:

(a)    tobacco growers, tobacco quota holders, and tobacco warehousemen for actual losses due to reduced quotas since 1998. For purposes of this subitem, 'tobacco quota owner' and 'tobacco grower' have the meaning provided in Section 46-30-210, and the reimbursement is for losses incurred in reduced cultivation of tobacco in this State. Reimbursements must be made pursuant to eligibility requirements established by the South Carolina Tobacco Community Development Board created pursuant to Section 46-30-230;

(b)    after the reimbursement provided pursuant to subitem (a), the balance must be held in an escrow account through June 30, 2012, and used as provided in subitem (a). After June 30, 2012, any account balance must be transferred to the Healthcare Tobacco Settlement Trust Fund.

(3)    Ten percent of the revenues, or the funds obtained proceeds of bonds issued pursuant to Chapter 49 of Title 11 Section 11-49-70(J)(2), must be deposited in a fund separate and distinct from the general fund and all other funds, which is hereby established in the State Treasury styled the Tobacco Settlement Economic Development Fund. Earnings on the fund must be credited to the fund. This fund must be used for the following programs:

(a)    the first eighty million dollars credited to the fund is set aside to be used for the purposes specified in this item except for subitem (b);

(b)    for Fiscal Year 2000-2001 only, the next ten million dollars credited to the fund must be set aside to be available to be appropriated and used in accordance with the provisions of Section 12-37-2735; and RESERVED

(c)    the remaining revenue credited to the fund must be used to fund the South Carolina Water and Wastewater Infrastructure Fund as provided in Section 13-1-45.

(4)    Two percent of the revenues, or the funds obtained proceeds of bonds issued pursuant to Chapter 49 of Title 11 Section 11-49-70(J)(2), must be deposited in a fund separate and distinct from the general fund and all other funds, which is hereby established in the State Treasury styled the Tobacco Settlement Local Government Fund. Earnings on the fund must be credited to the fund. This fund must be used to fund the operation of and grants distributed by the Office of Local Government of the Division of Regional Development of the Budget and Control Board, or its successor in interest.

(5)        Notwithstanding the provisions of this subsection, the Tobacco Settlement Revenue Management Authority may determine by resolution that some or all of the amounts on deposit in the funds provided in this subsection, whether in the form of principal or interest, may be used at any time to refund or purchase bonds issued pursuant to Chapter 49 of Title 11. Any resolution to refund or purchase bonds pursuant to this item must include a requirement that the Authority use a competitive bid process to effectuate the refund or purchase of bonds issued pursuant to Chapter 49 of Title 11."

SECTION    26.    Section 11-49-130 of the 1976 Code, as added by Act 387 of 2001, is amended to read:

"Section 11-49-130.    All of the state's tobacco receipts not needed to pay (1) expenses of the authority during the next twelve months, or (2) debt service on bonds during the next twelve months, or fully to fund reserve accounts established by the board with respect to bonds, not less frequently than annually and at a time determined by the board in its resolutions authorizing the issuance of bonds, must be transferred to the funds as identified as provided in Section 11-11-170(A). The determination by the board of the amount to be transferred is final and is not reviewable by any court or other body."

Part XII

Article designated

SECTION    27.    Sections 1-30-10 through 1-30-120 of the 1976 Code are designated as Article 1, Chapter 30, Title 1 of the 1976 Code and named "Departments of State Government".

Part XIII

Severability and Savings

SECTION    28.    (A)    If any section, subsection, paragraph, subparagraph, sentence, clause, phrase, or word of this act is for any reason held to be unconstitutional or invalid, such holding shall not affect the constitutionality or validity of the remaining portions of this act, the General Assembly hereby declaring that it would have passed this act, and each and every section, subsection, paragraph, subparagraph, sentence, clause, phrase, and word thereof, irrespective of the fact that any one or more other sections, subsections, paragraphs, subparagraphs, sentences, clauses, phrases, or words hereof may be declared to be unconstitutional, invalid, or otherwise ineffective.

(B)    The repeal or amendment by this act of any law, whether temporary or permanent or civil or criminal, does not affect pending actions, rights, duties, or liabilities founded thereon, or alter, discharge, release or extinguish any penalty, forfeiture, or liability incurred under the repealed or amended law, unless the repealed or amended provision shall so expressly provide. After the effective date of this act, all laws repealed or amended by this act must be taken and treated as remaining in full force and effect for the purpose of sustaining any pending or vested right, civil action, special proceeding, criminal prosecution, or appeal existing as of the effective date of this act, and for the enforcement of rights, duties, penalties, forfeitures, and liabilities as they stood under the repealed or amended laws.

Part XIV

Repeals

SECTION    29.    (A)    Joint of Resolution 370 of 2002 is repealed.

(B)    Sections 44-9-30, 43-21-10, 43-21-120 of the 1976 Code are repealed.

Part XV

Time Effective

SECTION    30.    Section 20-7-9525 of the 1976 Code, as added by Act 102 of 1995, is amended by adding a new subsection appropriately numbered to read:

"( )    The division at the negotiation conference must also require the following from the obligor in connection with any health insurance coverage of the obligor:

(1)    a written certification from the obligor's employer that the employer provides no health insurance coverage to the obligor or the obligor's dependent children or that such coverage is not available through that employer;

(2)    if the obligor is not the custodial parent of his or her child or children, written certification from the employer of the custodial parent that the employer does not provide health insurance coverage to the obligor or the obligor's dependent children or that such coverage is not available through that employer;

(3)    if the obligor is a single parent, a written certification from the employer of any person required by a court of competent jurisdiction to provide support for the obligor or the obligor's dependent children that the employer does not provide health insurance coverage to the obligor or his or her dependent children or that such coverage is not available through that employer."

SECTION    31.    This act takes effect upon approval by the Governor.

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