South Carolina General Assembly
117th Session, 2007-2008

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Bill 4648


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A BILL

TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, TO ENACT THE "REDUCTION OF RACIAL AND ETHNIC HEALTH DISPARITIES ACT" BY ADDING CHAPTER 119 TO TITLE 44 SO AS TO PROVIDE THAT THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL, SUBJECT TO FUNDS BEING APPROPRIATED, SHALL DEVELOP A GRANT PROGRAM TO PROVIDE FUNDING TO COUNTIES FOR THE DEVELOPMENT OF COMMUNITY AND NEIGHBORHOOD PROJECTS TO IMPROVE THE HEALTH OUTCOMES OF RACIAL AND ETHNIC POPULATIONS; TO PROVIDE FOR THE DUTIES OF THE DEPARTMENT IN CARRYING OUT ITS RESPONSIBILITIES UNDER THIS CHAPTER; TO ESTABLISH GRANT PROPOSAL CRITERIA; AND TO PROVIDE THAT FUNDING FOR THIS GRANT PROGRAM IS TO SUPPLEMENT, NOT SUPPLANT, EXISTING RACIAL AND ETHNIC HEALTH DISPARITIES PROGRAMS.

Whereas, the General Assembly finds that despite state investments in health care programs, certain racial and ethnic populations in this State continue to have significantly poorer health outcomes when compared to other populations. The General Assembly further finds that local solutions to health care problems can have a dramatic and positive effect on the health status of these populations; and that local governments and communities are best equipped to:

(1)    identify the health education, health promotion, and disease prevention needs of the racial and ethnic populations in their communities;

(2)    mobilize the community to address health outcome disparities;

(3)    enlist and organize local public and private resources and faith-based organizations to address these disparities;

(4)    evaluate the effectiveness of interventions; and

Whereas, even though initiatives have been undertaken to reduce racial and ethnic disparities in infant mortality and diabetes, in cervical, prostate, and colorectal cancer, in kidney disease, HIV/AIDS, hepatitis C, sexually transmitted diseases, and cardiovascular disease, efforts must be increased to obtain meaningful reductions in these health disparities; and

Whereas, it is therefore the intent of the General Assembly to provide grant funds within counties in this State to stimulate the development of community-based and neighborhood-based projects that will improve the health outcomes of racial and ethnic populations. Now, therefore,

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

SECTION    1.    Title 44 of the 1976 Code is amended by adding:

"CHAPTER 119

Racial and Ethnic Health Disparities

Section 44-119-10.    This chapter may be cited as the 'Reduction of Racial and Ethnic Health Disparities Act'.

Section 44-119-20.    As used in this chapter:

(1)    'Department' means the Department of Health and Environmental Control.

(2)    'Director' means the director of the Department of Health and Environmental Control.

Section 44-119-30.    (A)    Subject to funds being appropriated for this purpose, the Department of Health and Environmental Control shall establish and administer the 'Reducing Racial and Ethnic Health Disparities: Closing the Gap' grant program to implement this chapter. The purpose of this grant program is to foster the development of coordinated, collaborative, and broad-based participation by public and private entities and by faith-based organizations. This grant program shall function as a partnership between State and local governments, faith-based organizations, and private-sector health care providers, including managed care, voluntary health care resources, social service providers, and nontraditional partners.

(B)    The department shall do the following:

(1)    publicize the availability of funds and establish an application process for submitting a grant proposal;

(2)    provide technical assistance and training, including a statewide meeting promoting best practice programs, as requested, to grant recipients;

(3)    develop uniform data reporting requirements for the purpose of evaluating the performance of the grant recipients and demonstrating improved health outcomes;

(4)    develop a monitoring process to evaluate progress toward meeting grant objectives; and

(5)    coordinate with existing community-based programs, such as chronic disease community intervention programs, cancer prevention and control programs, diabetes control programs, the HIV/AIDS program, immunization programs, and other related programs at the State and local levels, to avoid duplication of effort and promote consistency.

(C)    The department shall establish measurable outcomes to achieve the goal of reducing health disparities in the following priority areas: asthma; breast, cervical, prostate, and colorectal cancer screenings; kidney disease; HIV/AIDS, hepatitis C; sexually transmitted diseases; adult and child immunizations; cardiovascular disease; and accidental injuries and violence. The department shall enhance current data tools to ensure a statewide assessment of the risk behaviors associated with the health disparity priority areas identified in this subsection. To the extent feasible, the department shall conduct the assessment so that the results may be compared to national data.

(D)    The director may appoint an ad hoc advisory committee to:

(1)    examine areas where public awareness, public education, research, and coordination regarding racial and ethnic health outcome disparities are lacking;

(2)    consider access and transportation issues that contribute to health status disparities; and

(3)    make recommendations for closing gaps in health outcomes and increasing the public's awareness and understanding of health disparities that exist between racial and ethnic populations.

Section 44-119-40.    (A)    A person, entity, or organization within a county may apply for a grant under this chapter and may serve as the lead agency to administer and coordinate project activities within the county and develop community partnerships necessary to implement the grant.

(B)    Persons, entities, or organizations within adjoining counties with populations of less than one hundred thousand may jointly submit a multi-county grant proposal. The proposal, however, must clearly identify a single lead agency with respect to program accountability and administration.

(C)    In addition to the grants awarded pursuant to this chapter, up to twenty percent of the funding for the grant program must be dedicated to projects that address improving racial and ethnic health status within specific urban areas identified by the department in regulation.

(D)    Nothing in this chapter prevents a person, entity, or organization within a county or group of counties from separately contracting for the provision of racial and ethnic health promotion, health awareness, and disease prevention services.

Section    44-119-50.    (A)    A proposal for a grant under this chapter must be submitted to the department for review.

(B)    A proposal for a grant must include:

(1)    the purpose and objectives of the proposed project; including identification of the particular racial or ethnic disparity the project will address. The proposal must address one or more of the following priority areas:

(a)    decreasing racial and ethnic disparities in:

(i)     maternal and infant mortality rates;

(ii)    morbidity and mortality rates relating to cancer;

(iii)    morbidity and mortality rates relating to HIV/AIDS;

(iv)    morbidity and mortality rates relating to cardiovascular disease;

(v)    morbidity and mortality rates relating to diabetes;

(vi)    oral health care.

(b)    increasing adult and child immunization rates in certain racial and ethnic populations;

(2)    identification and relevance of the target population;

(3)    methods for obtaining baseline health status data and assessment of community health needs;

(4)    mechanisms for mobilizing community resources and gaining local commitment;

(5)    development and implementation of health promotion and disease prevention interventions;

(6)    mechanisms and strategies for evaluating the project's objectives, procedures, and outcomes;

(7)    a proposed work plan, including a timeline for implementing the project; and

(8)    the likelihood that project activities will occur and continue in the absence of funding.

(C)    The department shall give priority to proposals that:

(1)    represent areas with the greatest documented racial and ethnic health status disparities;

(2)    exceed the minimum local contribution requirements specified in Section 44-119-60;

(3)    demonstrate broad-based local support and commitment from entities representing racial and ethnic populations. Indicators of support and commitment may include agreements to participate in the program, letters of endorsement, letters of commitment, interagency agreements, or other forms of support;

(4)    demonstrate a high degree of participation by the health care community in clinical preventive service activities and community-based health promotion and disease prevention interventions;

(5)    have been submitted from counties with a high proportion of residents living in poverty and with poor health status indicators;

(6)    demonstrate a coordinated community approach to addressing racial and ethnic health issues within existing publicly financed health care programs;

(7)    incorporate intervention mechanisms that have a high probability of improving the targeted population's health status; and

(8)    demonstrate a commitment to quality management in all aspects of project administration and implementation.

Section 44-119-60.    (A)    The department may award one or more grants in a county or in a group of adjoining counties from which a multi-county grant proposal is submitted. The department may award an urban area grant under Section 44-119-40(C) in a county or group of adjoining counties that are also receiving a grant award under Section 44-119-40 (A) or (B).

(B)    Units of local government may provide matching grants to supplement those made by the department.

(C)    The amount of the grant award must be based on the county or urban area's population, or on the combined population in a group of adjoining counties from which a multi-county application is submitted, and on other factors, as determined by the department in regulation.

(D)    The department shall begin disseminating grant awards no later than January 1, 2008.

(E)    The department shall fund a grant under this chapter for one year and may renew the grant annually upon application to and approval by the department, subject to the achievement of quality standards, objectives, and outcomes and to the availability of funds.

Section 44-119-70.    The provisions of this chapter are not intended to supplant existing programs directed at reducing racial and ethnic health disparities but to supplement them, and, to the extent possible, these existing programs shall continue to operate."

SECTION    2.    This act takes effect upon approval by the Governor.

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