A bill

 

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING CHAPTER 49 TO TITLE 43 SO AS TO REQUIRE THE CERTIFICATION OF COMMUNITY HEALTH WORKERS IN THE STATE OF SOUTH CAROLINA; TO ESTABLISH CERTIFICATION REQUIREMENTS AND AUTHORIZED SERVICES; TO REQUIRE THE DEPARTMENT OF PUBLIC HEALTH TO PROMULGATE CERTAIN REGULATIONS, INCLUDING CONTINUING EDUCATION REQUIREMENTS; TO PROVIDE FOR MEDICAID REIMBURSEMENT OF AUTHORIZED SERVICES; AND FOR OTHER PURPOSES; AND BY ADDING SECTION 44-6-75 SO AS TO REQUIRE THE STATE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO SEEK FEDERAL APPROVAL FOR A STATE MEDICAID PLAN AMENDMENT OR WAIVER INCLUDING SERVICES PROVIDED BY CERTIFIED COMMUNITY HEALTH WORKERS IN CERTAIN CIRCUMSTANCES.

 

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

 

SECTION 1.  Title 43 of the S.C. Code is amended by adding:

 

CHAPTER 49

 

Certified Community Health Workers

 

    Section 43-49-10.  As used in this chapter:

       (1) "Department" means the South Carolina Department of Public Health.

       (2) "Certified community health worker" means an individual who has been certified, in accordance with the provisions of this chapter, by the department as a community health worker.

       (3) "Core competencies" means the knowledge and skills a certified community health worker is expected to demonstrate in order to carry out the mission and goals of the profession as defined by the department through the promulgation of regulations.

 

    Section 43-49-20. (A) Effective January 1, 2027, no person shall represent himself or herself as a community health worker in South Carolina unless the person is certified as such in accordance with the provisions of this chapter.

    (B) In order to be eligible to apply for community health worker certification, an individual must:

       (1) be a legal United States resident;

       (2)(a) be a resident of South Carolina; or

           (b) be employed as a community health worker in the State of South Carolina;

       (3) be at least eighteen years of age; and

       (4)(a) complete a competency-based community health worker training and mentorship program offered by an organization approved by the department to provide community health worker training and mentorship; or

           (b) meet requirements established by the department through the promulgation of regulations for certification based on relevant and verifiable past community health worker-related work experience.

    (C) Community health worker certifications must be renewed annually and expire on October thirty-first of the year following the date of certification or recertification.

    (D)(1) In order to be eligible for recertification, a certified community health worker annually shall complete continuing education, as required by the department in promulgated regulations that address the core competencies of community health work.

       (2) Continuing education must be offered by an organization approved by the department to teach continuing education for certified community health workers.

       (3) Regulations promulgated pursuant to this subsection must include continuing education requirements related to oral health care, infant and maternal healthcare, and geriatric healthcare.

    (E) Notwithstanding any other provision of law to the contrary, an individual is eligible to earn college course credit for training, mentorship, and continuing education completed pursuant to subsections (B)(4) and (D).

 

    Section 43-49-30.  (A) If a Medicaid managed care organization contracted by the State Department of Health and Human Services for the delivery of Medicaid services employs a certified community health worker, the services provided by that certified community health worker shall not be considered to be duplicative of services, and shall not provide a basis to deny services or reimbursement for services, provided by a certified community health worker employed by an entity described in Section 44-6-75. Provided, however, a certified community health worker is not eligible to enroll as an independent Medicaid participating provider.

    (B) A certified community health worker may provide the following services:

       (1) direct preventative services or services designed to slow the progression of chronic diseases, including screenings for basic human needs and referrals to appropriate services and agencies to meet those needs;

       (2) health promotion education to prevent illness or disease, including the promotion of healthy behaviors to increase awareness and prevent the development of illness or disease;

       (3) facilitation between a beneficiary and a provider when cultural factors, such as language, socioeconomic status, or health literacy, become a barrier to properly understanding treatment options or treatment plans;

       (4) diagnosis-related patient education regarding self-management of physical, dental, or mental health; and

       (5) any other service approved by the State Department for Health and Human Services pursuant to Section 44-6-75.

 

    Section 43-49-40.  The South Carolina Department of Public Health shall:

       (1) promulgate regulations, necessary to carry out the provisions of this chapter, including establishing:

           (a) the core competencies of community health work;

           (b) the community health worker certification application and renewal process, including training, mentorship, and continuing education requirements;

           (c) a certification application and renewal fee;

           (d) procedures for certification denial, suspension, and revocation; and

           (e) the scope of practice for certified community health workers;

       (2) approve competency-based training programs and training providers, which shall include the South Carolina Technical College System;

       (3) approve organizations to provide continuing education for certified community health workers; and

       (4) work with the South Carolina Commission on Higher Education and the State Board for Technical and Comprehensive Education to ensure that appropriate college course credits are awarded to individuals who complete certified community health worker training, mentorship, and continuing education provided by competency-based providers approved by the department.

 

SECTION 2.  Article 1, Chapter 6, Title 44 of the S.C. Code is amended by adding:

 

    Section 44-6-75. (A)(1) By January 1, 2027, the State Department of Health and Human Services shall seek approval from the federal Centers for Medicare and Medicaid Services for a state plan amendment, waiver, or alternative payment model, including public-private partnerships, for services delivered by certified community health workers pursuant to Chapter 49, Title 43.

        (2) Any state plan amendment, waiver, or alternative payment sought by the department pursuant to this subsection shall provide reimbursement for services described in Chapter 49, Title 43 when provided by a certified community health worker who is employed and supervised by a Medicaid participating provider who is employed by:

           (a) an alcohol and other drug treatment entity;

           (b) a behavioral health services organization;

           (c) a community mental health center;

           (d) a federally qualified health center or a federally qualified health center look-alike;

           (e) a health system consisting of either at least one hospital and at least one group of physicians or more than one group of physicians;

            (f) a hospital;

            (g) a local public health department;

           (h) a primary care clinic;

           (i) a rural public health clinic; or

            (j) another Medicaid participating provider approved by the department.

    (C) The department shall promulgate regulations necessary to carry out the provisions of this section and obtain all necessary approvals from the federal Centers for Medicare and Medicaid Services.

    (D) As permitted by federal law, in any plan submitted for federal Title XXI approval of a children's health insurance program for South Carolina, the department shall include provisions for a preventive health insurance program for children with no copayment, deductible, coinsurance, or premium for services rendered by certified community health workers pursuant to Chapter 49, Title 43.

 

SECTION 3.  This act takes effect upon approval by the Governor.

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