Bill 132

                    Current Status

Bill Number:               132
Ratification Number:       150
Act Number                 83
Introducing Body:          Senate
Subject:                   To create the State Health and Human
                           Services Finance Commission

(A83, R150, S132)

AN ACT TO AMEND TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO HEALTH, BY ADDING CHAPTER 6 SO AS TO CREATE THE STATE HEALTH AND HUMAN SERVICES FINANCE COMMISSION, TO PROVIDE FOR ITS MEMBERSHIP AND ITS FUNCTIONS, DUTIES, AND RESPONSIBILITIES WHICH SHALL INCLUDE ADMINISTERING TITLE XIX OF THE SOCIAL SECURITY ACT (MEDICAID), TO ESTABLISH AN ADVISORY COMMITTEE AND A TRANSITION COMMITTEE TO ASSIST THE COMMISSION IN THE PERFORMANCE OF CERTAIN OF ITS DUTIES, AND TO REPEAL SECTION 44-5-30, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL BEING DESIGNATED AS THE SINGLE STATE AGENCY TO ADMINISTER THE STATE'S HEALTH PLANNING FUNCTIONS.

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

Legislative findings

SECTION 1. The General Assembly finds that the present system of planning, financing, and administration of interagency health and human services programs has developed piecemeal, and that a unified system is needed for the orderly development of a state policy to assure that essential services provided by such programs are carried out in the most effective and efficient manner. This act establishes an organizational and procedural framework for the planning, financing, and administration of the programs provided for in this act and establishes general policy for the allocation of resources.

State Health and Human Services Finance Commission

established

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

"CHAPTER 6

STATE HEALTH AND HUMAN SERVICES FINANCE COMMISSION

Section 44-6-10. There is created the State Health and Human Services Finance Commission to consist of seven members. One member must be elected from each congressional district of the State by the General Assembly. One must be appointed by the Governor from the State at large to serve as chairman. The terms of the members are for four years and until their successors are elected and qualify, except that the initial members from the first, third, and fifth congressional districts must be elected for terms of two years each. Vacancies must be filled by the Governor for the remainder of an unexpired term. No person may be elected who has a conflict of interest and no member shall serve more than two consecutive terms.

For the purpose of this chapter, a conflict of interest includes, but is not limited to, situations in which an individual's business interests or fiduciary obligations are affected by the decisions of the Commission.

Any person desiring to offer as a candiate for a position as a member of the Commission shall be screened and reviewed by the Joint Legislative Screening Committee pursuant to Chapter 19 of Title 2 of the 1976 Code.

Section 44-6-20. The Commission shall meet at least once a month upon the call of the chairman and the members are allowed the usual per diem, mileage and subsistence as provided by law for members of boards, committees, and commissions.

Section 44-6-30. The Commission shall:

(1) Administer Title XIX of the Social Security Act (Medicaid), including the Early Periodic Screening, Diagnostic and Treatment Program, and the Community Long-Term Care System.

(2) Be designated as the South Carolina Center for Health Statistics to operate the Cooperative Health Statistics Program pursuant to the Public Health Services Act.

(3) Administer the Social Services Block Grant Program.

(4) Be prohibited from engaging in the delivery of services.

Section 44-6-40. For all health and human services interagency programs provided for in this chapter, the Commission shall have the following duties:

(1) Prepare and approve state and federal plans prior to submission to the appropriate authority as required by law for final approval or for state or federal funding, or both.

Such plans shall be guided by the goal of delivering services to citizens and administering plans in the most effective and efficient ways possible.

(2) Compile and maintain in a unified, concise, and orderly form information concerning programs provided for in this chapter.

(3) Continuously review and evaluate programs to determine the extent to which they: (a) meet fiscal, administrative, and program objectives; and (b) are being operated cost effectively.

(4) Evaluate plans and programs in terms of their compatibility with state objectives and priorities giving specific attention to areas outlined in Section 44-6-70.

(5) Formulate for consideration and promulgation criteria, standards, and procedures that ensure assigned programs are administered effectively, equitably, and economically and in accordance with statewide policies and priorities.

(6) Inform the Governor and the General Assembly as to the effectiveness of the criteria, standards, and procedures promulgated pursuant to item (5) of this section.

(7) Develop in conjunction with other state agencies an information system to provide data on comparative client and fiscal information needed for programs.

(8) Develop a mechanism for local planning.

(9) Obtain from participating state agencies information considered necessary by the Commission to perform duties assigned to the Commission.

Section 44-6-50. In carrying out the duties provided for in Section 44-6-30 the Commission shall:

(1) Contract with health and human services agencies for eligibility determination with performance standards regarding quality control as required by law or regulation.

(2) Contract for operation of certified Medicaid management information claims processing system. For the first year of its operation it shall contract for such system with the Department of Social Services.

(3) Contract for other operational components of programs administered under this chapter as considered appropriate.

(4) Monitor and evaluate all contractual services authorized pursuant to this chapter to assure effective performance. Any contract entered into under the provisions of this chapter must be in accordance with the provisions of the South Carolina Consolidated Procurement Code.

(5) Establish a procedure whereby inquiries from members of the General Assembly concerning the Commission's work and responsibility shall be answered as expeditiously and definitively as possible.

Section 44-6-60. An advisory committee is established to assist and advise the Commission in its duties and functions. It shall address its efforts to overall policy and review of state plans and shall not have responsibility for specific allocation recommendations.

The membership shall consist of thirteen members and the members shall be appointed by the Governor for terms of four years and until their successors are appointed and qualify. The Governor shall designate a chairman who shall serve for a term of two years. Vacancies on the advisory committee shall be filled by appointment in the same manner of original appointment for the remainder of the unexpired term. Members of the advisory committee are paid the usual per diem, mileage, and subsistence as provided by law for members of boards, commissions, and committees.

The following are ex officio members, without voting rights:

The chairman, or his designee, of the Joint Appropriations Review Committee,

The chairman, or his designee, of the Senate Finance Committee,

The chairman, or his designee, of the House Ways and Means Committee,

The chairman, or his designee, of the Senate Medical Affairs Committee,

The chairman, or his designee, of the House Medical, Military, Public and Municipal Affairs Committee,

The chairman, or his designee, of the Health Care Planning and Oversight Committee,

The chairman of the Statewide Health Coordinating Council,

The chairman of the Medical Care Advisory Committee,

The chairman of the Social Services Advisory Committee,

The commissioner of the Department of Health and Environmental Control,

The commissioner of the Department of Social Services,

The commissioner of the Department of Mental Health,

The commissioner of the Department of Mental Retardation,

The executive director of the Commission on Aging,

The director of the Commission on Alcohol and Drug Abuse.

The legislative ex officio members may attend all meetings of the Commission and shall have access to all records of the Commission concerning policy and resource allocation decisions.

Section 44-6-70. A state plan must be prepared by the Commission for each program assigned to it and the Commission must also prepare resource allocation recommendations based on such plans. The resource allocation recommendations must be approved pursuant to state and federal law. The state plans must address state policy and priority areas of service with specific attention to the following objectives:

(a) Prevention measures as addressed in health and human services programs.

(b) Achievement of a balanced health care delivery system assuring that regulations, coverage, and reimbursement policies assure that while the most appropriate care is given, tailored to the client's needs, it is delivered in the most cost-effective manner.

(c) Simplification of paperwork requirements.

(d) Achievement of optimum cost effectiveness in administration and delivery of services provided quality of care is assured.

(e) Improvement of effectiveness of third party reimbursement efforts.

(f) Assurance of maximum utilization of private and nonprofit providers in administration and service delivery systems, provided quality of care is assured.

(g) Encouragement of structured volunteer programs in administration and service delivery.

Section 44-6-80. The Commission must submit to the Governor, the State Budget and Control Board, and the General Assembly an annual report concerning the work of the Commission including details on improvements in the cost effectiveness achieved since the enactment of this chapter and must recommend changes for further improvements.

Interim reports must be submitted as needed to advise the Governor and the General Assembly of substantive issues.

Section 44-6-90. The Commission may promulgate regulations to carry out its duties.

All state and local agencies whose responsibilities include administration or delivery of services which are covered by this chapter shall cooperate with the Commission and comply with its regulations.

Section 44-6-100. The Commission shall employ an executive director who may employ any other personnel he considers necessary to carry out the duties of the Commission within the limitation of funds provided to the Commission and approved by the Commission for that purpose. The executive director and other personnel shall have such other duties as the Commission determines and shall receive such compensation as determined by the Commission.

Other Commission employees shall have such general duties and receive such compensation as determined by the executive director and approved by the Commission. The executive director shall be responsible for administration of state personnel policies and general commission personnel policies which are approved by the Commission. The executive director shall have sole authority to employ and discharge commission employees subject to such personnel policies and funding available for that purpose. Except for the purpose of formal investigations, the Commission and its members shall deal with commission employees solely through the executive director, and neither the Commission nor its members shall give orders or instructions to commission employees.

In all instances, the executive director shall serve as the chief administrative officer of the Commission and the Commission and its members shall be confined to the policy making activities and duties prescribed in Sections 44-6-30, 44-6-40, and 44-6-50. The executive director shall have the responsibility of executing policies, directives, and actions of the Commission either personally or by issuing appropriate directives to commission employees.

The goal of the provisions of this section is to ensure that the Commission's business is conducted according to sound administrative practice, without unnecessary interference with its internal affairs and the Commission, its members, and all public officers and employees shall be guided by this goal and comply with these provisions.

Section 44-6-110. A transition committee is created to assist the Commission in becoming operational which must include the State Auditor; a representative of the Health Care Planning and Oversight Committee, to be appointed by the chairman; a representative of the Joint Appropriations Review Committee, to be appointed by the chairman; a representative of the Joint Committee on Personal Service Financing Budgeting, to be appointed by the chairman, the chairman of the Board of the Department of Social Services or his designee; the chairman of the Board of the Department of Health and Environmental Control or his designee; and such agency heads or others as the Governor determines to appoint so long as the total membership of the committee does not exceed ten persons.

The transition committee may in its discretion employ or designate a temporary executive officer for the transition committee. A report must be filed with the Governor within ninety days after the effective date of this section concerning plans for the implementation of this section. The State Health and Human Services Financing Commission shall be operational no later than July 1, 1984. All state and local agencies shall provide such assistance and cooperation as may be requested by the transition committee or executive officer.

Section 44-6-120. In order to carry out the provisions of this chapter as promptly as practicable the State Budget and Control Board shall transfer all necessary health and human services program planning and administrative functions including personnel, current appropriations, assets and liabilities from departments currently operating the programs cited in Section 44-6-30 and from any other related function delegated to the Commission. The Research and Statistical Services Division of the State Budget and Control Board must not be transferred to the Commission, but the Commission shall have full access to any and all material it needs from the Division. Employees or any function or program which is transferred to the Commission shall be transferred with state merit system coverage along with such function or program. The Commission shall develop an efficient and cost-effective organizational structure and the executive director shall offer available positions to the transferred employees who have the requisite qualifications if funds are available for that purpose and if individual employees have good work records. The director with Commission approval shall eliminate functions, programs, or positions which are not necessary for the accomplishment of the Commission's duties or are not cost efficient.

No such transfer shall be made unless prior approval is obtained when such approval is required by law.

Section 44-6-130. The first annual report of the Commission shall include the Commission's efforts to coordinate and more cost effectively plan, finance, and administer health and human service planning functions along with any other information concerning duties that may be assigned to the Commission and shall also include a list of the positions in the new agency transferred pursuant to this chapter."

Repeal

SECTION 3. Section 44-5-30 of the 1976 Code is repealed.

Time effective

SECTION 4. This act shall take effect upon approval by the Governor.