Bill 4789

                    Current Status

Bill Number:               4789
Ratification Number:       511
Act Number                 615
Introducing Body:          House
Subject:                   Joint Legislative Health Care Planning
                           and Oversight Committee

(A615, R511, H4789)

A JOINT RESOLUTION TO PROVIDE THAT THE JOINT LEGISLATIVE HEALTH CARE PLANNING AND OVERSIGHT COMMITTEE SHALL REVIEW REGULATORY REQUIREMENTS ON SMALL AND RURAL HOSPITALS, PROVIDE FOR TEMPORARY IMPLEMENTATION AND EVALUATION OF ALTERNATIVE STANDARDS, DEVELOP A RURAL HEALTH CARE PLAN MEETING THE CRITERIA UNDER THE ESSENTIAL ACCESS COMMUNITY HOSPITAL PROGRAM, AND REPORT ITS FINDINGS TO THE GENERAL ASSEMBLY.

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

Findings

SECTION 1. (A) The General Assembly finds:

(1) Small and rural hospitals serve as the hub of health care in their communities and through that role attract and retain in their communities physicians, nurses, and other primary care providers.

(2) Because of economies of scale compounded by changes in payment for services, many rural hospitals may close, and the smallest and most remote facilities are at highest risk of closing.

(3) Closing of small and rural hospitals will result in the departure of primary care providers and the loss of emergency medical services both to residents and persons traveling through the area.

(4) The State has not done a thorough study of regulatory requirements applicable to small and rural hospitals or of safe and effective alternatives to existing regulations. Licensure standards which may be appropriate for larger and urban hospitals are often unduly burdensome for small and rural hospitals.

(5) The Omnibus Budget Reconciliation Act of 1989 provides funds for up to seven states which have a rural health care plan that:

(a) provides for the creation of rural health networks;

(b) improves access to hospital and other health services for rural residents; and

(c) enhances emergency and other transportation services.

(B) The intent of this act is to:

(1) establish a mechanism for a thorough review of regulatory requirements applicable to small and rural hospitals;

(2) provide for the temporary implementation and evaluation of alternative standards;

(3) develop a rural health care plan which:

(a) provides for the creation of rural health networks;

(b) improves access to hospital and other health services for rural residents; and

(c) enhances emergency and other transportation services.

Definitions

SECTION 2. As used in this act:

(1) "Committee" means the Joint Legislative Health Care Planning and Oversight Committee.

(2) "Department" means the Department of Health and Environmental Control.

(3) "Small and rural hospital" means an acute care hospital which either:

(a) has no more than seventy-six acute care beds and is located in a census-dwelling place of fifteen thousand or less population according to the 1980 United States Census; or

(b) meets the federal criteria for participation in the Medicare or Medicaid swing bed program.

Committee duties

SECTION 3. (A) Between the effective date of this act and January 1, 1991, the committee shall:

(1) undertake a comprehensive review and assessment of the regulatory requirements currently imposed upon small and rural hospitals; and

(2) develop a rural health care plan which meets the federal criteria under the Essential Access Community Hospital Program authorized by the federal Omnibus Budget Reconciliation Act of 1989.

The committee may contract with a medical consultant or other advisers as necessary. Due to the necessity to provide relief to small and rural hospitals and meet necessary deadlines in applying for federal funds, the contracts are exempt from Chapter 35, Title 11 of the 1976 Code, the South Carolina Consolidated Procurement Code.

(B) The chairman of the committee shall appoint a technical advisory committee to provide advice on the implementation and administration of this act. Members appointed to the advisory committee must have knowledge and expertise in health care and health care management. At least one member must be a representative of the department. Members of the advisory committee must be reimbursed for any actual and necessary expenses incurred in connection with their duties as members of the committee.

Department of Health and Environmental Control duties

SECTION 4. (A) The department may authorize pilot projects in any specific small or rural hospital or group of small or rural hospitals permitting the use of alternate concepts, methods, procedures, techniques, equipment, personnel, personnel qualifications, or physical plant standards. These pilot projects may also include the development of alternative rural hospital models. The department may promulgate regulations, including emergency regulations, to implement this subsection.

(B) The department shall approve only those pilot projects that assure that patient safety and quality of care will be maintained. No project may continue more than twenty-four months from the start of implementation, unless the department determines that the project is likely to contribute substantially to the availability of quality health services in the State or a region of the State.

As a condition of participation in any pilot program approved under this section, any hospital or group of hospitals shall agree to provide statistical data and patient information that the department considers necessary for effective evaluation and monitoring. The department shall develop procedures to assure the confidentiality of patient information.

(C) Any authorized officer, employee, or agent of the department may, upon presentation of proper identification, enter and inspect any building or premises and any records, including patient records, of a pilot project participant at any reasonable time to review compliance with this act or to prevent any violation of this act or the regulations promulgated and standards adopted pursuant to this act. The department may suspend or withdraw approval of pilot projects with notice but without hearing if it determines that patient safety is being jeopardized.

(D) The department shall seek the advice of appropriate professional societies and appropriate licensing boards when approving pilot projects under this section. Nothing in this act may be construed as creating an exemption from the provisions of Title 40 of the 1976 Code concerning the licensing and regulation of health professionals.

Reimbursement and report

SECTION 5. The committee and the department shall cooperate and jointly pursue any waivers or state plan amendments that are necessary to permit hospitals that are participating in the regulatory relief program provided in this act to continue to participate in, and receive full reimbursement under, the federal Medicare and Medicaid programs.

The committee and the department shall submit a report to the General Assembly before January 2, 1993, which must include an evaluation of the impact on small and rural hospitals of the program authorized by this act. The report must address whether or not those regulations modified or waived by the department should be permanently modified or waived for small and rural hospitals and what further regulatory changes should be made based on the results of any pilot project approved pursuant to this act. The report must also consider health care costs, availability, safety, and quality of care.

Termination

SECTION 6. The provisions of this act and any regulations promulgated pursuant to this act terminate January 1, 1994.

Time effective

SECTION 7. This act takes effect upon approval by the Governor.

Approved the 25th day of April, 1990.