BIL: 753

TYP: General Bill GB

INB: Senate

IND: 20010607

PSP: Fair

SPO: Fair, Short

DDN: l:\council\bills\nbd\11861ac01.doc

RBY: Senate

COM: Medical Affairs Committee 13 SMA

SUB: Certificate of Need and Health Facility Licensure Act, requirements of; Residential Care Facilities, Medical, DHEC

HST:

Body Date Action Description Com Leg Involved

______

Senate 20020508 Recommitted to Committee 13 SMA

Senate 20020416 Read second time, notice of

general amendments

------20020327 Scrivener's error corrected

Senate 20020326 Committee report: Favorable with 13 SMA

amendment

------20020201 Scrivener's error corrected

Senate 20010607 Introduced, read first time, 13 SMA

referred to Committee

Versions of This Bill

Revised on 20020201

Revised on 20020326

Revised on 20020327

TXT:

Indicates Matter Stricken

Indicates New Matter

COMMITTEE REPORT

March 26, 2002

S.753

Introduced by Senator Fair

S. Printed 3/26/02--S. [SEC 3/27/02 2:45 PM]

Read the first time June 7, 2001.

THE COMMITTEE ON MEDICAL AFFAIRS

To whom was referred a Bill (S.753) to amend Section 447110, as amended, Code of Laws of South Carolina, 1976, relating to the citation to Article 3, Chapter 7, Title 44, 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, Section 44-7-130(1), page 3, line 35 by deleting /including/

Amend the bill, further, Section 447130(10), page 5, line 12 by deleting /methadone treatment facilities,/ and inserting /methadone treatment facilities,/

Amend the bill, further, Section 447130(10), page 5, line 13 by deleting /hospice facilities,/ and inserting /hospice facilities,/

Amend the bill, further, Section 447130, page 7, immediately after line 25 by inserting:

/(24) ‘Health Service Area’ means the service area defined by the service standard which is a combination of utilization criteria and travel time requirements as defined for each service in the applicable South Carolina Health Plan./

Amend the bill, further, Section 447160(3), page 8, line 10 by inserting after /amount;/ /establishment, implementation, or expansion of a diagnostic or therapeutic cardiac catheterization program;/

Amend the bill, further, Section 447160(4), page 8, by deleting lines 11 14 and inserting:

/ (4) a capital expenditure by or on behalf of a health care facility which is associated with the addition or substantial expansion of a health service for which specific standards or criteria are prescribed in the State Health Plan;/

Amend the bill, further, Section 447160(5), page 8, line 21 by deleting /a level III infant/ and inserting /level II enhanced and level III infants/

Amend the bill, further, Section 447160(8), page 8, line 38 immediately after /facility;/ by inserting /establishment, implementation, or expansion of a Positron Emission Tomography (PET) system or program;/

Amend the bill, further, Section 447160, page 8, line 39 by deleting /(9)/ and inserting /(9)/.

Amend the bill, further, Section 447160, page 9, immediately after line 2 by inserting:

/(10) a capital expenditure in excess of two million dollars which is associated with the addition, establishment, expansion, or implementation of a clinically related diagnostic, treatment, or rehabilitative service for which no specific standards or criteria exist in the State Health Plan. The cost of any studies, surveys, designs, plans, working drawings, specifications, and other activities essential to the development, acquisition, improvement, expansion, or replacement of any plant or equipment must be included in determining if the expenditure exceeds the prescribed amount.

(11) establishment, implementation, or expansion of an open heart surgery program or other cardiac revascularization program./

Amend the bill, further, Section 447170(B)(2), page 10, line 4 after /of/ by inserting /their respective/

Amend the bill, further, Section 447170(B)(2), page 10, by deleting line 19 and on line 20 by deleting /(8)/ and inserting /(7)/

Amend the bill, further, Section 447210(F), page 15 by deleting lines 26 through 31 and inserting:

/(F) The department may not issue a Certificate of Need approval for a methadone treatment facility until licensure standards are promulgated by the department, in accordance with the Administrative Procedures Act, for these facilities. The department shall convene a study group to revise and propose licensure standards for methadone clinics. The study group shall /

Amend the bill, further, beginning on page 16, by deleting Section 14 of the bill and inserting:

/SECTION 14. Section 446975 of the 1976 Code is amended to read:

“Section 446975. (A) A home health agency shall obtain a certificate of need before licensure. Procedures for applying for a certificate must be in accordance with the ‘State Certification Certificate of Need and Health Facility Licensure Act’. No certificate is required for home health agencies providing home health services before July 1, 1980.

(B) A continuing care retirement community licensed pursuant to Title 37, Chapter 11, may provide home health services and is exempt from subsection (A) obtaining a certificate of need if:

(1) the continuing care retirement community furnishes or offers to furnish home health services only to residents who reside in living units provided by the continuing care retirement community pursuant to a continuing care contract;

(2) the continuing care retirement community maintains a current license and meets applicable home health agency licensing standards;

(3) residents of the continuing care retirement community may choose to obtain home health services from other licensed home health agencies.

Staff from other areas of the continuing care retirement community may deliver the home health services, but at no time may staffing levels in any area of the continuing care retirement community fall below minimum licensing standards or impair the services provided.

If the continuing care retirement community includes charges for home health services in its base contract, it is prohibited from billing additional fees for those services. Continuing care retirement communities certified for Medicare or Medicaid, or both, must comply with governmental reimbursement requirements concerning charges for home health services.

For purposes of this subsection ‘resident’, ‘living unit’, and ‘continuing care contract’ have the same meanings as provided in Section 371120.

(C) Subsection (B) applies only to multilevel continuing care retirement communities which incorporate a skilled nursing facility.

(D) The continuing care retirement community shall not bill in excess of its costs. These costs will be determined on nonfacilitybased Medicare and/or Medicaid standards.”/

Amend the bill, further, by adding an appropriately numbered SECTION to read:

/SECTION __. The 1976 Code is amended by adding:

“Section 447175. The department is the sole agency responsible for determining the projects to which the provisions of this article do not apply and the projects that are exempt from the provisions of this article. A determination of inapplicability or exemption is not a contested case under the Administrative Procedures Act and may not be appealed.”/

Amend the bill, further, Section 16, page 17, line 8 by deleting /2001/ and inserting /2002/

Renumber sections to conform.

Amend title to conform.

HARVEY S. PEELER, JR. for Committee.

[753-1]

A BILL

TO AMEND SECTION 447110, AS AMENDED, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE CITATION TO ARTICLE 3, CHAPTER 7, TITLE 44, ENTITLED “STATE CERTIFICATION OF NEED AND HEALTH FACILITY LICENSURE ACT”, SO AS TO REVISE THE ARTICLE NAME; TO AMEND SECTION 447120, AS AMENDED, RELATING TO THE PURPOSE OF THIS ARTICLE, SO AS TO REVISE THE PURPOSE TO INCLUDE CARRYING OUT THE STATE’S HEALTH PLANNING EFFORT AND TO DELETE THE PROVISION RELATING TO DEVELOPING PROCEDURES FOR THE APPLICATION AND REVIEW PROCESS FOR CERTIFICATES OF NEED; TO AMEND SECTION 447130, AS AMENDED, RELATING TO DEFINITIONS USED IN THIS ARTICLE, SO AS TO REVISE CERTAIN DEFINITIONS AND TO DELETE OTHERS; TO AMEND SECTION 447150, AS AMENDED, RELATING TO DUTIES OF THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL IN CARRYING OUT THE PURPOSES OF THIS ARTICLE, SO AS TO INCLUDE DATA COLLECTION; TO AMEND SECTION 447160, AS AMENDED, RELATING TO CIRCUMSTANCES UNDER WHICH A CERTIFICATE OF NEED IS REQUIRED, SO AS TO REVISE THESE CIRCUMSTANCES; TO AMEND SECTION 447170, AS AMENDED, RELATING TO EXEMPTIONS FROM THE ARTICLE, SO AS TO REVISE THE EXEMPTIONS; TO AMEND SECTION 447180, AS AMENDED, RELATING TO THE HEALTH PLANNING COMMITTEE AND THE STATE HEALTH PLAN, SO AS TO REVISE THE CONTENTS OF THE PLAN AND TO REQUIRE THAT THE DEPARTMENT BE NOTIFIED WHEN A PERSON PROPOSES TO OFFER HEALTH SERVICES FOR WHICH UTILIZATION DATA ARE MAINTAINED IN THE STATE HEALTH PLAN; TO AMEND SECTION 447190 RELATING TO PROJECT REVIEW CRITERIA FOR USE IN DETERMINING THE NEED FOR HEALTH CARE FACILITIES, BEDS, SERVICES, AND EQUIPMENT, SO AS TO SPECIFICALLY DEFINE THE EQUIPMENT REQUIRING USE OF THIS CRITERIA IN DETERMINING THE NEED FOR THE EQUIPMENT; TO AMEND SECTION 447200, AS AMENDED, RELATING TO THE CERTIFICATE OF NEED APPLICATION, SO AS TO MAKE TECHNICAL CORRECTIONS; TO AMEND SECTION 447210, AS AMENDED, RELATING TO PROCEDURES FOR COMPLETION OF CERTIFICATE OF NEED APPLICATIONS AND FOR APPEALS OF STAFF DECISIONS, SO AS TO CLARIFY THESE PROCEDURES TO REVISE THE DATE INDICATING WHEN CERTAIN METHADONE TREATMENT FACILITIES DO NOT HAVE TO OBTAIN A CERTIFICATE OF NEED; TO AMEND SECTION 447220, AS AMENDED, RELATING TO JUDICIAL REVIEW OF A FINAL BOARD DECISION, SO AS TO MAKE A TECHNICAL CORRECTION; TO AMEND SECTION 447230, AS AMENDED, RELATING TO LIMITATIONS ON A CERTIFICATE OF NEED, SO AS TO PROVIDE PENALTIES WHEN IMPLEMENTATION OF A PROJECT OR THE OPERATION OF A FACILITY IS NOT IN ACCORDANCE WITH CERTAIN REQUIREMENTS; TO AMEND SECTION 446975, AS AMENDED, RELATING TO HOME HEALTH AGENCIES REQUIRING A CERTIFICATE OF NEED, SO AS TO DELETE THE PROVISION EXEMPTING HOME HEALTH AGENCIES FROM THE CERTIFICATE OF NEED IF THE AGENCY PROVIDED HOME HEALTH SERVICES BEFORE JULY 1, 1980; TO REQUIRE THE DEPARTMENT TO CONDUCT A STUDY BEFORE JULY 1, 2003, OF OTHER STATES THAT HAVE REPEALED THEIR CERTIFICATE OF NEED PROGRAMS; AND TO REPEAL SECTION 447185 RELATING TO A TASK FORCE TO STUDY OPEN HEART SURGERY AND THERAPEUTIC CARDIAC CATHETERIZATION SERVICES AND SECTION 447240 RELATING TO FACILITIES CONSTRUCTION PROGRAM.

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

SECTION 1. Section 447110 of the 1976 Code, as last amended by Act 670 of 1988, is further amended to read:

“Section 447110. This article may be cited as the ‘State Certification Certificate of Need and Health Facility Licensure Act’.”

SECTION 2. Section 447120 of the 1976 Code, as last amended by Act 511 of 1992, is further amended to read:

“Section 447120. The purpose of this article is to promote cost containment, prevent unnecessary duplication of health care facilities and certain services as required by Section 447160, guide the establishment of health facilities and certain services which will best serve public needs, carry out the state’s health planning effort, and ensure that high quality services are provided in health facilities in this State. To achieve these purposes, this article requires:

(1) the issuance of a Certificate of Need before undertaking a project prescribed by this article;

(2) adoption of procedures and criteria for submittal of an application and appropriate review before issuance of a Certificate of Need;

(3) preparation and publication of a State Health Plan as prescribed by this article;

(4)(3) the licensure of facilities rendering medical, nursing, and other health care.”

SECTION 3. Section 447130 of the 1976 Code, as last amended by Act 248 of 2000, is further amended to read:

“Section 447130. As used in this article:

(1) ‘Affected person’ means the applicant, a person residing within the geographic service area served or proposed to be served by the applicant, including persons located in the health service area in which the project is to be located and who provide similar services to the proposed project, persons who before receipt by the department of the proposal being reviewed have formally indicated an intention to provide similar services in the future, persons who pay for health services in the health service area in which the project is to be located and who have notified the department of their interest in Certificate of Need applications, the State Consumer Advocate, and the State Ombudsman. Persons This term does not include persons from another state who would otherwise be considered ‘affected persons’ are not included unless that state provides for similar involvement of persons from South Carolina in its certificate of need process.

(2) ‘Ambulatory surgical facility’ means a facility organized and administered for the purpose of performing surgical procedures for which patients are scheduled to arrive, receive surgery, and be discharged on the same day. The owner or operator makes the facility available to other providers who comprise an organized professional staff which must include, at a minimum, a chief of staff and a credentialing committee, governance by medical staff bylaws, and recorded minutes of medical staff meetings.

(3) ‘Board’ means the State Board of Health and Environmental Control.

(4) ‘Chiropractic inpatient facility’ means a facility organized and administered to provide overnight care for patients requiring chiropractic services, including vertebral sublaxation, analysis, and adjustment.

(5) ‘Competing applicants’ means two or more persons or health care facilities as defined in this article who apply for Certificates of Need to provide similar services or facilities in the same service area within a time frame as established by departmental regulations and whose applications, if approved, would exceed the need for services or facilities.

(6) ‘Community residential care facility’ means a facility which offers room and board and provides a degree of personal assistance for two or more persons eighteen years old or older.

(7) ‘Daycare facility for adults’ means a facility for adults eighteen twentyone years or older which offers in a group setting a program of individual and group activities and therapies. The program is directed toward providing communitybased care for those in need of a supportive setting for less than twentyfour hours a day, thereby preventing unnecessary institutionalization, and shall provide a minimum of four and a maximum of fourteen hours of operation a day.

(8) ‘Department’ means the Department of Health and Environmental Control.

(9) ‘The federal act’ means Title VI of the United States Public Health Service Act (the HillBurton Construction Program); Title XVI of the United States Public Health Service Act (National Health Planning and Resources Development Act of 1974 Public Law 93641); grants for all center and facility construction under Public Law 91211 (community mental health centers’ amendments to Title II, Public Law 88164, Community Mental Health Centers Act); grants for all facility construction under Public Law 91517 (developmental disabilities services and facilities construction amendments of 1970 to Part C, Title I, grants for construction of facilities for the mentally retarded Public Law 88164); and other federal programs as may exist or be enacted which provide for the construction of hospitals or related health facilities. RESERVED.