S 150 Session 110 (1993-1994)
S 0150 General Bill, By M.T. Rose
A Bill to amend the Code of Laws of South Carolina, 1976, by adding Chapter 54
to Title 44 so as to enact the "Assessment of and Intervention in the
Perinatal Effects of Alcohol, Controlled Substances, and Cigarettes Act" so as
to require that physicians provide counseling to pregnant women on these
effects; to require the South Carolina Department of Health and Environmental
Control and the South Carolina Commission on Alcohol and Drug Abuse to provide
educational programs and materials to physicians providing obstetrical and
gynecological care; to direct the Department of Health and Environmental
Control, the South Carolina Department of Mental Health, and the State
Department of Social Services to establish multidisciplinary teams to advise
physicians on these issues; to provide optional reporting to the Department of
Health and Environmental Control of families with children exposed to drugs or
alcohol; to allow the Department of Social Services to provide prevention
services; to require reporting of high risk pregnancies to the Department of
Health and Environmental Control and require the Department to conduct drug
prevalence tests to determine trends in pregnancy substance abuse; and to
amend Section 59-32-20, relating to Comprehensive Health Education
instructional units for school districts, so as to require school districts to
include the effects o
01/12/93 Senate Introduced and read first time SJ-65
01/12/93 Senate Referred to Committee on Medical Affairs SJ-65
01/26/93 Senate Recalled from Committee on Medical Affairs SJ-5
01/26/93 Senate Committed to Committee on Judiciary SJ-5
A BILL
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976,
BY ADDING CHAPTER 54 TO TITLE 44 SO AS TO ENACT THE
"ASSESSMENT OF AND INTERVENTION IN THE
PERINATAL EFFECTS OF ALCOHOL, CONTROLLED
SUBSTANCES, AND CIGARETTES ACT" SO AS TO
REQUIRE THAT PHYSICIANS PROVIDE COUNSELING TO
PREGNANT WOMEN ON THESE EFFECTS; TO REQUIRE THE
SOUTH CAROLINA DEPARTMENT OF HEALTH AND
ENVIRONMENTAL CONTROL AND THE SOUTH CAROLINA
COMMISSION ON ALCOHOL AND DRUG ABUSE TO PROVIDE
EDUCATIONAL PROGRAMS AND MATERIALS TO
PHYSICIANS PROVIDING OBSTETRICAL AND
GYNECOLOGICAL CARE; TO DIRECT THE DEPARTMENT OF
HEALTH AND ENVIRONMENTAL CONTROL, THE SOUTH
CAROLINA DEPARTMENT OF MENTAL HEALTH, AND THE
STATE DEPARTMENT OF SOCIAL SERVICES TO ESTABLISH
MULTIDISCIPLINARY TEAMS TO ADVISE PHYSICIANS ON
THESE ISSUES; TO PROVIDE OPTIONAL REPORTING TO THE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
OF FAMILIES WITH CHILDREN EXPOSED TO DRUGS OR
ALCOHOL; TO ALLOW THE DEPARTMENT OF SOCIAL
SERVICES TO PROVIDE PREVENTION SERVICES; TO
REQUIRE REPORTING OF HIGH RISK PREGNANCIES TO THE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
AND REQUIRE THE DEPARTMENT TO CONDUCT DRUG
PREVALENCE TESTS TO DETERMINE TRENDS IN
PREGNANCY SUBSTANCE ABUSE; AND TO AMEND SECTION
59-32-20, RELATING TO COMPREHENSIVE HEALTH
EDUCATION INSTRUCTIONAL UNITS FOR SCHOOL
DISTRICTS, SO AS TO REQUIRE SCHOOL DISTRICTS TO
INCLUDE THE EFFECTS OF PERINATAL SUBSTANCE ABUSE
IN THEIR DRUG AND ALCOHOL EDUCATION PROGRAMS.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. The 1976 Code is amended by adding:
"CHAPTER 54
Assessment and Intervention in the
Perinatal Effects of Alcohol,
Controlled Substances, and Cigarettes
Section 44-54-10. A physician licensed in South Carolina who
provides obstetrical or gynecological care to a patient who is pregnant
shall counsel the patient on the perinatal effects of smoking cigarettes,
the use of alcohol, and the use of a controlled substance as defined in
Section 44-53-110 for nonmedical purposes. The patient shall sign a
written statement on a form prepared by the South Carolina
Department of Health and Environmental Control certifying that she
received this counseling. The signed statement must be maintained as
part of that patient's medical file.
Section 44-54-20. The South Carolina Department of Health and
Environmental Control, in cooperation with the South Carolina
Commission on Alcohol and Drug Abuse, shall develop and provide
educational programs and materials to physicians who provide
obstetrical and gynecological care which include:
(1) the effects of cigarettes, alcohol, and controlled substances on
pregnancy and fetal outcome;
(2) procedures for taking an accurate and complete drug history
from a pregnant patient; and
(3) counseling techniques for drug-abusing women to improve
referral to and compliance with drug treatment programs.
Section 44-54-30. (A) The South Carolina Department of Health
and Environmental Control in cooperation with the State Department
of Mental Health and the South Carolina Department of Social
Services shall establish local multidisciplinary teams to advise
physicians and health care providers and shall include at a minimum
a public health nurse, a hospital staff representative, an experienced
child protection supervisor, an obstetrician, a neonatologist, a
pediatrician or a family practice physician with an interest in perinatal
medicine, a medical social worker, a child psychologist, and a drug
treatment provider. No compensation may be paid to the members of
the multidisciplinary teams. These teams shall report to the
commissioner of the Department of Health and Environmental Control.
Necessary expenses of teams may be paid from appropriations of the
Department of Health and Environmental Control upon approval by
the commissioner.
(B) These multidisciplinary teams must be trained in health issues
affecting pregnant mothers and their babies, care in the home for
medically-complex infants, developmental impairments of drug and
alcohol exposed infants, and treatment resources for drug-abusing
families. The teams must be trained in intervention in child abuse and
neglect cases and in community resources.
Section 44-54-40. (A) A physician or health care provider may
refer to the Department of Health and Environmental Control families
in which children may have been exposed to a controlled substance as
defined in Section 44-53-110 or alcohol as evidenced by:
(1) medical documentation of signs and symptoms consistent
with controlled substances or alcohol exposure in the child at birth; or
(2) results of a confirmed toxicology test for controlled
substances performed at birth on the mother or the child; and
(3) a written assessment made or approved by a physician,
health care provider, or by the Department of Social Services that
documents the child as being at risk of abuse or neglect.
(B) Nothing in this section shall preclude a physician or other
mandated reporter from reporting abuse or neglect of a child as
required pursuant to Section 20-7-510.
(C) Upon notification pursuant to subsection (A), the Department
of Health and Environmental Control shall offer service coordination
services to the family. The department shall coordinate social
services, health care, mental health services and needed education and
rehabilitation services. Service coordination services must be initiated
within seventy-two hours of notification. The department shall notify
the Department of Social Services and the Department of Mental
Health within seventy-two hours of initial notification.
(D) A physician or health care provider who in good faith complies
with this section is immune from any civil liability that might
otherwise result by reason of this compliance.
(E) Referral and associated documentation provided for in this
section is confidential and may not be used in any criminal
prosecution.
Section 44-54-50. (A) The State Department of Social Services
shall provide protective services and may provide preventive services
for children that meet the criteria established in Section 44-54-40.
(B) Until the physician or health care provider, or a designee of the
physician or health care provider, authorizes the file to be closed, no
services may be discontinued for a child exposed to substances as set
forth in Section 44-54-40 if a physician or health care provider has
made or approved a written assessment documenting the child as being
at risk of abuse or neglect.
Section 44-54-60. The South Carolina Department of Health and
Environmental Control shall establish and maintain a toll free
information line to provide information on resources for substance
abuse treatment and to assist with referral for substance-abusing
pregnant women.
Section 44-54-70. A pregnant woman referred for substance abuse
treatment must receive first priority for use of available treatment. All
records and reports regarding the pregnant woman are confidential.
The South Carolina Commission on Alcohol and Drug Abuse shall
ensure that family oriented substance abuse treatment is available, as
appropriations allow. Substance abuse treatment facilities that receive
public funds may not refuse to treat a woman solely because she is
pregnant.
Section 44-54-80. (A) A physician or health care provider who
provides services to pregnant women shall identify those women the
physician or health care provider serves who are high risk pregnancies
using the regulations developed by the Department of Health and
Environmental Control pursuant to this chapter. The physician or
health care provider upon identification of a high risk pregnancy shall
inform the woman of the availability of services and the option of
referral to the Department of Health and Environmental Control.
(B) Upon consent by a woman identified as having a high risk
pregnancy, the physician or health care provider shall make a report,
within seventy-two hours, to the Department of Health and
Environmental Control on forms approved by the department.
(C) A physician or health care provider who in good faith complies
with this section is immune from any civil liability that might
otherwise result by reason of this compliance.
(D) Referral and associated documentation provided for in this
section is confidential and may not be used in any criminal
prosecution.
(E) The consent required by subsection (B) is considered a waiver
of confidentiality solely for the purpose of making the report pursuant
to subsection (B).
Section 44-54-90. The Department of Health and Environmental
Control shall conduct periodic and scientifically appropriate drug
prevalence tests on a statistically significant sample of women or
infants at the time of delivery. Upon request from the department,
physicians who provide obstetrical or gynecological care shall obtain
test samples from their patients at the time of delivery and send these
samples to a central laboratory designated by the department. These
samples must be sent to the laboratory with no information identifying
the donor. The department, however, may require demographic
information necessary to interpret the results. The department shall
then conduct studies using data obtained from these samples to
determine the extent of use and harmful perinatal effects of cigarettes,
alcohol, and controlled substances as defined in Section 44-53-110.
Periodic screening results must be compared to those of the preceding
series of tests to determine trends in pregnancy substance abuse and
to assist in monitoring the effectiveness of this chapter. Prevalence
testing during the prenatal period may be conducted in the same
manner at the discretion of the department.
Section 44-54-100. (A) The Department of Health and
Environmental Control shall promulgate regulations based on a risk
assessment profile for substance abuse to be used by physicians and
health care providers to identify high risk pregnancies.
(B) Upon notification by a physician or health care provider that
a pregnant woman has been identified as having a high risk pregnancy
based on these regulations, the Department of Health and
Environmental Control shall offer service coordination services to the
woman. Service coordination services include a coordination of social
services, health care, and mental health services."
SECTION 2. Section 59-32-20 of the 1976 Code is amended by
adding a new paragraph at the end of the section which reads:
"All school districts shall develop and include in their drug
and alcohol education programs in grades one through twelve, age
appropriate drug education curricula concerning the physiological
effects and problems before and after birth caused by the use of
cigarettes, alcohol, and controlled substances."
SECTION 3. This act takes effect July 1, 1994.
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