General Appropriations Bill H. 4700 for the fiscal year beginning July 1, 1998
Hint: To avoid truncation when printing, be sure your software is set to print in Landscape Orientation. Adjust font size as needed.
Indicates Matter Stricken
Indicates New Matter
10 SECTION 8 - J02 - HEALTH AND HUMAN SERVICES, DEPARTMENT OF
11
12 8.1. (DHHS: Recoupment/Restricted Fund) The Department of Health and Human Services shall recoup all refunds and identified
13 program overpayments and all such overpayments shall be recouped in accordance with established collection policy. Further, the
14 Department of Health and Human Services is authorized to maintain a restricted fund, on deposit with the State Treasurer, to be used to
15 pay for liabilities and improvements related to enhancing accountability for future audits. The restricted fund will derive from prior year
16 program refunds. The restricted fund shall not exceed one percent of the total appropriation authorization for the current year. Amounts in
17 excess of one percent will be remitted to the General Fund.
18 8.2. (DHHS: Long Term Care Facility Reimbursement Rate) The Department, in calculating a reimbursement rate for long term care
19 facility providers, shall obtain for each contract period an inflation factor, developed by the Budget and Control Board, Division of Budget
20 and Analyses. Data obtained from Medicaid cost reporting records applicable to long term care providers will be supplied to the Budget
21 and Control Board, Division of Budget and Analyses. A composite index, developed by the Budget and Control Board, Division of Budget
22 and Analyses will be used to reflect the respective costs of the components of the Medicaid program expenditures in computing the
23 maximum inflation factor to be used in long term care contractual arrangements involving reimbursement of providers. The Division of
24 Budget and Analyses of the Budget and Control Board shall update the composite index so as to have the index available for each contract
25 renewal.
26 The Department may apply the inflation factor in calculating the reimbursement rate for the new contract period from zero percent (0%)
27 up to the inflation factor developed by the Division of Budget and Analyses.
28 8.3. (DHHS: Medical Assistance Audit Program Remittance) The Department of Health and Human Services shall remit to the
29 General Fund an amount representing fifty percent (allowable Federal Financial Participation) of the cost of the Medical Assistance Audit
30 Program as established in the State Auditor's Office of the Budget and Control Board Section 63E. Such amount shall also include
31 appropriated salary adjustments and employer contributions allocable to the Medical Assistance Audit Program. Such remittance to the
32 General Fund shall be made monthly and based on invoices as provided by the State Auditor's Office of the Budget and Control Board.
33 8.4. (DHHS: Medicaid Income Limitation) The income limitation for the Medicaid Program shall continue to be three hundred
34 percent of the SSI single payment maximum.
SECTION 8 - J02 - HEALTH AND HUMAN SERVICES, DEPARTMENT OF PAGE 418
1 8.5. (DHHS: Third Party Liability Collection) The Department of Health and Human Services is allowed to fund the net costs of any
2 Third Party Liability and Drug Rebate collection efforts from the monies collected in that effort.
3 8.6. (DHHS: Medicaid State Plan) Where the Medicaid State Plan is altered to cover services that previously were provided by 100%
4 state funds, the Department can bill other agencies for the state share of services provided through Medicaid. The Department will keep a
5 record of all services affected and submit periodic reports to the Senate Finance and House Ways and Means Committees.
6 8.7. (DHHS: Medically Indigent Assistance Fund) The Department is authorized to expend disproportionate share funds to all
7 eligible hospitals with the condition that all audit exceptions through the receipt and expenditures of these funds are the liability of the
8 hospital receiving the funds. To the extent that any disproportionate share funds authorized under this section exceed a specific hospital's
9 cost, such funds must be spent on health care services by a governmental entity. These funds must be used to reimburse the hospital for
10 expenses in providing uncompensated indigent care.
11 8.8. (DHHS: Admin. Days/Swing Beds Reduction Prohibition) Funds appropriated herein for hospital administrative days and swing
12 beds shall not be reduced in the event the agency cuts programs and the services they provide.
13 8.9. (DHHS: Nursing Home Sanctions) The Department of Health and Human Services is authorized to establish an interest bearing
14 Restricted Fund with the State Treasurer, to deposit fines collected as a result of nursing home sanctions. The Department may use these
15 funds to protect the life, health, and property of patients in nursing homes, including payment for the costs of relocation of residents to
16 other facilities, maintenance of operation of a facility pending correction of deficiencies or closure.
17 8.10. (DHHS: Reimbursement Formula Changes) To the extent the Department can increase Medicaid federal matching funds through
18 changes in reimbursement formulas for other state providers, the Department, with the permission of the state providers, is authorized to
19 retain these funds in an earmarked account on deposit with the State Treasurer and use these funds to cover unanticipated health and human
20 services expenditures. The Department should not hold any other state provider liable for disallowances resulting from these changes.
21 Any funds realized as a result of this proviso shall be reported as part of the following year budget process.
22 8.11. (DHHS: Managed Care) The Insurance Law of South Carolina and the regulations promulgated thereunder shall not apply to
23 partially capitated, primary care providers, insofar as such groups or individuals are defined by and agree to provide health care services
24 under South Carolina's Medicaid Managed Care Program.
25 8.12. (DHHS: Child Care and Development Block Grant) The Department of Health and Human Services (DHHS) shall use the funds
26 appropriated to provide matching funds for the new Child Care and Development Block Grant. DHHS, in coordination with the
27 Department of Social Services, shall use these child care funds to support the state's welfare reform program (Family Independence Act of
28 1995) and to provide temporary child care services to other low income working families.
29 8.13. (DHHS: Residential Care Optional Supplement) From the appropriation made herein for General Assistance Residential Care
30 Facilities, the Department will supplement the income of individuals who reside in those licensed residential care facilities that have an
31 approved Optional Supplement Request with the Department. Individuals who reside in those residential care facilities with approved
32 Optional Supplement Requests must also qualify as aged, blind or disabled under the definitions of Public Law 92-603, U.S. Code, or who
33 would qualify except for income limitations or residence in a residential care facility reclassified as a public institution by the Social
34 Security Administration. For the period of the current fiscal year, the Department will, based on availability of funds, supplement the
SECTION 8 - J02 - HEALTH AND HUMAN SERVICES, DEPARTMENT OF PAGE 419
1 income of the above defined group up to a maximum of $795.00 per/month and the residential care facilities are authorized to charge a fee
2 of $762.00 per/month for the defined group. Each individual in the defined group is allowed a $33.00 per/month personal needs
3 allowance. The Department will issue the recipient an Optional Supplement check in an amount that will permit the recipient to comply
4 with the above payments; however, DHHS will devise a payment system which will reflect a daily occupancy and will issue a single
5 check to each enrolled facility participating in the OSS program. if If the federal government grants a cost of living increase to Social
6 Security and Supplemental Security Income recipients, the Department will increase the residential care payment by the amount of the
7 cost of living increase minus $2.00 per recipient for an increase in the Personal Needs Allowance from $33 to $35. This increase to
8 the Personal Needs Allowance applies to all OSS recipients regardless of whether they receive Social Security and/or Supplemental
9 Security Income. The maximum amount of payment a facility can charge will be increased by the same amount as the cost of living
10 increase, less $2.00. the The maximum amount that the facility is permitted to charge is $762.00. The Department shall establish the
11 maximum number of Optional Supplement Requests that can be funded and will develop a waiting list based on present and future
12 applications received from each county. Each facility that participates in the Optional Supplement Program must submit a notarized
13 operating cost report. The cost information will include all income and operating costs for the facility. The Department will develop a time
14 schedule for reports to be submitted. Facilities failing to submit costs information and adhere to the time schedule will not be eligible to
15 serve Optional Supplement residents. Information received by the Department will be consolidated and submitted to the Senate Finance
16 Committee and the Ways and Means Committee. The Department shall explore any options for maximizing state matching dollars in the
17 provision of services to residents of licensed community residential care facilities and options for reviewing the quality and adequacy of
18 care and report to the Senate Finance Committee, the Ways and Means Committee and the Governor's Office no later than January 15,
19 1998. All services rendered to a Residential Care Facility resident must be in compliance with state health licensing laws and regulations.
20 8.14. (DHHS: Medical Home for Clients) The Department of Health and Human Services (DHHS) shall establish a program to
21 encourage physicians to establish a "medical home" for Medicaid clients. This program is intended to provide continuity of care for
22 Medicaid clients, increase access to primary care services for Medicaid clients and ensure increased and continued participation in the
23 Medicaid program by physicians who render primary care services. The DHHS shall have the responsibility to define a "medical home"
24 and have signed agreements with physicians willing to meet the requirements of providing a "medical home." Physicians signing
25 agreements to become medical homes for Medicaid will receive enhanced reimbursement to be defined by DHHS. Federally Qualified
26 Health Centers (FQHCs) and Rural Health Centers (RHCs) must meet the requirements set forth for a "medical home" in order to continue
27 to receive cost based reimbursement from DHHS.
28 8.15. (DHHS: Nursing Services) In the delivery of services in the Medicaid program, LPN's are authorized to provide services in home
29 or residential settings without on-site supervision by an RN provided the RN has approved the plan of care. RN's are authorized to
30 approve a plan of care which provides for LPN's to provide services in a home or residential setting without direct on-site supervision.
31 8.16. (DHHS: Div. on Aging - State Match Funding Formula) Of the state funds appropriated under "Distribution to Subdivisions",
32 the first allocation by the Division on Aging shall be for the provision of required State matching funds according to the Division's formula
33 for distributing Older Americans Act funds, based on the official United States census data for 1990. The balance of this item, but not to
34 exceed five hundred thousand dollars ($500,000) shall be distributed equally to the planning and service areas of the State. In the event
SECTION 8 - J02 - HEALTH AND HUMAN SERVICES, DEPARTMENT OF PAGE 420
1 State appropriations are reduced, reductions to the planning and service areas shall be based on amounts distributed in accordance with the
2 previous requirements.
3 8.17. (DHHS: Div. on Aging - State Matching Funds Carry Forward) Any unexpended balance on June 30 of the prior fiscal year, of
4 the required State matching funds allocation, of the amount appropriated in this section under Distribution to Subdivisions, shall be carried
5 forward in the current fiscal year to be used as required state matching funds for Federal funds awarded to subdivisions on or before
6 September 30 of the current fiscal year.
7 8.18. (DHHS: Div. on Aging - Recycle Program) The Division on Aging is hereby authorized to collect, expend, and carry forward not
8 more than $1,000 in revenues from the sale of items to be recycled.
9 8.19. (DHHS: Div. on Aging - Registration Fees) The Division on Aging is authorized to receive and expend registration fees for
10 educational, training, and certification programs.
11 8.20. (DHHS: Div. on Aging - Alzheimer's Matching Grants) Of the funds appropriated herein for Alzheimers, grants awarded to
12 assist communities and entities in addressing problems relative to Alzheimer's disease and other related disorders must be matched with
13 additional funds or in-kind contributions by the community or other entity equal to the amount of funds awarded in the grant.
14 8.21. (DHHS: Prescriptions) From the funds appropriated herein, the Department is directed to increase the prescription/refill
15 limit to four (4) prescriptions/refills per month for each recipient effective January 1, 1999, and to ensure that unlimited
16 prescription/refill coverage is available for children.
17 8.22. (DHHS: Dental Home) The Department shall establish a program to encourage dentists to establish a "dental home" for
18 Medicaid clients. This program shall provide Medicaid clients with continuity of care, increase access to dental care services and
19 ensure dentists' participation who render primary care services. The Department shall define "dental home" and administer signed
20 agreements with dentists agreeing to meet the requirements of the program. Dentists signing agreements will receive enhanced
21 reimbursements defined by the Department. Federally Qualified Health Centers must meet the requirements set forth for a "dental
22 home" in order to continue to receive cost based reimbursement.
23 8.23. (DHHS: Division on Aging Transfer) Notwithstanding any other provision of law, effective July 1, 1997, the duties, functions
24 and responsibilities of the Division on Aging in the Office of the Governor are transferred to the Department of Health and Human
25 Services as the Office on Aging. The director of the Department must employ a deputy director to be the administrator for the office.
26 8.24. (DHHS: Working Disabled) From the funds appropriated herein, the Department is directed to provide Medicaid benefits
27 during the current year to working disabled individuals whose family income is less than 250% of the federal poverty level and who
28 would be considered to be receiving Supplemental Security Income (SSI) benefits except for their earned income.
29 8.25. (DHHS: Residential Care Pilot Project) The Department shall establish a pilot project to determine the appropriateness and
30 feasibility of providing care to dementia patients, including Alzheimer's patients, in residential care facilities that meet nursing home
31 level of care criteria. In order to fund the appropriate level of care, the Department shall develop, if feasible, a methodology to
32 provide Medicaid services to these patients. State matching funds must be identified from the existing state funding provided to the
33 Optional Supplement Program. DHHS must report on the progress and findings of this pilot project to the House Ways and Means
34 Committee, the Senate Finance Committee and the Governor by March 15th of each year.
SECTION 8 - J02 - HEALTH AND HUMAN SERVICES, DEPARTMENT OF PAGE 421
1 8.26. (DHHS: Chiropractic Services) DELETED
2 8.27. (DHHS: Long Term Care System) The Department of Health and Human Services and the Department of Health and
3 Environmental Control shall, in coordination with other appropriate agencies and organizations, develop a system of services which
4 provides a continuum of long term care services for elderly individuals and their families. The system shall integrate available
5 funding streams, design a common intake system, incorporate recipient directed care and voucher options to the extent possible,
6 expand the current continuum to better address all levels of care needed and develop an eligibility/access system. The agencies will
7 identify any changes necessary in the certificate of need rules which will better support this system by lowering cost and increasing
8 access. The system shall include a process to routinely assess the system of care focusing on quality, access, outcomes and efficiency.
9 The agencies shall report annually to the Governor, to the Senate Finance Committee and to the House Ways and Means Committee no
10 later than January 15th on this system.
11