General Appropriations Bill H. 4700 for the fiscal year beginning July 1, 1998
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30 SECTION 8 - J02 - HEALTH AND HUMAN SERVICES, DEPARTMENT OF
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32 8.1. (DHHS: Recoupment/Restricted Fund) The Department of Health and Human Services shall recoup all refunds and identified
33 program overpayments and all such overpayments shall be recouped in accordance with established collection policy. Further, the
34 Department of Health and Human Services is authorized to maintain a restricted fund, on deposit with the State Treasurer, to be used to
35 pay for liabilities and improvements related to enhancing accountability for future audits. The restricted fund will derive from prior year
36 program refunds. The restricted fund shall not exceed one percent of the total appropriation authorization for the current year. Amounts
37 in excess of one percent will be remitted to the General Fund.
38 8.2. (DHHS: Long Term Care Facility Reimbursement Rate) The Department, in calculating a reimbursement rate for long term care
39 facility providers, shall obtain for each contract period an inflation factor, developed by the Budget and Control Board, Division of Budget
40 and Analyses. Data obtained from Medicaid cost reporting records applicable to long term care providers will be supplied to the Budget
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1 and Control Board, Division of Budget and Analyses. A composite index, developed by the Budget and Control Board, Division of Budget
2 and Analyses will be used to reflect the respective costs of the components of the Medicaid program expenditures in computing the
3 maximum inflation factor to be used in long term care contractual arrangements involving reimbursement of providers. The Division of
4 Budget and Analyses of the Budget and Control Board shall update the composite index so as to have the index available for each contract
5 renewal.
6 The Department may apply the inflation factor in calculating the reimbursement rate for the new contract period from zero percent (0%)
7 up to the inflation factor developed by the Division of Budget and Analyses.
8 8.3. (DHHS: Medical Assistance Audit Program Remittance) The Department of Health and Human Services shall remit to the
9 General Fund an amount representing fifty percent (allowable Federal Financial Participation) of the cost of the Medical Assistance Audit
10 Program as established in the State Auditor's Office of the Budget and Control Board Section 63E. Such amount shall also include
11 appropriated salary adjustments and employer contributions allocable to the Medical Assistance Audit Program. Such remittance to the
12 General Fund shall be made monthly and based on invoices as provided by the State Auditor's Office of the Budget and Control Board.
13 8.4. (DHHS: Medicaid Income Limitation) The income limitation for the Medicaid Program shall continue to be three hundred
14 percent of the SSI single payment maximum.
15 8.5. (DHHS: Third Party Liability Collection) The Department of Health and Human Services is allowed to fund the net costs of any
16 Third Party Liability and Drug Rebate collection efforts from the monies collected in that effort.
17 8.6. (DHHS: Medicaid State Plan) Where the Medicaid State Plan is altered to cover services that previously were provided by 100%
18 state funds, the Department can bill other agencies for the state share of services provided through Medicaid. The Department will keep
19 a record of all services affected and submit periodic reports to the Senate Finance and House Ways and Means Committees.
20 8.7. (DHHS: Medically Indigent Assistance Fund) The Department is authorized to expend disproportionate share funds to all eligible
21 hospitals with the condition that all audit exceptions through the receipt and expenditures of these funds are the liability of the hospital
22 receiving the funds. To the extent that any disproportionate share funds authorized under this section exceed a specific hospital's cost, such
23 funds must be spent on health care services by a governmental entity. These funds must be used to reimburse the hospital for expenses
24 in providing uncompensated indigent care.
25 8.8. (DHHS: Admin. Days/Swing Beds Reduction Prohibition) Funds appropriated herein for hospital administrative days and swing
26 beds shall not be reduced in the event the agency cuts programs and the services they provide.
27 8.9. (DHHS: Nursing Home Sanctions) The Department of Health and Human Services is authorized to establish an interest bearing
28 Restricted Fund with the State Treasurer, to deposit fines collected as a result of nursing home sanctions. The Department may use these
29 funds to protect the life, health, and property of patients in nursing homes, including payment for the costs of relocation of residents to
30 other facilities, maintenance of operation of a facility pending correction of deficiencies or closure.
31 8.10. (DHHS: Reimbursement Formula Changes) To the extent the Department can increase Medicaid federal matching funds through
32 changes in reimbursement formulas for other state providers, the Department, with the permission of the state providers, is authorized to
33 retain these funds in an earmarked account on deposit with the State Treasurer and use these funds to cover unanticipated health and human
34 services expenditures. The Department should not hold any other state provider liable for disallowances resulting from these changes.
35 Any funds realized as a result of this proviso shall be reported as part of the following year budget process.
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1 8.11. (DHHS: Managed Care) The Insurance Law of South Carolina and the regulations promulgated thereunder shall not apply to
2 partially capitated, primary care providers, insofar as such groups or individuals are defined by and agree to provide health care services
3 under South Carolina's Medicaid Managed Care Program.
4 8.12. (DHHS: Child Care and Development Block Grant) The Department of Health and Human Services (DHHS) shall use the funds
5 appropriated to provide matching funds for the new Child Care and Development Block Grant. DHHS, in coordination with the
6 Department of Social Services, shall use these child care funds to support the state's welfare reform program (Family Independence Act
7 of 1995) and to provide temporary child care services to other low income working families.
8 8.13. (DHHS: Residential Care Optional Supplement) From the appropriation made herein for General Assistance Residential Care
9 Facilities, the Department will supplement the income of individuals who reside in those licensed residential care facilities that have an
10 approved Optional Supplement Request with the Department. Individuals who reside in those residential care facilities with approved
11 Optional Supplement Requests must also qualify as aged, blind or disabled under the definitions of Public Law 92-603, U.S. Code, or who
12 would qualify except for income limitations or residence in a residential care facility reclassified as a public institution by the Social
13 Security Administration. For the period of the current fiscal year, the Department will, based on availability of funds, supplement the
14 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
15 fee of $762.00 per/month for the defined group. Each individual in the defined group is allowed a $33.00 per/month personal needs
16 allowance. The Department will issue the recipient an Optional Supplement check in an amount that will permit the recipient to comply
17 with the above payments; however, DHHS will devise a payment system which will reflect a daily occupancy and will issue a single check
18 to each enrolled facility participating in the OSS program. if If the federal government grants a cost of living increase to Social Security
19 and Supplemental Security Income recipients, the Department will increase the residential care payment by the amount of the cost of living
20 increase minus $2.00 per recipient for an increase in the Personal Needs Allowance from $33 to $35. This increase to the Personal Needs
21 Allowance applies to all OSS recipients regardless of whether they receive Social Security and/or Supplemental Security Income. The
22 maximum amount of payment a facility can charge will be increased by the same amount as the cost of living increase, less $2.00. the The
23 maximum amount that the facility is permitted to charge is $762.00. The Department shall establish the maximum number of Optional
24 Supplement Requests that can be funded and will develop a waiting list based on present and future applications received from each county.
25 Each facility that participates in the Optional Supplement Program must submit a notarized operating cost report. The cost information
26 will include all income and operating costs for the facility. The Department will develop a time schedule for reports to be submitted.
27 Facilities failing to submit costs information and adhere to the time schedule will not be eligible to serve Optional Supplement residents.
28 Information received by the Department will be consolidated and submitted to the Senate Finance Committee and the Ways and Means
29 Committee. The Department shall explore any options for maximizing state matching dollars in the provision of services to residents of
30 licensed community residential care facilities and options for reviewing the quality and adequacy of care and report to the Senate Finance
31 Committee, the Ways and Means Committee and the Governor's Office no later than January 15, 1998. All services rendered to a
32 Residential Care Facility resident must be in compliance with state health licensing laws and regulations.
33 8.14. (DHHS: Medical Home for Clients) The Department of Health and Human Services (DHHS) shall establish a program to
34 encourage physicians to establish a "medical home" for Medicaid clients. This program is intended to provide continuity of care for
35 Medicaid clients, increase access to primary care services for Medicaid clients and ensure increased and continued participation in the
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1 Medicaid program by physicians who render primary care services. The DHHS shall have the responsibility to define a "medical home"
2 and have signed agreements with physicians willing to meet the requirements of providing a "medical home." Physicians signing
3 agreements to become medical homes for Medicaid will receive enhanced reimbursement to be defined by DHHS. Federally Qualified
4 Health Centers (FQHCs) and Rural Health Centers (RHCs) must meet the requirements set forth for a "medical home" in order to continue
5 to receive cost based reimbursement from DHHS.
6 8.15. (DHHS: Nursing Services) In the delivery of services in the Medicaid program, LPN's are authorized to provide services in home
7 or residential settings without on-site supervision by an RN provided the RN has approved the plan of care. RN's are authorized to approve
8 a plan of care which provides for LPN's to provide services in a home or residential setting without direct on-site supervision.
9 8.16. (DHHS: Div. on Aging - State Match Funding Formula) Of the state funds appropriated under "Distribution to Subdivisions",
10 the first allocation by the Division on Aging shall be for the provision of required State matching funds according to the Division's formula
11 for distributing Older Americans Act funds, based on the official United States census data for 1990. The balance of this item, but not
12 to exceed five hundred thousand dollars ($500,000) shall be distributed equally to the planning and service areas of the State. In the event
13 State appropriations are reduced, reductions to the planning and service areas shall be based on amounts distributed in accordance with
14 the previous requirements.
15 8.17. (DHHS: Div. on Aging - State Matching Funds Carry Forward) Any unexpended balance on June 30 of the prior fiscal year, of
16 the required State matching funds allocation, of the amount appropriated in this section under Distribution to Subdivisions, shall be carried
17 forward in the current fiscal year to be used as required state matching funds for Federal funds awarded to subdivisions on or before
18 September 30 of the current fiscal year.
19 8.18. (DHHS: Div. on Aging - Recycle Program) The Division on Aging is hereby authorized to collect, expend, and carry forward
20 not more than $1,000 in revenues from the sale of items to be recycled.
21 8.19. (DHHS: Div. on Aging - Registration Fees) The Division on Aging is authorized to receive and expend registration fees for
22 educational, training, and certification programs.
23 8.20. (DHHS: Div. on Aging - Alzheimer's Matching Grants) Of the funds appropriated herein for Alzheimers, grants awarded to assist
24 communities and entities in addressing problems relative to Alzheimer's disease and other related disorders must be matched with
25 additional funds or in-kind contributions by the community or other entity equal to the amount of funds awarded in the grant.
26 8.21. (DHHS: Prescriptions) From the funds appropriated herein, the Department is directed to increase the prescription/refill limit
27 to four (4) prescriptions/refills per month for each recipient effective January 1, 1999, and to ensure that unlimited prescription/refill
28 coverage is available for children.
29 8.22. (DHHS: Dental Home) The Department shall establish a program to encourage dentists to establish a "dental home" for
30 Medicaid clients. This program shall provide Medicaid clients with continuity of care, increase access to dental care services and ensure
31 dentists' participation who render primary care services. The Department shall define "dental home" and administer signed agreements
32 with dentists agreeing to meet the requirements of the program. Dentists signing agreements will receive enhanced reimbursements
33 defined by the Department. Federally Qualified Health Centers must meet the requirements set forth for a "dental home" in order to
34 continue to receive cost based reimbursement.
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1 8.23. (DHHS: Division on Aging Transfer) Notwithstanding any other provision of law, effective July 1, 1997, the duties, functions
2 and responsibilities of the Division on Aging in the Office of the Governor are transferred to the Department of Health and Human
3 Services as the Office on Aging. The director of the Department must employ a deputy director to be the administrator for the office.
4 8.24. (DHHS: Working Disabled) From the funds appropriated herein, the Department is directed to provide Medicaid benefits during
5 the current year to working disabled individuals whose family income is less than 250% of the federal poverty level and who would be
6 considered to be receiving Supplemental Security Income (SSI) benefits except for their earned income.
7 8.25. (DHHS: Residential Care Pilot Project) The Department shall establish a pilot project to determine the appropriateness and
8 feasibility of providing care to dementia patients, including Alzheimer's patients, in residential care facilities that meet nursing home level
9 of care criteria. In order to fund the appropriate level of care, the Department shall develop, if feasible, a methodology to provide
10 Medicaid services to these patients. State matching funds must be identified from the existing state funding provided to the Optional
11 Supplement Program. DHHS must report on the progress and findings of this pilot project to the House Ways and Means Committee, the
12 Senate Finance Committee and the Governor by March 15th of each year.
13 8.26. (DHHS: Chiropractic Services) From the funds appropriated herein, the Department is directed to provide coverage for
14 medically necessary chiropractic services for Medicaid eligible recipients.
15 8.27. (DHHS: Long Term Care System) The Department of Health and Human Services and the Department of Health and
16 Environmental Control shall, in coordination with other appropriate agencies and organizations, develop a system of services which
17 provides a continuum of long term care services for elderly individuals and their families. The system shall integrate available funding
18 streams, design a common intake system, incorporate recipient directed care and voucher options to the extent possible, expand the current
19 continuum to better address all levels of care needed and develop an eligibility/access system. The agencies will identify any changes
20 necessary in the certificate of need rules which will better support this system by lowering cost and increasing access. The system shall
21 include a process to routinely assess the system of care focusing on quality, access, outcomes and efficiency. The agencies shall report
22 annually to the Governor, to the Senate Finance Committee and to the House Ways and Means Committee no later than January 15th on
23 this system.
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