Committee Report

January 10, 2024

 

S. 882

 

Introduced by Senators M. Johnson, Kimbrell, Gustafson, Climer, Garrett and Loftis

 

S. Printed 01/10/24--S.

Read the first time January 09, 2024

 

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The committee on Senate Family and Veterans' Services

To whom was referred a Bill (S. 882) to amend the South Carolina Code of Laws by adding Section 63-5-380 so as to provide that a parent or the legal guardian of a minor must be notified when a health, 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 1, by striking Section 63-5-380(A), (B), (C), (D), and (E) and inserting:

    (A) A person responsible for the welfare of a minor who has not reached the age of sixteen years must provide prior consent to a medical professional for the medical professional to prescribe medication to the minor.

    (B) The  the person responsible for the welfare of a minor to whom medication is prescribed may not be prohibited from reviewing the minor's prescription records regardless of whether those records are maintained with the parent or legal guardian's prescription records or are maintained separately in the minor's name.

    (C) The provisions of this section do not apply:

       (1) to an emancipated minor or to a married minor;

       (2) to a minor who has not reached the age of sixteen, is homeless pursuant to federal or state law, and who does not have a person responsible for the welfare of the minor;

       (3) when the prescribing medical professional reports suspected child abuse or neglect pursuant to Section 63-7-310, the prescription is necessary to treat a condition arising from the suspected child abuse or neglect, and the suspected child abuse or neglect results from acts or omissions committed by the person responsible for the welfare of the minor; or

       (4) when the prescribing medical professional refills a prior prescription for a minor who has not reached the age of sixteen years and the previous prescription complied with or was exempt from the provisions of this section.

    (D) For the purposes of this section, "person responsible for the welfare of the minor" or "person responsible for the welfare of a minor" means a parent, the legal guardian, or a person identified on the authorization for release of health information pursuant to HIPAA maintained by the medical professional of a minor who has not reached the age of sixteen years.

 

Renumber sections to conform.

Amend title to conform.

 

KATRINA SHEALY for Committee.

 

 

statement of estimated fiscal impact

Explanation of Fiscal Impact

 

State Expenditure

This bill requires a health care provider to immediately notify the parent or legal guardian of a minor who has been prescribed medication. Additionally, a pharmacist may not fill a prescription for medication for a minor without the prior written consent of the minor's parent or legal guardian. Further, if a minor needs emergency care, the aforementioned notification regarding medication must be made as soon as practicable, and consent is not required for medications directly related to the emergency care rendered. The provisions of the bill do not apply to an emancipated minor or to a married minor.

 

The Department of Labor, Licensing and Regulation. LLR does not anticipate that this bill will have an expenditure impact on the agency, Board of Medical Examiners, or the Board of Pharmacy since the bill does not alter the duties or responsibilities of the agency or boards. LLR further indicates that any expenses that may arise with implementation of the bill can be managed within existing resources.

 

The Department of Health and Environmental Control. DHEC indicates that this bill places the agency in violation of Title X funding since the bill requires parental consent to fill a prescription for medication for a minor. Currently, Title X funding prohibits obtaining consent and notification of prescriptions for minors for family planning services. DHEC estimates that this bill will result in the loss of $5,109,760 in Federal Funds, including approximately 74 FTEs, for violation of the Title X program. Additionally, DHEC indicates that the loss of Title X funding will also eliminate the agency's ability to access 340B program pricing on family planning pharmaceuticals. The 340B program provides reduced pharmaceutical pricing. On average, wholesale pricing is 172 percent higher than that of the 340B program. DHEC estimates that losing the 340B program pricing will result in a loss of $3,112,025 for family planning products. Therefore, DHEC estimates that this portion of the bill will increase General Fund expenses by $8,221,785 beginning in FY 2024-25 in order to continue to provide the current level of service. This amount includes funding for the 74 FTEs. Additionally, DHEC estimates that the family planning services covered by the Title X program generates approximately $5,566,367 in Other Funds revenue from insurance reimbursements through Medicaid, private insurance, and patient self-pay. However, DHEC indicates that if the agency receives General Funds for the aforementioned loss of Federal Funds, they will still be able to generate the estimated $5,566,367 in Other Funds revenue from reimbursements.

 

DHEC further estimates that it will need approximately 75 FTEs to implement the provisions of the bill. These new FTEs (nurses) will be responsible for obtaining the required consent for prescriptions and dispensing medications in the agency's 67 clinics across the state. DHEC indicates that the clinics are currently short-staffed and cannot handle the additional consent requirements pursuant to the bill. The new positions must be nurses to handle the required consent and to dispense medications. This portion of the bill will increase General Fund expenses of the agency by $9,498,256 in FY 2024-25. Of this amount, $9,164,956 is recurring for salary and fringe for the new FTEs, and $186,100 is recurring for miscellaneous supplies and licenses for the new positions. Nonrecurring costs are expected to total $147,200 for furniture, medical supplies, and equipment. Expenses for this portion of the bill will decrease to $9,351,056 beginning in FY 2025-26.

 

In total, this bill will increase General Fund expenses of DHEC by $17,720,041 in FY 2024-25. Expenses will decrease to $17,572,841 each year thereafter.

 

Department of Alcohol and Other Drug Abuse Services. DAODAS contracts with local alcohol and substance abuse providers. However, in certain programs, a doctor will prescribe Buprenorphine or Naloxone to assist in saving the life of a teenager. Under current protocol, the guardian is notified of this prescription. Therefore, this bill will have no fiscal impact on DAODAS.

 

Department of Mental Health. DMH provides children and adolescents experiencing mental illness with necessary inpatient and outpatient services. This bill will have no fiscal impact on DMH since the agency can manage the provisions of the bill within existing appropriations.

 

Medical University of South Carolina. The fiscal impact of the bill on MUSC is pending, contingent upon a response from the agency.

 

Department of Health and Human Services. The fiscal impact of the bill on DHHS is pending, contingent upon a response from the agency.

 

Department of Social Services. The fiscal impact of the bill on DSS is pending, contingent upon a response from the agency.

 

 

Frank A. Rainwater, Executive Director

Revenue and Fiscal Affairs Office

 

________

 

 

 

 

 

 

 

 

 

A bill

 

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 63-5-380 SO AS TO PROVIDE THAT A PARENT OR THE LEGAL GUARDIAN OF A MINOR MUST BE NOTIFIED WHEN A HEALTH CARE PROFESSIONAL PRESCRIBES MEDICATION TO THE MINOR, TO PROVIDE THAT A PHARMACIST CANNOT FILL A PRESCRIPTION FOR A MINOR WITHOUT THE MINOR'S PARENT OR LEGAL GUARDIAN CONSENTING, TO PROVIDE THAT A PARENT OR LEGAL GUARDIAN CANNOT BE PROHIBITED FROM VIEWING HIS MINOR'S PRESCRIPTION HISTORY, AND TO PROVIDE THAT THESE PROVISIONS DO NOT APPLY TO AN EMANCIPATED MINOR OR A MARRIED MINOR.

 

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

 

SECTION 1.  Article 3, Chapter 5, Title 63 of the S.C. Code is amended by adding:

 

    Section 63-5-380.  (A)  In the event that a minor is prescribed medication, the parent or legal guardian of a minor must be immediately notified by the health care provider prescribing the medication.

    (B) A pharmacist may not fill a prescription for medication for a minor without the prior written consent of the minor's parent or legal guardian.

    (C) The parent or legal guardian of a minor to whom medication is prescribed may not be prohibited from reviewing the minor's prescription records regardless of whether those records are maintained with the parent or legal guardian's prescription records or are maintained separately in the minor's name.

    (D) If a minor needs emergency care, as defined in Section 44-7-260(E), then the notification required in subsection (A) must be made as soon as practicable and the consent required in subsection (B) is not required for medications administered to the minor directly related to the emergency care rendered.

    (E) The provisions of this section do not apply to an emancipated minor or to a married minor.

 

SECTION 2.  This act takes effect upon approval by the Governor.

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