Legislative Updates

Legislative Update

HEALTHCARE
Last Tuesday, the House recalled from committee H. 4935 (Reps. Felder, Douglas, Ridgeway and Bryant) a Joint Resolution that creates the “South Carolina Palliative Care and Quality of Life Study Committee”. On Wednesday, the House approved the Joint Resolution by a vote of 103-3. It requires the study committee to consult with and advise the Division on Aging on matters related to the establishment, maintenance, operation, and outcomes evaluation of palliative care initiatives in this State, including needed state policies or responses and ways to provide clear and coordinated services to support and enhance the delivery of palliative care. After receiving a routine third reading yesterday, it now goes to the Senate for consideration.
The full Senate Medical Affairs Committee gave favorable approval to S. 212 (Sens. Davis, Hutto, Campbell and other) known as the “South Carolina Compassionate Care Act”. The bill would allow seriously ill patients to have access to a regulated medical marijuana system, as they do in 29 other states and the District of Columbia. The subcommittee had previously adopted a strike and insert amendment that made a number of changes, including a clear ban on smoking medical cannabis and more specific requirements for physicians, along with greater involvement of law enforcement in oversight of those licensed to conduct business in the program.
Under the amended bill, South Carolina would have one of the most carefully regulated programs in the country. By a 8-6 vote, the committee reported the bill out favorably as amended, to the full Senate. However, bill proponents and opponents understood the bill does not have a chance of passage this year and both sides will continue to work on the bill.
The Senate gave second reading approval to H. 3819 (Reps. Bedingfield, Fry, Henderson and others) which establishes requirements for prescribing opioid analgesics to minors. Also receiving second reading was H. 4116 (Reps. Ridgeway, Douglas, Spires, G. M. Smith, and others). The bill prohibits hospitals and insurance companies from enjoining physicians to secure a maintenance of certification. Both bills remain on the Senate calendar awaiting third and final reading.


BUDGET
The Senate completed floor debate on the FY 2018-19 General Appropriations Act H. 4950(Ways and Means Committee) and the Capital Reserve Fund H. 4951 (Ways and Means Committee) this past week and adopted the bill by a vote of 37-4. Included in it are the following for Heathcare:

Healthcare:
$26 million for DHHS for Medicaid Maintenance of Effort;
$11 million for opioid prevention and treatment;
$4 million increased funding for the Rural Health Initiative;
$1 million in recurring funding added to the Telehealth program.

The budget now goes back to the House where they can accept the Senate version, or most likely, amend the bill and send it to a conference committee to work out the differences. The Capital Reserve Fund appropriations are identical to the House version and will not need to go to a conference committee.


Maintenance of Certification
The Senate Medical Affairs Subcommittee approved H. 4116 (Reps. Ridgeway, Douglas, Spires, G. M. Smith, and others). The bill prohibits hospitals and insurance companies from enjoining physicians to secure a maintenance of certification. The bill now goes to the full committee for consideration.


Nursing Scope of Practice
The SC Medical Association and the Advanced Practice Registered Nurses have compromised in various areas with S. 345 (Sens. Davis, McElveen, Scott, and Fanning). The legislation calls for Nurse Practitioner, Certified Nurse-Midwife, and Advanced Practitioner Nurse to develop with physician a written agreement establishing medical aspects of care that NP, CNM or CNS can provide, including prescribing of medications. Below is the new wording:
Practice agreement’ means a written agreement developed by an NP, CNM, or CNS and a physician or medical staff who agrees to work with and to support the NP, CNM, or CNS. The practice agreement must establish the medical aspects of care to be provided by the NP, CNM, or CNS, including the prescribing of medications. The practice agreement must contain mechanisms that allow the physician to ensure that quality of clinical care and patient safety is maintained in accordance with state and federal laws, as well as all applicable Board of Nursing and Board of Medical Examiners rules and regulations.
The practice agreement must comply with Section 40-33-34. A CNM also may practice pursuant to written policies and procedures for practice developed and agreed to with a physician who is board certified or board eligible by the American College of Obstetricians and Gynecologists. Written policies and procedures constitute a practice agreement for purposes of compliance with Section 40-33-34 and must address medical aspects of care including prescriptive authority and must contain transfer policies and details of the on-call agreement with the physician with whom the policies and procedures were developed and agreed.
The on-call physician has the authority to designate another qualified physician to be the on-call physician if necessary. The on-call physician must be available to the CNM to provide medical assistance in person, by telecommunications, or by other electronic means.


Regulated Medical Marijuana Update
At the end of March, full Senate Medical Affairs Committee gave favorable approval to S. 212 (Sens. Davis, Hutto, Campbell and other) known as the “South Carolina Compassionate Care Act”. The bill would allow seriously ill patients to have access to a regulated medical marijuana system, as they do in 29 other states and the District of Columbia. The subcommittee had previously adopted a strike and insert amendment that made a number of changes, including a clear ban on smoking medical cannabis and more specific requirements for physicians, along with greater involvement of law enforcement in oversight of those licensed to conduct business in the program. Under the amended bill, South Carolina would have one of the most carefully regulated programs in the country. By a 8-6 vote, the committee reported the bill out favorably as amended, to the full Senate. However, bill proponents and opponents understood the bill does not have a chance of passage this year and both sides will continue to work on the bill.


Prescribing Opioids to Minors
Also, the Senate gave second reading approval to H. 3819 (Reps. Bedingfield, Fry, Henderson and others) which establishes requirements for prescribing opioid analgesics to minors. Also receiving second reading was H. 4116 (Reps. Ridgeway, Douglas, Spires, G. M. Smith, andothers). The bill prohibits hospitals and insurance companies from enjoining physicians to secure a maintenance of certification. Both bills remain on the Senate calendar awaiting third and final reading.