A BILL

TO AMEND SECTIONS 44-7-110, 44-7-120, 44-7-130, 44-7-140, 44-7-150, AND 44-7-320 OF THE 1976 CODE, ALL RELATING TO THE REGULATION OF HEALTH CARE FACILITIES IN THE STATE, TO ELIMINATE REFERENCES TO CERTIFICATE OF NEED REQUIREMENTS; TO REPEAL SECTIONS 44-7-160, 44-7-170, 44-7-180, 44-7-190, 44-7-200, 44-7-210, 44-7-220, 44-7-225, 44-7-230, AND 44-7-240 OF THE 1976 CODE, ALL RELATING TO THE CERTIFICATE OF NEED PROGRAM; AND TO RENAME ARTICLE 3, CHAPTER 7, TITLE 44 OF THE 1976 CODE AS THE STATE HEALTH FACILITY LICENSURE ACT .

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

SECTION      1.      A.      Article 3, Chapter 7, Title 44 of the 1976 Code is renamed the State Health Facility Licensure Act .

B.      Section 44-7-110 of the 1976 Code is amended to read:

Section 44-7-110.      This article may be cited as the State Certification of Need and Health Facility Licensure Act .

SECTION      2.      Section 44-7-120 of the 1976 Code is amended to read:

Section 44-7-120.      The purpose of this article is to promote cost containment, prevent unnecessary duplication of health care facilities and services, guide the establishment of health facilities and services which will best serve public needs, and ensure that high quality services are provided in health facilities in this State. To achieve these purposes, this article requires:

(1)      the issuance of a Certificate of Need before undertaking a project prescribed by this article;

(2)      adoption of procedures and criteria for submittal of an application and appropriate review before issuance of a Certificate of Need;

(3)      preparation and publication of a State Health Plan;

(4)      the licensure of facilities rendering medical, nursing, and other health care.

SECTION      3.      Section 44-7-130 of the 1976 Code is amended to read:

Section 44-7-130.      As used in this article:

(1)       Affected person means the applicant, a person residing within the geographic area served or to be served by the applicant, persons located in the health service area in which the project is to be located and who provide similar services to the proposed project, persons who before receipt by the department of the proposal being reviewed have formally indicated an intention to provide similar services in the future, persons who pay for health services in the health service area in which the project is to be located and who have notified the department of their interest in Certificate of Need applications, the State Consumer Advocate, and the State Ombudsman. Persons from another state who would otherwise be considered affected persons are not included unless that state provides for similar involvement of persons from South Carolina in its certificate of need process.

(2)       Ambulatory surgical facility means a facility organized and administered for the purpose of performing surgical procedures for which patients are scheduled to arrive, receive surgery, and be discharged on the same day. The owner or operator makes the facility available to other providers who comprise an organized professional staff.

(2)       Birthing center means a facility or other place where human births are planned to occur. This does not include the usual residence of a mother, any facility that is licensed as a hospital, or the private practice of a physician who attends a birth.

(3)       Board means the State Board of Health and Environmental Control.

(4)      Reserved. Children, adolescents, or young adults in need of mental health treatment in a residential treatment facility means a child, adolescent, or young adult under the age of twenty-one who manifests a substantial disorder of cognitive or emotional process that lessens or impairs to a marked degree that child s, adolescent s, or young adult s capacity either to develop or to exercise age-appropriate or age-adequate behavior, including, but not limited to, marked disorders of mood or thought processes; severe difficulties with self-control or judgment, including behavior dangerous to himself or others; and serious disturbances in a child s, adolescent s, or young adult s ability to care for or relate to others.

(5)       Competing applicants means two or more persons or health care facilities as defined in this article who apply for Certificates of Need to provide similar services or facilities in the same service area within a time frame as established by departmental regulations and whose applications, if approved, would exceed the need for services or facilities.

(6)       Community residential care facility means a facility which offers room and board and provides a degree of personal assistance for two or more persons eighteen years old or older.

(7)(6)       Day-care Daycare facility for adults means a facility for adults eighteen years or older which that:

     (a)      offers in a group setting a program of individual and group activities and therapies;. The program

     (b)      is directed toward providing community-based care for those in need of a supportive setting for less than twenty-four hours a day, thereby preventing in order to prevent unnecessary institutionalization,; and

     (c)      shall provide provides a minimum of four and a maximum of fourteen hours of operation a day.

(8)(7)       Department means the Department of Health and Environmental Control.

(9)(8)       The federal act means Title VI of the United States Public Health Service Act (the Hill-Burton Construction Program); Title XVI of the United States Public Health Service Act (National Health Planning and Resources Development Act of 1974 Public Law 93-641); grants for all center and facility construction under Public Law 91-211 (community mental health centers amendments to Title II, Public Law 88-164, Community Mental Health Centers Act); grants for all facility construction under Public Law 91-517 (developmental disabilities services and facilities construction amendments of 1970 to Part C, Title I, grants for construction of facilities for persons with intellectual disability Public Law 88-164); and other federal programs as may exist or be enacted which provide for the construction of hospitals or related health facilities. Facility for chemically dependent or addicted persons means a facility organized to provide outpatient or residential services to chemically dependent or addicted persons and their families based on an individual treatment plan including diagnostic treatment, individual and group counseling, family therapy, vocational and educational development counseling, and referral services.

(9)       Facility wherein abortions are performed means a facility, other than a hospital, in which any second-trimester or any five or more first-trimester abortions are performed in a month.

(10)       Freestanding emergency service or off-campus emergency service means an extension of an existing hospital emergency department that is intended to provide comprehensive emergency service but does not include a service that does not provide twenty-four hour, seven day per week operations or that is not capable of providing basic services as defined for hospital emergency departments. A service that does not qualify as a freestanding emergency service must not be classified as a freestanding emergency service and must not advertise, or display or exhibit any signs or symbols, that would identify the service as a freestanding emergency service.

(10)(11)       Health care facility means, at a minimum, acute care hospitals, psychiatric hospitals, alcohol and substance abuse hospitals, nursing homes, ambulatory surgical facilities, hospice facilities, radiation therapy facilities, rehabilitation facilities, residential treatment facilities for children and adolescents, intermediate care facilities for persons with intellectual disability, or narcotic treatment programs, and any other facility for which Certificate of Need review is required by federal law.

(11)(12)       Health service means clinically related, diagnostic, treatment, or rehabilitative services and includes alcohol, drug abuse, and mental health services for which specific standards or criteria are prescribed in the State Health Plan.

(12)(13)       Hospital means a facility that is organized and administered to provide overnight medical or surgical care or nursing care of for an illness, injury, or infirmity; that and may provide obstetrical care,; and in which all diagnoses, treatment, or care is administered by or under the direction of persons currently licensed to practice medicine, surgery, or osteopathy. Hospital Hospital may include a residential treatment facilities facility for children, and adolescents, or young adults in need of mental health treatment which are that is physically a part of a licensed psychiatric hospital. This definition does not include facilities which that are licensed by the Department of Social Services.

(14)       Intermediate care facility for persons with an intellectual disability means a facility that serves four or more persons with an intellectual disability or persons with related conditions and that provides health or rehabilitative services on a regular basis to individuals whose mental and physical conditions require services including room, board, and active treatment for their intellectual disability or related conditions.

(13)(15)       Nursing home means a facility with an organized nursing staff to maintain and operate organized facilities and services to accommodate two or more unrelated persons over a period exceeding twenty-four hours which is operated either in connection with a hospital or as a freestanding facility for the express or implied purpose of providing intermediate or skilled nursing care for persons who are not in need of hospital care.

(14)       Facility for chemically dependent or addicted persons means a facility organized to provide outpatient or residential services to chemically dependent or addicted persons and their families based on an individual treatment plan including diagnostic treatment, individual and group counseling, family therapy, vocational and educational development counseling, and referral services.

(15)(16)       Person means an individual, a trust or estate, a partnership, a corporation including an association, joint stock company, insurance company, and a health maintenance organization, a health care facility, a state, a political subdivision, or an instrumentality including a municipal corporation of a state, or any legal entity recognized by the State.

(17)       Radiation therapy facility means a person or a health care facility that provides or seeks to provide mega-voltage therapeutic services to patients through the use of high energy radiation.

(16)(18)       Residential treatment facility for children and adolescents means a facility operated for the assessment, diagnosis, treatment, and care of two or more children and adolescents in need of mental health treatment which provides:

     (a)      a special education program with a minimum program defined by the South Carolina Department of Education;

     (b)      recreational facilities with an organized youth development program; and

     (c)      residential treatment for a child or adolescent in need of mental health treatment.

(17)       Solely for research means a service, procedure, or equipment which has not been approved by the Food and Drug Administration (FDA) but which is currently undergoing review by the FDA as an investigational device. FDA research protocol and any applicable Investigational Device Exemption (IDE) policies and regulations must be followed by a facility proposing a project solely for research .

(18)       Children, adolescents, and young adults in need of mental health treatment in a residential treatment facility means a child, adolescent, or young adult under age twenty-one who manifests a substantial disorder of cognitive or emotional process, which lessens or impairs to a marked degree that child s, adolescent s, or young adult s capacity either to develop or to exercise age-appropriate or age-adequate behavior. The behavior includes, but is not limited to, marked disorders of mood or thought processes, severe difficulties with self-control and judgment including behavior dangerous to self or others, and serious disturbances in the ability to care for and relate to others.

(19)       Intermediate care facility for persons with intellectual disability means a facility that serves four or more persons with intellectual disability or persons with related conditions and provides health or rehabilitative services on a regular basis to individuals whose mental and physical conditions require services including room, board, and active treatment for their intellectual disability or related conditions.

(20)       Freestanding or mobile technology means medical equipment owned or operated by a person other than a health care facility for which the total cost is in excess of that prescribed by regulation and for which specific standards or criteria are prescribed in the State Health Plan.

(21)       Like equipment with similar capabilities means medical equipment in which functional and technological capabilities are identical to the equipment to be replaced; and the replacement equipment is to be used for the same or similar diagnostic, therapeutic, or treatment purposes as currently in use; and does not constitute a material change in service or a new service.

(22)       Facilities wherein abortions are performed means a facility, other than a hospital, in which any second trimester or five or more first trimester abortions are performed in a month.

(23)       Radiation therapy facility means a person or a health care facility which provides or seeks to provide mega-voltage therapeutic services to patients through the use of high energy radiation.

(24)       Birthing center means a facility or other place where human births are planned to occur. This does not include the usual residence of the mother or any facility that is licensed as a hospital or the private practice of a physician who attends the birth.

(25)       Freestanding emergency service also referred to as an off-campus emergency service, means an extension of an existing hospital emergency department that is an off-campus emergency service and that is intended to provide comprehensive emergency service. The hospital shall have a valid license and be in operation to support the off-campus emergency service. A service that does not provide twenty-four hour, seven day per week operation or that is not capable of providing basic services as defined for hospital emergency departments must not be classified as a freestanding emergency service and must not advertise or display or exhibit any signs or symbols that would identify the service as a freestanding emergency service.

(26)       Crisis stabilization unit facility means a facility, other than a health care facility, operated by the Department of Mental Health or operated in partnership with the Department of Mental Health that provides a short-term residential program, offering psychiatric stabilization services and brief, intensive crisis services to individuals eighteen and older, twenty-four hours a day, seven days a week.

SECTION      4.      Section 44-7-140 of the 1976 Code is amended to read:

Section 44-7-140.      The department is designated the sole state agency for control and administration of the granting of Certificates of Need and licensure of health facilities and other activities necessary to be carried out under this article.

SECTION      5.      A.      Section 44-7-150 of the 1976 Code is amended to read:

Section 44-7-150.      In carrying out the purposes of this article, the department shall:

(1)      require reports and make inspections and investigations as considered necessary;

(2)      to the extent that