• • 2022 Legislative Session Begins
• • Senate Begins Debate on Certificate of Need
• • Healthcare Loan Forgiveness Bill Leads Workforce Discussions
• • In Other News
• • Intros of Interest

The House and Senate returned to Columbia this week to begin the second year of their two-year session. Both bodies worked throughout the off session on redistricting matters, but still have Congressional districts to consider as they begin other regular work. We expect this year to include action on Certificate of Need, COVID-19 issues, vaccine mandates, and workforce shortages as well as a large focus on funding due to the one-time federal dollars flowing into the state and the better-than-expected economic outlook during the last year. 

The legislature meets Tuesday, Wednesday, and Thursday now through May 12 for regular session. Unless otherwise noted, The Pulse will be published on Friday each week to keep you updated on important healthcare issues discussed by policymakers. 

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The Senate wasted no time and set S. 290, a bill to repeal the Certificate of Need (CON) program in South Carolina, for special order on Tuesday - the first day of the regular legislative session. The move to set the bill to special order means they must debate and eventually dispense of the issue one way or another, even though it is objected to by one or more Senators. There are a limited number of special order slots on the Senate calendar, and they are generally reserved for high-priority legislation.

Debate on the bill began Wednesday, with several Senators speaking for or against the bill during the nearly four-hour debate. Senator Climer (R - York) is the bill's primary sponsor and lead the discussion to repeal the law, while Senator Davis (R - Beaufort) shared information from his research and testimony during last spring's subcommittee hearings on the issue, which he chaired. 

The issue has been debated nearly perennially for decades without action, but the move to set S. 290 for special order shows that the Senate plans to break that cycle this year and finally make changes to the healthcare law. There are no stakeholders supporting leaving the law as-is, but the degree to which different groups are comfortable changing the law varies greatly. 

SCHA proposed a reform of CON as an alternative to full repeal. The proposal made broad changes to the appeals process, financial thresholds, and specific items requiring review in an amendment offered by Senator Talley (R - Spartanburg). After much discussion of the proposed reform measures, the Senate voted to table the amendment by a 31-9 vote. This move signaled the strong sense of the Senate to make deeper changes to the law and move closer to repeal than the hospital community proposed. 

While some senators support an outright repeal of the CON program, a vote to go that far has not been taken - indicating that the desire of most senators is to make sweeping changes to the program but stopping short of full repeal. The Senate adjourned Wednesday in the middle of the debate on CON and did not continue the debate on Thursday, but S. 290 remains set for special order. It is expected that they will continue discussions when they return next week. 

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Wednesday morning a Senate Education Subcommittee, chaired by Sen. Nikki Setzler, met on S.712 (Davis), a bill to establish the Healthcare Professional Loan Forgiveness Program that would be managed by the SC Area Health Education Consortium (AHEC).  The program, contingent on funding by the General Assembly, would reimburse student loan payments for eligible healthcare professional graduates, specifically physicians, physician assistants, or advanced practice registered nurses practicing as nurse practitioners or certified nurse midwives.  A number of stakeholders testified in support of the bill, including the College of Osteopaths, the College of Emergency Room Physicians and AHEC, several requesting amendments. SCHA spoke to a letter sent to the committee supporting the bill and asking for consideration of inclusion of behavioral health providers in the program, as well as the addition of hospitals and other healthcare employers on the advisory committee.  The subcommittee carried the bill over to consider and draft amendments. Another subcommittee hearing on S. 712 is scheduled for next week.

This is the first of what is expected to be several discussions about the healthcare workforce in the upcoming session.

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• Medical Ethics and Diversity Act: A subcommittee of the Senate Medical Affairs committee met Wednesday to discuss S. 811, a bill to establish additional conscience protections for healthcare workers. This was the second meeting of the subcommittee on this bill, so they did not take public testimony this week. Instead, the committee heard from the bill's sponsor, Senator Kimbrell (R - Spartanburg). Ultimately, the subcommittee carried the bill over for additional consideration. 

• State of the State: The legislature adopted a resolution confirming the date and time of the Governor's State of the State Address. Governor McMaster will speak to the legislature next Wednesday, January 19, at 7:00pm. 

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• S. 960 (Gambrell and Goldfinch): a bill to establish ambulance service as essential and require each county to have at least one licensed ambulance - referred to Senate Judiciary
• H. 4546 (Davis): a bill to remove CON requirements for home health agencies - referred to House Ways and Means Committee
• H. 4549 (M. Smith): a bill to establish a 'acute hospital at home' program and guidelines in South Carolina - referred to House Ways and Means Committee
• H. 4558 (D.C. Moss): a bill to increase penalties for violence against healthcare workers - referred to House Judiciary Committee
• H. 4564 (Davis): a bill to remove CON requirements for opioid treatment facilities - referred to House Ways and Means Committee
• H. 4567 (Oremus, et al.): a bill to allow individuals diagnosed with a disease caused by a declared pandemic to use investigational treatments or drugs - referred to House 3M Committee
• H. 4595 (J.L. Johnson): a bill to require law enforcement agencies to have a mental health counselor on contract - referred to House Judiciary Committee 
• H. 4598 (Gilliard): a bill to require hospitals to report cases of workplace violence to DHEC - referred to House Judiciary Committee
• H. 4600 (West): a bill to amend the priority ranking for who can make healthcare decisions for an individual undergoing electroconvulsive therapy or major medical treatment - referred to House 3M Committee
• H. 4776 (Willis, et al.): a bill to enact the "Medical Ethics and Diversity Act" to provide conscience protections for healthcare workers - referred to House Judiciary Committee
• H. 4801 (J. Moore): a bill to require perinatal healthcare providers complete implicit bias training annually - referred to House 3M Committee

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