Creating a Bureaucracy to Manage Health Care and Infectious Disease at the State Level- Intellectual Disabilities
Is it possible to create an organization and its "Manager" that can do this without corruption? A case study, using Lessons Learned from the Covid-19 era
Part XXVI Bill S.915 Ch 20 20-30 Objectives and Definitions
Introduction
Title 44, Chapter 20 was, and will be, titled:
Section 44-20-10. This chapter may be cited as the "South Carolina Intellectual Disability, Related Disabilities, Head Injuries, and Spinal Cord Injuries Act".
However, it is really the chapter on the role and responsibilities of the Department of Intellectual and Related Disabilities. This department replaces what in the old Title 44 Chapter 20 was called the South Carolina Department of Disabilities and Special Needs.
The chapter begins with a preamble of what I understand as the objectives of the department.
Section 44-20-20. The State of South Carolina recognizes that a person with intellectual disability, a related disability, head injury, or spinal cord injury is a person who experiences the benefits of family, education, employment, and community as do all citizens. It is the purpose of this chapter to assist persons with intellectual disability, related disabilities, head injuries, or spinal cord injuries by providing services to enable them to participate as valued members of their communities to the maximum extent practical and to live with their families or in family settings in the community in the least restrictive environment available.
When persons with intellectual disability, related disabilities, head injuries, or spinal cord injuries cannot live in communities or with their families, the State shall provide quality care and treatment in the least restrictive environment practical.
In order to plan and coordinate state and locally funded services for persons with intellectual disability, related disabilities, head injuries, or spinal cord injuries, a statewide network of local boards of disabilities and special needs is established. Services will be delivered to clients in their homes or communities through these boards and other local providers.
It is recognized that persons with intellectual disability, related disabilities, head injuries, or spinal cord injuries have the right to receive services from public and other agencies that provide services to South Carolina citizens and to have those services coordinated with the services needed because of their disabilities.
South Carolina recognizes the value of preventing intellectual disability, related disabilities, head injuries, and spinal cord injuries through education and research and supports efforts to this end.
The State recognizes the importance of the role of parents and families in shaping services for persons with intellectual disability, related disabilities, head injuries, or spinal cord injuries as well as the importance of providing services to families to enable them to care for a family member with these disabilities.
Admission to services of the
South CarolinaDepartment of Intellectual and Related Disabilitiesand Special Needs doesnot terminate or reduce the rights and responsibilities of parents. Parental involvement and participation in mutual planning with the department to meet the needs of the client facilitates decisions and treatment plans that serve the best interest and welfare of the client.
The original text had this history:
HISTORY: 1990 Act No. 496, Section 1; 1993 Act No. 181, Section 1078; 2011 Act No. 47, Section 2, eff June 7, 2011.
So, the department name removes “South Carolina” and “Special Needs.” Apparently the only special needs are those “Related Disabilities” associated with “Intellectual.” That does make some sense given the overall title of the chapter. However, there are other kinds of special needs. Let’s see if this is reflected in change in change of scope or responsibilities as the text flows on.
Section 44-20-30 Definitions
Section 44-20-30. As used in this chapter:
(1) "Applicant" means a person who is believed to have intellectual disability, one or more related disabilities, one or more head injuries, one or more spinal cord injuries, or an infant at high risk of a developmental disability who has applied for services of the
South CarolinaDepartment of Intellectual and Related Disabilitiesand Special Needs.(2) "Autism" means Autism Spectrum Disorder as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders.
This definition of autism leaves the meaning of the law up to the authors of the cited reference. A lesson learned from the Covid-19 era is that could be manipulated for political ends. The definition should be given here in the law and modified after deliberation if changed anywhere else. The remainder of the definitions is pretty much the same as the original Title 44 except for the name change.
(2)(3) "Client" is a person who is determined by the Department of Intellectual and Related Disabilitiesand Special Needsto have intellectual disability, a related disability, head injury, or spinal cord injury and is receiving services or is an infant at risk of having a developmental disability and is receiving services.
(3)(4)"Commission""Advisory Board" means theSouth Carolina Commission on Disabilities and Special NeedsIntellectual and Related Disabilities Advisory Board, thepolicy-making and governing bodyentity that advisesofthe Department of Intellectual and Related Disabilitiesand Special Needsconcerning the policy and issues affecting the department's clients.
(4)(5) "Countydisabilities and special needs boardsIntellectual and Related Disabilities Board" or "County Board" means the local public body administering, planning, coordinating, or providing services within a county or combination of counties for persons with intellectual disability, related disabilities, head injuries, or spinal cord injuries, or autism and recognized by the department.
(5)(6) "Day programs" are programs provided to persons with intellectual disability, related disabilities, head injuries, or spinal cord injuries outside of their residences affording development, training, employment, or recreational opportunities as prescribed by the Department of Intellectual and Related Disabilitiesand Special Needs.
(6)(7) "Department" means theSouth CarolinaDepartment of Intellectual and Related Disabilitiesand Special Needs.
(7)(8) "Director" means theSouth CarolinaDirector of the Department of Intellectual and Related Disabilitiesand Special Needs, the chief executive directorappointed by thecommissionSecretary of Health and Policy.
(8)(9) "Disabilities and special needs services" are activities designed to achieve the results specified in an individual client's plan.
(9)(10) "High risk infant" means a child less than thirty-six months of age whose genetic, medical, or environmental history is predictive of a substantially greater risk for a developmental disability than that for the general population.
(10)(11) "Least restrictive environment" means the surrounding circumstances that provide as little intrusion and disruption from the normal pattern of living as possible.
(11)(12) "Improvements" means the construction, reconstruction of buildings, and other permanent improvements for regional centers and other programs provided by the department directly or through contract with county boards of disabilities and special needs, including equipment and the cost of acquiring and improving lands for equipment.
(12)(13) "Intellectual disability" means significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.
(13)(14) "Obligations" means the obligations in the form of notes or bonds or contractual agreements issued or entered into by the commission pursuant to the authorization of this chapter and of Act 1377 of 1968 to provide funds with which to repay the proceeds of capital improvement bonds allocated by the State Fiscal Accountability Authority.
(14)(15) "Regional residential center" is a twenty-four hour residential facility serving a multicounty area and designated by the department.
(15)(16) "Related disability" is a severe, chronic condition found to be closely related to intellectual disability or to require treatment similar to that required for persons with intellectual disability and must meet the following conditions:(a) It is attributable to cerebral palsy, epilepsy, autism, or any other condition other than mental illness found to be closely related to intellectual disability because this condition results in impairment of general intellectual functioning or adaptive behavior similar to that of persons with intellectual disability and requires treatment or services similar to those required for these persons.
(b) It is manifested before twenty-two years of age.
(c) It is likely to continue indefinitely.
(d) It results in substantial functional limitations in three or more of the following areas of major life activity: self-care, understanding and use of language, learning, mobility, self-direction, and capacity for independent living.
(16)(17) "Residential programs" are services providing dwelling places to clients for an extended period of time with assistance for activities of daily living ranging from constant to intermittent supervision as required by the individual client's needs.
(17)(18) "Revenues" or "its revenues" means revenue derived from paying clients at regional residential centers and community residences but does not include Medicaid, Medicare, or other federal funds received with the stipulation that they be used to provide services to clients.
(18)(19) "State capital improvement bonds" means bonds issued pursuant to Act 1377 of 1968.
(19)(20)"Department" shall mean the State Department of Administration as constituted pursuant to Chapter 11, Title 1."State Health Services Plan" means the State Plan for Health developed by the Secretary of Health and Policy.
The history of the original Title 44 text is:
HISTORY: 1990 Act No. 496, Section 1; 1993 Act No. 181, Section 1078; 2011 Act No. 47, Section 2, eff June 7, 2011.
Link back to Part I: Act 60- The Reorganization Directive Bill
---- Begin Discussion of existing law on Natural and Health Disaster Management: Act 44
Link back to Part II: Title 44, Chapter 1
Link back to Part III: Title 44, Sections 4-100-120 Legislative Findings and Intent
-----Definition of Deep State Conundrum and Solution Outline
Link back to Part IV: The Deep State Conundrum and Solution
---- Continuing Discussion of existing law on Natural and Health Disaster Management: Act 44
Link back to Part V: Title 44, Section 4 130 Definitions
Link back to Part VI: Title 44 Section 4 300, 310 Natural Disasters
Link back to Part VII: Title 44 Section 4 320 Disposal of Human Remains
Link back to Part VIII: Title 44 Section 4 330 Supply Purchase and Logistics
Link back to Part IX: Title 44 Section 4 340 Destruction of Property in a Public Health Emergency
Link back to Part X. Title 44 Section 4 500 and 520 Control and Treatment of Infectious Disease
Link back to Part XI: Title 44 Section 4 530 and 540 Quarantine and Isolation
Link back to Part XII: Title 44 Section 4 550 Specimen Collecting
Link back to Part XIII: Title 44 Section 4-560 Access to protected health information
Link back to Part XIV: Title 44 Section 4-570 Emergency Powers Regarding Human Resources
-----Primary Solution to Deep State Conundrum
Link back to SCHIAS: One part of the solution to the Deep State Conundrum: An Independent State-wide Open Source Medical Data and Analytics System
------ Begin Discussion of Bill S.915, which implements Act 60 and has yet to pass
Link back to Part XV: Bill S.915 Revision of Title 44 Adding Chapter 12
------ What was the methodology for selecting the consultant?
Link back to: The problem of reorganizing government agencies: the fox in the henhouse
------ Continuing Discussion of Bill S.915, which implements Act 60 and has yet to pass
Link back to Part XVI: Bill S.915 Revisions to Title 44, Ch 12 50, 60, Organization of the Executive Office of Health and Policyd
Link back to Part XVII. Bill S.915 Revisions to Title 44, Ch. 1 50-100 Powers.
Link back to Part XVIII: Bill S.915 Ch 6 Dept of Health Financing Ch 6-5 to 115
Link back to Part XIX: Bill S.915 Ch 6 Dept of Health Financing Ch 6- 132 to 910 Medicaid
Link back to Part XX: Bill S.915 Ch 6 The Medical Pharmacy and Therapeutics Committee Ch 6- 30 to 40
Link back to Part XXI: Bill S.915 Ch 6 Data Oversight Council Ch 6- 170-180
Link back to Part XXII: Bill S.915 Ch 7 Residential Care
Link back to Part XXIII: Bill S.915 Ch 7 Hospital Infections Disclosure Ch 7 2410-2440
Link back to Part XXIV: Bill S.915 Ch 9 Dept of Behavioral Health Ch 9 10-90
Link back to Part XXV: Bill S.915 Ch 9 Dept of Behavioral Health Ch 9 90-160