E. Evolving Hospital Issues in South Carolina

• Library: A Practical Guide to Elder and Special Needs Law in South Carolina (SCBar) (2021 Ed.)

E. EVOLVING HOSPITAL ISSUES IN SOUTH CAROLINA

1. Community Benefit Requirement

Under federal law, non-profit hospitals are required to devote resources to "community benefits," and they must report these efforts to the Internal Revenue Service (IRS) each year in order to stay exempt from paying federal income taxes.¹⁸ Hospitals are given broad discretion in determining what health services constitute the "community benefit." In addition to charity care, the "community benefit" can include financial assistance at cost, losses related to participating in Medicaid and other means-tested government health programs, health professions education, research, and a category of services known as "community health improvement."

2. Medical-Legal Partnerships (MLPs)

An exciting innovation now providing a good option for access to free legal advice and representation through a medical provider is called a medical-legal partnership (MLP).

Medical-legal partnerships embed lawyers as specialists in health care settings. When some of the most complex and intractable problems that can directly affect a patient's health - like an illegal eviction - are detected, clinical staff refer patients directly for legal services within the health care setting. Where MLPs exist then just like other non-clinical members of the health care team (e.g. social workers, clergy, etc.), embedded legal staff are directly and timely available to consult with clinical and non-clinical hospital staff about individual patient "health-harming legal barriers" as well as systemic and policy barriers to health care. Across the U.S., a number of these innovative medical-legal partnerships go further, leveraging their considerable knowledge and expertise to advance local and state policies that lead to safer and healthier environments.¹⁹

Currently in South Carolina there are two MLPs in operation: The Upstate MLP based in Greenville with partners Prisma Health, Furman University, and S.C. Legal Services ("legal aid") started in late 2016, and CHAMPS, an MLP based at the School of Law at the University of South Carolina in Columbia.²⁰ At the time of publication, a nascent MLP partnered with MUSC in Charleston is in advanced development, and the strong potential exists for several other MLPs or MLP-like referral networks to address 'health-harming civil legal needs' all across South Carolina.

3. Telemedicine

Telemedicine has been defined as "the practice of medicine using electronic communications, information technology, or other means between a licensee in one location and a patient in another location with or without an...