SOUTH CAROLINA REVENUE AND FISCAL AFFAIRS OFFICE
S
TATEMENT OF ESTIMATED FISCAL IMPACT
WWW.RFA.SC.GOV • (803)734-3793
This fiscal impact statement is produced in compliance with the South Carolina Code of Laws and House and Senate rules. The focus of
the analysis is on governmental expenditure and revenue impacts and may not provide a comprehensive summary of the legislation.
Page 1 of 5
S. 0054
Fiscal Impact Summary
Section 1 of this bill cites this act as the Medical Informed Consent Act. Section 2 creates a new
offense that makes it unlawful for any person, corporation, higher learning institution, the state
and its political subdivisions to implement a vaccine mandate as a precondition for employment,
building entry, attendance, participation, or receipt of a good or service. Further, this bill states
that a person who violates this: for a first offense is guilty of a misdemeanor and upon conviction
must be fined not more $1,000, imprisoned for not more than one year, or both; for a second
offense is guilty of a misdemeanor and upon conviction must be fined not more than $2,500,
imprisoned for not more than three years, or both for a second offense; and for a third or
subsequent offense is guilty of a felony and must be fined not more than $5,000, imprisoned for
not more than five years, or both.
Section 2 of the bill may result in an increase in the number of circuit court cases and potentially
the number of incarcerations, which may increase the workload of the court system and the
Commission of Indigent Defense (CID), the Commission on Prosecution Coordination (CPC),
the Department of Corrections (Corrections), and the Department of Probation, Parole, and
Pardon Services (PPP). Judicial anticipates that the potential impact of the caseload in court can
be managed within existing appropriations. However, if this bill results in a significant increase
in the caseload, Judicial anticipates an increase in General Fund appropriations may be
requested. The potential increase in expenses for each agency will depend upon the increase in
the number of cases related to repeat offenders and number of incarcerations. These agencies
indicate that if this bill results in a significant increase in the workload, then an increase in
General Fund appropriations may be requested. For information, according to Corrections, in FY
2023-24, the annual total cost per inmate was $40,429, of which $36,553 was state funded.
Section 3 of this bill prohibits employers from taking adverse action against individuals who
decline to receive a vaccine and provides penalties for those who violate this section. This
section of the bill could result in an impact to unemployment benefits, dependent upon the
number of violations. Additional information has been requested from the Department of
Employment and Workforce (DEW) on the potential fiscal impact from this section.
Section 4 of this bill permits a pharmacist the right to refuse to fill or refill a prescription under
specific circumstances. The Department of Labor, Licensing and Regulation (LLR), which
Bill Number: S. 0054 Introduced on Januar
y 14, 2025
Subject: Medical Informed Consent
Requestor: Senate Medical Affairs
RFA Anal
yst(s): Boggs
Impact Date: March 26, 2025 - Updated for Additional Agency Response
Page 2 of 5
S. 0054
oversees the Board of Pharmacy, anticipates that this bill will have no expenditure impact
because the bill does not alter the responsibilities of the department or its boards.
Sections 5 – 11 of this bill give sheriffs and police officers the discretion as to whether they will
aid and assist the director of the Department of Public Health (DPH) in carrying out orders
during a state of public health emergency. Currently local law enforcement must aid DPH during
a state of public health emergency. Additionally, this bill removes DPH’s ability during a public
health emergency to require in state health providers to assist in the performance of vaccinations,
treatment, examination, or testing of any individual as a condition of licensure, authorization, or
the ability to continue to function as a health care provider in the state. Further, this bill provides
a deadline for a petition for an order authorizing the isolation or quarantine of an individual or
group of individuals. DPH expressed concern that limiting the agency’s ability to respond to a
public health emergency could result in costs to the state, as well as a loss of Federal Funds that
could potentially aid the state in an emergency. However, due to the unknown nature of future
health emergencies, DPH is unable to provide an estimate of the potential impact to the General
Fund and Federal Funds.
The Office of Revenue and Fiscal Affairs (RFA) contacted all counties and the Municipal
Association of South Carolina (MASC) to determine the impact on local law enforcement. RFA
received a response from the counties of Beaufort, Chesterfield, Florence, and Horry. Beaufort,
and Horry Counties anticipate this section of the bill will have no expenditure impact.
Chesterfield and Florence Counties expressed that a potential undetermined impact may occur if
a state of public health emergency were to be declared. MASC anticipates that this section of the
bill could result in an undetermined decrease in expenditures for municipalities as it allows them
to participate to the extent that their resources permit.
Horry County anticipates that Section 3 of the bill may result in an increase in the number of
magistrates court cases. The potential increase in expenses for the county will be dependent upon
the increase in the number of cases brough under this section. Therefore, the local expenditure
impact is undetermined.
Additionally, the South Carolina Department of Education (SCDE) indicates that Section 2 of
this bill may be in conflict with current vaccine mandates required for public school attendance.
While SCDE indicated it is unsure what impact this bill may have on school attendance, it
anticipates this bill will have no expenditure impact for the agency nor the school districts as
they anticipate managing the provisions of this bill with existing appropriations.
This fiscal impact statement has been updated to include an additional response from SCDE.
Page 3 of 5
S. 0054
Explanation of Fiscal Impact
Updated for Additional Agency Response on March 26, 2025
Introduced on January 14, 2025
State Expenditure
Section 1 of this bill cites this act as the Medical Informed Consent Act. Section 2 of this bill
creates an offense that makes it unlawful for any person, corporation, higher learning institution,
or the state and its political subdivisions to implement a vaccine mandate as a precondition for
employment, building entry, attendance, participation, or receipt of a good or service. Further,
this bill states that a person who violates this: for a first offense is guilty of a misdemeanor and
upon conviction must be fined not more $1,000, imprisoned for not more than one year, or both;
for a second offense is guilty of a misdemeanor and upon conviction must be fined not more than
$2,500, imprisoned for not more than three years, or both for a second offense; and for a third or
subsequent offense is guilty of a felony and must be fined not more than $5,000, imprisoned for
not more than five years, or both.
This section of the bill may result in an increase in the number of circuit court cases and
potentially the number of incarcerations, which may increase the workload of the court system
and CID, CPC, Corrections, and PPP. Judicial anticipates that the potential impact of the
caseload in court can be managed within existing appropriations. However, if this bill results in a
significant increase in the circuit court caseload, Judicial indicated an additional General Fund
appropriations request may be made. The potential increase in expenses for each agency will
depend upon the increase in the number of cases related to repeat offenders and number of
incarcerations. These agencies indicate that if this bill results in a significant increase in the
workload, then an increase in General Fund appropriations may be requested. For information,
according to Corrections, in FY 2023-24, the annual total cost per inmate was $40,429, of which
$36,553 was state funded.
Section 3 of this bill prohibits employers from taking adverse action against individuals who
decline to receive a vaccine. Additionally, if an employer violates this, then an aggrieved
employee shall have the right to apply for and receive unemployment benefits subject to the
benefit amounts, duration, and requirements provided in Article 1, Chapter 35, Title 41, as well
as back pay, front pay, lost wages, consequential damages, emotional damages, court and
litigation costs, and attorney's fees. Additionally, under this section, the employer could also be
liable to the employee or prospective employee for punitive damages in the treble amount of the
actual damages awarded.
This section of the bill could result in an impact to unemployment benefits, dependent upon the
number of violations. Additional information has been requested from DEW on the potential
fiscal impact from this section.
Section 4 of this bill permits a pharmacist the right to refuse to fill or refill a prescription under
specific circumstances. LLR, which oversees the Board of Pharmacy, anticipates that this bill
will have no expenditure impact because the bill does not alter the responsibilities of the
department or its boards.
Page 4 of 5
S. 0054
Sections 5 – 11 of this bill give sheriffs and police officers the discretion as to whether they will
aid and assist the director of DPH in carrying out orders during a state of public health
emergency. Additionally, this bill removes DPH’s ability during a public health emergency to
require in state health providers to assist in the performance of vaccinations, treatment,
examination, or testing of any individual as a condition of licensure, authorization, or the ability
to continue to function as a health care provider in the state. Further, this bill provides a deadline
for a petition for an order authorizing the isolation or quarantine of an individual or group of
individuals. DPH expressed concern that limiting the agency’s ability to respond to a public
health emergency could result in costs to the state, as well as a loss of Federal Funds that could
potentially aid the state in an emergency. However, due to the unknown nature of future health
emergencies, DPH is unable to provide an estimate of the potential impact to the General Fund
and Federal Funds.
Additionally, SCDE indicates that Section 2 of this bill may be in conflict with current vaccine
mandates required for public school attendance. However, SCDE anticipates this bill will have
no expenditure impact for the agency as they anticipate managing the provisions of this bill with
existing appropriations.
This section has been updated for an additional response from SCDE.
State Revenue
N/A
Local Expenditure
RFA contacted all counties and MASC to determine the impact on local law enforcement. RFA
received a response from the counties of Beaufort, Chesterfield, Florence, and Horry. Beaufort
and Horry Counties anticipate Sections 5 – 11 of the bill will have no expenditure impact.
Chesterfield and Florence Counties expressed that a potential undetermined impact may occur if
a state of public health emergency were to be declared. MASC anticipates that this section of the
bill could result in an undetermined decrease in expenditures for municipalities as it allows them
to participate to the extent that their resources permit.
Horry county anticipates that Section 3 of the bill may result in an increase in the number of
probate court cases. The potential increase in expenses for the county will be dependent upon the
increase in the number of cases brough under this section. Therefore, the fiscal impact is
undetermined.
Additionally, SCDE indicates that Section 2 of this bill may be in conflict with current vaccine
mandates required for public school attendance. While SCDE indicated it is unsure what impact
this bill may have on school attendance, the agency anticipates this bill will have no expenditure
impact for school districts as they anticipate managing the provisions of this bill with existing
appropriations.
This section has been updated to include an additional response from SCDE.
__________________________________
Frank A. Rainwater, Executive Director
DISCLAIMER: THIS FISCAL IMPACT STATEMENT REPRESENTS THE OPINION AND INTERPRETATION OF THE
AGENCY OFFICIAL WHO APPROVED AND SIGNED THIS DOCUMENT. IT IS PROVIDED AS INFORMATION TO
THE GENERAL ASSEMBLY AND IS NOT TO BE CONSIDERED AS AN EXPRESSION OF LEGISLATIVE INTENT.
Page 5 of 5
S. 0054
Local Revenue
N/A