COLUMBIA — This fall, a panel of a senators will evaluate ways for South Carolina to better administer health care services, a significant undertaking that could change the way five state agencies operate.
Senate Majority Leader Harvey Peeler appointed a medical affairs subcommittee that will decide whether to split the Department of Health and Environmental Control into two divisions with separate oversight, and merge the Department of Mental Health, the Department of Alcohol and Other Drug Abuse Services and the Continuum of Care. The two bills also would put the governor in charge of those agencies.
A third bill for the senators to consider also would move the Department of Disabilities and Special Needs to the governor's Cabinet.
The panel will meet for the first time later this month in Columbia.
Peeler, a Gaffney Republican, said the goal of the legislation and the Senate review is to make the services more streamlined and efficient.
Also a factor in the debate will be whether moving the agencies under the governor's oversight will provide more accountability. But legislators also could use the current controversy with Gov. Mark Sanford as a reason to continue to limit the executive branch's power.
Sanford has made restructuring a top priority during his last 16 months in office. He thinks legislators who previously were unwilling to give him a political victory could support restructuring efforts now that it is clear his time in public office will end with his second term as governor.
Peeler said also at play will be "a good bit of turf guard" from the agencies.
Interest in the restructuring efforts is high, especially among the business and environmental community when it comes to DHEC, Peeler said.
Splitting up DHEC might make it more business friendly and shorten the time it takes to receive a permit, Peeler said.
DHEC is the state's sixth-largest state agency in terms of the number of employees. It has more than 3,850 full-time workers and about 500 in temporary and hourly positions. The budget is more than $550 million, including state, federal and other sources.
Advocates for restructuring say the agency's scope is too large to protect both the health of South Carolinians and the environment.
Patrick Moore, who handles government affairs for the Coastal Conservation League, said splitting up the oversight to two boards — one for environmental issues and one for health matters — makes good sense. As it is now, seven board members come from a mix of backgrounds that could mean a wetlands ecologist, for example, is weighing in on a decision about a new heart hospital, Moore said.
Moore said the conservation league is hopeful that restructuring the agency and providing two boards with specific scientific expertise will mean that twice as many projects can be reviewed and that the proposals will be evaluated with the broader impact in mind.
"What's important to the conservation community is making DHEC an accountable and responsible agency that robustly protects the environment," Moore said.
Sen. Brad Hutto, an Orangeburg Democrat, is one of the five members of the subcommittee. He said subcommittee members are going into the process with an open mind and a unified goal, to improve the services that are provided.
For example, Hutto said oftentimes mental health issues and drug and alcohol dependency can go hand-in-hand. That makes it worth evaluating whether it makes sense to combine and streamline the Mental Health Department and the Department of Alcohol and Other Drug Abuse Services. The Continuum of Care also would be merged, under the proposal.
The Continuum of Care, which is run out of the Governor's Office, is a little-known agency that seeks to meet the needs of children with severe emotional disturbance and their families.
Peeler said the mix of subcommittee members — Republican and Democrats from across the state — should be able to build a consensus on the bills that will withstand the scrutiny of the rest of the Senate.
After the subcommittee completes its work, the members will make recommendations for the full Medical Affairs Committee to vote on. Next, the legislation would go to the Senate floor for consideration.
The Legislature reconvenes in January.
THE PROPOSALS
Senators this fall will begin work on three proposals aimed at improving the way health care services are administered by restructuring agencies. The Senate Medical Affairs subcommittee will consider the following bills:
384: Splits oversight for the Department of Health and Environmental Control into two boards each with three members appointed by the governor. A new secretary of health and environmental control would be appointed by the governor and report directly to him. The bill was filed in February and would need to pass the House and Senate. Read the full bill, (S.C. Statehouse web site).
3199: Merges the Department of Mental Health, the Department of Alcohol and Other Drug Abuse Services and the Continuum of Care into a new Cabinet agency to be called the Department of Behavioral Health Services. The House gave the bill key approval in 108-0 vote in May. The full Senate also would need to approve it. Read the full bill, (S.C. Statehouse web site).
3314: Moves the Department of Disabilities and Special Needs under the governor’s oversight as a Cabinet agency and calls for the chief executive to appoint a secretary. The current board would serve an advisory role. The House voted 86-26 in March to give the bill key approval. It still needs a vote on the Senate floor. Read the full bill, (S.C. Statehouse web site).