DHEC suspending South Carolina's Certificate of Need program

Law requires approval

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COLUMBIA — State health officials told doctors and hospitals across South Carolina they can buy whatever equipment they want and start building whatever they think they need after a program that reviewed those requests was suspended.

Department of Health and Environ­mental Control Director Catherine Temple­ton is telling South Carolina health care providers that her agency will no longer run the Certificate of Need program and won’t look at any projects awaiting a review, according to a letter from the agency obtained Friday by The Associated Press.

The House sustained Gov. Nikki Haley’s veto of money for the program Wednesday, so Templeton said there is no way to run the program without funding. She understood the actions of the governor and Legislature meant they didn’t want the program anymore.

“Suspending the program has the practical effect of allowing new and expanding health care facilities to move forward without the Certificate of Need process,” Templeton wrote.

However, the chairman of the House committee that helps writes the state budget said the House didn’t intend for the program to be suspended when it removed $1.7 million from its budget.

House Ways and Means Chairman Brian White issued a statement Friday reiterating what he said on the House floor two days before – that DHEC could find other money in the agency’s budget to run the program

“If the governor and the agency director wish to unilaterally discontinue the program, as they have indicated, then that is a decision that lies exclusively within the executive branch and one which may be contrary to law but is certainly contrary to the will and intent of the House of Representatives,” the Anderson Republican said in his statement.

Even if lawmakers return in January and give the program money, Templeton said she would not take action against medical com­panies that expand unless the General As­sembly specifically instructed her to do so.

Law requires approval

About three dozen projects worth about $90 million are awaiting DHEC approval.

Supporters of the Certificate of Need program, such as the South Carolina Hospital Association, said its goal was to make sure medical services didn’t just go to the richest and most populated areas of the state. They also said it kept medical costs down by requiring hospitals to prove a new medical complex or machine that costs more than $600,000 was needed and wouldn’t sit idle while patients paid for it. All new nursing homes and substance abuse clinics must go through DHEC to get a certificate as well.

In Haley’s veto message, she said she wanted to get rid of the program to let the free market work. But hospital association executive vice president Allan Stalvey said her veto would do the opposite because since the law requiring the approval remains on the books, financing for projects wouldn’t be available because of the confusion.

“Unless the administration acts to resolve the uncertainty it has created in the marketplace, the only avenue available to health care facilities will be costly litigation,” Stalvey said in a statement.

In her letter, Templeton said the decision won’t affect DHEC’s licensing program, which will continue to inspect health care facilities and ensure doctors and nurses are qualified to practice.

“With these protections in place, we do not believe the suspension of the Certificate of Need program presents any threat to the health, safety, and welfare of the public,” Templeton said.

Governor criticized

Several lawmakers in the House gave passionate speeches Tuesday, begging their colleagues to override the veto. Rep. Walt McLeod, D-Little Mountain, warned of anarchy in the state’s health care system. The House voted 56-65 on Wednesday to sustain Haley’s veto. A two-thirds vote was needed to override it.

That decision took any action out of the Senate’s hands the next day. But Sen. Joel Lourie took the floor to condemn the backdoor methods the governor used to get rid of a program she hasn’t liked since she was a fundraiser for Lexington Medical Center and DHEC initially denied that hospital’s request to do open-heart surgery.

Lourie, a Columbia Democrat, said the law requiring medical facilities to get a Certificate of Need remains on the books and predicted lawsuits. He said if the governor didn’t like the program, she should have changed the law, not just cut the program’s funding.

“It needs reform,” he said of the program. “But this is not the way to govern.”

Haley said in a statement Friday that 14 states have gotten rid of similar programs and she wants the Legislature to take the next step and repeal the law.

“The Certificate of Need program does three things: restricts access, drives down quality and drives up costs,” Haley said. “We’re for competition, and since taking office, have fought for better health for all South Carolinians – that’s what this is all about.”

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