COLUMBIA, SC — South Carolina hospitals and nursing homes now have to ask permission of the state before they can expand or add services. But what if there was no one to ask?
That is the question state health officials and health care providers were grappling with Wednesday after the S.C. House upheld Gov. Nikki Haleys veto of the $1.7 million certificate-of need program.
The state Department of Health and Environmental Control has 32 certificate of need applications pending before it, seeking state approval for projects in 15 counties worth $86.4 million, according to the latest update on that agencys website.
The projects include:
• A $7.9 million expansion of the radiation-treatment facility at Lexington Medical Center
$2.6 million for Columbias Palmetto Health Baptist to renovate for a new MRI machine
• Construction of a 16-bed, in-patient hospice facility in Laurens County
The law that requires health care providers to get permission for those projects still stands. But, by upholding Haleys veto, House lawmakers voted to cut the $1.7 million that the state health agency uses to process those applications.
Right now, we are in a situation where the law is neither funded nor repealed, said Mark Plowden, a spokesman for the Department of Health and Environmental Control, which oversees the certificate-of-need program. We heard the direction of our executive and legislative branches today, and we are working to determine how to implement their instruction.
In asking lawmakers to uphold Haleys veto, House Ways and Means chairman Brian White, R-Anderson, said DHEC has other funds in that agency they can use and move other people over for that purpose.
But DHEC spokesman Plowden said, The director testified before the General Assembly this year that the agency would not, and could not, administer unfunded mandates.
Its very confusing, and you know were very concerned about how this process will be handled at DHEC, said Randy Lee, president of the S.C Health Care Association, which represents 190 S.C. nursing homes. It can have a very negative impact on expansion, and were very concerned about it.
This is the second consecutive year that Republican Haley who once worked for Lexington Medical Center, a hospital that had trouble with the certificate-of-need program in getting state approval for an expansion that it wanted to make has vetoed the money for the program.
The certificate of need program is an intensely political one through which bureaucratic policymakers deny new health care providers from offering treatment, Haley wrote in her veto message. We should allow the market to work rather than politics.
Allan Stalvey, executive vice president for the S.C. Hospital Association, said he did not think DHEC could pay for the program with other money in its budget because the Legislature , who is responsible for appropriating funds, which means directing how funds are spent, specifically said now we dont want any money spent on the certificate-of-need program.
Just about everybody else in the state recognizes the value of the certificate-of-need program except (Gov. Haley), Stalvey said. Expansion in the health care market means expansion of jobs, capital investment, all those type things. So, she has, in essence, shut that down.
Overall, the House voted Wednesday to sustain 28 of Haleys 81 budget vetoes. The House voted to overturn 53 other vetoes.
The state Senate is scheduled to take up those 53 vetoes at 11 a.m. Thursday, including portions of the S.C. Arts Commissions operating budget. For three years in a row, Haley has vetoed some or all of that agencys budget.
This year, Haleys veto came one day before a Legislative Audit Council report found the agency did not spend at least 70 percent of its state money on arts grants, as state law requires. The agency spent 68.9 percent, missing the 70 percent threshold by $21,285.
Arts Commission officials said they did award 70 percent in grants, but some of the award winners did not spend the money and ended up returning it to the commission. Commission director Ken May said the agency carried that money over into this budget year and spent it on new arts grants.
If you read the full report, its by no means an indictment, May said. Id say its almost more of a validation.
In announcing her vetoes Tuesday, Haley emphasized her decisions were not personal.
But Rep. Tommy Stringer, R-Greer, took offense at Haleys veto of $100,000 for the Bleeding Disorders Premium Assistance Program. Stringers son has hemophilia, a blood disorder, and Stringer told lawmakers about how his wife had to put on surgical gloves to treat him Wednesday morning.
Thats a very personal thing when you are sticking a needle in the chest of your son, Stringer said.
House members voted, 121-1, to overturn the bleeding disorder veto.
What the colors mean
General appropriations vetos
Capital Reserve Fund vetoesVideo: Haleys veto news conference (afternoon of June 25)
Reach Beam at (803) 386-7038.