New bill would merge six SC health agencies into one

COLUMBIA, S.C. (WCSC) - This summer, one of South Carolina’s largest state agencies, the Department of Health and Environmental Control, will split into two new agencies over public health and environmental services.

Now lawmakers are looking to strike an even more seismic shift into who oversees the state’s health services, and it could have a major impact for millions of South Carolinians.

Right now, seven separate state agencies are responsible for the delivery of health services and human services in South Carolina.

Not only is that uncommon compared to the rest of the nation — it makes South Carolina an outlier.

“South Carolina is the most fragmented structure for health and human services delivery in the country,” Colleen Desmond with Boston Consulting Group (BCG) told a Senate subcommittee Wednesday, saying a plurality of states, 19, have integrated all health and human services under a single umbrella organization.

The state’s Department of Administration contracted with BCG last year to study whether more changes to agency structure would benefit South Carolinians, following the legislature’s 2023 decision to split DHEC in 2024.

BCG’s final report to lawmakers is due by April, but representatives from the group presented an interim report this week to senators.

Desmond explained this fragmentation of health- and human-service delivery across several agencies creates challenges for South Carolinians who don’t know where to go for care, especially when multiple agencies handle the same issue — for example, both the Department of Mental Health and Department of Alcohol and Other Drug Abuse Services treat substance-use disorders.

Then, Desmond said, too many people fall through the gaps because these agencies don’t coordinate and communicate as well as they could.

“They all have their own information systems, they all have their own board of directors, they all have their own objectives, and you’ve got a very disjointed model,” Sen. Tom Davis, R – Beaufort, said.

A bipartisan bill filed last week, S.915, aims to fix that by combining six separate state agencies into one, a new “Executive Office of Health and Policy.”

This office would merge the existing Departments of Alcohol and Other Drug Abuse Services, Disabilities and Special Needs, Health and Human Services, Mental Health, and Aging, plus the new Department of Public Health that will be created this summer when DHEC splits.

Under the bill, a new Secretary of Health and Policy would lead the new agency. That person would be a member of the governor’s cabinet and appointed by the governor, with senators’ approval.

Davis, who meticulously shepherded the DHEC bill through the Senate last year and has been working on this legislation, said there is a correlation between the current fragmentation of health-related agencies and poor health outcomes for South Carolinians.

The interim BCG report found South Carolina is spending more money than some other states to boost people’s health, but it’s not paying off: South Carolinians rank among the unhealthiest Americans.

“I really think this can be transformational in terms of how the state helps public services being delivered to South Carolinians,” Davis said.

Gov. Henry McMaster told reporters Thursday he believes this consolidation is necessary, calling it one of the most important bills lawmakers can take up this year.

“Our mental health system is just not functioning. Some have said it’s the worst in the country. It was designed over time and different pieces and may have worked at one time, but now, the problems are so strong,” he said. “We must have mental health for our people, and it’s got to be available, and they’re not getting it now, so yes, I support that.”

The bill is scheduled to have its first official hearing next week, and it has strong backing in the Senate: Its lead sponsor is Senate Finance Committee Chair Harvey Peeler, R-Cherokee, who was also the lead sponsor of the DHEC bill.

In addition to Davis, Peeler’s co-sponsors include Senate President Thomas Alexander, R-Oconee, and Senate Medical Affairs Committee Chair Danny Verdin, R-Laurens, and two prominent Democrats: Senate Minority Leader Brad Hutto, D-Orangeburg, and former Minority Leader Nikki Setzler, D-Lexington and the longest-serving sitting state senator in the country.

Lawmakers are under a tight deadline to get it passed in the Senate and the House of Representatives and onto the governor’s desk in the next few months, before the bill dies when the legislative session ends in May.

By comparison, it took multiple attempts over several years to finally enact the legislation last year to split DHEC.

But Davis said he is optimistic this new bill will get there this year because of how much legwork has already gone into it.

“We had a yearlong study into looking under the hood, looking at how we deliver public health services, figuring out best practices, and coming up with a model that delivers those services better to South Carolinians,” he said, adding he hopes to get the bill passed in the Senate and over to the House within the next three weeks.

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