A program that state health officials use to regulate whether South Carolina hospitals can add new beds, build additional facilities or even buy expensive equipment appears to have been gutted after the House agreed Tuesday with Gov. Nikki Haley to remove more than $1.7 million in funding.
House members voted 56-65 on Wednesday to sustain the Republican governor’s veto of money for the Department of Health and Environmental Control’s Certificate of Need program. A two-thirds vote was needed to override the veto.
Director Catherine Templeton testified earlier this year that she was against unfunded mandates, DHEC spokesman Mark Plowden said. Plowden noted the program is now neither funded nor repealed and said DHEC plans to follow the wishes of the governor and the Legislature.
“We are working to determine how to implement their instruction,” Plowden said.
State Rep. Walt McLeod warned that getting rid of the money was a backdoor way to get rid of the program and it would cause health care to become more expensive and less available in rural areas.
“If you want to have anarchy reign in the health care system of South Carolina, you should vote to sustain this veto,” said McLeod, D-Little Mountain.
The veto was among 28 of Haley’s 81 vetoes that the House sustained. House members overrode 53 vetoes, which will be sent to the Senate Thursday. If senators give the vetoes a two-thirds vote, the items will return to the state’s $6.7 billion spending plan.
Other vetoes overridden Wednesday included $3 million requested by Lt. Gov. Glenn McConnell to pay for vouchers so caregivers can hire someone to stay with elderly relatives for a day in case of family emergencies or other conflicts and more than $2 million to health programs designed to combat various disorders. This included money for HIV and colon cancer prevention and the organ donor registry, as well as $5 million to increase payments for nursing homes.
The House also restored money to the South Carolina Arts Commission and the Sea Grant Consortium, which have been targeted every year by Haley and saved by the Legislature.
The House dealt with the vetoes efficiently, taking less than five hours to go through the list before adjourning for the year. By far, the most contentious argument came over the money for the Certificate of Need program.
The goal of the program is to make sure medical services don’t just go to the richest and most populated areas of the state. Hospitals and other medical businesses have to show a need if they want to build a new complex or buy a machine that costs more than $600,000. All new nursing homes and substance abuse clinics must go through DHEC to get a certificate.
In her veto message, Haley called the program intensely political. “We should allow the market to work rather than politics,” the governor said.
Haley had her own brush with the program when she worked as a fundraiser for Lexington Medical Center before she became governor. The hospital fought with DHEC for a decade to be able to do open heart surgery. Health officials initially denied the certificate, saying there wasn’t enough need for the third heart center in Columbia. The Lexington hospital got a bill passed allowing it to do the surgery, but Gov. Mark Sanford vetoed it. Eventually, the hospital got its heart center in a settlement over a lawsuit.
A spokesman for Haley left no doubt she wants to see the program end.
“The House just confirmed they agree it is time to change the statute and permanently rid our state of this political obstacle to quality of care,” Haley spokesman Rob Godfrey said.
The South Carolina Hospital Association thinks the program is important. Executive Vice President Allan Stalvey said medical programs don’t follow normal economic forces because if there are too many hospital beds or other facilities, people will still use them, driving up costs. The program also ensures medical companies don’t abandon rural areas.
“It helps control the growth in health care costs by keeping unnecessary expenses down,” Stalvey said.
About three dozen projects worth about $90 million are awaiting DHEC approval. It is unclear what will happen to them because the law requiring them to get a certificate remains on the books, Stalvey said.
Most of the vetoes only had brief discussions.
The governor and the Legislature have gotten along better recently, but there was still some acrimony in the vetoes. In striking more than $2 million to health programs designed to combat various disorders, Haley said choosing what charities to help is a personal decision, not one that should be made by government.
Rep. Tommy Stringer said he often agrees with Haley’s vetoes, but made a passionate speech asking the House to override her decision to strike $100,000 from the S.C. Bleeding Disorders program because his son is a hemophiliac.
“If you start reading down these vetoes, they are all personal,” said Stringer, R-Landrum.
The House also overrode about $2 million in five items that Haley’s veto message called “old-fashioned pork.” It included $1 million for a visitor’s center in Orangeburg, $150,000 for a boat ramp in Georgetown County and $453,000 to improve the lighting in parking areas around the Family Circle Tennis Center on Daniel Island.
Rep. Jim Merrill, R-Charleston, put his name on the provision to get the lighting. He said it shouldn’t be considered out of order to ask for money if a lawmaker’s name is attached to it.
“Somebody has the guts to go and put their name on the dadgum thing,” Merrill said.
The total proposed budget for 2013-14 is $22.8 billion, when adding in $7.6 billion in federal money and $8.4 billion in “other funds,” which includes agency fees, fines and grants. The fiscal year starts July 1.