South Carolina budget bill adds certificate of need exception for standalone emergency facilities
(The Center Square) – A bill to repeal South Carolina’s certificate of need law died in a state House committee this spring.
But that didn’t prevent a pair of CON-related clauses from making their way into the state’s budget appropriations bill.
One of those clauses, categorized as a rural health initiative, remains in the bill while another was removed late in the process in the Legislature. On Wednesday, Gov. Henry McMaster returned the appropriations bill to the Legislature with 73 line-item vetoes with the Legislature set to meet from June 28-30 to complete the state’s $13.8 billion budget.
The CON exception that remains in the bill is a proviso that would allow for a sponsoring hospital to create a standalone emergency facility or department within 35 miles of its current hospital without going through the CON process.
Certificate of need laws were mandated by the federal government in 1974 and regulate how many medical facilities are available in an area and what services they provide in an effort to reduce consumer costs. Even though Congress later eliminated the CON requirement in 1987, many states retained them.
South Carolina is one of 35 states with a certificate of need program.
The proviso that was initially in the bill and then was later removed would have allowed for a hospital to move locations within its current county during this fiscal year without going through the CON process.
The exception was believed to be targeted at Charleston’s Roper St. Francis hospital, which announced last year that it plans to move from the flood-prone peninsula in downtown to follow population growth in outlying areas.
“Today, I make this promise that whether you live in downtown Charleston or the farthest reaches of Berkeley, Dorchester and Charleston counties, Roper St. Francis Healthcare will be a short drive away to serve your health care needs,” Dr. Jeffrey DiLisi, Roper St. Francis Healthcare president and CEO, said while announcing the move.
A stipulation in that since-defeated proviso called for the current location to be used “in a manner that furthers healthcare delivery,” with the Medical University of South Carolina taking over the old building.
“The fact that it was put in there to begin with I think is concerning when hospitals were fighting us tooth and nail on full repeal and wanted to have a loophole put in there for themselves,” said Americans for Prosperity – South Carolina State Director Candace Carroll.
Carroll said that she didn’t believe Roper St. Francis, in particular, had testified against the CON bill but that the South Carolina Hospital Association has fought against it.
“The state’s hospitals and health systems believe that a fair and reasonable CON program is critical to ensuring that everyone has access to care when they need it,” SCHA says on its website. “Hospitals are required by federal law to treat everyone who walks through their doors, regardless of ability to pay. Meanwhile, other facilities like outpatient surgical and diagnostic centers have the ability to avert patients that are uninsured or underinsured that often end up in hospital emergency departments.”
Carroll said that adding loopholes in the CON law for existing hospital groups while not allowing outside companies to do the same thing is bad for South Carolina residents.
“I think it’s a terrible thing to add loopholes,” Carroll said. “I think it, honestly, shows the hospital associations’ cards in saying that certificate of need is not working for South Carolinians if they are wanting to add loopholes to get around the program but they’re wanting to keep it in place for everyone else.
“It becomes a corporate welfare issue, it becomes a CON for thee but not for me issue and really hinders other physicians and other facilities from being able to open because of the CON process while hospitals are able to expand without having to go through certificate of need.”
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