South Carolina Restructuring: House Approves Health Care Consolidation Bill

Conservative lawmakers offer amendments …

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This Wednesday (February 28, 2024), the South Carolina House of Representatives voted to send a bill to the State Senate consolidating six health agencies into a single “Executive Office of Health and Policy.” The move is the latest bid by lawmakers to restructure the health-related functions of state government.

Last May, legislators approved (and governor Henry McMaster signed into law) S. 399, a bill abolishing the S.C. Department of Health and Environmental Control (SCDHEC) and creating in its place a state Department of Public Health (SCDPH) and a state Department of Environmental Services (SCDES).

Our founding editor Will Folks editorialized on the legislation recently.

“The move – which I support in theory – would be great if these two agencies were absorbing all of the attendant health care and environmental bureaucracies currently operating in the Palmetto State,” he wrote. “And undertaking efforts to ensure these consolidations created streamlined structures providing more efficient, better coordinated delivery of services.”

The (Charleston, S.C.) Post and Courier editorial writer Cindi Ross Scoppe also weighed in on the new law.

“For all its boasting about conservative lawmaking, one of the most consequential things (S. 399) did was to grow our state government,” Scoppe wrote, referring to the additional  $21 million (initially) and $14 million (annually) taxpayers must shell out to maintain the bifurcated agencies.



Since the passage of the DHEC split, lawmakers commissioned the Boston Consulting Group (BCG), to conduct a study of all of the state’s healthcare agencies and provide recommendations for further consolidation.

Months later, BCG consultant Colleen Desmond told senators at a subcommittee hearing that “South Carolina (has) the most fragmented structure for health and human services delivery in the country.”

In the wake of the Covid-19 pandemic, BCG published a healthcare policy white paper in which Desmond wrote that “the pandemic harshly exposed gaps in the nation’s decentralized, public-private health care system.”

South Carolina’s decentralization was on full display during the pandemic.

Desmond (and BCG’s) conclusion … “The pandemic was a crisis too valuable to waste.”

It seems as though a bipartisan coalition of legislative leaders – alongside governor McMaster – were also keen to consolidate power.

(Click to View)

Covid testing in Great Falls, S.C. (Via: SCARNG)

On January 9 of this year, a group of senators filed S.915 in the hopes of consolidating the state’s six health-related agencies under one leadership structure – putting the department of Alcohol and Other Drug Abuse Services (DAODAS), Disabilities and Special Needs (DDSN), Health and Human Services (HHS) and Mental Health (DMH) under one roof.

This bill rapidly advanced through the Senate, receiving the vote of every senator save for Tom Corbin of Greenville

After the passage of the Senate bill, a group of House members filed H. 4927 – a companion piece of legislation that was also put on the fast track, rocketing through the judiciary committee and onto the House floor. There, a number of conservative members asked for debate on the proposed legislation.

The primary concern of many members is language subordinating the state’s elected sheriffs to the newly appointed head of the Department of Public Health. The law would require “all sheriffs and constables in the several counties of this state” – as well as police officers and local health officials – to “aid and assist the Director of the Department of Public Health” and to “carry out and obey his orders” – including enforcing “any and all restrictive measures and quarantine regulations that may be prescribed.”

(Click to View)

Representative Josiah Magnuson speaking on the floor of the S.C. House of Representatives (

Rep. Josiah Magnuson of Spartanburg argued sheriffs should maintain their ability to exercise discretion in the implementation of emergency public health orders.

Referencing recent heavy-handed impositions made unilaterally by health officials during the Covid-19 pandemic, Magnuson told the body he didn’t believe they were “at a time in history where we should just throw caution to the wind and not have eternal vigilance continue to be the price of liberty.”

Amendments attempting to strike or weaken this ultimate authority were repeatedly voted down by a coalition of Democrat and Republican lawmakers.


State representative Adam Morgan attempted to add language preventing lobbyists from being appointed to run the newly created Department of Public Health.

“Lobbyists are people who are paid to come up here and lobby government officials for specific interests, and there’s nothing wrong with lobbyists, they serve a specific purpose,” Morgan said. “But I think it’s important that people who are doing that don’t then come and run the agencies they were just lobbying for.”

State representatives Gil Gatch and Todd Rutherford vehemently argued against the amendment, with Rutherford accusing Morgan of “saying someone who volunteers to come up and lobby for MADD (Mothers Against Drunk Driving)… is evil enough that they can’t be an agency head.”

“I don’t support that,” Rutherford said.

Morgan told Rutherford the amendment would only apply to registered (paid) lobbyists – and reminded him “there was bipartisan support” when the state’s current statutes limiting lobbyists were implemented “because there were clear issues where you had entanglements between the lobbyists and the government.”

(Click to View)

(Via: FITSNews YouTube)

Morgan’s amendment was tabled by a broad coalition of Democrats and Republicans.

Representative John McCravy, who said he understood the concerns raised in some of the amendments, argued modifications would have been more appropriate if they had been introduced during the committee process – and suggested future legislation might address the concerns raised by some legislators.

Self termed “medical freedom” proponents are hopeful the Senate’s recent advancement of a bill bolstering anti-vaccine-mandate laws could result in positive change – but proponents of amending the bill on the house floor argued it’s better to fix problems before they become law.

South Carolina’s bloated healthcare bureaucracy is certainly in need of streamlining and accountability. This news outlet has said as much for years, but we’re also skeptical when legislative leaders implement solutions without a clear ideal of their fiscal impact.



Only time will tell the full impacts – fiscal and otherwise – of this move to consolidate health agencies, but given the convoluted and duplicative nature of the state’s current system, taxpayers are hopeful for improvements in efficiency.

Readers can count on FITSNews’ continued coverage of the ongoing debate over agency consolidation.



(Via: Travis Bell)

Dylan Nolan is the director of special projects at FITSNews. He graduated from the Darla Moore school of business in 2021 with an accounting degree. Got a tip or story idea for Dylan? Email him here. You can also engage him socially @DNolan2000.



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Mark Jones Top fan March 2, 2024 at 6:18 am

Appointing a health tsar with mandatory police power, after what we endured during COVID-19, what could go wrong? We might as well have turned our health matters over to the WHO.

What They Endured During COVID-19 March 4, 2024 at 11:30 am

“I refuse to wear a mask! Give me liberty or give me death!”

“Sir, this is a Wendy’s.”

Wayne Hegamyer Top fan March 2, 2024 at 8:15 am

Nice job on the interactive map. The possibilities are unlimited when you have the data to support visualization in maps.


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