The ad hoc committee, tasked with reviewing the state’s Certificate of Need (CON) process, met for the first time Wednesday, laying out a plan to present recommendations to the General Assembly for the start of the 2015 legislative session. The committee is chaired by Representative Murrell Smith of Sumter, and also includes Republican representatives Bill Herbkersman of Beaufort and Jim Merrill of Charleston, as well as Democratic representatives Mike Anthony of Union and Bill Clyburn of Aiken. Rep. Clyburn was the only committee member absent for the organizational meeting.
The committee began its work by hearing from DHEC Director of External Affairs Jonathan Yarborough to provide a brief synopsis on the history and current status of CON. Yarborough laid the groundwork for the day’s discussion by reviewing federal and state laws that led to the establishment of the CON program in South Carolina. He also covered the legislative and regulatory aspects of CON, including the work of the DHEC CON Review Panel that approved many of the recommendations offered in last year’s CON reform bill (S.568) sponsored by Senator Harvey Peeler of Gaffney. Yarborough noted that the DHEC Board had also approved many of the provisions in S.568, but conceded that the legislation stalled in the Senate due to competing interests who couldn’t reach a consensus on the legislation. He cited the raising of the equipment threshold and the issue of grandfathering in projects undertaken while the CON program was not enforced as main impediments to passing S.568 last year. Yarborough said that around 70 projects, that would have required a CON, were undertaken during the suspension of the program and he estimated that about 75% of those projects were related to home health.
Committee members pointed out that many of these projects would still need to be addressed, as they never received a CON or grandfather status, and the license granted by DHEC would be up for renewal soon. Yarborough assured committee members that the DHEC board would take that into consideration as they continue work to update CON regulations. The CON program now has a new director, attorney Sam Phillips, and will be working to develop an analytic application to take the subjectivity out of CON decisions. However, Yarborough said many of the organizations that undertook projects are resubmitting their CON applications for consideration by DHEC.
Chairman Smith acknowledged the fact that aside from conflict over the equipment threshold and grandfathering, stakeholders were in agreement over most of the legislative recommendations to improve CON. “We have agreement on 95% of this stuff, and what we don’t, we’ll have a healthy debate on,” said Smith.
Rep. Merrill pointed out that while there was some consensus on CON reform, he still wanted to consider whether or not there was a need for the CON program in South Carolina.
Moving forward, Chairman Smith announced that the committee was looking to host at least two more committee hearings on CON. The next meeting will be a stakeholder meeting to give all affected parties and the public an opportunity to present testimony on CON, while the following meeting will be a working meeting focused on drafting the committee’s recommendations. The meetings have not yet been scheduled, but Smith suggested that the stakeholder meeting will occur in a few weeks. His goal is to have a legislative recommendation for the General Assembly when they return in January.
For more information about Certificate of Need, click here.