SC Senate Oks bill making opening hospitals easier. Opponents say rural health care could suffer

In a move to try to increase access to health care in South Carolina, the state Senate voted 35-6 to get rid of a process that requires hospital to receive state approval before building a new facility.

The certificate-of-need process requires that health-care providers receive approval from the S.C. Department of Health and Environmental Control before building a hospital or acquire large medical equipment.

However, the process also allows competing entities to object to a project, which can lead to delays or possibly kill proposals.

Currently eight applications are under review by DHEC, and 28 certificate-of-need decisions are under appeal.

To address concerns about whether getting rid of the process would adversely hurt rural areas, lawmakers added a provision to have a committee study the effect the lack of a certificate of need would have on rural areas and make recommendations for possible legislative or regulatory changes to address any reduction in health-care services.

Four rural hospitals have closed in the state since 2010.

“I think repeal of the certificate of need is the first step, It’s not the only step,” said state Sen. Tom Davis, R-Beaufort.

Proponents of getting rid of the process say the move will increase access to health care for patients by allowing the market place to decide whether a facility can financially survive. And they hope the move encourages providers to go to rural areas without the possibility of a competitor holding up the project.

“We’ve got to open up competition,” said state Sen. Mike Fanning, D-Fairfield.

The bill also would stop any current court proceedings related to the certificate of need.

The South Carolina Hospital Association objected to repealing the certificate-of-need process and advocated for reform to the process.

The hospital association proposed a reform that included exempting construction projects of less than $5 million and equipment purchases of less than $2 million, from the process. That change would reduce about two-thirds of certificate-of-need applications, the hospital association said.

“SCHA remains concerned that outright repeal of the certificate-of-need program would jeopardize access to care in rural communities, as it has in other states,” hospital association spokesman Schipp Ames said. “Today, the Senate amended its bill to require further study of this risk. We welcome this addition and look forward to further debate in the House of Representatives.”