COLUMBIA, SC (AP) – South Carolina public health workers have been tasked with maintaining a safe state for 143 years, since lawmakers set up a health board in 1878 after an outbreak of yellow fever that killed 20,000 Americans.
Now, as the coronavirus pandemic escalates, lawmakers are trying to break their agency.
As in most states, the South Carolina public health agency had underfunding and overwork long before he had to maintain a grueling defense against a virus that humans had never seen before.
Since then, criticism has risen from all sides: due to a slow deployment of evidence, the agency’s refusal to publish detailed data on initial cases and to appear to have sidelined its lead epidemiologist.
Now, a new director has entered what many see as a leadership gap, but lawmakers trying to dismantle the Department of Health and Environmental Control don’t cut it short.
Dr. Edward Simmer is the first doctor to run the agency in nearly four decades, which surprises Simmer himself. He told The Associated Press in an interview that he would put science at the center of his relations with the public, the legislature and the governor.
“Obviously, there are political aspects of what DHEC does. My approach is to be as apolitical as possible, ”Simmer said.
Unlike most public health agencies, South Carolina’s portfolio has included environmental regulations since the 1970s. It now has about 4,000 employees, who oversee from water quality, dams and landfills to hospitals and vaccine distribution.
The extended agency only responds indirectly to elected officials, through an eight-member board appointed by the governor. State officials have said for years that he has become powerful and unmanageable.
Lawmakers have accused the agency of not vigorously defending prevention measures or backing Republican Gov. Henry McMaster’s decisions to reopen businesses. They said DHEC staff shunned responsibility by letting the council decide how to allocate limited vaccines; that the board, made up mainly of business people and only one doctor, lacks transparency; and those board members moved too slowly to find a new director after the last cessation, halfway through the pandemic.
Senate President Harvey Peeler is ready to split DHEC, pooling public health tasks with the state’s mental health department and channeling environmental permitting operations to other state agencies. McMaster has said he also supports the breakup of DHEC.
“No one has control over the DHEC and hasn’t done so for quite some time,” Peeler said in December when he announced the bill that would restructure the agency.
Public health agencies have become political scapegoats across the country after years of inadequate funding, and a lack of federal leadership and coordination has made the response to the pandemic even more difficult, Simon Haeder said. , a professor of public policy at Penn State.
In some other states with Republican-controlled legislatures such as Michigan, Montana, Ohio and Oklahoma, lawmakers seek to curb the powers of proactive state and local health departments.
In South Carolina, the predominant sentiment is the desire to make the agency more effective, after the response has been obstructed by a series of politically appointed directors who did not last and other staff changes.
“You can make all the structural changes you want, but you have to choose people who are really good at it,” said former Gov. Jim Hodges, who served from 1999 to 2003.
Sen. Dick Harpootlian, a Columbia Democrat who has been insensitive to the agency’s refusal to shut down companies that violate public health guidelines, said the plan to split DHEC is a “distraction” and should be to replace the board of directors: “They have been useless. Useless is a euphemism.”
There are indications that other basic agency functions are falling through the cracks.
Expired water pollution permits at three of the state’s coal-fired power plants had been exhausted for about a decade before environmentalists sued the agency last summer to do their job. Finally, the agency agreed in January to review the permits.
“Abdicating your responsibility to make sure you protect citizens from the state of pollution is a pretty serious shortcoming,” said Amy Armstrong of the South Carolina Environmental Bill.
More recently, a change in computer system left families and funeral homes without death certificates, as bodies awaiting cremation piled up in at least one funeral home, The Post and Courier reported.
Still, people who have worked closely with the agency say splitting DHEC without adequate funding and staffing will only make matters worse and that trying to do so during a pandemic is not right.
In any case, the two sides of the agency should coordinate even more closely as the dangers to human health due to climate change and other environmental threats increase, said John Simkovich, regional director of public health. who left in 2013.
Lawmakers reduced public health resources during the Great Recession and the terms of board members expired under Gov. Mark Sanford. Her successor, Gov. Nikki Haley, remade the board, and Catherine Templeton, previously approved by Haley to cut jobs in the state labor department, was named director. Templeton initiated further cuts, centralizing offices and firing experienced staff.
Dr. Robert Ball, one of the state’s leading infectious disease epidemiologists until 2012, said morale dropped after the arrival of Templeton, prompting an exodus of longtime employees that drained quickly institutional knowledge.
Wages remain relatively low for healthcare professionals and scientists, so younger employees are quickly moving on to earning more elsewhere, say former employees.
Simmer told lawmakers who confirmed it this month that he believes half of the environmental and public health agency complement each other. He asked senators to give him a year of work to figure out reforms before trying to separate the agency.
So far, he said, no one has promised him that time.