12 steps to jumpstart a post-COVID Palmetto State

Quality of Life
May 8, 2020

Oran P. Smith, Ph.D

Senior Fellow

Governor McMaster clearly wants the state back open for business. He also clearly wants no sudden spike in coronavirus that could overwhelm our hospitals and cost lives. While we can’t entirely eliminate this risk, we can work together to smartly manage it.

This means moving quickly away from an ambiguous “essential v. non-essential” approach and replacing it with a common-sense “safe v. unsafe” mindset to jumpstart our economy and let people restart their lives as their health status permits.

We offer these 12 steps as a place to start.


    1. More Licensing Reform.

The COVID-19 pandemic and the sweeping temporary licensing reform that followed illustrate how restrictive our licensing regulations have become. As other states have done, most recently Florida, South Carolina should consider a comprehensive look at our occupational and professional licensing laws to determine what is and is not needed. SC should also consider licensing reciprocity in certain fields so that licensed professionals moving into South Carolina can get to work quickly and those licensed in neighboring states can contribute to the South Carolina economy. South Carolina recently passed license reciprocity for military spouses.

In the medical field, South Carolina is a part of an EMT compact a physical therapy licensure compact and a nursing licensure compact. The SC House passed the Uniform Emergency Volunteer Health Practitioner Act (UEVHPA) for physicians. This compact is a long-term solution to emergency management that will allow physicians and practitioners to enter states with declared emergencies and perform services. The Senate should find a way to get this reform to the Governor’s desk.

    1. More Regulatory Common Sense.

Unnecessary regulations should be eliminated. A good example of licensing dead wood is forbidding a barber or cosmetologist from performing services in residences. Virginia has done away with this. In recent interviews, Palmetto Promise found that  hairdressers support this safe and convenient option that is currently illegal.And, according to the South Carolina Brewers Guild, 65% of South Carolina breweries say they’ll only be able to last between one and three months without extra relief. Many SC breweries have said that waiving restrictions on beer delivery would help them survive. States such as California and Alaska have already implemented similar measures.

  1. Make Energy Cheaper.

The post-COVID economy will be all about efficiency. The state should explore true competition for electricity service, and at the very least join a Regional Transmission Organization (RTO) to oversee the grid, trade in real time, and keep prices competitive.


The General Assembly will have an opportunity to revisit the spending plan passed earlier this year. This is a wide-open opportunity for fiscal restraint.

  1. Return Funds to Taxpayers, Reform Our Tax Code.

The General Assembly has done well in resisting efforts to raise general taxes this session. When it gets a do-over of the 2020-21 budget, it should tighten the belt to return significant funds to taxpayers, many of whom are out of work and need their money. Real tax reform juices state economies, as North Carolina has amply proven. Our current tax code puts us at a big competitive disadvantage. It’s time for South Carolina to get back in the game.

  1. Freeze Hiring and Incentivize Early Retirements.

In the Continuing Resolution (CR), by Executive Order, or as a Fiscal Accountability Board directive, the state should follow the lead of several state universities and initiate a hiring freeze in non-health related fields. Universities have also offered early-retirement packages to shrink their payrolls and protect cash. The state should do the same.

  1. Replenish Rainy Day Funds.

Several state contingency funds were to be replenished significantly in the initial House budget. The Senate should bite the bullet and keep the commitment to those funds, in addition to any shoring up needed for the state’s unemployment insurance reserve fund.

  1. Renegotiate the Santee Cooper Price and Sell the Agency.

The offer for Santee Cooper was generous but leaves certain liabilities with the state. These points should be renegotiated and the cash from the sale should be used to help balance state’s books this fiscal year and next. Try explaining to out-of-work South Carolinians and people to whom the state has made promises why we need to keep an unaccountable, government-owned electric utility whose sale could provide actual budget relief.

  1. Open Up the Books.

Handwashing may be the right prescription for our personal health, but for government spending, sunlight remains the best disinfectant. Are taxpayers feathering the personal nests of politicians? Has South Carolina fallen prey to the unrestricted practice of earmarks that gave us the National Bean Museum and “bridges to nowhere?” While transparency should be standard practice any time, with anticipated tight budgets, lawmakers must be more accountable than ever for their stewardship of our tax dollars.


The educational, medical, and economic necessities of the COVID-19 pandemic have identified a host of opportunities that were dim but are now crystal clear in light of the crisis. Especially in the area of healthcare, many rules previously in place were temporarily suspended. There’s very little reason why these should only be temporary adjustments. 

  1. Close the Digital Divide.

Leaders here and nationwide are in feverish discussion to address broadband and wireless connectivity gaps in rural and other underserved areas. With massive infusions of federal funds being sent to states to help them adjust to the extended need for distance learning, policymakers can seize the moment to make the most of these one-time funds to get every student connected once-and-for-all. No more excuses.

  1. Embrace and Expand Virtual Learning Options.

Palmetto Promise has been promoting a dramatic expansion of virtual learning since our founding. Once students are connected, high-quality content to fill the virtual instruction pipeline is essential. States like Texas and Louisiana have shown that it is technologically possible for any child in South Carolina to take any course anywhere, accelerating equitable learning and easing burdens on parents and teachers in this stressful time of distance learning.

  1. Make Temporary Health Reforms Permanent.

Telehealth. While telemedicine is legal in South Carolina, when COVID-19 hit, there were still some licensing restrictions that made practicing telemedicine more cumbersome. They have been temporarily set aside. This reform is a common-sense measure that would deliver an obvious benefit to patients over the long term.

Certificate of Need. In a move to ensure an adequate supply of hospital beds in critical areas should there be a COVID-19 surgeGovernor McMaster directly suspended hospital bed limits and allowed temporary facilities, giving them flexibility for expansion during the crisis. A permanent repeal of CON laws has been supported by both the Obama and Trump Administrations and would be a big win for South Carolina patients. 15 states have already fully repealed CON and evidence shows that it increases access and decreases costs. If CON is a barrier to healthcare access in good times and an obstacle to response in a healthcare emergency, why would we keep these limits when this crisis is over?

Scope of Practice and Number of Practitioners. The SC Department of Labor, Licensing and Regulation Board of Medical Examiners suspended the requirement that a nurse practitioner or physician assistant licensed in good standing in North Carolina and/or Georgia enter into a practice agreement with a physician licensed in South Carolina. South Carolina should make this a permanent change, giving much needed flexibility to nurses and physician assistants to respond to needs across state lines.

  1. Require Healthcare to Operate on Market Principles.

Patients who are willing to shop around for the best price for a medical procedure should be rewarded. This is known as The Right to Shop. Patients should also know the cost of their procedures in advance with no surprises.