Arcane SC regulations could hinder hospitals’ response amid Coronavirus outbreak

March 16, 2020

Private: Lawson Mansell

Policy Content Manager

(March 19th): 3 days after this article was published, Governor Henry McMaster
 issued an Executive Order specifically directing DHEC to suspend CON regulations for the duration of this public health emergency.
(March 17th): DHEC Director Rick Toomey told the Senate Finance Committee, in response to questions, that there would be flexibility on CON bed limits.

Flatten the curve.  

You’re probably tired of hearing those words, but as you may know, the goal of flattening the curve is to prevent overwhelming our hospital system during the peak of coronavirus patients. The reason it’s so important is because many worry that this virus will overwhelm hospitals and prevent people from getting the care they need during the outbreak.  

The Post & Courier recently took a look at South Carolina’s current hospital bed count and laid out a few very important stats:  

  • South Carolina currently has around 12,000 hospital beds, 60% of which are already filled at any given time (on average), which leaves around 5,000 open beds.  
  • The CDC says that in a typical pandemic, 12% of those who contract a virus will need hospitalized 
  • In SC, around 9,000 people may suddenly need hospital beds.   

Those are rough estimates, but still, that puts South Carolina 4,000 beds short. Those numbers paint a potentially bleak picture for South Carolina’s capacity to handle this pandemic. Hospitals across the country are facing similar numbers. What can be done?  

An obvious question: How can local hospitals add more beds? Unfortunately, it may not be as simple as you would think.  

South Carolina, among many other states, actually requires healthcare providers to submit a request for a “Certificate of Need (CON) to the state (DHEC) in order to add more hospital beds to their facilities. Those providers then have to wait for the state to approve their request, which is often expensive and time-consuming.  

North Carolina, seeing the potential need for a quick addition of hospital beds in that state, decided on March 12th to temporarily waive their CON requirement for hospital beds. The North Carolina DHHS said they did this in order to, “allow the hospital to provide temporary shelter and temporary services to adequately care for patients that may be stricken by COVID-19.” Connecticut Governor Ned Lamont has issued an Executive Order that would also waive some CON requirements during the crisis. 

While North Carolina requires hospitals to request a CON if they want to increase their bed capacity by more than 10%, South Carolina’s law appears to be even stricter, requiring providers to obtain a CON for “addition of one or more beds…”  

Additionally, as of February of this year, there are several SC providers waiting on a CON decision to add more hospital beds to their facilities, totaling hundreds of beds that have yet to be approved.  

Nonetheless, as of this writing, South Carolina’s Department of Health and Environmental Control (DHEC) has not issued CONs for those additional bed capacity requests through the normal process timeline or waived existing bed limits in the face of the crisis.   

Palmetto Promise has long advocated for repealing South Carolina’s CON laws. Hospitals should not require government permission slip to add beds to their facilities. Now, it’s even more critical during this epidemic to cut through government red tape inhibiting essential emergency response.  

As other states take action, will South Carolina find a way to waive potentially life-threatening CON regulations in response to more and more coronavirus cases?

We will keep you updated as this story develops