WIN FOR SOUTH CAROLINA CITIZENS: Health Agency Restructuring Passes Both Chambers

This afternoon, the South Carolina House of Representatives unanimously passed S.2, the bill to restructure South Carolina’s fragmented health agencies. The legislation takes three siloed behavioral health agencies—the Department of Mental Health, the Department of Disabilities and Special Needs, and the Department of Alcohol and Other Drug Abuse Services—into one, cohesive Department of Behavioral Health and Developmental Disabilities. 

This was an incredible victory for Palmetto Promise Institute’s Palmetto Freedom Agenda, as the passage of this bill streamlines state agencies’ health functions and represents a crucial step towards modernizing our state’s healthcare in order to better serve all South Carolinians.

No longer will patients with complex needs (say, someone who struggles with drug abuse AND mental illness) be shuffled between different agencies in search of help. With this new agency, citizens will have “one door” they can visit to receive services, and these divisions will be able to collaborate in treatment for patients, removing unnecessary duplication.

Talk about increasing government efficiency!

Under the Department of Behavioral Health and Developmental Disabilities, South Carolina will be able to provide more coordinated care to its most vulnerable citizens, all while reducing the costs needed to maintain three separate agencies.

This win comes after a long battle in 2024 to consolidate state health agencies, an effort that unfortunately ran out of time at the end of the legislative session.

To support the work of S.2 sponsors Senator Peeler and Senator Davis in advancing this much-needed legislation, Palmetto Promise staff dug into the archives at the South Carolina State Library to find historical documents where the South Carolina State Reorganization Commission proposed exactly these changes back in the early 1990’s.

For his testimony before the Senate Medical Affairs Committee and the House 3M Committee, Dr. Oran Smith showed legislators a chart of state government structure prior to the 1992 restructuring under Governor Carroll Campbell. South Carolina’s fragmented health agencies are a direct result of the sprawling, disorganized boards and commissions that used to dominate state government.

PPI was able to access archived health department consolidation records from the South Carolina State Library to use in a testimony before the Senate Medical Affairs Committee and House Medical, Municipal, Military (3M) Committee. Dr. Oran Smith highlighted the importance of improving on previous attempts at healthcare restructuring. He highlighted the bill’s incorporation of lessons learned from past debates and addressing concerns raised by stakeholders. 

You can watch Dr. Smith’s full testimony here:

With S.2 passing the Senate earlier this month, the upper chamber will just have to agree with the House’s technical amendment made in committee and send the legislation to the Governor’s desk for a final signature.

Governor McMaster has vocally expressed support for the consolidation of the state’s health agencies. In his State of the State address in January, he said,

“South Carolina has the most fragmented and siloed health and human service delivery system in the nation, with the lowest ranking, causing unnecessary suffering….

Immediate changes are needed at the Department of Mental Health and the Department of Disabilities and Special Needs. They are run by a board of commissioners who are accountable to no one – and it’s virtually impossible for a governor to remove them.  ‘If everyone is in charge – then no one is in charge.’

South Carolinians should be able to hold one person – their governor – accountable for the actions of the Department of Mental Health and the Department of Disabilities and Special Needs. That was the notion that fueled Governor Carroll Campbell’s successful effort to begin the restructuring of state government agencies in the early 1990s.

This year – let’s finish this job with a stroke of a pen by making the Department of Mental Health and the Department of Disabilities and Special Needs cabinet agencies that are directly and immediately accountable to the governor.”

With the passage of S.2, the General Assembly has done just that, and more, by also including the Department of Alcohol and Drug Abuse.

Once the legislation is signed into law, the restructuring will not only save taxpayer dollars but also ensure that South Carolinians, especially those navigating complex healthcare needs, receive the quality care they deserve. Today is a proud moment for all South Carolinians, especially those who have advocated for improved healthcare in our state!