A bureaucratic procedure at the center of a dispute over whether Hilton Head Hospital can build an outpatient center in Bluffton was among several health programs stricken from South Carolina's budget Friday by Gov. Nikki Haley.
Citing "the virtues of free markets and open competition," Haley vetoed the certificate-of-need program, which enables the S.C. Department of Health and Environmental Control to evaluate whether proposed services or facilities are needed.
"Bureaucracy should not be telling us which community has or does not have sufficient need for a hospital or a particular piece of complex medical equipment," Haley wrote in her veto message.
A certificate of need was the focus of the recent controversy over the new medical facility proposed for Bluffton.
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Savannah-based St. Joseph's/Candler Health System opposed Hilton Head Hospital's request for the Bluffton outpatient center, and DHEC initially rejected the hospital's application for a certificate of need in February. That prompted appeals, the most recent of which will be reviewed by the S.C. Administrative Law Court in Columbia.
Beaufort Memorial Hospital had also been involved in the legal battle but withdrew its appeal. Beaufort Memorial and St. Joseph's/Candler operate outpatient centers in Bluffton and had contended that patient demand is insufficient to warrant another similar facility.
According to DHEC, South Carolina is one of more than 35 states that use a certificate-of-need process to contain health care costs and prevent duplication of health care facilities. The program would have cost the state $727,189, according to Haley's veto message.Haley also opposed the program last year, but state legislators overrode her veto. The same thing could happen this year, when legislators return to Columbia this month for a special session to consider Haley's actions. Overriding a veto requires a two-thirds majority vote of both houses of the legislature.
Until the General Assembly weighs in, the impact of Haley's veto on the legal dispute is unclear, said St. Joseph's/Candler spokesman Scott Larson.
The S.C. Hospital Association announced Monday it would work to override her veto.
"While the (certificate of need) is not a perfect system, it is the best approach available to protect community resources and safeguard access to care and quality of services," wrote executive vice president Allan Stalvey. Both Hilton Head Hospital and St. Joseph's/Candler also endorse the certificate-of-need program.
"Research has shown that the certificate-of-need programs can be cost-effective if structured and funded correctly," St. Joseph's/Candler president and CEO Paul P. Hinchey said. "We support CON because it can ensure that the cost of new medical buildings or technology meets the actual need of the community being served."
Haley also elected to ax other health-related costs, including $200,000 to combat head lice, $100,000 toward those afflicted with hemophilia and $500,000 for the S.C. Office of Rural Health benefit bank.