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| Wednesday, Jan 29, 2003 |
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Posted on January 28, 2003 Audit: Single department could cover all health agencies By JACOB JORDAN Associated Press Writer Restructuring South Carolina's health agencies to eliminate duplicating services could save the state money and make it easier for residents to receive health care, according to an audit released Tuesday. Members of the General Assembly asked the Legislative Audit Council last year to review the organizational structure of South Carolina's health and human service agencies. The report says agencies should do a better job of collecting money from South Carolinians receiving health care and the governor should appoint a Cabinet secretary to head a new department that would oversee all health and human services agencies. But the audit doesn't give a bottom line figure on how much the state could save by restructuring the agencies, LAC Director George Schroeder said. "We don't know exactly what it would cost. We do think it would be significant savings," he said. "It depends on how it's implemented. ... We believe it would be millions." An exact number is important because the state could face up to a $1 billion shortfall in the fiscal year that begins July 1. Restructuring government has been a theme repeated often during Gov. Mark Sanford's campaign, and he said Tuesday it's important to eliminate duplicative programs. "We're in a situation with the budget where we can't afford inefficiency and a lack of accountability - two problems our government restructuring plan addresses in detail," he said. The audit says one governor-appointed Cabinet member could oversee planning, budgeting and delivering services throughout the health and human services system. Rep. Rex Rice, R-Easley, has introduced a bill that mirrors many of the audit's restructuring recommendations. The bill, which has been referred to committee, would create a new department to oversee the state's eight existing health-related agencies. Other state health services also would be under the proposed Health, Human and Medicaid Services Department. Rice's bill already has drawn criticism from Rep. Jerry Govan, D-Orangeburg, who says "it creates a mega-health agency." Govan complained that House Democrats weren't involved in drafting the legislation and restructuring efforts a decade ago were far more collaborative between Democrats and Republicans. "This is a massive bill. I think this Democratic Caucus needs to have some say on it," Govan said. "I think we need to take a close look at it." Currently five of the eight health agencies are overseen by boards or commissions rather than a governor-appointed director. Those eight departments have more than 19,000 employees in total and a combined budget of more than $1.15 billion in state funds. The Alcohol and Other Drug Abuse Services, Health and Human Services and Social Services departments have governor-appointed directors. The departments of Mental Health, Disabilities and Special Needs, Health and Environmental Control and Vocational Rehabilitation as well as the Commission for the Blind have boards that appoint their directors. Most agencies weren't willing to immediately support restructuring the state's health system, saying more time was needed to study the ramifications. Vocational Rehabilitation Commissioner Larry Bryant said an umbrella organization wouldn't be in the best interest of his agency because of its clients focus on gaining employment and it has proven accountability. Department of Health and Environmental Control Commissioner Earl Hunter said his agency "would hope that a great deal of study be given to the issue before any hasty decisions are made." Three other departments - HHS, Social Services and Mental Health - operate senior and long-term care programs. The audit recommended letting a new agency handle all of those services. Even if administrative costs increase with a new agency, "they could be partially offset through consolidation of the more than 100 offices that provide senior and long-term care throughout the state," the audit said. The audit also said Mental Health, Alcohol and Other Drug Abuse Services and DHEC should collect more money from the clients they serve. The audit said, for example, for every 10 percent increase in collections from patients, the Mental Health Department would obtain about $840,000 in additional revenue. Agency Director George Gintoli said Mental Health officials were working on improving collections. --- On the Net: |
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