COLUMBIA, SC (AP) – South Carolina public health workers have been tasked with keeping the state safe for 143 years since lawmakers established a health council in 1878 after an outbreak of yellow fever killed 20,000 Americans.
As the coronavirus pandemic worsens, lawmakers are trying to tear their agency apart.
As in most states, the South Carolina Public Health Service was short on funds and overworked long before it had to maintain an exhaustive defense against a virus that humans had never seen before.
Criticism has since risen from all quarters – over a slow rollout of tests, the agency’s refusal to release detailed data on early cases, and because it appears to be sidelining its best epidemiologist.
Now, a new director has stepped into what many see as a leadership vacuum, but lawmakers looking to dismantle the Department of Health and Environmental Control aren’t cutting him much.
Dr. Edward Simmer is the first physician to run the agency in nearly four decades – a fact that amazes Simmer himself. He told The Associated Press in an interview that he will put science at the center of his dealings with the public, the legislature and the governor.
“It is clear that there are political aspects to what DHEC does. My focus is to be as apolitical as possible, ”said Simmer.
Unlike most public health agencies, South Carolina’s portfolio has encompassed environmental regulations since the 1970s. It now has nearly 4,000 employees overseeing everything from water quality, dams and landfills to hospitals and vaccine distribution.
The sprawling office responds to elected officials only indirectly, through a board of eight members appointed by the governor. State officials have been saying for years that it has become too powerful and unmanageable.
Lawmakers have accused the agency of not advocating forcefully enough for preventative measures or pushing back on Republican government Henry McMaster’s decisions to reopen companies. They said the DHEC staff evaded responsibility by letting the board decide how to allocate limited vaccines; that the board, which consists mainly of business people and only one doctor, is not transparent; and that board members went too slow to find a new director after the last one stopped, mid-pandemic.
Senate Chair Harvey Peeler is poised to split DHEC, pool public health duties with the state’s mental health department and direct environmental permit operations to other government agencies. McMaster has said he also supports breaking up DHEC.
“Nobody is in control at DHEC and has not done so for a long time,” Peeler said in December when he announced the bill that would restructure the agency.
Public health agencies have become nationwide political scapegoats after years of inadequate funding, and a lack of federal leadership and coordination has made responding to the pandemic even more difficult, said Simon Haeder, a professor of public policy at Penn State.
In some other states with Republican-controlled legislatures, such as Michigan, Montana, Ohio, and Oklahoma, lawmakers are trying to curb the powers of proactive state and local health departments.
In South Carolina, there is a desire to make the agency more effective, after the response is paralyzed by a string of politically appointed directors who failed to hold up and other staff changes.
“You can make any structural changes you want, but you have to pick people who are really good at this,” said former administration Jim Hodges, who served from 1999 to 2003.
Senator Dick Harpootlian, a Columbia Democrat who spoke out against the agency’s refusal to shut down companies that ignore public health guidelines, said the plan to split DHEC is a “ distraction ” and it is the council that should be replaced: useless. Useless is an understatement. “
There are signs that other fundamental agency functions are falling through the cracks.
Expired water pollution permits at three of the state’s coal-fired power plants had been burned down for about a decade before environmentalists sued the agency last summer to do its job. The agency finally agreed in January to review the permits.
“Releasing your responsibility to ensure that you protect citizens from pollution is a pretty serious shortcoming,” said Amy Armstrong of the South Carolina Environmental Law Project.
More recently, a switch in computer systems has left families and funeral homes without a death certificate, as bodies pending cremation have accumulated in at least one funeral home, The Post and Courier reported.
Still, people who have worked closely with the agency say that splitting up DHEC without adequate funding and staff will only make the problems worse, and that it is ill-timed to do so during a pandemic.
In any case, the agency’s two sides should coordinate even more closely as threats to human health from climate change and other environmental threats increase, said John Simkovich, a regional director of public health who left in 2013.
During the Great Recession, lawmakers cut public health resources, and under Governor Mark Sanford, the terms of board members were dropped. His successor, Governor Nikki Haley, remade the board, and Catherine Templeton, who had previously been approached by Haley to cut jobs in the state labor department, was appointed director. Templeton started with more cuts, centralized offices, and laid off seasoned employees.
Dr. Robert Ball, one of the top infectious disease epidemiologists in the state until 2012, said morale went downhill after Templeton arrived, leading to an exodus of old workers who quickly depleted institutional knowledge.
Salaries for skilled health workers and scientists remain relatively low, so younger workers move on quickly to earn more elsewhere, former workers say.
Simmer told lawmakers who confirmed to him this month that he believes the environmental and public health halves of the agency complement each other. He asked senators to give him a year in work to implement reforms before attempting to take the bureau apart.
Until now, he said, no one has promised him that time.