S.2 Select Subcommittee of the Medical Affairs Committee April

S.2 Select Subcommittee of the Medical Affairs Committee April 28, 2021

DHEC’s Role Mission: To improve the quality of life for all South Carolinians by promoting and protecting the health of the public and the environment Vision: Healthy people living in healthy communities

DHEC Overview South Carolina’s public health and environmental protection agency Oversight by the DHEC Board Operation and management provided by a Director and an Executive Leadership Team A centralized structure with four regions managing operations in all 46 counties

DHEC by the Numbers DHEC Team Current staffing 3,531 full time equivalents 804 hourly 104 temporary grant and time-limited Operating 105 facilities in all 46 counties across the state Legal Responsibilities DHEC legal responsibilities currently touch on more than 360 state and federal statutes, regulations and state provisos

Day-to-Day Operations DHEC in an average year: Environmental Affairs Over 50,000 active environmental permits Nearly 100,000 environmental inspections 24,511 environmental health complaints investigated On average 2,300 dams subject to regulation OCRM preserves sensitive and fragile areas while promoting responsible development in our state’s 8 coastal counties

Day-to-Day Operations Healthcare Quality Over 2,000 healthcare facilities and services inspected and investigated Over 12,000 licensed and certified health professionals 25,788 Prescription Monitoring Program (PMP) users registered Oversight of many types of facilities, EMS services, and radioactive providers, hospitals controlled including: substances materials nursing homes tattoo facilities athletic trainers assisted living facilities body piercing facilities x-ray machines medical labs

Day-to-Day Operations Public Health Over half a million clinical client encounters in our local health departments Hundreds of acute disease outbreak investigations conducted Tens of thousands of reports of acute diseases reviewed Over 3 million public health laboratory tests performed More than a quarter million birth and death records filed COVID-19 - oversight of 7 million tests and close to 3 million vaccinations

Improving the Future of Public Health and the Environment in South Carolina DHEC is committed to providing timely, relevant facts, knowledge and insights to policymakers This includes helping ensure we are serving the best interest of all South Carolinians through sound science and stakeholder input Several options have been proposed to best serve South Carolina Current structure

Current Model: Health and Environmental Control in One Agency DHEC is structured to support an integrated response mutually beneficial to health and safety of people and environment Major events/outbreaks: COVID-19 Hurricanes/natural disasters Train derailments 2017 Zika Virus response Landfill fires Train derailments Everyday responses: Lead exposures Food-borne illnesses Rabies incidents Vector-borne illnesses Radiation protection Sanitary sewer overflows Statewide Hepatitis A outbreak Hazardous substance releases Harmful algal blooms Drinking water emergencies

Current Model: Health and Environmental Control in One Agency Our environment is a critical determinant of our health Policy decisions on environmental matters can have a profound impact on public health. DHEC’s current structure: facilitates inclusive, cross-sector decision-making among our public health and environmental experts eases data sharing to monitor environmental quality and risk factors impacting chronic disease is a powerful tool for rapid response to emergencies (COVID, hurricanes, hepatitis A, radiological) eases administrative burden (and cost) through the

S. 2 – Separate Health and Environmental Agencies Combines mental health, public health, healthcare quality, and substance abuse Mental health and substance abuse are two top public health concerns Promotes synergies across agencies that provide health services to the people of South Carolina Supports further coordination of efforts Consolidates resources

S. 2 – Separate Health and Environmental Agencies Establishes a stand-alone environmental control agency Emphasizes the importance of environmental protection in a new prominent way Holistic approach to management of water resources (combined planning and regulatory functions)

Planning Considerations Substantial transition planning will be needed to support infrastructure, budgets, programming, etc. Certain programs with strong coordination and topical overlap: Disease Control (COVID-19, Hepatitis A, Rabies, Foodborne Outbreaks, Vector-Borne Diseases, etc.) Radiological Health Childhood Lead Exposure Laboratory Support Services Hurricane Disaster Preparedness and Response Many DHEC administrative functions are fully integrated at the enterprise level

Task Force to Strengthen the Health and Promote the Environment of S.C. Helping to SHaPE a better future of health and environmental services for all South Carolinians

SHaPE SC Brings together a cross-section of diverse stakeholders from across the state to review and provide strategic guidance on the future of DHEC The task force will be charged with: Evaluating current and potential structure responsibilities Making recommendations to the Board and the Legislature based on their evaluation Our goal: Improving the quality of life for all South Carolinians by promoting and protecting the health of the public and the environment

SHaPE SC Next Steps and Estimated Timeline Approved by the Board this month Committee members to include healthcare services, industry representatives, advocacy groups, state and local officials, and community stakeholders. Estimated Timeline: Aim is to schedule the first meeting for next month Presentation and report to the Board and Legislature by late fall 2021

Edward D. Simmer, MD, MPH, DFAPA Director S.C. Dept. of Health & Environmental Control Email: [email protected] Buck Wilson Legislative Affairs S.C. Dept. of Health & Environmental Control Email: [email protected]