Post and Courier. February 25, 2024.
Editorial: The sabotage effort has already begun; hang tough on fixing SC health services
There’s not a single, perfect way to consolidate South Carolina’s many disjointed, uncommunicative health agencies. You could merge every agency that touches even tangentially on health care, or you could leave out, say, the social services or veterans’ affairs offices, as legislation the Senate passed on Wednesday does.
Likewise you could create one completely consolidated super agency from the get-go or leave the six individual agencies largely intact but grouped under a single secretary with pretty much absolute authority, as S.915 and and its companion H.4927 do.
But there’s a perfect way to keep our state’s long-awaited consolidation from happening — or at least a tried and true way: It’s to let one individual agency talk its way out of the consolidation, or even a little piece of it. That creates blood in the water, and the other independent fiefdoms start circling, demanding first small concessions and then complete exemptions, and their legislative supporters start forming coalitions — I’ll vote to keep your agency independent if you vote to keep mine independent — until the entire thing unravels.
This is what has happened every time legislators have tried to bring some sanity to this huge portion of our state government, and every time, we’ve gotten left once again with eight separate agencies that divvy up the job of providing crisis mental health care, physical health care, substance abuse services, disability and special needs services and assistance to the elderly and at-risk — in sometimes overlapping ways, often with no coordination or communication, diminishing the quality of care, increasing its cost and forcing patients to navigate a confusing labyrinth of bureaucratic entities.
And now, just barely one step into the most promising effort ever at consolidation, the House already has yielded to the first request for an out.
The original legislation embraced by Senate and House leaders and Gov. Henry McMaster would have ended the practice of sending $17 million a year in alcohol taxes to the counties for alcohol and drug abuse education and treatment and instead allowed the secretary of the new Executive Office of Health and Policy to allocate that money. That way, the state could get matching federal Medicaid funding that the counties can’t draw down and, more importantly, make sure the money was spent where it was most needed, rather than being distributed on a per-capita basis.
Earlier this month, the Behavioral Health Services Association of South Carolina, a lobbying group for the 31 independent alcohol and drug abuse authorities that serve the 46 counties, started urging legislators to let them keep the $17 million, predicting calamity if they lose the funding and helpfully providing legislators with a breakdown of how much each county stood to lose. And presto chango, the House bill — which was still a skeleton when the lobbying began — suddenly emerged with no reference to redirecting the money.
Senate leaders initially refused to budge. When the Senate agreed Tuesday to let the counties keep $12 million, it was only after Sen. Tom Davis discovered that the current law was being read in a way that gives the agencies much more money than he and other authors of the bill realized, and urged the Senate to reallocate only the $5 million they had thought they were targeting.
Now, it’s possible that the House will agree to the Senate’s approach, but it’s worrisome that its initial response to the usual sort of sabotage was to give in. It’s worrisome not so much because changing the allocation for a few million dollars is essential but because lobbyist-driven erosion begets more lobbyist-driven erosion. Until, again, there’s nothing left.
It was clear during the Senate debate that some of the local authorities aren’t happy with the state using any of that money in a smarter way. And their initial volley also complained that the tiny Department of Alcohol and Other Drug Abuse Services was being subsumed into the huge Mental Health Department rather than being held out as a co-equal branch in the new Department of Behavioral Health. The Senate didn’t change that, but the locals still have another crack at it when House debates its bill, likely this week. The House needs to see to it that they fail.
As Sen. Davis reminded his colleagues, this legislation isn’t a solution in search of a problem. Merging the departments of Mental Health, Aging, Disabilities and Special Needs, Alcohol and Other Drug Abuse Services, Health and Human Services and the health side of DHEC is based on a thorough examination by national and state experts who found that South Carolina, with the most disjointed health delivery service in the nation, desperately needs this change because “we aren’t getting the health care outcomes that we deserve based on the resources that we’re putting in.”
It’s time we got the outcomes we deserve, and are paying for. The only way that happens is if we get the law we deserve — without it being scuttled by the usual death-by-a-thousand-cuts assault.
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Times and Democrat. February 24, 2024.
Editorial: Highway heroes should not be at such great risk
Helping stranded motorists on the side of the road should not be one of America’s most lethal jobs, but it is.
On average, two emergency responders are struck and killed every month by a driver failing to obey the law by moving over to an adjacent lane and allowing the roadside rescuers the space to operate, according to the U.S. Bureau of Labor Statistics.
Struck and killed – nearly four times more than reported. It’s the chilling reality for RAPs, including tow truck drivers, mobile mechanics, emergency roadside technicians, and safety service patrols who put themselves at risk every day to help others.
A new study from the AAA Foundation for Traffic Safety examined the conditions of crashes in which roadside assistance workers were struck and killed by vehicles, and why the problem is even bigger than previously believed.
“This new research reveals that vehicle collisions with roadside workers are not always the result of poor visibility,” said Tiffany Wright, spokesperson, AAA-The Auto Club Group in the Carolinas. “More often than not, speed, driver distractions and/or impairment are a factor.”
AAA Foundation researchers combed through diverse information sources and determined that 123 roadside assistance providers were killed by passing vehicles between 2015 and 2021. This grim figure dwarfs the approximately 34 noted in national crash data.
AAA says the discrepancy is because state police crash reports incorrectly cited the crash victims as “pedestrians” instead of roadside assistance providers. While yearly total traffic fatalities increased significantly over the study period, the data suggest that roadside assistance provider fatalities increased even more.
Key findings are:
• Speed limits – 89% of the crashes occurred at locations with 55 mph or higher speed limits, almost all on interstates or other limited-access highways.
• Weather conditions – 84% of crashes occurred in good weather without precipitation/slippery road conditions.
• Time of day – 63% occurred during darkness, of which nearly two-thirds were at locations without street lighting. But 34% of the crashes were in daylight.
• Driver distraction/impairment/fatigue – 63% occurred in crashes in which the striking vehicle had already left the road and was traveling on the shoulder or beyond before impact. This suggests the involvement of factors such as impairment, fatigue or distraction. More than a third of striking drivers who were tested for alcohol were alcohol-positive. But nearly half were not tested.
AAA urges action on several fronts:
• Shield the vulnerable: Utilize countermeasures to prevent vehicles from striking workers. The foundation studied several countermeasures, and an electronic vehicle-mounted variable message sign was very effective. With VMS activated, drivers changed lanes and slowed down more than when the VMS was not operating. The odds of a vehicle moving over were 95% higher when the VMS was used.
• Train for survival: Teach roadside workers to prioritize work away from traffic and equip them with strategies to avoid harm’s way. Training for roadside assistance providers should emphasize the importance of not working or standing on the traffic-facing side of the incident whenever possible and minimize time spent on the traffic-facing side of the scene.
• Slow down, move over: Reinforce life-saving laws, reminding drivers to give space to ANYONE (including but not limited to roadside assistance, police, fire, EMS) working on the side of the road. Every ounce of awareness could be the difference between life and death.
In South Carlina, the move-over law requires drivers – if they deem it is safe to do so – to move a lane away from any law enforcement or emergency vehicle on the side of the road. Law enforcement, emergency and utility vehicles should be stopped with lights flashing to alert drivers to move over.
It is also required that motorists slow down and approach cautiously when driving by a stopped emergency vehicle.
Failure to adhere to the law is considered a misdemeanor punishable by a fine of not less than $300 nor more than $500.
Too many people are not aware of the law but they should see that moving over away from those on the roadside is common sense -- for the safety of drivers as well as those outside.
Jake Nelson, AAA’s traffic safety and advocacy director, is on target: “It’s a shared responsibility to solve this safety challenge. Roadside workers and all of us who drive by them have to take action to move towards zero traffic deaths.”
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