Creating a Bureaucracy to Manage Health Care and Infectious Disease at the State Level- Powers of the New Depart of Public Health

Is it possible to create an organization and its "Manager"that can do this without corruption? A case study, using Lessons Learned from the Covid-19 era

Part XVII.  Continuing with Bill S.915 Changes to Title 44 Chapter 1: Powers

Introduction

Continuing with the commentary on changes to Chapter 1 of Title 44. 

Bill S.915 starts by changing the name of DHEC to “Department of Public Health”.  Many of the changes have to do with the way DHEC was previously set up.  There was a Board of citizens that oversaw the operations of DHEC.  Whatever powers the board had were moved either to the “Executive Office of Health and Policy” or to the Secretary.  This defines some of those powers.

Section 44-1-50:  Permit Authority and Advisory Boards

Section 44-1-50:  the Office makes final determination

in matters involving the issuance, denial, renewal or revocation of permits, licenses, or other actions of the department which may give rise to a contested case pursuant to Chapter 23 of Title 1.

So, the Office will determine the organization of the departments under it; the Secretary can appoint advisory boards. 

As mentioned previously, this is way too much power for one person:  the budget for such processes must be understood.  Furthermore, if the Secretary were, say, of like mind to the current DHEC Director, this would result in mis- and dis-information regarding whatever the Secretary had in mind or whatever decisions were made.  All would be signed, sealed, and delivered by the handpicked advisory board as part of a psyOps campaign.  We have learned from the Covid-19 era experience that this process will be abused and death and maiming is likely to result.

One would think that a key lesson learned from our experience would be that this is a perfect example of the Deep State Conundrum and should this implementation must be avoided.

Section 44-1-60  Licensing and Legal Issues

Section 44-1-60 is about licensing and legal issues.  I don’t see anything in this section that requires comment.

Section 44-1-80  Powers of the Department of Public Health to Prevent the Spread of Diseases

I’ve already commented on the existing text of this section in an earlier post.  https://aletheiatheyounger.substack.com/p/creating-a-bureaucracy-to-manage-c58

In Bill S.915 there have been some organizational name changes.  There has also been a change in the approval process with respect to how preventive measures, such as quarantine, are established:

The Department of Public Health, upon approval of the Governor, may and must enforce or prescribe these preventive measures as may be needed to suppress or prevent the spread of these diseases by proper quarantine or other measures of prevention, as may be necessary to protect the citizens of the State. The Board Department of Public Health and Environmental Control or its designated agents shall declare, when the facts justify it, any place as infected and, in case of hydrophobia or other diseases transmitted from animals to man, must declare such animal or animals quarantined, and must place all such restrictions upon ingress and egress of persons or animals therefrom as may be, in its judgment, necessary to prevent the spread of disease from the infected locality.

Adding the Governor to the process is an improvement, though quarantine is a medical matter and, with respect to health, should be an issue handled by a citizen’s healthcare professional.

Regarding the issue of disease transmission from animal to man:   this situation has and will be mishandled by a bureaucracy, with the bird flu being the latest example.  The criteria for this process is now more political than scientific.  The impact on the food supply and on the agricultural economy can be significant.  This is an example of The Deep State Conundrum.  It is more complicated because even more disciplines need to provide expertise, especially veterinarians. I don’t see an easy solution to this corruption. It is now complicated because if there is an outbreak of an animal disease anywhere, an analog can be built in a matter of weeks to infect humans using the mRNA-LNP technology.

I’ve already commented on the remainder of the text in the previous post.  This section is of great concern and should be substantially modified, with Bill S.975 with amendments being a model for the solution.

Section 4-1-100  Power of the Secretary and Governor to Require Sheriffs and Constables to Aid the Director of Public Health

This section was discussed in a previous post.

The text of Bill S.915 does not remove this very distastful section, but it splits the baby by replacing the word “must” with “may”, and inserts that the authority lies with the Governor, not the Secretary, making the section optional:

Section 44-1-100.  All If so ordered by the Governor, all sheriffs and constables in the several counties of this State and police officers and health officers of cities and towns must may aid and assist the Director of the Department of Public Health and Environmental Control and must may carry out and obey his orders, or those of the Department of Public Health and Environmental Control, to enforce and carry out any and all restrictive measures and quarantine regulations that may be prescribed. During a state of public health emergency, as defined in Section 44-4-130, the director may request assistance in enforcing orders issued pursuant to this chapter and pursuant to Chapter 4, Title 44, from the public safety authority, as defined in Section 44-4-130, other state law enforcement authorities, and local law enforcement. The public safety authority may request assistance from the South Carolina National Guard in enforcing orders made pursuant to this chapter or pursuant to Chapter 4, Title 44, which may be deployed or activated only upon order of the Governor.

The addition of the requirement that the deployment of the National Guard only be deployed upon order of the Governor is an important improvement.  However, I believe the general situation here may be relevant to a natural disaster, but is not relevant to a health disaster.  In that case, this section should be moved to a new natural disaster chapter.

Remainder of Chapter 1

There are no substantial changes of interest to infectious disease with respect to Chapter 1.

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Link back to Part I: Act 60- The Reorganization Directive Bill

---- Begin Discussion of existing law on Natural and Health Disaster Management:   Act 44

Link back to Part II: Title 44, Chapter 1

Link back to Part III: Title 44, Sections 4-100-120 Legislative Findings and Intent

-----Definition of Deep State Conundrum and Solution Outline

Link back to Part IV: The Deep State Conundrum and Solution

---- Continuing Discussion of existing law on Natural and Health Disaster Management:   Act 44

Link back to Part V:  Title 44, Section 4 130 Definitions

Link back to Part VI:  Title 44 Section 4 300, 310 Natural Disasters

Link back to Part VII:  Title 44 Section 4  320  Disposal of Human Remains

Link back to Part VIII:  Title 44 Section 4  330 Supply Purchase and Logistics

Link back to Part IX:   Title 44 Section 4 340 Destruction of Property in a Public Health Emergency

Link back to Part X.  Title 44 Section 4 500 and 520 Control and Treatment of Infectious Disease

Link back to Part XI:  Title 44 Section 4 530 and 540 Quarantine and Isolation

Link back to Part XII:  Title 44 Section 4 550 Specimen Collecting

Link back to Part XIII:  Title 44 Section 4-560 Access to protected health information

Link back to Part XIV:  Title 44 Section 4-570 Emergency Powers Regarding Human Resources

-----Primary Solution to Deep State Conundrum

Link back to SCHIAS:  One part of the solution to the Deep State Conundrum: A State-wide Open Source Medical Data and Analytics System

------ Begin Discussion of Bill S.915, which implements Act 60 and has yet to pass

Link back to Part XV:  Bill S.915 Revision of Title 44  Adding Chapter 12

------ What was the methodology for selecting the consultant?

Link back to:  The problem of reorganizing government agencies:  the fox in the henhouse

------ Continuing Discussion of Bill S.915, which implements Act 60 and has yet to pass

Link back to Part XVI:  Bill S.915 Revisions to Title 44, Ch 12- 50 and 60, Organization of the Executive Office of Health and Policy