Organizational Structure and Leadership Update

South Carolina DHEC is a centralized state public health and environmental protection agency. The agency has at least one public health clinic in each of SC’s 46 counties, for a total of 62 facilities across the state’s four regions: Upstate, Midlands, Lowcountry, and Pee Dee. As a centralized public health system, Title V programmatic activities in these regions, counties, and clinics are coordinated by the agency’s central office, located in Columbia, SC. This structure allows DHEC to have the capacity to promote and protect the health of SC mothers and children, including CYSHCN. SC DHEC’s Client Services includes all the regional and local public health offices and clinics across the state as well as the state public health laboratory.

DHEC’s Agency Director was filled in February 2021 by Dr. Edward Simmer. A native of Cleveland, Ohio, Dr. Simmer most recently served as a Captain in the U.S. Navy, where he held increasing leadership positions, including as the Chief Medical Officer for the TRICARE Health Plan and Commanding Officer and CEO at the Naval Hospital in Oak Harbor, WA. He brings with him over 25 years of extensive clinical leadership and team-building experience with a strong track record of transforming large health care systems.

He received his Doctor of Medicine from Saint Louis University and holds a Master of Public Health, with a focus on epidemiology, from the Eastern Virginia Medical School/Old Dominion University Consortium as well as a bachelor of arts from Hiram College. In addition, Dr. Simmer is Board Certified in General and Forensic Psychiatry by the American Board of Psychiatry and Neurology and has an Administrative Psychiatry Certification from the American Psychiatric Association.

The vacant Public Health Director position was filled in April 2021 by Dr. Brannon Traxler, who had been serving as the interim director since Fall 2020. The Public Health Director leads one of our three core deputy areas at DHEC, assisting us in achieving our vision of healthy people living in healthy communities.

Dr. Traxler served as Chief Medical Officer for the state’s COVID-19 response prior to assuming her position as PH Director. During her time with the agency, Dr. Traxler has overseen: 

• the agency’s response to the ongoing, historic pandemic,
• statewide testing highs for the number of people being tested for COVID-19,  
• the rollout of South Carolina’s COVID-19 vaccination plan,
• the state’s Hepatitis A response as Chief Medical Officer, and  
• the agency’s completion of the process which helped led DHEC to becoming a nationally accredited public health agency. 

She is trained and board certified in General Surgery. In addition, Dr. Traxler previously practiced as a surgeon in South Carolina before changing her specialty focus to public health, serving as physician for DHEC in the areas of infectious disease surveillance and control and emergency preparedness and response. 

DHEC’s Public Health Diversity, Equity and Inclusion (DEI) Office was formed in late 2020, and a Comprehensive Needs Assessment

MCH Bureau Structure and Leadership Update

The Title V MCH and CYSHCN program continue to be housed within the MCH Bureau, which remains with the Public Health Deputy Area of the agency. Lisa Davis continues to serve as Chief of Staff for Public Health reporting to the Director of Public Health, and Kimberly Seals continues to serve as the SC MCH Director.

The bureau did undergo several leadership changes in 2021. Anna Bleasdale was promoted from the CYSHCN Nurse Consultant to the Director after Tammy McKenna retired in 2021. A new Deputy Director position for the MCH Bureau was created to assist with Title V and bureau-wide operations and was filled by Kristen Shealy in February 2021. Ms. Shealy previously served as the Senior MCH Epidemiologist, where she provided analytic support for Title V and will remain the Principal Investigator for the State Systems Development Initiative (SSDI). Dr. Michelle Myer was promoted to the Director of the Division of Children’s Health and Perinatal Systems where she previously served as the division’s nurse consultant. And Dr. Josh Sellner was hired as Director for the newly added Division of Population Health Surveillance, which provides analytic and epidemiologic support to Title V and MCH programs across the bureau, as well as housing several key MCH surveillance projects.

MCH Programmatic Updates

The SC MMRC voiced the need to collect information on circumstances surrounding a maternal death. A social worker was hired as part of the MMRC to conduct at home interviews with families of the deceased.

State and Community Health Assessments

The South Carolina Department of Health and Environmental Control was awarded national accreditation through the Public Health Accreditation Board on February 19, 2021. In order to effectively assess the health status of communities, South Carolina actively engaged the public throughout the 2018-2019 development of South Carolina’s first-ever State Health Assessment (SHA) and the State Health Improvement Plan (SHIP) through the Live Healthy SC Initiative. Accordingly, the new iteration of the SHA, currently under development, includes a maternal and infant health component within the child and adolescent health segment, which will serve to foster the priority need selection process.

Additionally, Community Health Assessments (CHA) have been implemented with a two-fold approach—Data Walks and the SC Community Health Needs Assessment.

Data Walks: Data on a wide range of county-specific health indicators are analyzed and presented to key city and county leaders and public health professional on large-scale posters by DHEC data experts in the form of structured Data Walks. To date, 32 County Data Walks have been conducted, and evaluations show they are valued and the information is well-received by the participants. The sharing of data and information is followed by rich discussion with the group as a whole, leading to the selection of the top health concerns for the community to address. Local workgroups are formed around the selected priorities, and work then begins on the development of their Community Health Improvement Plan. Maternal and Infant Health was prioritized as a leading health concern within the following 10 counties: Aiken, Chester, and Saluda (Midlands Region); Lee, Williamsburg (Pee Dee Region); Oconee, Laurens (Upstate Region); and Charleston, Berkeley, Dorchester (Lowcountry Region).

South Carolina Community Health Needs Assessment (SCCHNA): The SCCHNA was implemented in March 2022 to gather consumer healthcare experience information which will serve to improve the development and delivery of healthcare services for South Carolinians and their families. More specifically, the SCCHNA serves to assess consumer prioritization of nutrition for prenatal care, and assess the prioritization of maternal, infant, and child health in order to gather healthcare consumer surveillance information specific to maternal healthcare experiences. Currently the SCCHNA is utilized and distributed to healthcare consumers via eight hospital systems throughout the state which provide healthcare services for 71% of the state population. From March to July 2022, approximately 2,500 healthcare consumers have completed this survey. Results from this survey are included within local-level data walks to better inform community partners and stakeholders towards consumer healthcare experiences.

Diversity, Equity and Inclusion Needs Assessment

Newly established in late 2020, the DHEC’s Public Health Office of Diversity, Equity and Inclusion (DEI) launched a needs assessment process in the Fall of 2021 in order to adequately develop a strategic plan, or service delivery plan for the DEI Office. To ensure accountability and a solid framework, it was deemed that adherence to the continuous improvement process would be ideal. However, as a new office, there was no process to be improved, and data would be needed to commence the cycle.

The needs assessment committee, or working group, understood that data would have to be collected to start the process. Data was collected with a consultant via a survey sent to all public health staff and four focus groups. The survey and focus groups details were developed by the working group and a consultant and then shared with an advisory group for feedback. Analysis of the survey data was completed by PH data specialists, and the areas of greatest concern formed the basis for the focus groups. The data of the survey and focus groups were shared with the working group and advisory groups. 

The findings were also shared with DHEC administration and HR as there were cross-cutting issues beyond public health that impact the agency and will assist in its current development of a strategic plan. The agency is also hiring a Chief Diversity Officer who can assist with certain aspects of the findings. For the PH DEI specific findings, the PH DEI office is in the process of obtaining quotes from vendors. A vendor will help facilitate the process of creating a strategic, or service delivery plan for the PH DEI office.

The strategic, or service delivery (SDP), plan is to be based off of the findings applicable to the PH DEI office from the PH DEI comprehensive needs assessment (CNA). The SDP have specific, measurable, attainable, realistic, and time bound (SMART) measurable program outcomes (MPO). The SDP with SMART MPOs will serve as the basis for the program evaluation of the PH DEI office. This will keep the PH DEI office accountable to the SMART MPOs. Further, this will establish the baseline for the PH DEI's continuous improvement cycle.