SC Discretionary Funding Fiscal Year 2020

As its EMS workforce numbers continue to decline, Lancaster County EMS finds itself battling an opioid epidemic, rapid population increase, and an aging population. Private EMS companies in neighboring counties and retirement have depleted Lancaster County EMS of valuable talent. However, with grant funding, Lancaster has plans for a unique recruiting and training strategy to bolster its workforce to combat the growing turmoil within its borders.

Prisma Health-Upstate, University of South Carolina School of Medicine Greenville (UofSCSOMG), and Clemson University School of Nursing in Greenville, SC (CUSON) will develop and implement Project TRANSFORM (Teaching Recovery-informed Addiction Care And Negating Stigma FOR Medical Professionals) to provide training for professionals in the health care team who in the course of their roles may serve individuals and families affected by SUD. The proposed module-type educational pedagogy includes review of sensitivity to the unique needs of those affected, information on various substances of use, and clinical considerations and supportive intervention strategies for health care professionals. The project will serve an estimated 5,200 students over the two year period. The Project Goal is to expand the number of practitioners to deliver high-quality, evidence-based SUD treatment. The objective is to expand the integration of substance use disorder (SUD) education into the standard curriculum of a minimum of 20 relevant healthcare and health services education programs over two years. The proposed approach for this project is to: 1. Develop an online curriculum that will cover each of the subject areas required in the FOA. The modules will be in an online platform where the instructor can either assign the curriculum to be done outside of the class or the instructor can use the curriculum as a part of their lecture. 2. Provide each module to consist of the evidence based educational piece followed by a short quiz on the topic, then a review of the quiz and topic. Following the module will be brief videos, produced by national experts in addiction medicine, education and recovery in collaboration with a professional video company, interviewing people in recovery and their experience with that particular drug and what was helpful to them in recovery. This innovative approach of integrating the medical knowledge with lived experience education provided by individuals living with addiction and in recovery will result in an educated, compassionate and involved healthcare workforce addressing SUD.

To address the projected increase in the number of South Carolinians experiencing mental health and/or substance use crises, the South Carolina Department of Mental Health (SCDMH) will implement the SCDMH COVID-19 Crisis Response Initiative, a three-pronged, statewide approach to expanding crisis services that will provide linkages to more intensive, integrated care, as well as financial assistance to remove barriers to care. The SCDMH COVID-19 Crisis Response Initiative consists of the following new programming: the Crisis Counseling Program (CCP), a telephone line designed to connect COVID-19 affected persons who are experiencing serious mental illness (SMI), a mental illness of lesser degree (MI), and/or a substance use disorder (SUD) to existing available resources and care (including but not limited to crisis services, assessment, therapies delivered using evidence-based models, peer support, employment assistance, care coordination/case management, suicide prevention assistance, homeless/housing assistance, nursing care, psychiatric care, primary care, deaf services, and services for non-native English speakers); a Financial Assistance Program which will assist persons suffering from SMI, MI, and/or SUD - including those in the justice-involved population facing reentry to society due to early release from detention to limit the spread of COVID-19 - in paying for treatment services and medication; and the Healthcare Outreach Team (HOT), a telehealth team that will specifically address the needs of healthcare workers experiencing crisis due to COVID-19. The department is confident that these programs will fulfill our goals of expanding access to crisis services and assisting more of our states citizens in obtaining mental health and substance abuse services. To achieve these goals, SCDMH will partner with the South Carolina Department of Alcohol and Other Drug Abuse Services (DAODAS) via SCDMHs existing Community Crisis Intervention and Response (CCRI) call line, via the new CCP call line, and via the Healthcare Outreach Team telehealth program. To monitor our progress in reaching and serving patients affected by COVID-19, we will develop a marker in our existing electronic medical records system to flag COVID-19 patients; we will track all incoming calls on the CCP and CCRI lines from COVID-19 affected patients seeking SCDMH and/or DAODAS services; we will monitor the amount of financial assistance we are able to provide to underinsured/uninsured SMI, MI, and SUD patients; and we will track the number of healthcare workers receiving telehealth services through the HOT. Once these programs are fully implemented, we expect to see an uptick in the overall number of patients served by the agency and estimate that in the first year of the program we will begin providing services to an additional 200 persons per week over our normal volume, which would result in an increase of 10,400 persons served annually and more than 13,000 persons served over the course of the grant period.

To serve South Carolinians experiencing mental health and substance use crises due to the impact of Hurricane Florence, the South Carolina Department of Mental Health (SCDMH) will implement the Highway to Hope Mobile Response Program (H2H) for adults and children. This mobile care program will integrate mental health and primary care and take services directly to affected rural patients who may not have funds or transportation needed to obtain care. The H2H concept is based on a successful, sustainable mental health mobile program implemented by the SCDMH Charleston-Dorchester Mental Health Center for rurally-located patients. The H2H will offer direct crisis services, assessment, evidenced-based therapies, primary care, nursing care, psychiatric care, and suicide prevention strategies. The H2H will also provide a one stop shop for referrals to additional community-based services, such as employment assistance, care coordination/case management, peer support, homeless/housing assistance, deaf services, and services for non-native English speakers. Both in-person and virtual services will be offered. The H2H will utilize a fleet of nine RVs that will be operated by staff to be hired by three SCDMH outpatient mental health centers. Six RVs will be staffed full-time by an RN, an adult serving mental health professional (MHP), and a child serving MHP and will be designated for patients in the areas most rural communities. Three RVs will be staffed full-time by an RN, a school mental health (SMH) clinician, and an adult clinician and will be designated for patients at local schools not currently offering SCDMH SMH services and their parents. While SCDMH has one of the most robust SMH programs in the nation (currently deploying school mental health clinicians to over 848 schools out of more than 1,200 public schools in the state), the mental and physical well-being of children living in this area are still of concern, as at least 87 have not been in contact with either the local school districts in these catchment areas or the South Carolina Department of Social Services (DSS) since the arrival of COVID-19 in the state in March 2020. Also, there are 88 schools in the affected area that do not currently offer SCDMH SMH services. To monitor progress in reaching and serving citizens affected by the overwhelming devastation of Hurricane Florence, SCDMH will track figures related to patients seen, services rendered, caseloads, diagnoses, improvements to daily living skills, and reductions in the level of care needed. SCDMH projects that during the initial year of implementation, the H2H program will have a mental health caseload of at least 1,440 adults and 360 children across the service area at any given time; new patients/SCDMH readmissions across the service area will total 3,000; daily living skills will increase for 80% of patients, and levels of care will be reduced for 75% of patients. Through the H2H, SCDMH will produce demonstrable and productive outreach and care to some of the states most rural and disenfranchised citizens. SCDMH is confident the H2H will become a model program for other rural areas by providing mental health and primary care in the right place, at the right time.

Through the 988 State and Territory Improvement Grant, South Carolina's (SC) Hope4SC grant initiative (988Hope) will focus on improving SC's response to 988 contacts (including calls, chats, and texts) originating in the state/territory. The goals of this project include enhancing the SC 988 infrastructure to increase answer rates, call care quality, and care transitions and implementing additional technology and security measures to fully support 988 infrastructures beyond the life of this grant and effective coordination across the crisis care continuum. This project will have a data-driven approach to improve 988 contacts in SC, as well as coordination with 911 and Mobile Crisis. The project will increase the workforce to ensure SC has an answer rate of 90% or higher for calls, chats, and texts. Including a focus on expanding MOUs between 988 call centers and 911 Public Safety Answering Points (PSAP), and Mobile Crisis, including leading a crisis care continuum collaborative involving Mobile Crisis, 911, and 988. Improvements around SC's follow-up care, data collection, communication plan, and referral policies will also be key points of this project. 988Hope is committed to strengthening 988 to improve crisis support for the people of SC. As of May 2023, SC answered 67% of calls, 34% of chants, and 31% of texts originating from the state. This grant will assist SC in improving its capacity to answer the steadily increasing calls, chat, and text contacts. 988Hope4SC (988Hope) expects to serve 45,000 people in year one, 50,000 in year two, and 55,000 in year three with a total of 150,000 people served over the life of the grant.

South Carolina State University’s Master of Art Rehabilitation Counseling (MARC) program, proposes to implement the Substance Use Disorder Expansion of Practitioner Education (SUD-Prac-Ed) project. This project will expand the integration of SUD education into the standard curriculum of the Rehabilitation Counseling program and will increase the number of practitioners that can deliver high-quality, evidence-based SUD treatment by offering a two-prong project. Phase I of the project will consist of integration of the SUDs curriculum. The curriculum will be divided into 4 Modules and will build from essential SBIRT skills to specialized application. Phase II will be the development and implementation of an online Addiction and Trauma Certificate, of which participants will enroll in. Project Name: Substance Use Disorder Expansion of Practitioner Education (SUD-Prac-Ed). Population Served: Graduate students enrolled in the Rehabilitation Counseling program. Strategies/Interventions: SBIRT curriculum. Goals: To increase the number of Rehabilitation Counseling students who are capable of delivering high-quality evidence-based SUD treatment. Objectives: Objective 1) By the end of June (60 days after start date), the project director will develop a high quality, comprehensive curriculum on identification and treatment of SUDS, including screening, brief intervention, referral to treatment strategies, assessment and treatment principles and their application; Objective 2) By the end of year two, the Project Director will integrate the SUDs curriculum and revised SUD curriculum into 2 Rehabilitation courses, including the Introduction to Rehabilitation Counseling and the Medical and Psychosocial Aspects of Disability courses; Objective 3) By the end of year one, the external evaluator will collect and assess data from at least 25 students and 4 educators in the MARC program on the utility of the SUDs curriculum; Objective 4) By the end of year 2 of the project, the project director and adjuncts will develop and provide a high quality program of training and field experience to 10 Rehabilitation Counseling students in the online Addiction and Trauma Certificate program; and Objective 5) By the end of year two, the project director and adjunct faculty will collaborate with licensing and certification boards to aim to implement examination questions related to SUD on licensing and certification exams. Number Served: 50 (25 each year)

Brookland Lakeview Empowerment Center is located in the City of West Columbia, in Lexington County, South Carolina. With funding, Brookland Lakeview Empowerment Center will implement a Mental Health Awareness Training initiative, bringing desperately needed training resources to Lexington County and the City of West Columbia, delivering eight-hour evidence-based Mental Health First Aid training sessions to at least 500 individuals annually. Monthly training sessions, held at Brookland Lakeview Empowerment Center and Lexington County School District Two facilities, will recruit approximately 45 individuals each. Annual projected populations include: Non-profit Staff (25); Police / Fire / EMT (50); Educators (80); Healthcare Workers (60); Community Members (185); and Students over the age of 16 (100). Brookland Lakeview Empowerment Center and Lexington County School District Two facilities are centrally located, ADA-compliant, easily accessible, and equipped for trainings with meeting room space, presentation equipment, and internet services. Suicide is a persistent and growing challenge among all populations in South Carolina, and for this reason, the identified “population of focus” will include the general public. Brookland Lakeview Empowerment Center’s Mental Health Awareness Training (MHAT) initiative will train 500 individuals annually, reaching 2,500 (unduplicated) residents of Lexington County, South Carolina over five years. The primary goal of the MHAT initiative is to build local capacity to address mental health issues. Partners will be crucial to reaching 500 individuals annually in Lexington County. ? Agape Counseling and Training Services, Inc.: Experience delivering evidence-based and culturally-appropriate behavioral and mental health supportive services to the targeted population. Will accept referrals for behavioral health needs, including adult, adolescent, and children counseling; family programs; case management services; and wellness education groups. ? Lexington County School District Two and East Point Academy: Delivers K-12 education at ten campuses in the West Columbia community. Will host trainings, facilitate teacher / staff / older student participation in 8-hour MHFA training, will advertise MHFA trainings to families, recruiting participants. ? City of West Columbia Government / Fire Department / Police Department: Provides first responder services to the targeted population of West Columbia, South Carolina. Will facilitate member participation in MHFA training, advertise trainings and recruit participants. In addition, the University of South Carolina, Arnold School of Public Health; Brookland Baptist Church; the Brookland Foundation; South Carolina Institute of Medicine and Public Health; South Carolina Department of Health and Environmental Control; Benedict College and Midlands Technical College have all signed Letters of Commitment documenting their intention to facilitate member / student participation in MHFA trainings, advertise MHFA trainings, and recruit participants.