January 25, 2012 Presented by John H. Magill, State Director

1. The South Carolina Department of Mental HealthSouth Carolina House of RepresentativesWays and Means CommitteeHealthcare SubcommitteeFY2013 Budget Hearing January 25, 2012 Presented by John H. Magill, State Director South Carolina Department of Mental Health

2. I. SCDMH Today In FY2011, the South Carolina Department of Mental Health, through its 17 Community Mental Health Centers, 44 Mental Health Clinics, 4 Hospitals, 4 Nursing Homes, and 2 Inpatient Forensics Programs – - Served 89,485 people in its Community Mental Health Centers with 1,175,481 appointments and 4,345,095 services provided; - Served 5,137 people in its Inpatient Facilities with 529,991 bed days; - Served other populations – not recorded in the numbers noted above – through detention center services, mental health court, and the Department of Juvenile Justice, among others.

3. I. SCDMH Today The Department is one of only a few integrated systems in the 50 states and 8 territories that provides a continuum of services that allows clients to receive, as appropriate, necessary inpatient and outpatient services. - Care for patients in an Inpatient Facility is coordinated through the system, so that, upon discharge, a follow-up visit has already been arranged with a Community Mental Health Center in the client’s domicile county. - In a single Community Mental Health Center, a client can receive services from a psychiatrist and a therapist, coordinate care with a case manager, and receive medication monitoring. - The Department coordinates with community resources, including advocacy organizations and service providers to ensure that the supports clients need to work towards recovery are in place. This includes the Department’s efforts to integrate primary care services.

4. I. SCDMH Today The Department continues to act as an industry leader in such blue ribbon programs as – - Telepsychiatry - Deaf Services - Multi-Systemic Therapy (MST) - School-Based Services - Individual Placement and Supported Employment - Housing and Homeless Services - Assessment and Resource Center (ARC) - Jail Diversion/Forensic Services - Dialectical Behavior Therapy - Co-Occurring Disorders (COSIG) - Towards Local Care

5. I. SCDMH Today The Department has a variety of sources of funds. Over time, the proportions have significantly changed.

6. I. SCDMH Today Other Funds Summary The South Carolina Department of Mental Health’s Other Funds revenue consists primarily of Earned Revenue received from Medicaid, Medicare, Veterans Administration, and other client-related payments. The Department also receives Other Funds revenue from County Appropriations, Drug Fines, Grants, and contracts. Various provisos provide the authorization to retain these funds and also direct certain expenditures.

7. I. SCDMH Today The loss of state appropriations has had a direct impact on the number of people the department has been able to serve through its Community Mental Health Centers.

8. I. SCDMH Today The loss of state appropriations has had a direct impact on the average daily census and the number of bed days in the Department’s Inpatient Facilities.

9. I. SCDMH Today The loss of state appropriations has also directly impacted the staffing level of the Department’s workforce. Note: FTEs for the Forensics Program moved from Hall Psychiatric Institute to Bryan Psychiatric Hospital during the period measured in this table

10. Mandated Programs Even while the Department has experienced significant declinations in state appropriations, certain programs have been held harmless. These mandated programs consume an increasing percentage of the Department’s budget. The programs include the Sexually Violent Predator Program, Forensics, Campbell Veterans Nursing Home, and Veterans Victory House. The percentage these programs in total consume of the Department’s total budget increases from 11.67% in FY2008 to a forecasted 17.67% in FY2012. Budget Implementation

11. Mandated Programs In FY2012, the Sexually Violent Predators Program will incur $9,901,194 in expenditures due to continued growth in the program. State appropriated funds for this program are $5,061,754. Budget Implementation

12. II. FY2013 Budget Requests The Department has requested the following amounts to maintain its operations and to continue its mission to support the recovery of people with mental illnesses – - Operating Budget Programs Sexually Violent Predator Program $7,280,841 Sustainability of Mental Health System 7,000,000 Recruitment and Retention 1,230,761 Uncompensated Medical Care 750,000 - Non-Recurring Requests Inpatient Electronic Medical Record $4,905,000 Pharmaceutical Automated Dispensing Machine 1,000,000 Law Enforcement Vehicles 126,005 Physical Plant Vehicles for Patient Transport 599,148

13. II. FY2013 Budget Requests The Department has also requested the following amounts to maintain its operations and to continue its mission to support the recovery of people with mental illnesses – - Capital Budget Requests Inpatient & Support Buildings Deferred Maint. $10,173,000 Community Buildings Deferred Maintenance 3,333,630 Columbia Area MHC Carter Street Renovations 2,500,000 Roddey Nursing Home FRTW Roof Replacement 3,700,000 Harris HVAC Renovations 7,100,000 Santee-Wateree MHC Construction 9,500,000 Anderson-Oconee-Pickens MHC Construction 12,000,000 Catawba MHC Construction 9,500,000

14. III. SCDMH Tomorrow: Without Approval of Budget Requests Without approval of its FY2013 Budget Requests, the Department must further constrict the number of clients it is able to serve in its Community Mental Health Centers. A conservative estimate based on past trends indicates that the Department will serve approximately 4,000 fewer clients in FY2013, and even fewer in subsequent years as the effects of reduced funding carry over from year to year.

15. III. SCDMH Tomorrow: Without Approval of Budget Requests A conservative estimate based on past trends indicates that Inpatient Facilities will serve approximately 300 fewer patients by FY2013, and even fewer in subsequent years as the effects of reduced funding carry over from year to year. From FY2012 to FY2013, the Department will further reduce the Average Daily Census by 31 and Total Bed Days by 11,224.

16. The South Carolina Department of Mental Health South Carolina Department of Mental Health Key Agency Representatives John H. Magill, State Director Geoff Mason, Deputy Director, Community Mental Health Services Versie Bellamy, Deputy Director, Inpatient Services Robert Bank, M.D., Medical Director Mark Binkley, Esq., General Counsel and Deputy Director, Administrative Services Dave Schaefer, Director, Financial Services Rochelle Caton, Legislative Liaison (898-8570, 201-8683, rrc57@scdmh.org)