South Carolina Department of Mental Health


Director’s Column

John H. Magill, State Director

John H. Magill
State Director

In this edition of IMAGES, the Director's Column has been written by a guest writer, Deputy State Director of Community Mental Health Services Geoff Mason.

Where Are We Going?
An Update on the SCDMH Long Term Planning Committee

By Geoff Mason, Community Mental Health Services

The February Director's Column presented the SCDMH Long Term Planning Committee's process to date, with highlights of the activities and presentations made to set the groundwork for future agency direction. In this update, I want to provide some of the initial ideas that are being generated by the subcommittees as they continue their work to meet the challenges of the Healthcare Reform Act.

Clearly, we are entering into a period where there will be significant changes in the way behavioral health care is provided and financed. The requirement to do more with less will be the prevailing parameter for the foreseeable future. The impacts of less state appropriations, growth of managed care, and reductions in Medicaid have already been seen in SCDMH operations, and these budgetary constraints will continue to pose challenges to SCDMH leadership and our stakeholders.

So, what ideas have the five subcommittees been generating against this ominous backdrop? While these deliberations are a fluid process and specific recommendations for future direction have not yet been prepared, shared goals and strategies are developing in each committee's work. These key, shared goals are related to the agency business plan, core mission/services, core population, public/private partnerships, and state/federal initiatives. Some of the draft ideas that have surfaced for consideration are listed below, by subcommittee:

1. Medicaid Financing Platform Subcommittee

  • Develop an action plan for pursuing options regarding behavioral health services under the Affordable Care Act (ACA).
  • Improve access for patients and expand array of Medicaid sponsored behavioral health services, such as 1915i options and ACA Health homes.
  • Increase effectiveness and efficiency of entitlement processes through partnerships with the SC Department of Health and Human Services and the Social Security Administration.
  • Strengthen SCDMH's position as gatekeeper and oversight authority for behavioral health in South Carolina.
  • Examine other funding options, including grants and other payor-sponsored coverage

2. Clinical Services Delivery Subcommittee

  • Define the Agency's mission for core services and establish clear patient inclusion criteria for SCDMH services.
  • Explore outpatient commitment laws and their impacts.
  • Establish a standardized intake process and clear admission criteria.
  • Ensure patient-driven and endorsed treatment expectations and plans of care.
  • Expand use of telemedicine to include many outpatient services.
  • Decrease no-shows at community mental health centers, through administrative and scheduling efficiencies, so it is a needs-centered services system.
  • Review integration with primary health care facilities.
  • Increase capacity for care coordination options to improve community tenure and treatment through maximization of care coordination collaborations.

3. Governance Subcommittee

  • Examine what should be the business of SCDMH, and the current mission, priorities, and values to see if they should be redefined.
  • Review SC laws pertaining to behavioral health.
  • Increase staff recruitment and retention activities and determine the best ways to maintain a quality workforce.
  • Increase public/private partnerships.
  • Look at the organizational structure of the SCDMH and see if it is the best way to function effectively.

4. Data Committee

  • Survey the Agency’s internal data systems for relevance and
    redundancy.
  • Look at centralizing data within the SCDMH and the linkage of all data warehouses, so a standard, unified set of data is available.
  • Develop a daily system “key” data reports for managers, to better manage the agency and aid in strategic planning.

5. Administrative Services

  • Identify opportunities to increase efficiencies in Human Resources, Financial Services, Information Technology, Physical Plant, Quality Assurance, and Public Safety.
  • Examine decentralization versus centralization of administrative services.
    Identify the optimal way to support clinical services.

These subcommittees will continue to meet and refine their proposals and recommendations. Much positive thinking and brainstorming have been done to date; initial subcommittee findings were distributed to each of the fifty Full Committee members for their review, suggestions, and amendments in March. A Full Committee meeting was held on April 18, to gather and discuss all the changes to the findings. Following the April meeting, work began on a draft report, which will be prepared and submitted to SCDMH Senior Management for comment and the preparation of a final report.

It is anticipated that this final report will serve as a blueprint for guiding the SCDMH’s vision to address the behavioral health care needs of our citizens. Provision of a quality, recovery-driven system of care for current patients and future patients is, and always has been, the key principle of this initiative. The SCDMH faces many challenges in the future, but, through close collaboration with our partners, flexible thinking, and the proactive approach exhibited during this planning process, those with mental illness can be assured of effective and efficient treatment. We want to be proactive, not reactive, so that our agency, which has existed since 1821, and has served over 3.5 million South Carolinians during that period, will continue to meet the behavioral needs of our citizens.

 

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May 2011