South Carolina Behavioral Health Action Plan

CaroNova is working with the South Carolina Department of Health and Human Services and state partners to realize a behavioral health system that meets the basic and comprehensive needs of South Carolinians, while also serving as a national model of excellence in providing behavioral health care.

In January 2022, Governor Henry McMaster directed the South Carolina Department of Health and Human Services (SCDHHS) to “initiate an immediate review of our State’s behavioral health funding and delivery system.” In addition, the South Carolina General Assembly directed SCDHHS to “undertake an effort to assess existing gaps in coverage for or the supply of inpatient psychiatric care, crisis stabilization, and other inpatient or outpatient behavioral health services” in its 2022-2023 General Appropriations Bill (117.153).

In August 2022, SCDHHS established a Master Plan Advisory Committee (MPAC) of agency leaders, subject matter experts, and stakeholders to identify and address additional behavioral needs and opportunities to improve coordination throughout the state’s mental health delivery system. CaroNova was engaged to support the MPAC with coordination, research, and strategy. MPAC’s membership includes representation from state agencies, hospital systems, other health payors, state universities, and the provider community.

The advisory committee’s efforts helped guide SCDHHS’ behavioral health crisis stabilization grant program, contributed to the state’s collaborative investment in a new behavioral health hub in Florence, South Carolina, and ultimately led to the development of the South Carolina Behavioral Health Action Plan (SCBHAP).

• Ensure the work is patient-centered.

• Encourage close coordination among state agencies, providers, law enforcement, etc.

• Prioritize solutions that are easy for all parties to use.

• Develop a plan that provides a blueprint for an accessible, cost-effective and sustainable system of care.

• We recognize that if services are reimbursed at an appropriate level, the free market will move to increase capacity.

During the collaborative process of creating the SCBHAP, CaroNova supported the MPAC and state agencies in implementing recommendations as they were developed, including:

• The innovative new MUSC Health Jean and Hugh K. Leatherman Pavilion: This new facility will serve as a regional behavioral health center and include a combination of triage, crisis stabilization, telehealth, outpatient, and inpatient services that will expand much-needed behavioral health resources in the Pee Dee region. The facility is scheduled to open in 2025. This historic investment includes a unique combination of state and local funds.

• SCDHHS awarded grants to 13 South Carolina hospitals to develop and implement EmPATH units, specialized hospital-based emergency department units dedicated to behavioral health crises. CaroNova helped facilitate a learning collaborative that fostered a shared learning environment for South Carolina hospitals to learn from experts and one another on how to create, implement and sustain successful EmPATH services as these units have become operational. The learning collaborative is supported by a contract with the South Carolina Hospital Association and provides technical assistance services, data collection and reporting assistance, protocol development and onsite assistance for the participating hospitals.

• SCDHHS has established new or enhanced Medicaid services that will allow for the delivery and reimbursement of critical behavioral health services. This includes updating the operational requirements and rates for psychiatric residential treatment facilities, updating peer support policies to increase opportunities for peer support services across the state and adding intensive in-home services using the Homebuilders model.

• During SCBHAP development, SCDHHS and the MPAC identified the need for more preventative supports to respond to the growing youth mental health crisis and to meet youth where they are: in the community and in schools. Leveraging SCDHHS’s unique position in providing healthcare coverage to nearly 60 percent of children in South Carolina through Medicaid, as well as CaroNova’s existing work to develop a collaborative, cross-sector model of behavioral healthcare for K-12 youth, CaroNova and a Pilot Design Workgroup developed a comprehensive school-based mental health model and piloted it during the 2024-25 school year in the Florence 1 Schools district.

SCDHHS is currently working with partners and other state agencies to finalize and implement the MPAC’s recommendations for the South Carolina Behavioral Health Action Plan.