Wednesday, May 7, 2025
5/7/2025
FY 2024 Behavioral Health Service Expansion - Family Health Centers, Inc., Grant Number: H80CS00090 Family Health Centers, Inc., (FHC), is the main source of comprehensive primary and preventive care, regardless of ability to pay in Orangeburg, Bamberg, and Calhoun Counties, and the rural portions of Dorchester County in South Carolina. The rural service area covers more than 2,000 square miles and has a majority African American population. Nearly 30% of service area residents have income below 100% of Federal Poverty Guidelines (FPG), and nearly half have income below 200% of FPG. Approximately 70% of the population lives in rural isolation outside of towns or cities. More than half of all area households with children are headed by a single parent (50.5%) compared to the national average of 31.7% (ACS, Census Bureau, 2017-2021). In Bamberg and Orangeburg Counties 100% of school children are enrolled in free or reduced lunch programs, and one in five households received SNAP benefits. Poverty, rural residence, minority status, exposure to racism, and intentional or unintentional neglect in childhood are all recognized as factors that increase the risk for mental health issues and substance use. High rates of mental health problems and limited access to behavioral health care contribute to the mortality rate due to mental and behavioral disorders of 38.0, which exceeds the national rate of 34.5 (per 100,000 residents, age-adjusted). In addition, the suicide rate in the service area is 15.4, exceeding the US rate of 13.8 (WONDER, CDC, 2016-2020). The rate of drug-induced mortality linked to the opioid epidemic is a particular concern for rural residents (Rural Action Plan, US DHHS, 2020). According to the South Carolina Department of Health and Environmental Control (DHEC) statewide, deaths caused by prescription drugs (including opioids and non-opioids) more than doubled between 2017 and 2021. Fentanyl deaths quadrupled from 362 to 1,494 in that period. In the service area, drug-induced mortality was 19.7/100,000 in 2020, nearly twice the rate of 10.8/100,000 in 2015 (WONDER, CDC, 2016-2020, 2011-2015). Opioid prescriptions were dispensed at a rate of 751.3 per 1,000 residents in the service area, compared to 686.0 per 1,000 residents in South Carolina. The rate of opioid-related overdoses (per 10,000) is 14.4 in the service area (SC Just Plain Killers Opioid Epidemic by County, 2020). In addition to other risk factors that increase vulnerability to misuse of pain medications, the service area has a higher-than-average proportion of the population that is elderly (20.4% vs. the national average of 16%), and/or disabled (14.8% vs. the national average of 13%). FHC provides mental health services with a staff of 1.5 FTE LCSWs. In calendar year 2023 the health center provided mental health services to 214 patients. No patients were served with substance use disorder (SUD) services, or medication treatment for opioid use disorder (MOUD). Access to MOUD in the rural service area is limited. In order to address this gap in services, FHC proposes to use Behavioral Health Service Expansion funding to increase behavioral health staffing and to implement direct provision of MOUD. FHC has space available at its Holly Hill site to accommodate the 2-day induction period required for patients initiating MOUD. We propose to add an Addiction Medicine Physician, and a Psychiatric Nurse Practitioner to current behavioral health staff, and to increase Pharmacy staff to dispense the MOUD medications. A Peer Counselor will be added to staff to support SUD services including MOUD. We anticipate that as a result of funding that by December 31, 2025 the number of patients receiving behavioral health services will increase from the current baseline by 350 mental health patients, 230 SUD patients, and 200 MOUD patients, for a total of 564 mental health, 230 SUD and 200 MOUD patients, of which 100 will be newly enrolled as a result of BHSE funding.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).