FY 201 8 -20 19 Ways and Means Healthcare B udget B riefing J anuary 24, 2018
Agency Attendees • David Wilson – Acting Director • J ennifer Read – Chief of Staff • Rick Caldwell – Senior Director of Legislative Affairs • Darbi McPhail – Chief Financial Officer • Bruce C. Busbee – Budget Director • Katie Phillips – Legislative Director • Lilian Peake, MD – Director of Public Health • Shelly Kelly – Director of Health Regulation • Myra Reece – Director of Environmental Affairs
DHEC by the Num bers DHEC EC Team • Currently over 3, 3,200 e 200 employees s st rong • 3,045 full-time • 106 temporary grant • 28 hourly • Operating 99 locations in 46 46 count ies across the state Legal l Responsib ibilit ilit ie ies • DHEC legal responsibilities currently touch on more t t han 360 360 state and federal statutes and regulations, and state provisos
Day -to-Day Operations Sna napsho hot of wha hat "bus usine ness as us usua ual" looks like for DHEC in n an an av averag age year ar: Public lic Healt lt h • 696, 696,953 953 clinical client encounters in our local health departments • 238 238 acute disease outbreak investigations conducted • 44, 44,809 809 reports of acute diseases reviewed • Over 1, 1,000, 000,00 000 public health laboratory tests performed, including 536 individuals tested for Zika virus • More t han 300, 300,000 000 requests fulfilled for birth and death certificates
Day -to-Day Operations Sna napsho hot of wha hat "bus usine ness as us usua ual" looks like for DHEC in n an an av averag age year ar: Healt lt h Regula lat io ion • Over 10, 10,000 000 health regulation inspections & investigations conducted • 10, 10,285 285 new prescription monitoring program users • 1, 1,623 623 state and local law enforcement officers trained to carry and administer naloxone to combat opioid overdoses Envir ironment al l Affair irs • Over 39, 39,900 900 active environmental permits • Over 61, 61,000 000 environmental inspections • 47, 47,500 500 environmental health complaints investigated
Special Operations Hur urricane ne Irma Respons nse • DHEC asse ssesse ssed the condition of 91 91 dams in areas impacted by the storm • No d dam s s were found to have breached • 1 E Em er ergen ency Order er was issued to owner of regulated dam • 18 C Consen ent Agreem eem en ent s are being finalized • 3 Boil il Wat er Advis isorie ies were issued • 5 Spec ecial Med edical Need eeds Shel elt er ers opened for a total of 23 23 shel elt er erees ees • 25 in inpat ie ient healt lt h care f facilit ilit ie ies, including 1 hospital, evac acuat at ed from the medical evacuation zones; 2 hospitals and 1 nursing home sheltered in place; 14 pat ien ent s wer ere e t ransport ed ed
Special Operations Zika Virus Prep epared ednes ess • In February 2016, DHEC began preparing for the rapidly developing Zika virus outbreak in the Caribbean and Central and South America • Creat at ed a Z a Zika a Task Force, which led to the successful development of the SC SC Zika R Resp sponse se Plan • Hel eld t t he S e SC Zika Forum to bring together and educate more than 200 s 200 st at e an and l local al p par art ners about their roles and responsibilities in preventing, detecting and responding to Zika • Test ed 5 536 in indiv ivid iduals ls f for Z Zik ika over the last year through our public health laboratory
Recap of FY 1 8 Increased Funding Elect ct ronic c Healt h Reco cords ($3. $3.8M 8M) • Request for Proposals (RFP) for an Electronic Health Record system was published on August 1, 2017 Dat a Cen ent er er Rel elocat ion ($3. $3.2M 2M + $8M $8M in FY17) 17) • Migration scheduled to be complete by end of J une 2018 St roke e Preven ent ion ($147, $147,500) 500) • Hired stroke coordinator and developed stroke regulation that was approved by the DHEC Board (now headed to the General Assembly) Lea ead Screen eening ($511, $511,234) 234) • Hired 3 EPA-certified lead assessors, funded a new lead tracking data system, and provided training for nurses doing lead investigations
Recap of FY 1 8 Increased Funding Bes est Chance e Net et work (Cancer er Screen eenings) ($1, $1,000, 000,000) 000) • 1,015 women have received mammograms so far this year using state funding • Contracted with the University of SC for additional screenings through the Center for Colorectal Cancer Prevention Network Dam am Saf afet y ($4. $4.9M 9M one-t ime + $595K $595K recurring in FY17) 17) • Increased staffing levels from 2.57 FTEs in 2012 to 14.5 FTEs today, allowing DHEC to place six engineers in our regional offices throughout the state to inspect and work closely with dam owners in their local areas • Now have inundation maps for all high and significant hazard dams • All high and significant hazard dams have updated emergency action plans • Completed inspections on 2,000 dams across the state • Utilize the CodeRed emergency notification system to send automatic voice call, text messages and emails to dam owners and operators
FY 201 9 Budget Request Overview Tot al Recur urring ng Fund unds Reque uest ed: $3, $3,979, 979,354 354 1) Reducing the spread of communicable diseases in SC $998,717 $998,717 2) Required SC emergency medical services (EMS) reporting $350,000 $350,000 3) Ensuring quality data for decision making $214,856 $214,856 4) Mitigating public health impacts from mosquito-borne diseases $489,166 $489,166 5) Increasing access to cancer screenings $1,000,000 $1,000,000 6) SC groundwater quantity permitting and planning $192,461 $192,461 7) Protecting public health by preventing petroleum $250,000 $250,000 contamination to SC drinking water supplies 8) Office of Rural Water efforts to improve wastewater $484,154 $484,154 infrastructure
FY 201 9 Budget Request Overview To Tot al One-Time e Funds Req eques est ed ed: $591, $591,556 556 1) Reducing the spread of communicable diseases in SC N/ N/A 2) Required SC emergency medical services (EMS) reporting N/ N/A 3) Ensuring quality data for decision making N/ N/A 4) Mitigating public health impacts from mosquito-borne diseases N/ N/A 5) Increasing access to cancer screenings N/ N/A 6) SC groundwater quantity permitting and planning $106,354 $106,354 7) Protecting public health by preventing petroleum $291,000 $291,000 contamination to SC drinking water supplies 8) Office of Rural Water efforts to improve wastewater $194,202 $194,202 infrastructure
FY 201 9 Budget Requests Red educing t he e Sprea ead of Communicable D e Disea eases es: $998, $998,717 717 • Need eed: Rates for sexually transmitted infections (STIs) are rising in SC. • Sol olut ion on: Create a three-member team for each public health region to better target communicable disease prevention, including: • allowing a more seamless referral and follow-up relationship between field and clinical staff, • decreasing wait times for appointments, • increasing outreach efforts, and • providing more flexibility for education and specialty clinics. • Met hod odol olog ogy: • Personnel cost for 12 FTEs: $944, $944,516 516 (4 Registered Nurse II, 4 Human S ervices Coordinator I, 2 Medical Assistant T echnician II, 2 Health E ducator II) • Regional travel costs and routine training for 12 FTEs: $30, $30,000 000 • General supplies, computers and operating costs for 12 FTEs: $24, $24,201 201
FY 201 9 Budget Requests Req equired ed S SC EMS Rep eport ing: $350, $350,000 000 • Need eed: Funding for the SC Emergency Medical Services Performance Improvement Center system was lost due to a change in federal funding guidelines. • Sol olut ion on: Secure funding to support the EMS PIC system, which addresses our statuto tory r requirement to collect and report patient and provider information for the EMS community, including training, certification, licensing, and inspection and regulation of ambulances. The system also will allow us to continue to track ambulances in an emergency situation, such as during hurricane response efforts. • Met hod odol olog ogy: • EMS PIC system current contract price: $350, $350,000 000
FY 201 9 Budget Requests Ensurin ing Qualit lit y Dat a for Decis isio ion Makin ing: $214, $214,856 856 • Need eed: DHEC does not currently have an Office of Quality Assurance to evaluate processes or Quality Assurance Project Plans (QAPPs), as required by federal grant commitments. • Sol olut ion on: Create two positions to satisfy Environmental Protection Agency (EPA) requirements on ensuring lab and data competency as addressed during recent EPA audits. • Met hod odol olog ogy: • Personnel cost for 2 FTEs: $192, $192,291 291 (1 E nvironmental Health Manager II, 1 E nvironmental Health Manager III) • Travel and training costs for 2 FTEs: $5, $5,308 308 • General supplies, computers and operating costs for 2 FTEs: $7, $7,257 257 • Automated data review software: $10, $10,000 000
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