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Fiscal year 1994-1995 was a productive and progressive year for Morris Village. The major thrust of activities focused on improving working relationships with other DMH facilities and local treatment providers throughout the state, evaluating the quality and effectiveness of treatment services, preparing for a reaccreditation survey by the Commission on Accreditation of Rehabilitation Facilities (CARF), and enhancing staff development.

One of our primary goals is to maintain an optimal working relationship with other DMH facilities, community mental health centers, probate judges, alcohol and drug commissions, and other community treatment and recovery resources. The establishment of a Coordinator of Community Services position will allow us to give focused attention to improving relationships between Morris Village and the community. A quarterly meeting with community-based Addiction Specialists and the Morris Village staff has been re-established; this will bring together inpatient and community service providers to deal with common issues. Additionally, the Morris Village Advisory Board, established in March, includes consumers, family members of consumers, and community professionals. This board provides a mechanism for input on Morris Village treatment services from consumers and community stakeholders.

Reorganization and redesign of the treatment program for adolescents is in process. One goal of the redesign is to integrate Morris Village adolescent services with the DMH adolescent and children's services, and increase accessibility to referrals from community mental health centers. Treatment services for older patients underwent some changes, as well. The chemical dependency unit for seniors at Crafts Farrow State Hospital relocated to Morris Village on March 1, 1995; this was the first step toward consolidating DMH alcohol and drug treatment at one facility.

The Outcome Based/Program Evaluation System that was initiated 12/1/94 is providing invaluable data that will assist in evaluating treatment services. Outcome data will be incorporated into organizational planning.

Preparation for the CARF accreditation survey involved staff at every level of the organization. Although official results have not been received,

Staff growth and development continues to be a high priority issue. All clinical staff are being encouraged and supported to pursue licensure/credentialing in their respective fields. Half of the registered nurses on staff are pursuing certification as addiction nurses. Certification recognizes the nurse's ability to apply knowledge from nursing and related disciplines to the care of persons with problems resulting from patterns of abuse, dependency and addiction. Two additional staff physicians met all requirements for certification by the American Society of Addiction Medicine; three of the five physicians on staff are now certified.

Goals for fiscal year 1995-1996 include engaging in a long range strategic planning process; continued focus on relationships with other DMH facilities and community referral sources; collaboration with DMH and Harris Psychiatric Hospital management regarding the possible transfer of that hospital's alcohol and drug treatment services to Morris Village; and collaborating with DAODAS and Hall Institute to explore the possibility of a "Step Down" or intensive outpatient unit for Morris Village.

Morris Village has a solid foundation of patient services upon which to build. Pursuit of state-of-the-art treatment approaches, active collaboration with other providers of alcohol and other drug treatment services, and long range strategic planning will enhance the leadership role of Morris Village in the state, and propel the Village toward its ultimate goal of decreasing the negative impact of alcohol and other drug dependency on the citizens of South Carolina.

1995 has been a year of improved communication and cooperation between the various state and local agencies providing alcohol and other drug treatment services to the citizens of South Carolina. In past years, differing philosophies and approaches to treatment have presented barriers to continuity of patient care between the Department of Mental Health and the Department of Alcohol and Other Drug Abuse Services. This year we

An example of interagency collaboration is the proposed detoxification center in Spartanburg. After years of discussion and negotiation, an agreement has been reached that will provide funding for a community-based detoxification program in Spartanburg County. The Probate Judge, Spartanburg Commission on Alcohol and Drug Abuse, and the Spartanburg Mental Health Center spearheaded the planning effort. Funding for the program comes from DAODAS, DMH and various local funding sources including Spartanburg Regional Hospital, County Council, the Sheriff's Office, and foundations. This local detoxification program will provide more cost-efficient services locally and will serve as an alternative to involuntary commitment to the state operated inpatient facilities. Space for the facility has been located, and the project is scheduled to open in mid-December of 1995.

The South Carolina Department of Mental Health is developing and implementing several projects designed to address clinical issues of dual diagnosis. The Department of Mental Health continues to offer a three day curriculum on Dual Diagnosis to DMH employees. The curriculum, which was jointly developed by DMH and DAODAS, is offered six times per year through the DMH Office of Training and Staff Development.

The South Carolina Public-Academic Mental Health Consortium, established in 1990, includes fourteen academic programs from seven colleges and universities which prepare mental health professionals for work in public mental health. The State Mental Health Department is represented at community, state hospital and central office levels. This year, the Consortium has been addressing the need to train professional staff to work with dually diagnosed clients. A Dual Diagnosis Work Group, made up of professional front line staff currently working with individuals with dual diagnosis, has been working for several months to analyze the knowledge, skills and attitudes needed for future treatment teams and individual employees to work effectively with patients with dual diagnosis. The Work Group will publish its recommendations in a report due to be distributed this fall.

In March of 1995 the Research Committee of the Public Academic Consortium presented a one day conference on dual diagnosis at South

Dr. Jennie Jerrell, Research Professor at Hall Institute, is working in collaboration with DAODAS, DMH and local providers to establish intensive outpatient dual diagnosis treatment programs in four communities in the state. These programs will provide specialized treatment services for individuals who have both a mental illness and substance abuse problem. These patients are prone to relapse and often have multiple admissions to inpatient programs. specialized local intensive outpatient treatment will provide better care to patients with a dual diagnosis and should decrease the need for expensive inpatient services. Funding for this project is being sought from a variety of federal, state and private sources.

Improving the statewide system of alcohol and other drug treatment is a priority for the Department of Mental Health. This goal can best be achieved through a cooperative effort with other treatment providers. Weaknesses in the system of care need to be identified and innovative, collaborative efforts need to be focused on improving our treatment system.

An integral part of the Department's rehabilitation response to the needs of persons with vocationally limiting substance abuse disabilities is Palmetto Center in Florence and Holmesview Center in Greenville. These two residential alcohol treatment centers, operated by Vocational Rehabilitation, provide clients with a comprehensive program of group and individual therapy; vocational assessment; personal and social adjustment training; psychological evaluation; recreational, family, nutritional and

Referrals to the centers come from human service agencies and interested individuals all over South Carolina. These referrals are coordinated through the local Vocational Rehabilitation counselor to provide initial assessment and establish a service relationship with the individual prior to admission. Following treatment, the local counselor assists the client with aftercare therapy, vocational counseling and job placement. Such a continuum of care is unique and provides optimum opportunity for the client's recovery. In FY 1995, Palmetto Center in Florence provided residential treatment services to 558 clients, whose average length of stay was 25 days, with total client services days of 11,761. Also, 889 treatment hours of group therapy were rendered through Family Therapy. During this same year, Holmesview Center in Greenville served 419 clients whose average stay was 30 days, totaling 9,673 total client days of service.

In addition, the South Carolina Vocational Rehabilitation Department continues to operate a program in cooperation with the South Carolina Mental Health Department at Earle E. Morris, Jr., Alcohol and Drug Addiction Treatment Center. This program provides vocational assessment, adjustment training, counseling and referral to local Vocational Rehabilitation counselors for job placement and followup services. During FY 1995, Vocational Rehabilitation services were provided to 314 Morris Village residents with 234 referred for follow-up services by Vocational Rehabilitation offices throughout the State and 100 were provided followup services after discharge by the Morris Village Vocational Rehabilitation staff.

In addition to this network of specialized facilities and programs, the Department has counselors in the majority of its local offices who specialize in Vocational Rehabilitation services to substance abuse clients. These specialty counselors also serve as liaison with other

In order to better serve the private and public sectors, the South Carolina Vocational Rehabilitation Department has implemented employee intervention programs with a variety of employers. These programs address individual needs of troubled employees before they have to be separated from their present employment due to substance abuse.

The needs of persons with substance abuse problems are complex and place considerable demands on South Carolina's treatment network. Whether these persons are unemployed or in danger of losing their employment, their rehabilitation needs are continuing to be addressed by the South Carolina Vocational Rehabilitation Department as indicated in the following table.

			CLIENTS
			RECEIVING	CLIENTS
FY	DISABILITY	REFERRALS	SERVICES	REHABILITATED
91	Drug
	Abuse/Dependence	1,717	3,056	771
	Alcohol
	Abuse/Dependence	2,539	4,293	1,090
92	Drug
	Abuse/Dependence	2,093	3,471	739
	Alcohol
	Abuse/Dependence	2,780	4,837	1,170
93	Drug
	Abuse/Dependence	2,426	4,652	1,191
	Alcohol
	Abuse/Dependence	2,473	4,110	944
94	Drug
	Abuse/Dependence	2,820	4,564	1,018
	Alcohol
	Abuse/Dependence	2,259	4,245	1,153

BACKGROUND:

Since FY'88, the number of admissions to the South Carolina Department of Corrections (SCDC) has increased 23 percent - from 8,502 inmates in FY'88 to 10,489 inmates in FY'95. Likewise, the SCDC custody population has increased from 11,068 in FY'88 to 19,397 in FY'95.

During this same time period, the number of inmates incarcerated with a dangerous drug conviction as their most serious offense more than doubled, from 11.1 percent of the inmate population in FY'88 to 23 percent in FY'95. Of the most serious offenses in South Carolina, the dangerous drug category has the highest frequency rate. Of the 19,347 SCDC inmates in the June 30, 1995, jurisdictional population, 5,695 (29.4%) had a dangerous drug conviction on this admission. Of these 5,695 inmates, 4,493 inmates had a dangerous drug conviction as their most serious offense. Also, 967 inmates had at least one DUI offense. Ten thousand, nine hundred (56%) inmates self-reported, that they were under the influence of alcohol or drugs at the time of the crime. Finally, 16,160 (83.5%) had at least one indicator of an alcohol or other drug abuse problem.

The FY'95 admissions for the year present a similar profile with a slight increase in percentages. Thirty-one percent of the admissions had at least one dangerous drug conviction on this admission and 2,641 (25%) had a dangerous drug conviction as their most serious offense. This indicates that the drug conviction trend is not abating and that more intervention resources are needed.

ASSESSMENT OF RESOURCES DEVOTED TO CRIME AND DRUG CONTROL PROGRAMS:

In an effort to counter the alcohol and other drug abuse problems and ensure the agencies goals of public safety and institutional security are

Comprehensive residential AOD services are being provided through Addiction Treatment Units at five institutions and 746 inmates received intensive treatment services during FY '95. The ATU program lengths are ninety day minimum or more and include:

- 48 bed facility for male inmates at Watkins Pre-Release Center in Columbia. The Unit was established in August, 1989, and was initially funded by the Governor's Division of Public Safety. It is currently funded through state appropriations.

- 60 bed facility for male inmates at Livesay Work Center in Spartanburg. The unit was established in October 1994, and is being funded by the Department of Public Safety - Office of Safety and Grants.

- 30 bed facility for female inmates at State Park Correctional Center in Columbia. The Unit was established in September 1994, and is being funded by the Department of Public Safety, Office of Safety and Grants.

- 250 bed facility for male inmates at Manning correctional Center in Columbia. The unit was established in October, 1994, and is funded by the U.S. Center for Substance Abuse Treatment. The construction phase was funded by the Department of Public Safety, Office of Safety and Grants.

- 48 bed facility for male youthful offenders who are under the jurisdiction of the Department of Probation, Parole, and Pardon Services. The unit is funded by the Bureau of Justice Assistance of the U.S. Department of Justice.

The development and implementation of the Addictions Treatment Unit (ATU) program is a on-going collaborative approach since 1986 between the Department of Corrections, Department of Alcohol and Other Drug Abuse Services, Department of Probation, Parole and Pardon Services and the Governor's Office, Department of Public Safety, Office of Safety and Grants.

The number of institutional-based alcohol and drug abuse counseling services provided by staff to inmates during FY'95 were:

- Alcohol and Drug Education. . . . .16,465

- Alcohol and Drug Group Therapy. . . . .3,805

- Alcohol and Drug Individual Therapy. . . . .102

Self-help groups, Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are active in the Department and have provided extensive support to the structured treatment programs. Also, their significant involvement in aftercare with inmates who have successfully completed the ATU programs is substantial, especially during the first 90 days after the inmates' release to the community. The number of self-help services provided to inmates for FY'95 were:

- Alcoholics Anonymous. . . . .9,064

- Narcotics Anonymous. . . . .2,694

The Department's interdiction and deterrence are increasing. Urinalysis testing was conducted on 6,239 inmates at work centers and 453 inmates were tested prior to being approved for work release. From July 1, to September 1, 1995, the K-9 Drug Interdiction Unit was responsible for 35 arrests involving drug interdiction, weapons violations and alcohol consumption on state property. Also, the Unit participated in 30 arrests with other law enforcement agencies for crimes involving narcotic trafficking and other crimes during drug raids.
The initial funding for the specially trained drug dog and handler was provided by the Department of Public Safety, Office of Safety and Grants. The Department now funds the unit, however, a second drug dog and handler was recently funded by Department of Public Safety for FY'95.

The Department of Corrections is fully supportive of the 1995 state strategy. The commitment by the Drug Control and System Improvement Program to our Addiction Treatment Units, drug testing (urinalysis) and drug dog interdiction has provided the impetus over the past seven years for comprehensive agency AOD planning and collaboratively working with other agencies for follow-up treatment and continuing care.

Department goals for the coming year are listed below:

- Enhancement the Reception and Evaluation Centers' screening for AOD inmate problems.

- Further implement evaluation plan to adequately assess treatment outcome, recidivism and relapse data to determine the inmates who are most likely to succeed and their characteristics.

- Identify inmates with a dual diagnosis (addiction and mental illness) and provide therapeutic intervention services.

- Provide intensive AOD treatment for youthful inmates, specifically "shock incarceration" participants.

- Identify and implement therapeutic intervention services for DUI Offenders.

- Establish additional intensive residential AOD treatment units at medium/maximum institutions.

The development of South Carolina's FY 1995 Statewide Strategy is a reflection of lessons learned during the past eight years of administration of the Drug Control and System Improvement Formula Grant Program. While great strides have been made in all areas of the criminal justice system in fighting the "war on drugs and violent crime," the belief that this is strictly a criminal justice problem is no longer held. Rather, the problem of alcohol and other drug abuse and violent crime in our state and nation has become a community problem, and society now owns a part in this war. For this reason, the Statewide Strategy reflects the opinion that the role of the community is possibly the most essential element in addressing the problem of crime and violence. With this in mind, the criminal justice system should be anchored in the community

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