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VERMONT CAREPARTNERS
VERMONT CAREPARTNERS
A statewide network of sixteen
non-profit, community-based
agencies providing mental
health, substance use, and
intellectual and developmental
disability services and supports.
For More Information:
Vermont Care Partners
137 Elm Street, Montpelier, VT 05602 • (802) 223-1773
Community-Based Care: High Quality and Cost Effective for Vermont
www.vermontcarepartners.org
FY2019 OUTCOMES AND DATA REPORT
2 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 3
This publication was made possible by a grant from the Health Resources and Services Administration (HRSA), an operating division of the U.S. Department of Health and Human Services, Grant Number: DO6RH27764. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Health Resources and Services Administration or the U.S. Department of Health and Human Services.
Vermont Care Partners is a collaboration between the Vermont Council for Developmental and Mental Health Services and Vermont Care Network.
Table of Contents
From the Board Presidents and Executive Directors . . . . . . . . . . . . . . . . . . . 3
About Vermont Care Partners Network Staff . . . . . . . . . . . . . . . . . . . . . . . 4-5
The Basics: Housing and Employment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
The Basics: Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9
Crisis Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-11
How Network Agencies Meet Health Goals. . . . . . . . . . . . . . . . . . . . . . . . . 12-13
Clinical Supports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-15
Wellness & Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-17
Peer Driven Support and Innovations . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18-19
Community Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Promotion of System Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Needs and Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Advocacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Vermont Care Partners Network Agencies. . . . . . . . . . . . . . . . . . . . Back cover
What is Vermont Care Partners?
Vermont Care Partners (VCP) is a statewide network of sixteen non-profit community-based agencies providing services and supports to people with mental health conditions, substance use disorders, and intellectual and developmental disabilities. Network agencies provide person- and family-centered, recovery-oriented care to the most vulnerable Vermonters regardless of income. Unlike other organizations that provide coordination of care and referral, network agencies actually provide these services and supports, coordinating with other community providers as needed so that Vermonters can thrive in their home, school, community and work lives.
Vermont Care Partners’ mission is to provide statewide leadership for an integrated, high quality system of comprehensive services and supports. Vermont Care Partners and network agencies advocate for policies that promote this important work, and are fully invested in state payment reform efforts to improve population health. By supporting Vermont’s most vulnerable people, the VCP network contributes to the triple aim of improving overall health, controlling the cost of health care, and promoting access to quality care.
None of this work would be possible without the tremendous dedication of network agency staff, many of whom work in programs requiring 24 hours per day, seven days per week coverage. In addition to clinicians, medical providers, case managers, and home providers, the success of the agencies would not be possible without the tireless efforts of countless employees who provide maintenance, administrative, and operations support. This year’s report is dedicated to them.
Julie TesslerExecutive DirectorVermont Council / Vermont Care Partners
Simone Rueschemeyer Executive DirectorVermont Care Network / Vermont Care Partners
Todd BaumanExecutive DirectorNorthwestern Counseling and Support Services /Vermont Council Board President
Lorna MatternExecutive DirectorUnited Counseling Services/ Vermont Care Network Board President
Vermont Care Partners Staff
Cath BurnsQuality Director,
Vermont Care Network
Dillon BurnsMental Health
Services Director, Vermont Council
Erin CamposAdministrative Director,
Vermont Council
Ken GingrasHealth Information Technology Director,
Vermont Care Network
Lynne ClevelandVitzthum
Developmental Services Director, Vermont Council
CLINICAL SERVICES
EMPLOYMENT SUPPORTS
HOUSING
CRISIS RESPONSE
MEDICAL SERVICES
PUBLIC HEALTH PROMOTION
WELLNESS PROGRAMS
EDUCATION SUPPORTS
HOSPITAL DIVERSION AND CRISIS BEDS
PUBLIC EDUCATION
CRIMINAL JUSTICE PROGRAMS
RESIDENTIAL SUPPORTS AND FACILITIES
INTEGRATED HEALTH CARE
4 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 5
Network staff are dedicated to supporting consistent and meaningful relationships to those they serve. The Packard family, pictured here with R.T., recently celebrated their 33 year relationship by traveling the world together.
Jenni Campbell, a leader at the Clara Martin Center’s children’s program, was recognized for her outstanding work with the Dr. Brewster Martin Award.
Network staff are truly dedicated to improving the lives of others. Courtney Randall, a Developmental Services Shared Living Program Manager at United Counseling Service, enjoys finding creative ways to enrich the lives of others in the community. Her work and advocacy makes others feel valued.
About VCP Network Staff
The rewarding work found at agencies inspires staff to remain and grow professionally. Diane Petterson from Clara Martin Center recently celebrated 40 years of service as a Billing Supervisor.
Agencies hire people who are skilled at providing support to others, helping to promote a positive work environment that makes a difference in the lives of the people we serve. Becca Brown, Manager of Nursing
Services at Health Care & Rehabilitation Services, supports many in her agency through education, medical support, and collaborative care.
Network agency staff work with all people, of all ages, providing high quality services and supports. Amy Irish, from Northwestern Counseling & Support Services, is one such champion who has received national recognition for her work developing school services.
Health Care & Rehabilitation Services staff stand up against child abuse
Network Agency Staff Make a DifferenceOver 4,200 people were employed in direct service and clinical positions.
Countless others supported individuals as shared living and respite providers.
Network agency staff provide services 24 hours per day, seven days per week
despite low pay. This dedicated group of people are the backbone of the network
and have an immensely positive impact upon people’s lives, homes, schools,
communities, and places of work. They are the reason that Vermont is a leader in
the United States for services to people with mental health conditions, substance
use disorders, and intellectual/developmental disabilities.
Staff are highly skilled and trainedAgency staff come to their work with a passion for supporting Vermont’s most
vulnerable people. Many come with extensive life experience and education.
Others learn quickly through training programs provided by agencies as they
onboard.
• 21% of all staff have a master’s or doctorate degree
• 18% of developmental services staff have their QDDP certification (Qualified
Developmental Disability Professionals)
Staff are well supported as they grow in their positions• Agencies provide weekly individual and group supervision
» 20% of graduate level staff receive supervision towards professional
licensure, 38% of whom ultimately became licensed in FY19
» Numerous in-house trainings are provided from on-boarding new staff to
promotion of new skills and expertise for existing staff
• Staff receive competitive insurance, vacation and sick leave packages
• Many agencies use cutting edge approaches to promote staff retention
• All agencies provide continuing education and professional development
opportunities
For people with intellectual and developmental disabilities, needs are very complex• 57% have co-occurring mental health diagnosis
• 10% have co-occurring substance abuse diagnosis
• 47% have other significant health problems
• 35% have history of trauma/abuse
• 20% have history of homelessness
• 84% of people surveyed said services improved their quality of life
Agency staff provide services to over 34,000 people, many with complex needsPeople seeking services through agency programs often have complicated
histories and concerns that require comprehensive and coordinated approaches
• 73% of people are funded through Medicaid or Medicare
• Many have significant histories of trauma, substance use, depression and anxiety
• Some struggle with finding housing, employment, a suitable educational
environment, or a supportive social network
13%
8%
12%
12%
22%
33%
Over 34,000 people supported in FY19 through our community based programs
Alcohol and Drug Abuse Services
Community Rehabilitation and Treatment
Developmental Services
Emergency Services
Adult Mental Health Services
Children, Youth and Family Services
Over 34,000 people supported in FY19 through our community based programs
Agencies receive international recognitionSandy Smith, Director of Counseling Service of
Addison County’s Community Rehabilitation and
Treatment, and Dr. Robert Jimerson, Medical Director,
were guest speakers at “Good Practice Services:
Promoting Human Rights and Recovery in Mental
Health” in Trieste, Italy. It was organized by World
Health Organization (WHO) and its Collaborating
Centre for Research and Training in Mental Health.
WHO is developing guidance on good-practice,
community-based services that promote recovery,
operate without coercion, and promote autonomy
and inclusion in line with international human
rights standards. Smith and Jimerson discussed the
human rights implications of Open Dialogue, a model
incorporated into CSAC’s practice over the past several years.
Sandy Smith, Director of Community Rehabilitation and Treatment at the Counseling Service of Addison County (CSAC)
6 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 7
Carol and Tiara, partners in employment at NKHS
The Basics: Housing and Employment
In Their Words
“My name is Tiara K. Mendala. I learned about the Job Connect Program through my Case Manager, Carol Simmons. At 15 years old I was a very unruly individual, and I really didn’t care about anyone but myself and my own feelings. I wasn’t responsible, organized, or even respectful to others.
I learned how to take care of myself, manage my money better, and to take constructive criticism. I have learned to care about how others may feel and to be completely honest with myself and others. If you stay focused and committed, even when things are extremely emotional and hard, this program will do all of you a world of good. Remember if you really apply yourself I mean really, really try hard, you can be successful.”
Last year Champlain Community Services provided home and shared living supports to 36 people (27 through Developmental Services and nine through Homeward, an Adult Family Care program).
Homeward Director Marie Greeno found Joan a home. Joan loves going out to dinner and socializing in the community now that she’s moved to her new home in Georgia, VT. Joan said that with country living in a family home and close proximity to town, “It’s like having the best of both worlds and I couldn’t be happier. Marie found me my perfect match.”
Entrepreneur Aung Htet, Director of Operations at AGH Fulfillment in South Burlington, earned the Theresa Villemaire Award this year for his partnership with the Way2Work program at Champlain Community Services (CCS).
Eve Whitney is a staff member with the Employment Associates program at Counseling Service of Addison County (CSAC). Eve supports adults with developmental disabilities at their places of employment. Through this work, consumers who may not otherwise be able to hold jobs due to limits in transportation, memory, or behavioral or other difficulties are able to become contributing members of their community. Supported employment assists an average of 185 individuals in finding or keeping paid employment in their community.
Agencies Provide Housing and Housing StabilityHaving a home in a community is critical for health and wellness. Network
agencies provide residential programs to our most vulnerable people, as well as
offer services and supports to help people secure and maintain stable housing.
Collaborations with community partners are key, and network programs work
closely with housing organizations to promote successful housing experiences.
Agencies Support Employment Being employed is important for recovery and inclusion as people find meaningful
ways to expand their experience, feel self-sufficient, and contribute to their
communities. Network agencies provided over 95,000 employment services
in FY19. Vermont enjoys high employment rates for people with mental health
conditions and I/DD relative to the national average and network agencies are at
the forefront of national models for promoting full inclusion through employment.
People with significant mental illness are employed more in Vermont than nationwide
49% of people with Intellectual and Developmental Disabilities in the network
were employed an average of nine hours per week, contributing over $5 million
to Wage and Payroll Taxes, and saving over $2 million in Social Security Income
payments.
Northwestern Counseling & Support Services’ Berry Hill Respite Program for people with Intellectual and Developmental Disabilities (I/DD)
Vermont Comforts of HomeVermont Comforts of Home (VCOH) is a joint
venture between Lincoln Street Inc. and Upper
Valley Services. VCOH helps people who need
a nursing home level of care who are no longer
able to live alone. VCOH is committed to the belief that all people, regardless
of their age or care needs, should have a voice in where they live and how they
are supported.
VCOH provides home support, service coordination and respite support
throughout Vermont. By identifying caring, reliable Vermonters who are
interested in sharing their home with someone in need of support, VCOH is
able to provide services which are individualized and specific to those we serve.
VCOH currently provides services to more than 40 people living happily in the
community of their choice, supporting them to participate in activities that
bring them fulfillment.
96%have a place
to live
30%own their
residence
86%of people with
I/DD like where
they live
28.5% 22.2%
8 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 9
The Basics: Education
Katie Lorah, a teacher at Health Care & Rehabilitation Services’ Kindle Farm School is passionate about supporting her students by providing an emotionally safe atmosphere that encourages the skills and habits necessary for life. Katie values her relationships with her students and colleagues. It is demonstrated in how she shows up every day, ready to play, laugh, teach, and above all, learn.
Katie is often seen outside playing games like soccer or running afternoon activities and immerses her students in nature through bird watching and tracking animals.
Kindle Farm is lucky to have Katie leading the charge by taking in the youngest students. Her work to help students feel safe, heard, and challenged as they start their Kindle Farm career is an essential component to the thriving community here.
Open house event at Health Care & Rehabilitation Services Kindle Farm School
Lacey Boleyn, RN is our Washington County Mental Health Services school nurse. Having a nurse housed within our school building allows students immediate access to medical care and knowledge. Lacey facilitates medication management for students, coordinates school medical screenings, keeps medical records current for the state, provides medical and wellness education, and conducts daily triage of any medical concerns/needs that arise. She is a positive support for both staff and students alike.
Youth build confidence and skills with indoor rock climbing with Community Care Network/Rutland Mental Health Services Child and Family Services clinicians
Kids enjoy summer at Camp Be A Kid at United Counseling Service
Agencies Support EducationNetwork programs support children and youth ages 3-21 to fully participate in
education by:
• Supporting Vermont’s youngest children to participate in quality child care and
early education programs
• Promoting coordinated care through Child Integrated Services (CIS) teams with
community providers and educators
• Creating innovative programs that promote post-secondary involvement
• Providing critical care to children and youth in their local schools, along with
consultation and education to educators who are interested in learning more
about mental health conditions, substance use disorders, and intellectual and
developmental disabilities
Over 10,000 school aged youth 5-22 were supported by network programs.
Consistent with Vermont’s values, services and supports for these youth were
provided where children live, learn and play including in their homes (8%),
community (20%), and schools (35%).
65% of Vermont schools benefited from the support of a VCP network agency school-based program.
Network agencies supported 34 people with intellectual and developmental
disabilities in post-secondary education. 100% of graduates from these programs
were employed upon graduation.
Agencies Help Children and Youth Engage in EducationOur network uses the Success Beyond Six (SBS) funding mechanism to support
children and youth with the most acute needs through therapeutic support often
provided across their school, home and community lives.
Programs are cost effectiveIn FY19, 772 children and youth required the highest level of support (independent
school placement or a behavior interventionist model) because they were at risk
of costly residential placement for stabilization. The cost of residential placements
is high ($1,425 per day) and the placements do not promote integration and
stabilization in the community. In contrast, SBS contracts cost less than 10% of
a residential placement and are often provided in a youth’s home school, saving
Vermont millions of dollars.
Programs are clinically effectiveYouth fared better if they remained in school: 50% of youth discharged from a
behavior interventionist programs returned to their public school without agency
support. Only seven youth required residential placement.
• 94% of schools responded positively to a survey about Success By Six School
Based Services
Academic programs for students with disabilitiesChamplain Community Services
(CCS) coordinates Bridging, an
academic-year program for students
with disabilities, in partnership
with five Chittenden County High
Schools (Burlington, Colchester, Mt.
Mansfield Union, South Burlington,
and Winooski). Bridging’s mission
is to assist school-aged youth with
disabilities to step confidently into their adult years by introducing them to
meaningful community opportunities, exploring topics connected to healthy
adult living and building healthy relationships. Bridging offers students strong
pre-vocational, career exploration and community engagement opportunities.
The most recent year-end Bridging Gala, held at Vermont Public Radio,
celebrated the accomplishments of the 14 program participants.
Rutland Mental Health provides high quality care to youth and familiesFor the past 16 years, Scott Louiselle
has been an integral part of the
Community Care Network Child
and Family Services program.
As the program’s Outpatient and
Community-Based Services Manager,
he is well-respected for his advocacy
and support of employees and
families as well as for his attention
to customer service. Scott was
instrumental in the implementation
of the agency’s new EMR-Credible. He has also led Child and Adolescent Needs
(CANS) implementation initiatives at Community Care Network and serves on
the State CANS implementation team. Outside of his work at Community Care
Network, Scott serves as President of the Board for the Rutland Community
Cupboard and enjoys time with his family, antiquing, and live music.
65%
27%
4%
4%
Mental Health Services (fee for Service)
School Based Clinicians and Consultants
Behavior Interventionist Model
Independent Schools
Models of School-Aged Services and Supports
10 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 11
Northwestern Counseling & Support Services honoring Lieutenant Maurice Lamothe as a Community Partner Award recipient.
Crisis Services
State Hospital Utilization* (per 1000 people)
30 day Readmission Rate*(per 1000 people)
Community Hospital Utilization* (per 1000 people)
“This is the most beneficial program I have been affiliated with since I began at the Vermont State Police. With the current and constant pressure on how law enforcement deals with people in crisis, this might be an opportune time to ask for assistance from other State departments in helping to fill the crisis worker role(s)”.
— Lt. Maurice Lamothe, St. Albans Station Commander
of the VT State Police
Howard Center’s Street Outreach Team meets people where they are, when support is needed. They recently expanded the program to include Richmond.
Hinesburg Police enjoy First Responder Appreciation Gifts from Howard Center.
Agencies Support Vermonters in CrisisOur services are accessible, with all agencies providing 24 hour crisis lines for
people who are experiencing a mental health crisis. Services are for anyone,
regardless of diagnosis, disability, or ability to pay.
• Mobile outreach teams providing community-based support and intervention
– only 19% of evaluations occured in the Emergency Department or in an
inpatient hospital setting
• Crisis and respite beds
• Peer support warm lines and mentors
• Extra staffing and clinical support
• Collaboration with providers and families to promote stabilization
• Funding for hotels and/or support in homeless shelters
• Coordinated follow up care
When you experience a crisis, you are seen again quicklyPeople who receive support quickly after a crisis or discharge from a psychiatric
hospital are less likely to reexperience the crisis or to be readmitted to a hospital.
When follow up care is provided, even by phone, the risk of readmission for
suicidality or self harm is dramatically decreased.
• Mental health crisis follow up:
» 37% received follow-up within 24 hours, 79% were seen within 7 days• Follow up after discharge from a psychiatric placement:
» People with significant mental illness were supported more quickly post
discharge compared to the national average
ο Vermont - 54%* supported the same day (*FY18 data)
ο Vermont - 83%* supported within 7 days compared to National estimate
of 37% ** (**FY17 data)» People with I/DD were seen the same day of their discharge 99% of the time
Crisis supports prevent costly hospitalizations People go to the hospital less and are readmitted less frequently than the
national average as seen in comparison statistics on the left.
Agencies Promote Community Safety When a mental health crisis arises, whether it is within a family home, at a high
school or in a public place, it is critical that the first responders are trained in
mental health issues, in mental health law, and working together to resolve
the crisis. Team Two seeks to both educate the first responder and to build the
relationships necessary to work together in a crisis. Team Two is beginning
its sixth year, with 35 law enforcement and mental health crisis workers
collaboratively training peers in five regions around the state. Team Two has
also received national recognition for its effectiveness.
Suicide prevention and mental health first aidThis national model is highly effective at providing information to a broad
audience about how to prevent and support peole who are at risk of suicide.
In FY19:
• 30 Youth Mental Health First Aid (YMHFA) and 43 Adult Mental Health First Aid
(MHFA) new trainers were certified to support suicide prevention in Vermont
• 1,406 Vermonters were trained in Cultural and Linguistic Competency
• 120 Residential Advisors at UVM were trained in MHFA
• 710 agency workforce were trained in Y/MHFA
• 696 community members were trained in Y/MHFA
• 1,817 youth/adults were referred to services as a result of Y/MHFA training
When disasters occur, network agency staff are there for you175 network agency staff supported over 1,600 people who experienced 82
community events and disasters including support following untimely deaths by
suicide, accidents, and natural disasters.
Diversion from jails• Public Inebriate Beds providing a safe place to return to sobriety diverted 50%
of people screened from jail.
• 70% of those screened accepting referrals for further support for substance use
concerns.
*2018 SAMHSA NOMS dataThis year’s Frank Silfies, Sr. Mental Health Provider of the Year award was presented to Talaia Thomas, Washington County Mental Health Services (WCMHS) Emergency Screener by Chief Tony Facos (Montpelier PD and WCMHS Board member),and Kristin Chandler, (Director of Team Two and WCMHS Board member).
In Their Words
.13
1.2%
.87
.39
7.2%
1.58
Community Care Network (Rutland Mental Health Services) Emergency Services expanding community-based services
In an effort to reduce unnecessary Emergency Department visits for mental
health issues, CCN-RMHS is focused on restructuring the foundation of its
Emergency Services Team to provide more community-based crisis services.
In FY2019, the CCN-RMHS crisis team screened more than 1,000 individuals,
with approximately 80% being seen in the Rutland Regional Medical Center
Emergency Department. Approximately 70% of individuals presenting at the
hospital for a mental health issue did not require hospitalization, creating an
opportunity to divert some of these visits to a lower level of care. Expansion of
community-based outreach, counseling, case management and peer support
services provides the range of care to better meet the community needs.
Reintegrating with Emergency Managers in local municipalities has also
allowed the team to refresh its Disaster Mental Health planning process.
Medical Services
Peer Supports
Employment Programs
Residential Facilities
Housing Stabilization
Treatment for Mental Health and Substance Use Disorders
Education Support
Criminal Justice Programs
Hospital Diversion and beds
Wellness Programs
Public Inebriate Beds
Crisis Response
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Emer
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Dep
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Law
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Community
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12 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 13
How Network Agencies Meet Health Goals
Vermont Care Partners Network Agencies Impact Population Health
Promoting healthy behaviors• 100% of agencies have wellness programs
for staff and clients that promote
decreased tobacco use, improved
nutrition, increased exercise, and
better wellness outcomes
• Agencies provide support and treatment
for mental health conditions and
substance use disorders across the state
• Agencies educate their communities
about the prevention and treatment for
mental health conditions and substance
use disorders, and supports for intellectual
and developmental disabilities
Promoting community safety• Many agencies embed clinicians with local
police departments
• Team Two has 35 law enforcement
and mental health crisis working
collaboratively to train peers about how
to work together when responding to a
mental health crisis
• 114 people were supported through Public
Safety funds under Act 248
• 50% of people screened for public
inebriation were diverted from jail to a
safe place to attain sobriety
Reducing suicide• Most agencies provide Youth and Adult
Mental Health First Aid (MHFA)
• In FY19, 696 community members, 120
resident advisors, and 710 agency staff
members were trained resulting in 1,817
people who were referred to mental health
crisis screening and services
• All agencies provide 24/7 emergency
response
• Seven agencies are involved in the Zero
Suicide initiative that has been nationally
recognized for preventing suicide
Addressing social and economic factors:Housing: Agency programs provide or support
people to find and maintain housing:
• 96% of people supported by network agencies
were housed
Employment: Agency programs support people to
find and maintain employment
• 28.5% of people with significant mental illness
were employed
• 49% of people with intellectual and
developmental disabilities were employed
Education: Agencies provide services where
children live, learn and play
• Services and supports are provided in 66% of
Vermont’s schools, and in 91% of supervisory
unions
Family and Social Support: Parent education
and supports, in-home services, and promotion
of natural social supports are provided so all can
access what they need.
• 91% of people said they received the services
they needed
• 90% said they received the services that were
right for them
Improving access to quality services and supports• 99% of inquiries for services for individuals with
intellectual and developmental disabilities were
responded to within 48 hours
• Many agencies have same day access to
outpatient services
• 100% of mental health agencies have 24/7 crisis
response for mental health concerns
• Follow up supports for people who experienced
a mental health crisis, were discharged from a
psychiatric placement, or who were discharged
from a crisis bed were provided services more
quickly compared to the national average
• Network agencies strive for quality - eight
agencies have achieved certification as a
Vermont Care Partner Center of Excellence, and
four are in the process. 100% of agencies plan
to be reviewed by the end of FY20
• Vermont was ranked #3 in the country by the
United Cerebral Palsy foundation for inclusion
practices for people with intellectual and
developmental disabilities
14 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 15
Clinical Supports
Mentoring at United Counseling Service of Bennington County (UCS) — Youth and Family Services
UCS served the community for over 30 years in partnership with Big Brothers Big Sisters (BBBS) of America. BBBS has made changes to its model that would require additional staffing and resources, that UCS was not able to do.
Mentoring changes lives and UCS was excited to roll out a new chapter this year by creating Mentoring at UCS. The program works in the community to build relationships, skills and experiences to help our matches achieve their goals. We continue to match youth with amazing mentors.
Howard Center has been named the recipient of the National Council for Behavioral Health’s 2019 Excellence in Addictions Treatment Award. Selected from 230 nominations from across the country, the award was presented to Howard Center in Nashville, Tennessee, during the Awards of Excellence Celebration in conjunction with the National Council Conference – NatCon19. The National Council for Behavioral Health’s Awards of Excellence recognize and honor individuals and organizations in behavioral health care for their ingenuity, hard work and dedication to improving the lives of Americans with mental illnesses and addictions.
Agencies Support Mental Health and Substance Use Recovery Network programs provide a variety of therapeutic services and supports for
people in recovery from mental health conditions and substance use disorders.
These include case management and planning to help people secure housing and
employment, supports in the community to practice skills and access services,
foster care, residential supports, psychiatry and individual, family and group
psychotherapies.
• Nine agencies are preferred providers with the Vermont Alcohol and Drug
Abuse Prevention Program
• All agencies provide co-occurring mental health and substance use disorder
supports and treatment, and/or coordinate with ADAP preferred providers to
ensure people obtain the supports they need
Innovative treatment approaches include:• Continued participation in the treatment of substance use disorders by providing
hub and spoke locations
• Mindfulness sobriety intensive outpatient programming
• Expanded telehealth services
• Public inebriate programs that divert over 50% of people from jails and
emergency departments
• Infused co-occurring programming for people experience mental health and
substance use disorders across agencies
• Open dialogue practices for people with addictions
People are provided with individualized service• Average caseload size - adult outpatient - 37
• Average caseload size - CRT - 22
Agencies Provide Accessible Programs to Vermonters• Most agencies provide a single point of contact and increasingly, agencies are
offering walk in or same day appointments for clinical services
• Over 50% of services and supports are provided in the community where people
live, work, learn and play
• Eight agencies provided treatment services at 55 primary care offices and
emergency departments in the State providing evidenced-based approaches
to screening and treatment for mental health conditions and substance use
disorders
• Nine agencies provided psychiatric consultation to primary care and
Emergency Departments
• Three agencies provided bidirectional care by supporting primary care provider
use of agency space
Treatment for substance use disorders is accessible and timely
“First Responders do a great job of taking care of those entrusted in our care, however we do not do the best job of taking care of ourselves.
Emergency Medical Services is an industry where emergency medical professionals are placed in extremely intense, stressful, and dangerous environments every day. Having United Counseling Service of Bennington County Employee Assistance Program as a local resource available for our professionals is a key component of making sure they are healthy, happy, and ready to handle any emergency.”
— Forest Weyen, Executive Director, Bennington Rescue Squad
In Their Words
Northwestern Counseling & Support Services (NCSS) Integrated Behavioral Health Adult TeamNCSS’ community integrated behavioral health initiative extends well beyond
a clients’ point of contact. Whether in the NMC Emergency Department, in
Primary Care Patient Centered Medical Homes, working with local and State
police, in school settings, with the crisis team or, mobile outreach, a team of
professionals work to provide the best access and care in a person’s time of
need. NCSS’ collaboration with NMC has reduced Emergency Department visits
with 48 NCSS clients by 61% in the past year.
Services make a differenceWhen people come to us for clinical supports, they are often experiencing
increasing mental health and substance use symptoms that are impacting their
ability to work, have relationships, go to school, and be a part of their community.
Upon discharge, clinicians reported that 80% of people’s symptoms had improved or were no longer increasing.
Wait Time in Days for Service
16 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 17
Howard Center staff receive the Governor’s Excellence in Worksite Wellness – GOLD Level Award
Wellness & Prevention
Color Splash Race at the Clara Martin Center
Clara Martin Center has a well developed wellness program for people with significant mental illness that promotes overall physical health through smoking cessation, nutritional, educational, physical, and coordination activities.
After assessing individual physical and medical needs, people are supported to quit smoking, eat healthier, be more active and see their primary care provider (PCP) regularly. Individual action plans help people to develop attainable goals. Group education is provided to teach proper nutrition and group activities at local gyms and pools that occur several times each week. Case managers and coordinators are included in planning so that people can be supported to purchase healthier foods, work physical activity into their weekly schedules, and attend regular preventative healthcare appointments. People’s PCPs are included in their plans so that medical issues can be attended to quickly. The participation has doubled over the past six years, and people have been enjoying decreased weight, blood pressure and other improved metabolic indicators.
UCS staff participate in the inaugural 5K Superhero Fun Run to raise money for client wellness
Agencies Promote Wellness and PreventionPromoting wellness is key to health and recovery. People who suffer from severe
mental health illnesses often have very poor physical health for a variety of
reasons such as poor diet, lack of exercise, smoking, poor access to medical care,
as well as long-term adverse effects of psychotropic medications. Over time, many
develop obesity, diabetes, heart disease, COPD, and cancer, and die on average 20-
30 years younger than the general population. Network agencies pride themselves
on providing creative and effective programs that support physical and mental
health, including:
• Smoking cessation and education
• Nutrition and cooking classes
• Physical activities and group fitness classes
• Education about wellness and self-care
• Community education activities
• Extracurricular activities including art, yoga, mindfulness, and gardening
• Support to access and maintain an ongoing relationship with a primary care provider
Agencies Support Staff WellnessHealthy staff are better able to support others. Agencies provide staff wellness
activities including:
• Smoking cessation and incentives to quit smoking
• Nutrition education, consultation, and cooking classes
• Wellness fairs that often include massages, flu vaccines, biometric screening,
information about local health promoting activities and prizes for participants
• Physical activity clubs including FitBit challenges, walking, running, yoga, Tai
Chi, acupuncture, mindfulness, kickboxing, cross fit, hiking and biking
• Activities for wellness including art classes, sleep hygiene courses, and
education about health promotion
• Employee assistance programs for staff to access mental health and substance
use supports for themselves or loved ones
• Financial incentives to participate in community fitness programs and activities
• Discounted ski passes and access to private fitness companies
Carrie Vignatti, Residential Specialist, Jonathan Sabol, Residential Specialist, and Maria Tevolini, Community Integration Specialist, pose with veggies, bread, and flowers that are all grown or made at Health Care & Rehabilitation Services’ Hilltop Recovery Residence.
Having fun in the summer at Health Care & Rehabilitation Services!
A young Vermonter greets finishers at Howard Center’s 11th annual Zoe’s Race.
Zoe’s Race celebrated its 11th anniversary on Sunday, August 25, at Oakledge Park in Burlington. The family-friendly event offered a 1K fun run, a 5K run/walk and a 10K run, along with a raffle, music, and prizes. The event has raised more than $200,000 with support from numerous local businesses and individuals and has completed 23 home accessibility projects. Home modifications have a lasting impact on the daily lives of Howard Center clients and their families. One mother and recent recipient said, “Our family is grateful for the support provided to remodel our bathroom. My son now has the necessary accommodations he needs and it literally has been life-changing.”
Helping employees quit smokingGreen Mountain Support Services provides a $3,500 bonus to the first five
employees who quit smoking for a full two years. Because of their creative
approaches to promoting employee health and wellness, they were featured in
the Vermont Department of Health’s 3-4-50 campaign!
Enjoying an art class at United Counseling Service
18 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 19
Peer Driven Support and Innovations
Telemedicine launched at Rutland Mental Health Services to improve access to care
Rutland Mental Health Services (RMHS) launched a telemedicine pilot program in 2019 to improve access to care in its Community Rehabilitation and Treatment program. The pilot project started with 18 participants, and with the rollout of the service that number is expected to grow to more than 70 within a year.
In the future, telemedicine and telehealth services in general will encompass more services for RMHS clients who have difficulty getting to an office appointment or are unable to leave the hospital.
Champlain Voices is an active self-advocates group hosted at and co-facilitated by Champlain Community Services (CCS). It is one of 23 local chapters of the statewide Green Mountain Self-Advocates network.
Ribbon cutting ceremony for the Clara Martin Center’s Safe Haven Program
Safe Haven celebrates its 20th anniversary as a collaboration between Clara Martin Center, Vermont Psychiatric Survivors, and NAMI. It is the first peer and agency-run crisis bed in the state.
This redevelopment project turned a vacant historic building into new affordable housing for homeless individuals living with a mental illness. The project is bringing much needed housing to this rural area that had seen a decrease in bed capacity at the Clara Martin Center’s Safe Haven program following a reduction in federal HUD funding in 2014.
Vermont’s Department of Mental Health recognizes that housing is an important aspect of one’s health care and stability. Residents of Safe Haven will be able to access the services and supports to help with any care needs they may have.
Fletcher LIbrary in Burlington and Howard Center collaborate to provide an Outreach desk.
Joanne Matthew, Psychiatric APRN practicing telemedicine at Rutland Mental Health Services.
Lamoille County Mental Health Services Genoa Pharmacy grand opening providing on-site pharmacy services to clients and staff.
Peer Leaders Make a DifferenceAgencies provide better services when people with lived experience advise, staff
and/or manage the programs that provide:
• Residential supports and programs such as Safe Haven run by the Clara Martin
Center, a transitional living shelter for people who are homeless and who also
have mental health conditions
• Mental health crisis response services in the community and in the
emergency department
• Crisis bed programs, such as Maple House, a peer run program operated by
Washington County Mental Health Services
• “Warm” phone response line for support
• Consultation to families whose young family member is in crisis
• Peer mentoring to support people who are transitioning into the community
from a higher level of care
• Outreach to schools to support youth with I/DD who are transitioning to adult
services
• Staffing a wellness center or day program for people in recovery from
significant mental illness
• Providing training on Mental Health First Aid and Intentional Peer Support
Other important peer-led initiatives include• Participation in ethics teams and clinical standards reviews
• Liaison to self-advocates, executive and governing boards
• Preparation of information and materials for people coming into services
• Community living coaches
• Participation on medication delivery teams
• Research based topical discussion groups
• Youth for Change, led by youth for youth exploring topics and activities that
promote safe and healthy socialization in safe spaces with peers
• Youth led peer movement groups co-facilitated with an agency clinician
designed to promote physical and mental well being through movement and
activity
Agencies Are InnovativeWhile network agencies are required to provide specific services to people
in Vermont, innovation is also an unwritten requirement so that unique and
ever changing community needs can be addressed in a timely manner. Some
innovations include:
• Expansion of peer support and advocacy beyond programming to include
informing policy initiatives
• Integration with police departments with embedded agency social workers
• Promotion of independent living for people with intellectual and developmental
disabilities through the use of technology
• Provision of technical assistance to promote communication of choice by a
specialist trained in Augmentative and Alternative Communication
• Death Doulas who provide critical support at the end of life
• Formation of Year One - an embedded clinician in a pediatric practice who
provides support to parents and caregivers through the first year of a child’s life
• Low Barrier Medication Assisted Treatment services for people recovering
from opioid addiction
• Single point of access and intake
• Child Parent Psychotherapy Training Collaborative
• Expansion of Zero Suicide intitiative to seven agencies
• Coordinating with the University of Vermont to study the impact of mental
health, substance use disorder, homelessness, history of abuse and major
health care stressors on health in people with intellectual and developmental
disabilities
• Integration of social workers in Patient Centered Medical Homes, law
enforcement and local schools
• Involvement in Police Crisis Negotiation Unit
20 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 21
Jean Grover, RN celebrates 20 years of skilled nursing oversight and hands- on support and training to staff and contractors at Lincoln Street, Inc
Community Education
Promotion of System Quality
Rita Hammond, Administrative Assistance at Lamoille County Mental Health Services (LCMHS), received the Shirley Hayden Award for her compassion, loyalty, honesty, and dedication to human services
Central to all network agencies’ missions is the promotion of equity for people regardless of race, culture, socioeconomic background, gender orientation, spiritual orientation or other issue. Network agencies are uniquely positioned to provide education for the communities they serve, often at low or no cost, to promote this mission.
VTC students and NCSS trainers at the spring 2019 training
Northwestern Counseling & Support Services Center of Excellence Committee members proudly display the plaque received during the 2019 VCP Annual Conference.
Lamoille County Mental Health Services staff were awarded the Green Mountain Career and Technology and Career Center Award
Agencies Educate CommunitiesIn FY19 over 240 educational experiences were provided to community members
in Vermont communities, including:
• Suicide prevention - Mental Health First Aid for Youth and Adults, Zero Suicide,
U Matter, and informational movie screenings and presentations to schools,
church communities, and hospitals about suicide and its prevention
• Trauma across the life span - Agency staff are experts in the assessment and
treatment of trauma using evidenced based models. Trainings about trauma
and its impacts have been provided to parent groups, schools, hospitals, and
caregivers for people with intellectual and developmental disabilities who are
known to have a disproportionately high rate of trauma histories
• Intentional Peer Support (IPS) - IPS is another trauma informed model that
uses positive relationships and self-determination to promote healthier, stronger,
interconnected communities
• Person Centered Thinking (PCT) - PCT supports positive control and self-
direction in the lives of people with intellectual and developmental disabilities
• Parenting support and education for parents whose children have experienced
trauma and/or who have been involved in the child welfare system using the
Resource Parenting Curriculum
• Community forums to promote increased knowledge about State policy reform
within the Vermont Departments of Mental Health (DMH), Disabilities, Aging and
Independent Living (DAIL), and Alcohol and Drug Abuse Programs (ADAP)
• Consultation to community partners about evidenced based practices and
their implementation for people living with mental health conditions, substance
use disorders, and intellectual and developmental disabilities
• Community education about important topics including recovery, Cannabidiol
(CBD) and its uses, brain health, talking to children about substance use, vaping
and E-cigarettes, opioid addiction and its treatment, responding in emergency
mental health situations, managing difficult behaviors in health care and
educational environments using evidenced based models, and many more
• Annual VCP Conference, Stepping Forward Together promoting health equity
and cultural and linguistic competency within agencies, across communities, and
the broader health care network
Agencies Promote ExcellenceWorking to continually improve network agency services,
VCP has developed the Vermont Care Partners Centers
of Excellence (VCP-COE) modeled after the National
Council’s Centers of Excellence (Jarvis, 2014). The
VCP-COE promotes quality improvement and high quality services through
agency review by expert peers from the network and from the Jeffords Institute
for Quality at The University of Vermont Medical Center.
The VCP “System of Excellence” is a vision of the VCP Network that guides
each of the 16 network agencies in becoming a Center of Excellence and known to
the entire community as, “…a great place to get care and a great place to work,”
Jarvis, 2014.
Our work toward a System of Excellence includes agreeing on standards and
measures, onsite peer review using measures aligned with local and national
measure sets that inform continuous quality improvement across all services.
The following agencies have earned certification as a VCP Center of Excellence
Howard Center’s Annual Conference
United Counseling Services staff providing education at a community event
22 Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org Vermont Care Partners, 137 Elm Street, Montpelier, VT 05602 • (802) 223-1773 • www.vermontcarepartners.org 23
AdvocacyNeeds and Challenges
Marla Simpson received the Community Advocate of the Year Award on Mental Health Advocacy Day. Marla has been a strong public advocate to support mental health services in Orange County and the State of Vermont. She is a member of the Board Advisory and local standing committee for Clara Martin Center. The members of this committee are involved in the development of the local system of care plans for various programs at the agency. Marla has been and will continue to be a passionate advocate for members of the community of Randolph, Orange County and the larger state mental health system.
Clara Martin Center’s Christie Everette, Marla Simpson, and Jena Trombly
Kids get out and have fun at United Counseling Service
Staff enjoying each other at an Employee Appreciation Day
Lamoille County Mental Health Services staff participate in the Lace Up for Cancer Benefit Walk
Mark and Hasan serve on the Board of Directors at Champlain Community Services (CCS)
CCS supports its consumers to take leadership roles within the organization (two consumers serve on the Board of Directors) and in the community. Mark (left) is Vice President and Hasan is President of our Champlain Voices self-advocates group. Each has testified and offered proposals to legislators and other community leaders and groups.
ChallengesPublic funding for developmental, mental health and substance use disorders
has not kept up with demand for services or inflation impacting access and quality
of care.
Workforce shortages and competition from state government, schools, and
health care which offer better pay and benefits make recruitment and retention
of qualified staff more difficult. At any one time there are over 400 staff vacancies
with an annual turnover rate of 28% system wide.
Vermont children/youth are more stressed, have more acute mental health
needs, are more likely to have parents with Opioid Use Disorder, and are more
likely to be in the custody of the State.
Suicide rates are increasing and are especially high for veterans. Vermont’s
suicide rate is 35% above the national average with suicide being the eighth most
common cause of death.
The number of people with developmental and intellectual disabilities has
grown and the complexity of their needs is also increasing:
Advocating for SolutionsInvest in network agencies to improve access to quality care that addresses
the social determinants of health, reducing the cost of acute health care, law
enforcement and corrections, including:
• Raise Medicaid rates to address gaps in compensation to recruit and retain high
quality staff.
• Invest in tuition assistance and loan repayment to retain qualified staff and
support their professional development.
• Invest in eldercare mental health services to support our growing population
of older Vermonters.
• Invest in school-based mental health and independent therapeutic schools to
enable students to thrive and prevent greater challenges for them in the future.
• Promote Zero Suicide pilots and Mental Health First Aid to prevent suicide,
destigmatize mental illness and enable communities to identify and support
individuals experiencing mental health problems.
• Increase ADAP rates for substance use disorder treatment services to ensure
access to quality care.
• Educate on developmental services systems reforms and develop ombudsman
program to maintain high quality care and support individual rights.
• Invest in community-based services to reduce hospital emergency department
back-ups and reduce stays for psychiatric hospitals.
Oper
ati
ng E
xpen
ses
Rev
enu
es
Workforce expenses
Infrastructure
Federal & State Regulations
Inflation
Deferred capital needs
Delivery System & Payment Reform
Payer Mix (Medicare dependent)
Capped funding sources
Low reserves
80%have co-morbidity
with chronic health
conditions
66%have mental health
conditions
19%have a history of
homelessness
26%of people with
I/DD have histories
of abuse
FRANKLIN ORLEANS
CALEDONIA
LAMOILLECHITTENDEN
WASHINGTON
ORANGE
WINDSOR
WINDHAM
RUTLAND
ADDISON
BENNINGTON
ESSEX
GRAND ISLE
NCSSNKHS
GMSS
LCMHSCCS
HC NFI
CSAC
RMHS
HCRS
UCS FFSV
LSI
UVS
WCMHS
CMC
• Champlain Community Services (CCS):
www.ccs-vt.org
• Clara Martin Center (CMC): www.claramartin.org
• Counseling Service of Addison County (CSAC):
www.csac-vt.org
• Families First in Southern Vermont (FFSV):
www.familiesfirstvt.org
• Green Mountain Support Services (GMSS):
www.gmssi.org
• Health Care & Rehabilitation Services (HCRS):
www.hcrs.org
• Howard Center (HC): www.howardcenter.org
• Lamoille County Mental Health Services (LCMHS):
www.lamoille.org
• Lincoln Street, Inc. (LSI): www.lincolnstreetinc.org
• NFI Vermont Inc. (NFI):
www.nfivermont.org
• Northeast Kingdom Human Services (NKHS):
www.nkhs.org
• Northwestern Counseling & Support Services (NCSS):
www.ncssinc.org
• Rutland Mental Health Services / Community Care
Network/ (RMHS): www.rmhsccn.org
• United Counseling Service of Bennington County (UCS):
www.ucsvt.org
• Upper Valley Services (UVS):
www.uvs-vt.org
• Washington County Mental Health Services (WCMHS):
www.wcmhs.org
Vermont Care Partners Network Agencies
137 Elm Street, Montpelier, VT 05602
(802) 223-1773
www.vermontcarepartners.org
VERMONT CAREPARTNERS
VERMONT CAREPARTNERS