The Vermont Care Partners FY19 Outcomes and Data Report highlights the positive impact of its designated and specialized service agency programs on population health. Vermont Care Partners’ (VCP) is a statewide network of sixteen non-profit, community-based agencies provide mental health, substance use, and intellectual and developmental disability services and supports. Initiatives to impact population health have targeted: reducing suicide; improving social determinants of health such as housing and employment, improving access to quality services, increasing healthy behaviors to reduce the incidence of chronic disease, and improving community safety. As noted by Simone Rueschemeyer, the Executive Director of the Vermont Care Network, one branch of Vermont Care Partners, “People supported by VCP agencies present with the most complex needs, and often require comprehensive programming.  Our agencies respond with innovative and effective programs that directly impact the social determinants of health”. With over 50% of services and supports provided where people live, work, learn, and play, VCP agencies are uniquely positioned to positively impact the health of the most vulnerable Vermonters.

Reducing Suicide

We know that people who receive support quickly after a crisis or discharge from a psychiatric placement are at lower risk of suicide and self-harm. VCP network agencies provide 24/7 emergency mobile community response to support people who are experiencing a mental health crisis.  These services are provided to anyone who calls regardless of their age, disability status, or ability to pay. In FY19, over 33,000 crisis services were provided in Vermont communities, with over ⅓ of those assessed for a mental health crisis receiving another support within 24 hours to ensure their safety.  VCP Agency staff often drive people home from psychiatric and crisis placements, providing immediate support and care to reduce the likelihood of costly hospital readmissions. Agencies also place a high premium on educating the community about suicide prevention through the provision of Youth and Adult Metal Health First Aid trainings. In FY19 alone these trainings resulted in 1,817 referrals to mental health screening and services. Additionally, seven of the network agencies are involved in the Zero Suicide initiative that has been recognized nationally as an effective model of suicide prevention.

Addressing Social and Economic Factors

While other programs provide navigation to services, VCP agencies actually provide the services that help people find and retain housing, initiate and maintain employment, participate in education, and develop social supports in their community. In Vermont, people with significant mental illness and intellectual and developmental disabilities enjoy higher employment rates than the national averages because of agency innovation. Network agencies are fully committed to supporting Vermonters of every age. They are in 91% of Vermont’s school supervisory unions, with clinicians, case managers, and behavior interventionists providing support to youth who struggle in school due to social, behavioral and/or emotional issues. We know that providing community-based services works, because people tell us that they are receiving the services they need (91% approval) and that the services were right for them (90% approval).

Improving Access to Quality Services

VCP network agencies recognize the importance of providing services and support as quickly as possible when people reach out with needs. Many VCP agencies have same day access to outpatient services, and 99% of inquiries for support for individuals with intellectual and developmental disabilities are responded to within 48 hours. All agencies provide services and supports that are coordinated with primary care by embedding clinicians within primary care, providing bi-directional care within their agencies, and supporting people’s access to primary care.  Improving access to care has become a focal point of quality improvement for the VCP network as agencies work to shorten the length of time people wait for services.

Increasing Healthy Behaviors

People with significant needs often present with complex medical histories and national studies consistently indicate that those with significant mental illness die younger than their non-affected counterparts.  This difference is due largely in part to the higher incidence of cardiovascular disease and other metabolic disorders. To address this issue, 100% of VCP agencies provide wellness programs targeting improved nutrition, exercise, and overall wellness activities. All agencies promote tobacco cessation programs, and all provide ongoing education about the positive effect of wellness on overall well-being.

Supporting Community Safety

VCP Agencies are at the forefront of efforts to promote community safety through initiatives such as Team Two where law enforcement and mental health crisis workers train together to be able to respond more effectively when a person is experiencing a mental health crisis. In FY19, 114 people were effectively supported through Act 248 Public Safety funds targeting individuals with intellectual and developmental disabilities who present as a threat to self or others.  And, many agencies provide safe alternatives to jail for individuals arrested for public inebriation to attain sobriety.  These programs routinely divert 50% of people from the criminal justice system with 70% of those screened accessing further supports for substance use disorders.

Promoting Health Equity

Health equity is essential to the health of Vermonters and VCP is at the forefront of this important work.  VCP provides statewide trainings such as Cultural and Linguistic Competence to Address Disparities and Inequities provided by Maria Mercedes Avila, PhD, MSW. VCP’s Annual Conference, Stepping Forward Together:  Creating Solutions that Promote Health Equity  on March 13th will bring a diverse group of people together to understand and explore solutions that actively promote health equity. Please check out this link and come join us! All agencies actively train their staff on best practices that promote cultural competence and equity, and this work is an important part of our network wide quality improvement effort, the Vermont Care Partners Centers of Excellence.

Call to Action!

VCP Agencies struggle with workforce shortages, inadequate Medicaid rates, and increased complexity of needs of those coming to the agencies for services and supports. Solutions exist. VCP is advocating for a 3% Medicaid rate increase to address the lack of parity in staff compensation compared to those employed by the state, health care and schools to ensure that vulnerable Vermonters have access to quality care from experienced staff. Other legislative priorities include: improving funding for services to older Vermonters; support for school-based services; improving payment rates for substance use disorder services; creation of an ombudsman for developmental disability services; and education about upcoming changes to these services.