November 26, 2022

LEBANON — Three community mental health agencies serving the Upper Valley received federal grants to expand and sustain their services amid an ongoing workforce shortage and an increase in demand for services following the height of the COVID-19 pandemic.

Lebanon-based West Central Behavioral Health, Springfield, Vt.-based Health Care and Rehabilitation Services of Southeastern Vermont and Randolph-based Clara Martin Center each received grants of $4 million over four years from the Substance Abuse and Mental Health Services Administration. The grants, intended to help the mental health agencies to become certified community behavioral health clinics (CCBHCs), started at the end of last month and run through Sept. 29, 2026.

While the impact of the grants may not be immediately apparent to clients, West Central CEO Roger Osmun said he is hopeful that in the long run the grants will help boost Medicaid rates and change the way mental health care is reimbursed, bringing reimbursement rates closer to the cost of providing the services.

“Frankly the federal government is increasing the Medicaid match for states that use the CCBHCs model,” Osmun said.

The model is somewhat analogous to the one used by federally qualified health centers, which receive money from the federal government to help them provide certain health care services.

But part of getting that increased reimbursement involves tracking data to show the cost of providing the quality of care the certified centers are required to provide. Osmun said he expects 80% of the grant to go toward wages and benefits and the remainder to go toward training. West Central is currently seeking a CCBHC quality data analyst and project evaluator and a project director.

Osmun said the grant “won’t radically change what we do.” Of the nine required “core areas,” West Central is already fulfilling eight. The ninth involves organizing services for veterans and active military personnel.

HCRS, in a recent news release, celebrated its receipt of the grant and said that it will allow for increased flexibility in the way it provides services, expand professional development opportunities for employees and increase the organization’s collaboration with primary care providers.

While West Central and HCRS were first-time recipients of planning, development and implementation grants, the Clara Martin Center’s grant expands on work it began in early 2021 when it first got what was then a two-year $4 million planning grant.

Christie Everett, Clara Martin’s director of operations, said that the first grant “just opened up so many avenues for us.”

For example, she said the grant has enabled them to provide services to uninsured people. It enabled Clara Martin to open weekend walk-in hours at one of its locations, add nursing care to an outpatient substance use treatment program and build a peer support program.

“It really was able to allow us to do a lot to really address some needs,” Everett said, noting that Clara Martin also was able to boost wages for hard to recruit master’s level clinicians.

“It really does put agencies on the potential path for financial stability,” she said. “That is the hope.”

Clara Martin plans to use its next round of funding to focus on expanding programs for youth, ages 16 to 22, and for elders, ages 55 and older. The focus on those two groups came out of a survey the organization conducted as part of the first grant.

The Transition Age Youth Program aims to offer youth and their families mentorship and support, as well as substance use treatment and therapeutic adventure-based programs. The program aims to help young people develop self-esteem, problem-solving skills, goal-setting and communication skills.

Meanwhile, the Elder Care Services program aims to provide psychological support to elders at home or in an office setting, helping them improve mental health symptoms, overall functioning and quality of life, while also addressing issues such as substance use and isolation that are intensified by the rural nature of Orange County. Clara Martin plans to increase its ability to respond to people’s homes to provide counseling, care coordination and integrated physical health care.

“Mental health care is health care, and it’s all tied together,” Everett said.

Noting that there are still people in crisis awaiting inpatient mental health beds in emergency departments, Everett said she hopes that this investment in “upstream” services helps to prevent people from hitting a crisis point.

The grant’s focus on providing “more holistic care in one place” is in line with the Vermont Department of Mental Health’s goals, Alison Krompf, the department’s deputy commissioner, said. In particular, the CCBHC model focuses on providing mental health and substance use treatment together, as well as providing peer support, services geared specifically for veterans and military personnel and mobile crisis response, which is “something that the state is very interested in moving toward,” Krompf said.

Ultimately, “More stringent quality standards and better access to care; everybody wants to do that,” she said.

Krompf was cautious about the difference the model might make in funding mental health care. She said it was not a “cost-based reimbursement” model, but a “cost-related” model. “There’s an angle here to talk about what it costs,” she said.

In spite of the increased demand for care following the height of the COVID-19 pandemic and the workforce shortage, Krompf said, “We’re glad people are still willing to check out innovative options.” The department is “open and interested to see where this goes.”

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.

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