LEBANON – Three community mental health agencies serving the Upper Valley have received federal grants to expand and sustain their services amid continued labor shortages and increased demand for services following the peak of the pandemic of COVID-19.
Lebanon-based West Central Behavioral Health, Springfield, Vt., Health Care and Rehabilitation Services of Southeastern Vermont, and Randolph-based Clara Martin Center each received four-year, $4 million grants from the Substance Abuse and Mental Health Services Administration. The grants, intended to help mental health agencies become Certified Community Behavioral Health Clinics (CCBHCs), began late last month and will run until September 29, 2026.
While the impact of the subsidies may not be immediately apparent to customers, West Central CEO Roger Osmun said he hopes that in the long run, the subsidies will help raise Medicaid rates and change how mental health care is reimbursed, bringing reimbursement rates closer to the cost of providing services.
“Frankly, the federal government is increasing the Medicaid match for states that use the CCBHC model,” Osmun said.
The model is somewhat analogous to that used by federally licensed 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 the quality of care that certified centers are required to provide. Osmun said he expects 80% of the grant to go to salaries and benefits and the rest to training. West Central is currently seeking a Quality Data Analyst and CCBHC Project Evaluator and Project Manager.
Osmun said the grant “is not going to drastically change what we do.” Of the nine required “core areas”, West Central already fulfills eight. The ninth is to organize services for veterans and serving military.
UNHCR, in a recent press release, celebrated the receipt of the grant and said it will allow for increased flexibility in the way it delivers services, expand professional development opportunities for employees and strengthen collaboration between organization with primary care providers.
While West Central and HCRS were early recipients of planning, development, and implementation grants, the Clara Martin Center grant expands the work he began in early 2021 when he was first awarded times what was then a two-year, $4 million planning grant.
Christie Everett, COO of Clara Martin, said the first grant “opened up so many possibilities for us”.
For example, she said the grant allowed them to provide services to uninsured people. This allowed Clara Martin to open weekend walk-in hours at one of her locations, add nursing to an outpatient addiction treatment program, and create a peer support.
“It really allowed us to do a lot to really meet some needs,” Everett said, noting that Clara Martin was also able to raise salaries for hard-to-recruit clinicians at the master’s level.
“It really puts the agencies on the potential path to financial stability,” she said. “It’s hope.”
Clara Martin plans to use her next round of funding to focus on expanding programs for youth ages 16-22 and seniors ages 55 and older. The focus on these two groups emerged from a survey the organization conducted as part of the first grant.
The Youth in Transition Program aims to provide youth and their families with mentorship and support, as well as substance abuse treatment and therapeutic adventure programs. The program aims to help young people develop their self-esteem, problem-solving, goal-setting and communication skills.
Meanwhile, the Elder Care Services program aims to provide psychological support to seniors at home or in an office, helping them improve mental health symptoms, general functioning and quality of life, while addressing issues such as substance use and isolation which are intensified by the rural nature of Orange County. Clara Martin plans to increase her ability to respond to people’s homes to provide counselling, care coordination and integrated physical health care.
“Mental health care is health care, and it’s all connected,” Everett said.
Noting that there are still people in crisis waiting for inpatient mental health beds in emergency departments, Everett said she hopes this investment in “upstream” services will help prevent people to reach a crisis point.
The grant’s focus on providing “more holistic care in one place” is consistent with the goals of the Vermont Department of Mental Health, said Alison Krompf, the department’s deputy commissioner. In particular, the CCBHC model focuses on the joint delivery of mental health and addictions treatment, as well as the provision of peer support, specially designed services for veterans and military personnel, and mobile crisis response, which is “something the state is very interested in moving towards,” Crompf said.
Ultimately, “Stricter 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.
Despite the increased demand for care after the peak of the COVID-19 pandemic and labor shortages, Krompf said, “We are happy that people are still open to discovering innovative options. The department is “open and interested to see where this leads”.
Nora Doyle-Burr can be reached at [email protected] or 603-727-3213.