VT Discretionary Funding Fiscal Year 2023

The regular, at-home presence of a SASH Clinician has been shown, through quantitative and qualitative data evaluation over 3 years, to improve the health and wellbeing of the 200 residents participating in the Burlington pilot, and reduce unnecessary Emergency Room visits. This project will expand the mental health pilot across Vermont through SASH's existing regional delivery system built on formalized partnerships between SASH housing organizations and community based organizations including the Designated and Specialized Services Agencies, Home Health, Area Agencies on Aging, and Primary Care, to serve 1,200 unduplicated older adults and adults with disabilities residing in SASH affordable housing sites. Six full time SASH Clinicians, to be employed by six local community mental health designated agencies, will be embedded into the SASH teams comprising of a SASH care coordinator and wellness nurse (RN) in Chittenden, Rutland, Washington, Windsor, Windham, and Bennington counties and the Northeast Kingdom of VT. The SASH Clinician provides an array of services directed by participants including individual and couples therapy, short-term and ongoing psychosocial support, psychoeducation and process groups, and workshops; care coordination, and staff education. In addition to a focus on topics like managing anxiety or depression or dealing with grief, group programs target social isolation and loneliness. Education, support, and access to appropriate level of care treatment for substance use disorders is also provided. The project will also offer four Regional Mental Health Clinicians statewide who will lead public health approaches to lower barriers and support improved mental and emotional wellness throughout all SASH panels. They provide virtual and in-person education for participants and SASH staff, and support the SASH teams that will not have a SASH Clinician. Five overarching goals of the project include: 1. SASH Participants at program sites have access to and engage in expedited mental health supports, within 1-3 days of referral. 2. SASH Participants at program sites will experience decreased stigma associated with seeking mental health supports. 3. SASH Participants at program sites will experience fewer unnecessary Emergency Department visits over time and experience resiliency when health emergencies arise. 4. SASH Participants at program sites will experience a reduction in depression and anxiety over time. 5. SASH Staff will attain knowledge, confidence, tools and strategies aimed at improving mental wellbeing of participants in their panels.

Vermont is proposing to increase staffing to increase efficiency and implement technology to enhance coordination of mobile crisis outreach and 988 in order to meet the targeted answer rate of 90%.

ACCESS VT (Accessible Community-Based Care for Everyone. Stop the Stigma) is a statewide collaboration between Vermont Care Network, Vermont’s Community Mental Health Agencies, and Vermont Leadership Education in Neurodevelopmental Disabilities Program. ACCESS VT will train 48 Teen, Youth, and Adult Mental Health First Aid (T/Y/MHFA) instructors, 5000 Vermonters in T/Y/MHFA and 250 Vermonters in Cultural and Linguistic Competency (CALC). The goals of ACCESS VT are to: 1) Expand Vermont’s statewide infrastructure of T/Y/MHFA instructors to identify mental health needs throughout the state and increase collaboration among community base providers; 2) Increase the capacity of community members and others supporting the populations of focus to recognize the early warning signs of suicide and the signs and symptoms of mental illness and to gain a greater understanding of available resources; 3) Increase the capacity of mental health agencies to provide culturally responsive services to diverse populations. In addition to general community members, targeted populations include: school staff, students in grades 10-12, students and staff in higher education, first responders, Black, Indigenous and People of Color (BIPOC) communities, and Refugee and Immigrant (R/I) communities. ACCESS VT goals will be accomplished through the following objectives: By 12/21 VCN will complete an instructor gap analysis; By 12/21 VCN will expand community based partnerships with youth and adult serving organizations, adding two partners per grant year; By 2/22 VCN will develop and begin to implement a marketing plan, inclusive of social media strategies and reflective of community members and populations of focus; By the end of year 1, instructors will train 200, 10th, 11th, and/or 12th graders in Teen MHFA and 250 additional individuals in each following year for a total of 1,200; By the end of year 1 instructors will train 300 individuals in Youth MHFA and 400 additional individuals in each following year for a total of 1900; By the end of year 1 instructors will train 300 individuals in Adult MHFA and 400 additional individuals in each following year for a total of 1900; Of the 5000 mental Health First Aiders trained throughout the grant, 50% will be within workforce development and 50% general community members; In year 1, VCN will develop a resource guide template, describing available services and referral options; By the end of the grant period, referrals to mental health services will show a 150% increase from baseline; By the end of the grant at least 6,000 youth and/or adults will be supported by a step of the ALGEE Action Plan and/or referred to mental health services by First Aiders; By the end of the grant VCN will contract for consultation on culturally responsive hiring practices provided to 75% of the community mental health centers; By the end of the grant, 250 youth and adult serving community members and/or mental health providers will be trained in the CALC curriculum; By the end of the grant, 4 Cultural Responsiveness Summits will be held.

Howard Center proposes to enhance and expand its array of programs and services to meet Certified Community Behavioral Health Clinic certification criteria. Adding to Howard Center’s already robust programming will provide comprehensive, coordinated behavioral health care that is person- and family-centered and will include a range of outreach, screening, assessment, treatment, care coordination, and recovery supports in alignment with CCBHC certification criteria. This project will serve the people of Chittenden County, Vermont.

Pathways Vermont's Rural Outreach and Service (PROS) project will expand the capacity of its Housing First program to engage and connect an additional 290 Vermonters with serious mental health challenges (SMI) or co-occurring SMI and substance use (COD) who are experiencing homelessness to behavioral health services, case management, and recovery support services. The PROS team will serve individuals throughout Vermont. The target population for this grant will be individuals identified by the Coordinated Entry System (CES) with SMI/COD who have the highest needs, greatest vulnerability and are historically marginalized. Population demographics are expected to mirror Vermonters experiencing homelessness and individuals served by the Housing First program. All participants will have SMI, and 1 in 3 will struggle with substance use. English will be spoken by 95% of participants; interpreter services will be provided when necessary. More than 80% of participants will be unemployed, and 85% will live below the federal poverty line; most participants will have high school diplomas or GEDs (76%). Participants demographics will be: 55% identify as men, 44% as women, and 1% as nonbinary, 5% identify as LGBTQ2S+, 10% Black, 2% Native, 1% Asian, 5% multi-racial, and 82% white, 2.9% Hispanic or Latinx. All participants will be adults: 5% aged 18-29, 22% aged 30-39, 25% aged 40-49, 23% aged 50-59, 21% aged 60-69, and 4% aged 70+. Through assertive engagement, Critical Time Intervention, Harm Reduction, and a peer-model of service the PROS team will engage with individuals who have been reticent to connect with providers. The PROS team will coordinate somatic health, mental health and substance recovery services with various local providers in rural communities throughout Vermont. The project goals and objectives are: 1. Improve access to behavioral health services, case management and substance use recovery support for persons experiencing homelessness in Vermont. A. Outreach and screening to 365 individuals experiencing homelessness, 65 in year 1, 75 in years 2-5. Provide information and referral services to individuals found ineligible for program services. B. Enroll 290 individuals in services, 50 in year 1, 60 in years 2-5. C. Conduct training to improve utilization of evidence-based practices for serving persons experiencing homelessness. 2. Participants will have access to resources and benefits A. Within 60-days of enrollment 90% of participants will be enrolled in health insurance. B. Within 6-months of enrollment 80% of participants will have a source of income. C. Participants will access SNAP, TANF, WIC, VocRehab, childcare and/or other programs within 90 days of enrollment. 3. Ensure cultural competency and sensitivity to underserved and overrepresented populations. A. Ensure cultural competency and representation in Pathways Vermont staff through recruitment, training, and resource offerings. B. Decrease racial disparities amongst persons experiencing homelessness in Vermont through systems assessment and change C. Provide training for staff and community partners in serving persons who are LGBTQ2S+. 4. Participants will exit homelessness to permanent housing and supportive services. A. Approval for housing subsidy within 45 days of enrollment B. Access to permanent affordable housing within 90 days of subsidy approval C. Ongoing support services that meet participant needs. 5. Decrease experiences of institutionalization among participants. A. 70% decrease in psychiatric hospitalization and incarceration B. 50% decrease in ER visits C.85% housing retention. 6. Improve somatic health and social connections. A. 90% participants engaged with PCP after 6 months B. 75% decrease risk from substances through harm reduction C. 60% of participants will increase community connections.