VT Discretionary Funding Fiscal Year 2023

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.

The Copeland Center for Wellness and Recovery will conduct a WRAP First training program for medical care providers in five California counties. The training program, facilitated by people with lived experience in recovery, equips medical care providers with the knowledge and skills to identify and assist individuals experiencing serious mental illness and substance use disorders and then to connect those individuals to recovery-oriented mental health treatment and supports. The project will train 300 annually and 1,500 medical providers over a five-year period. The individuals being targeted to receive mental health awareness training from the Copeland Center are medical care providers, including primary care providers and front-line emergency medical workers. The population of focus are recipients of medical care and their loved ones, including COVID-19 patients and loved ones, who struggle with serious mental illness (SMI) and substance use disorders (SUD). The geographic catchment area will be five California Counties located in the Pacific coastal region of North Central California, including Alameda, Santa Clara, San Joaquin, San Mateo and Solano counties. Nearly one in six adults in California experiences a mental illness of some kind, and one in 24 has a serious mental illness that makes it difficult to carry out major life activities. Research indicates that about 6 percent of Californians are dependent on alcohol and 3 percent are addicted to illicit drugs. Over the last two decades, California has seen a dramatic increase in opioid deaths. Californians with behavioral health problems are more likely to seek medical care than psychiatric care and, despite positive progress that has been made in the 21st century, the California healthcare system is still fragmented, and medical care providers all too often ignore or misdiagnose SMI and SUD. Californians who experience a psychiatric crisis increasingly are seeking help in the state's medical emergency rooms. However, California's emergency medical professionals and support staff are ill-equipped to identify and assist individuals with SMI and SUD. The overarching goal of the WRAP First training program is to improve the capability of medical providers to better serve their patients with SMI and SUD. The measurable objectives of the WRAP First training program is to train medical care providers to: 1) Understand and embrace the principles and values of the Wellness Recovery Action Plan (WRAP); 2) Recognize the warning signs of when a patient or loved one is experiencing SMI and/or SUD; 3) Use WRAP tools to deescalate a mental health crisis; 4) Connect individuals experiencing SMI and/or SUD to recovery-oriented treatment and supports; and 5) Identify triggers and stressors in the environment in order to enhance their own self-efficacy. The WRAP First training program is an adaptation of the evidence-based practice of peer-facilitated WRAP groups that is listed in the National Registry of Evidence-Based Programs and Practices. Dr. Judith A. Cook, Professor and Director of the University of Illinois at Chicago (UIC) Center on Mental Health Services Research and Policy, has recognized WRAP First as a promising adaptation of the evidence-based practice of peer-facilitated WRAP groups.

According to the Suicide Prevention Recommendations 2020 Report to the Legislature, Suicide is the eighth leading cause of death in Vermont overall and the second leading cause of death for Vermonters age 15 to 34. Rates of death from suicide in Vermont are higher than- and increasing at a faster rate than- the national average. The funding from this opportunity will enable Vermont to increase capacity across both primary Lifeline Centers to meet established target rates for chat and text services while not affecting call coverage and capacity, coordinate efforts with stakeholders, develop quality improvement and sustainability plans, and assess training opportunities around high-risk populations.

Vermont will build on its innovative delivery system for publicly funded mental health and substance use disorder (SUD) services and certify CCBHCs to expand access to timely, integrated, and high quality care across all regions of the state. Today, Vermont has a network of ten designated agencies (DAs), community based mental health and SUD providers located in all regions of Vermont that serve a predominantly low income population. The DAs provide a comprehensive suite of mental health and SUD services including many of the CCBHC required services. The State anticipates that with technical assistance, DAs will be able to achieve CCBHC certification to provide more integrated mental health and SUD services to Vermonters with mental illness, SUD, and co occurring conditions. See attached documents for the remainder.