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Howard Center warns proposed cuts would reduce crisis and outreach capacity
Summary
Howard Center leaders told the committee that proposed governor’s budget cuts — including elimination of a $160,000 community outreach grant and a $78,304 embedded primary-care clinician position funded through EPSDT — would reduce crisis staffing and shift costs to municipalities.
Sandy McGuire, chief executive officer of the Howard Center, and Beth Holden, the center’s chief client services officer, told the House Human Services Committee that three cuts in the governor’s budget target Howard Center programs: a $160,000 community outreach grant, an embedded clinician position in a primary-care office supported by EPSDT funding (about $78,304), and funding that supports five crisis clinicians.
McGuire said Howard Center’s average days of cash on hand are about 13, although the organization averages 20 to 30 days most of the year. She said the agency has been operating with a program-related deficit for three years, uses a line of credit (not yet drawn) and that cash can be seasonal; she reported that in a recent autumn week the center’s cash balance fell to six days.
Holden described the embedded Milton Family Practice clinician position as a long-standing, community-based role that provides in-office and in-home work, serves caseloads of roughly 11 to 20 children and families, and is supported by about $78,000 in EPSDT funding. She said some of the position’s work overlaps with other state-funded programs but that it is distinct in being community based, performing school and DCF meeting work, doing home visits and following families who do not want to be opened to the mental-health system.
On the proposed cut to community outreach, Holden said the $160,000 grant supports outreach across nine Chittenden County communities. The outreach team responds to a range of needs — from people in urgent crisis to those who need repeated engagement — and partners with local police and town managers. Holden said the proposed elimination would shift costs to municipalities, which currently contract with Howard Center for the service and would be asked to fund it directly.
McGuire and Holden said the proposed reduction tied to crisis staffing would reduce about five positions and amount to roughly a 19 percent reduction in that component of the crisis team. The Howard Center described the outreach program as a low-barrier service that helps keep people out of emergency departments and reduces law-enforcement involvement when appropriate.
McGuire urged the committee to consider the operational consequences of cuts and to weigh the time needed to transition service models such as enhanced mobile crisis and centralized access lines (for example 988). She said the state should aim for equity in core services while preserving locally tailored responses where communities value them.
Committee members asked about billing, duplication with Blueprint community-health teams, municipal funding options and how the cuts would affect response times. Howard Center representatives said some services are Medicaid-billable under the mental-health case rate but that funding streams are historically siloed; they said other federal/state funding carved out of case rates historically supported particular positions and crisis capacity.
