Providers say 988, mobile crisis teams and urgent‑care centers are central to Vermont’s crisis response

Representatives of Vermont Care Partners told lawmakers on Jan. 29 that the state’s crisis continuum — anchored by the 988 lifeline, enhanced mobile crisis teams and behavioral urgent‑care centers — is diverting people from emergency departments and, in at least one case, helped save a life.

At the hearing, Simone Rishmeier, executive director of Vermont Care Partners, said 988 call coverage in Vermont is handled by local designated agencies, with NKHS and NCSS sharing day/night duties, and that callers generally reach a live person quickly. “If you call, you will get somebody,” Rishmeier said, noting answer times have fallen from an average of 25 seconds in 2021 to about six seconds more recently.

The group described a layered crisis continuum: 988 phone coverage, enhanced two‑person mobile crisis teams that can respond within an hour, and a growing set of community behavioral urgent‑care centers for people who need a physical location but not an emergency room. “About 95% of all calls are resolved on the phone,” Melanie Gidney, executive director of Clara Martin Center, said. She and other presenters said urgent‑care sites and mobile teams reduce emergency department use and provide better environments for youth and other people in crisis.

Speakers emphasized the role of proactive street outreach and embedded clinicians working from state police barracks. Kelsey Stebseth, executive director at Orange County Human Services, described street outreach as relationship‑building and prevention that is hard to fund under current Medicaid billing rules. “A lot of the work they’re doing isn’t technically billable under Medicaid standards,” Stebseth said, adding that outreach fills gaps that help avert more acute crises.

Panelists also described an instance in which a 988 caller who was actively suicidal provided limited location information; because agencies are networked, staff were able to contact a local designated agency and arrange a wellness check that intervened. “That connection between the designated agencies was essential to saving that person’s life,” Rishmeier said.

Presenters acknowledged operational limits: mobile teams cover large rural areas, making response times longer in some places, and some crisis‑response positions are grant‑funded rather than billable, which complicates sustainability. Agencies reported rising utilization of urgent‑care and mobile crisis programs as trust in those services grows, but said it takes months to build capacity and public awareness.

The session included questions from lawmakers about how calls reach local responders, average call lengths and age breakdowns of callers; presenters said detailed call‑volume and timing data exist and offered to provide it to the committee. They also said programs are experimenting with technology (for example, geolocation routing for 988) and distributed staffing models that allow on‑call clinicians to work remotely.

Ending: Speakers asked legislators to consider funding and policy changes that would support nonbillable but preventive services such as street outreach, and to preserve the local 988 coverage model that allowed coordinated response in the life‑saving case described at the hearing.