Department of Mental Health outlines crisis continuum, requests $2.1 million budget adjustment

The Department of Mental Health told the Appropriations Committee that Vermont’s system of care extends from community supports and crisis response up to secure residential and hospital-level units, and that its fiscal-year adjustment request totals about $2.1 million.

Commissioner Emily Haas opened the presentation with an overview of the department’s “pyramid” of services, describing community outpatient supports, crisis response (including crisis beds and six recently opened mental-health urgent cares), intensive residential treatment, secure residential care at River Valley Therapeutic Community, and hospital-level inpatient units. “A bed isn’t necessarily a bed,” Haas said, describing situations where staffing, unit suitability or transportation can prevent a clinically appropriate placement even when a physical bed is available.

Financial director Shannon Thompson walked committee members through the department’s ups-and-downs packet. Thompson described funding columns shown in the packet — general fund, special funds (including hospital billings), interdepartmental transfers, federal funds and two Medicaid/global commitment columns — and said some line items in the packet are…