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Rutland FQHC outlines integrated behavioral‑health model, asks for reimbursement for non‑billable care
Summary
Community Health Centers of Rutland described embedded behavioral‑health services, care‑transitions work, a crisis room and low no‑show rates, while warning that much of the care‑coordination work supporting outcomes is non‑billable and needs sustainable funding.
Christopher Chadwick of Community Health Centers of Rutland told the House on April 8 that his organization employs about 63 behavioral‑health staff, delivered roughly 45,000 billable behavioral‑health visits last year, and embeds behavioral‑health providers across its primary‑care sites. Chadwick said the center manages about 4,000 behavioral‑health referrals annually and is planning a geriatric behavioral‑health outpatient clinic.
Chadwick described several operational features: partnerships with inpatient psychiatric units and a dedicated care‑transitions manager to coordinate discharge planning, scheduling follow‑up visits within three days of discharge to reduce relapse risk, a living‑room style crisis room to provide an on‑site alternative to emergency department visits, and embedded crisis‑team coordination to protect patient privacy during transports.
He reported strong engagement indicators — a 98% patient‑satisfaction score for behavioral‑health services and an ~8% no‑show rate — and significant growth in behavioral‑health staffing (approximately 68% growth over four years). Committee members probed how community‑health teams funded through the Blueprint interact with embedded, billable behavioral‑health providers. Chadwick said community‑health‑team employees supplement practice teams (including pediatric support) and that funding comes from multiple sources including hub‑and‑spoke opioid services, Blueprint care‑management agreements and grant funding.
Chadwick repeatedly asked for sustainable reimbursement to support case management and care coordination that are critical to keeping patients out of higher levels of care; he said many such activities are currently absorbed by the health center because they are not billable under fee‑for‑service contracts.
The exchange contained no formal motions or votes; it focused on implementation challenges and on funding models that could support integrated behavioral health across Vermont’s FQHCs.
