MIDDLEBURY — The Vermont Agency of Human Services (AHS) has picked two Addison County nonprofits to team up in delivering mental health and child care services more cost-effectively and efficiently to citizens ranging in age from birth to 22.
The collaboration, if successful, could serve as an operational blueprint for human service agencies statewide as Vermont state government looks to pare back its expenses.
At issue is a proposed Integrated Family Services program, known as IFS, that will be piloted by the Addison County Parent-Child Center and the Counseling Service of Addison County (CSAC). The two local organizations recently stepped forward with the concept of sharing computer, personnel and other resources to serve a common population — infants, toddlers, teens and young adults — with more continuity, as well as with less bureaucracy and expense.
State officials are hoping the Addison County collaboration will prove successful and that it can be replicated statewide for a huge savings.
“We are trying to make family services better coordinated and more holistic,” explained Melissa Bailey, director of IFS for the AHS.
Bailey said that some human services providers share clients who are recognized in separate case files and under different billing procedures. The IFS program will seek to break down such barriers — particularly for Medicaid patients — thanks to a waiver that allows Vermont to spend its federal dollars more flexibly, Bailey noted.
Donna Bailey, co-director of the Addison County Parent-Child Center, explained that collaborating with CSAC will not represent a big leap. Addison County social service agencies have had a long history of helping each other out, she said.
“When a family is in need of services — behavioral health or early childhood — they generally walk into either our doors or the counseling services doors,” Bailey said.
Once the family walks in, Bailey noted, officials at either agency are able to determine what services the clients need and what revenue stream must be tapped to pay for them.
But hunting down those funds can be time consuming, she said.
“We want to do the work with families and not have to worry about all the money,” Bailey said. “This is what the pilot program is about — how can we stop thinking about these different (funding) programs and focus more on serving the needs of zero to 22-year-olds in Addison County.”
Cheryl Huntley, director of youth and family services for CSAC, agreed.
“We really want to be able to say to families, ‘What do you need?’” Huntley said. In essence, it means less time spent figuring out whether patients “fits in this cubby hole or that cubby hole,” she said.
With that in mind, the IFS program will include a more singular state- and federal funding stream for parent-child center and CSAC clients, Bailey noted. That will make billing more uniform and less complicated. And the parent-child center is sharing a “cabinet” in the CSAC computer system, a drawer that will maintain the confidentiality of individual patients while reducing paperwork and providing smoother access to basic client profile information.
It is not an insignificant client population. The CSAC youth and family division serves around 850 children per year, according to Huntley. The parent-child center serves around 1,200.
A simpler billing process will be welcomed, Huntley said. The youth and family services division currently process more than 1,300 claims per week. She estimates the new system could cut insurance claims by more than 50 percent.
“(The process) is insurance-driven now, so it depends upon your health insurance — what kind of coverage you have, what that coverage allows to  be offered for services,” Huntley said. “There are unending regulations around Medicaid … It means as agencies, we have been completely dependant upon fee-for-service billing.”
Under the IFS program, Huntley explained, the agencies will receive payment as long as they can prove they are effective in the work they do.
“It turns from fee-for-service to outcomes-based or performance-based contracting,” Huntley said. “If we can show the AHS we’ve been doing good work with Addison County kids, and that kids and families are doing better, then we are not chasing dollars in the way we are now.”
Parent-child center and CSAC officials are currently developing a system of measuring patient outcomes.
And Bailey noted the IFS program will allow for greater flexibility in providing preventative services to clients “so we don’t have to wait for a big crisis” when the solution is more complex and costly.
“Unfortunately, I think the system is set up now so that you have to wait until a kid gets hurt or somebody is in a mental health crisis or suicidal before we can really intervene,” Bailey said.
Using a more proactive approach, Huntley said, the hope is to reduce the number of cases of children requiring psychiatric hospitalizations, residential treatment, and who are suffering from abuse and neglect.
“We want a healthy community,” Huntley said.
“It means we will have more local control over what we do.”
Reporter John Flowers is at [email protected].