HEIDI MELBOSTAD, WHO soon will lead Bristol’s Mountain Community Health, brings a commitment to giving the public access to good health services.

BRISTOL — Heidi Melbostad has spent the past several years helping ensure Vermonters receive the treatment and health care services they need, most recently through her leadership of the Howard Center’s Chittenden Clinic, a medication-assisted treatment program in Burlington. 

She’s looking to continue that work in Addison County later this month when she’ll take on a new position as CEO of Bristol’s Mountain Community Health. The Federally Qualified Health Center provides a variety of services to patients, including primary care and dental care. 

Melbostad said the health center’s comprehensive approach to serving all community members aligned with the kind of work she aims to do.   

“That was so appealing to me, that here is an organization that is really thriving in a very dynamic community that is truly supporting the community and truly committed to making sure that everyone in the community has an opportunity to obtain health care services,” Melbostad said. “It really aligns with my own values, with my own goals professionally, and with the ways that I think we need to be approaching the care and supporting the wellbeing of all members of our society.” 

Melbostad has spent the past 15 years in Vermont. After obtaining her doctorate in general/experimental psychology from the University of Vermont, she completed a postdoctoral fellowship at UVM in the Vermont Center on Behavior and Health. Prior to that, she worked at Healthcare and Rehabilitation Services in Springfield doing community outreach, particularly focused on young children and families. She also worked at the Springfield Area Parent Child Center.   

“They had a teen pregnancy program at the time,” Melbostad recalled. “At the time, it was all young women, and I was responsible for providing mental health services, behavioral health support to the women who were enrolled in the program and whose children were at daycare at the parent child center.” 

CHITTENDEN CLINIC WORK 

More recently, Melbostad has served as director of the Chittenden Clinic since 2021. The clinic provides outpatient treatment and pharmacotherapy to individuals with Opioid Use Disorder. 

Melbostad began leading the clinic in the midst of the pandemic, at a time when the federal regulations for outpatient opioid programs throughout the country had shifted due to COVID-19. 

In particular, patients began receiving “take-home” medication, Melbostad said. 

“Instead of someone having to come to the clinic daily to pick up their medication, all of a sudden they were receiving a week’s worth, or two-week’s worth, up to a month’s worth,” she said. “(That change) was very, very different for the majority of patients who had to daily dose for a long time or maybe every other day. Suddenly they had this flexibility in their treatment that they hadn’t had before.” 

Melbostad said she saw the shift as a silver lining of the pandemic. 

“It provided this opportunity for the government, for communities, for researchers, for clinicians to experience what it would be like to have people enrolled in treatment have access to medication in a way that they hadn’t before, because a lot of the restrictions around medication were due to concerns about safety and diversion,” Melbostad said. 

She noted that opioid treatment programs dispense buprenorphine and methadone, a full opioid agonist that reacts in the brain similar to how heroin does.  

“It’s a treatment medication, it supports people in gaining stability, but there are still side effects, and there are still concerns about if someone who wasn’t prescribed (for instance, a child, a dog or some other animal) had access to it accidentally,” Melbostad explained. 

She said the shift in treatment-related restrictions during the pandemic helped address such concerns. 

“I think what we’ve seen because we had that opportunity and the literature has now shown is that a lot of the concerns people had about diversion didn’t come to fruition,” Melbostad said. “We certainly have to continue to be thoughtful about diversion and safety always … but also it gave (the Substance Abuse and Mental Health Services Administration) the information they needed to sustain some of the changes they made to regulations.” 

Melbostad said navigating that shift was significant for both patients and staff at the Chittenden Clinic, who adjusted to those changing regulations while also responding to changes within the drug-use landscape. 

She noted that the use of drugs like fentanyl has become more prevalent over the past few years.  

“All of a sudden people were taking this substance that was much, much stronger, and the drug supply in general became more and more contaminated,” Melbostad said. “Most recently we have xylazine in the substance, which is a veterinary medicine, it’s a sedative.”

Melbostad said the clinic began seeing a change within the community as well. 

“People were presenting with much higher acuity, much higher service needs. They lacked housing, they lacked food security, there were a lot more psychosocial issues that people were presenting with,” she said. “That really made us focus on ‘how do we increase access to treatment,’ so we spent a lot of time thinking about how do we support people in just showing up to our clinic and how do we continue supporting them in making sure they remain in treatment.” 

Melbostad and other clinic staff participated in and created initiatives focused on treatment access, both internally and also through partnerships with the Burlington mayor’s office and the University of Vermont Medical Center’s emergency department. 

“People are now able to go the emergency department and start buprenorphine or methadone, and then they can bridge to us,” Melbostad. 

JOINING MOUNTAIN HEALTH

Melbostad sees helping Vermonters access health care services as a key part of her work in the profession, and one she feels aligns with that of the MCH team she’ll join later this month. 

“When I’ve thought about how I want to contribute to my community, how I want to support people in having access to good, quality health care, it’s always been in the back of my mind how important a holistic approach to health is,” she said. “When I think about MCH and the fact that they’re a Federally Qualified Health Center; they’re providing primary care, they’re providing dental, they have behavioral health services, they have a medically-assisted treatment program with buprenorphine.” 

As she settles into the new role, Melbostad said her priority will be getting to know the ins and outs of the health center and its staff. 

“To me what feels paramount is to really learn about the program and to learn about the people and build relationships with the people that are there,” she said. “What I’m excited about is the staff and the board have some really great ideas and they’re really motivated and excited about the possibility of reinforcing and supporting all of the services that are working really well and contemplating opportunities for expansion.”

Melbostad outlined a couple of other primary areas of focus, which include patient and community access to services and exploring ways to generate additional revenue that could support staff and additional programming. 

Melbostad will officially take the reins of Mountain Community Health on June 24. Mark Mulqueen serves on the MCH Board of Directors and said the team is excited to welcome Melbostad aboard. 

“Mountain Community Health is very fortunate that after a rigorous, well thought out nationwide search we were able to find a candidate so well suited to our needs right here in our area,” Mulqueen said. “Dr. Melbostad impressed us with her experience working in a nonprofit public health environment, which comes with a unique set of issues and its own regulatory environment. Dr. Melbostad felt like an excellent fit for both our public-facing staff and administrators. We are excited to welcome her as MCH continues bringing quality health access to the 5-town region. The future looks promising.”