Vermont Legislature SmartTranscripts:

[Chair Theresa Wood]: Okay,

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: welcome

[Chair Theresa Wood]: folks to House Human Services here this afternoon. We are taking up the proposal in the Department for Children and Families budget around, well, it's called a housing proposal. I have some questions about that term. Recognizing, however, that it is a cross AHS initiative and or a series of initiatives. So we'll be having a number of witnesses this afternoon. And so feel free to adjust the chairs at the head of the table when you need to. But we're going to start off with the Deputy Secretary and the Interim Commissioner of DCF. So welcome. And I think you all have seen us all before, so. And I'm just gonna ask people who are listening in, if you are unable to hear the witnesses or anybody else at the table, if you could let us know that, because I get a little sort of moving around of microphones, because we had interview last Friday when we were having a joint hearing, so with being able to hear witnesses. So I think everything should be all set. So the floor is yours and welcome.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Thank you so much for having us. For the record, I'm Krista McClure, the Deputy Secretary of Agencies of Human Services.

[Sandy Hoffman (Interim Commissioner, Department for Children and Families)]: And I'm Sandy Hoffman, the Interim Commissioner for the Department for Children and Families.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: And thank you so much for having us and our whole team today. So you'll be hearing from a number of our departments, because much like you heard this morning for budget, we really view this as a team approach across all the departments. So the commissioner and I will take you through an overview of what's in the budget, the chair's budget, and how it relates to different components of the bill. So we can go to the next slide. So this is a high level overview. And from an approach perspective, we're looking to build a future to better serve clients, better serve communities in a way that is sustainable with improved outcomes. And we see this as a phased approach over a few years. So you'll hear us talk about that. You'll hear us talk about phased approach, about transition. And we really want to be thoughtful and deliberate about how we do that. There are things that are working quite well in the system. We want that to continue. And you'll hear us talk about things that we want to modify, improve within this greater system. And there are things that are not working as well that we want to leave behind. So you'll hear us talk about those components. In this, we're recommending investing in more shelter capacity. So investing this year for additional shelter capacity to come online in state fiscal year 'twenty eight and maybe early 'twenty nine. So investment now for more capacity in the future. You'll also hear us talk about modifying how we use hotel motel. So we're not saying do away with hotel motel, but we do need to utilize them differently, again, to better serve clients and better serve communities. And our team member here, Lily, doesn't like when I use this phrase, shelter like options. But you'll hear us talk about that. Using hotel motel in a different way, more like a shelter. So having services, having police management, having some house rules, again, functioning as much like a shelter in hotelmotels as we transition. Again, through this, it's really about connecting people with services better. And when we talk about investing in shelters, the way we think of that is also investing on services in those shelters. We'll also talk about leveraging programs that provide alternative housing options. And again, we need more units. That's a theme that we've heard throughout, and we will continue to talk about that. Part of this also is to focus on Vermonters that have no other options. We really do need to focus on those in our community that have no other options. And we want to, again, serve them better. Also in this, it's about driving a system change, not just for our agency and again, we're here represented by many departments because we are starting to do that system change but also how we work and the way we work with our community partners. And that includes our CAP agencies, our community action agencies. It includes our shelter providers, our municipalities, our mental health providers, our substance use providers, our AAAs. It includes the full breadth of the team that's needed to support. On the graph here, so I do briefly want to touch on the graph, because at times we have been asked about, well, what does this look like from a capacity standpoint? So this is our attempt to reflect that. The bar on the left, that's current state fiscal year, so state fiscal year 'twenty six. And this is this week's data on the left. So this is pretty current. The bar on the right, it shows a different mix. So again, I'm talking about, and we will all be talking about, utilizing things in a different way to be more effective. That's how the bar on the right is reflected. It's a different mix, again, to better serve clients and better serve communities.

[Chair Theresa Wood]: Deputy Secretary, how would you and, I guess, the rest of the team like to handle questions? We have a lot of witnesses to go through, and you have a lot of material to cover. So I'm just trying to get a sense of how that will be helpful to you. Yeah, I think

[Krista McClure (Deputy Secretary, Agency of Human Services)]: the commissioner and I welcome questions throughout. And if a question does come up where we'll address it on a later slide, we'll certainly mention that. Okay, so I have a

[Chair Theresa Wood]: question on this. Sure, please. Just thought I'd asked before, So I just blurted out the I appreciate sort of seeing that from a visual perspective in terms of the mix. So we've heard in testimony yesterday about the actual numbers of people who are homeless in the state for the data that we have, approaching about 4,500 individuals. So what is the plan for the other 2,000 people that aren't covered in this remix of what you have here? And then also, I've asked this question many times over the course of the last few years. What do you believe is the shelter capacity that we need in the state sort of on an ongoing basis, at least for the foreseeable future? And I realize that in this proposal, you're adding a mix of different types of shelters, But what you do see believe as the overall capacity that's needed for shelter or I guess to use term that really doesn't like shelter like capacity. Good to know that I don't Welcome another term. Yeah, know, another, gonna have to come up with another term. That's two questions really.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: I'll take the first question first. So as we go through, we will talk about addressing unsheltered homelessness and investments in that space, as well as investments in emergency cold weather shelters. So we will touch on that a little later. For the total shelter capacity, I don't want to give you a number right now, but I'll tell you how we're thinking about this item. So as we look at this bar on the right, we have in flight about 100 more shelter capacity beds currently in flight that will come online within the next twelve months. And then if we continue to invest like we are proposing, probably about another 100 is probably a, I'll say, conservative estimate. And then also in the proposal is about 300 shelter like options as well. I think it's also really important, as we think about that, is we think about who really has no other option. And that's one of the reasons why we are proposing, as we go through, some eligibility changes to what we know is traditional DA, so

[Renee B. (Director of Complex Care and Field Services, AHS)]: we can really focus on those who

[Krista McClure (Deputy Secretary, Agency of Human Services)]: have truly no other options.

[Chair Theresa Wood]: So all of those, in my head, math is accurate. That's about 1,200 spots. If we look at the six fifty roughly, six forty nine current shelter capacity, at least reported in December, I think, and then the one hundred and one hundred and then 300, I think that brings us up

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: to that

[Chair Theresa Wood]: number. So I guess we'll wait and see a little bit more about your testimony about, essentially, you're looking at further shrinking who is eligible for those services.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Is that my understanding? I would phrase it as really targeting those who have no other option. And we can talk more about examples specifically around that.

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: Not just about eligibility.

[Chair Theresa Wood]: I think it's the services, too. We're not looking at it as they'll be chronically homeless. We're hoping to engage them in services or connect them with housing options so that they're not remaining homeless. Any other questions before I move on? Okay, thank you.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Again, we see this as a phased approach. We'll talk about transition over a few years. We think both stability, doing this, maintaining the stability. Again, what's currently working well in the system, we want to maintain and keep that. And we want to add improvements to the system. So again, stability has to be enhanced as we go through. So we see state fiscal year 'twenty seven as a transition year. Again, we're investing in shelter capacity and services in those shelters. We've heard that loud and clear from shelter providers and community action agencies. We need services in the shelters to directly provide services to the clients that are right there. You'll hear us talk more about enhanced case management for both sheltered and unsheltered. So it's consistent across the populations. Also in this transition year, again, talking about that shelter like option for the targeted population, so families with children and medically vulnerable, really providing them shelter like options and utilizing hotel motel through this transition period until they can move to other, more sustainable housing options, whether that's shelter or more permanent units. But in that transition period, making sure services are provided on-site, lease management is provided, and again, those house rules. As I mentioned, we'll talk about modified eligibility to traditional GA, traditional emergency housing. You'll also hear some rental assistance that we're recommending in the budget. And again, as I mentioned at the beginning, building a system wide rules responsibility across the full provider network, not just the traditional housing shelter providers, but really all of our providers that play a role in this space. Then as we look to the future, again, fiscal year twenty eight, that's where we would expect these investments in shelter capacity to start coming online. We will continue that enhanced case management. And that targeted population at shelter like, that will continue to transition. So it may be in a hotel motel in fiscal year 'twenty eight, or it may be shifting to, again, more long term settings for that space. And again, you'll see the rental assistance in our base budget. That'll continue. And I want to note, throughout the transition, we will see this about flexibility. So again, transition, these aren't firm dates we're providing, but we really need to have flexibility throughout the transition. Here is the budget. And again, this is the overall, for the most part, DCF budget. We're not going to go through every line item here. And I do want to note, because you'll hear this from the other departments, from DMH, from BDH, from Dale, their components of some of their case management and providers we don't have reflected here because that's embedded in their budgets. However, we did pull out some key items. So there are two main items we want to draw your attention to, and those are the totals at the bottom. So you see the total for state fiscal year 'twenty six and the total for state fiscal year 'twenty seven that we're requesting. So for state fiscal year 'twenty seven, we're requesting $89,300,000 to invest in improving the system. And that's about an 8,000,000 increase year to year. The other item that's important to note is the mix. So you'll see a shift from one time funding in here to base budget. And that's about a 39% increase in base budget.

[Chair Theresa Wood]: I think it's important for people to note the DOC transitional housing, which is not something we have necessarily seen in the DCF budget when we're comparing year to year. If you were to include it in both or take it

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: out in both, you'll have I

[Chair Theresa Wood]: mean, because I think there are other things that actually could be included in here as well that we have funded over not just the DOC transitional housing. We did

[Krista McClure (Deputy Secretary, Agency of Human Services)]: include the DOC transition because we talk about it a little later, both in the presentation and today, as it's referenced in the bill. So now we'll step through

[Chair Theresa Wood]: I'm sorry, before you go, have you before we move to the next one, Amy have you projected out what it would be for FY 'twenty eight? Because during FY 'twenty seven and still in FY '26, have shelter development occurring and need for ongoing shelter operations. Honestly, we need to understand what we're committing to if we commit to a plan like this, what we're committing to for additional resources being required in FY 'twenty eight and potentially 'twenty nine in the out years. So we need additional information beyond just this 'twenty six, 'twenty seven look. I think we can take a shot at forecasting that, recognizing things could change. But I think we could take a shot at forecasting that based on this proposal.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: So here, now we have organized this in the structure of the bill. So that's how we'll go through it because we thought that would be consistent with your work day in, day out as you read through the bill. So we're also utilizing language, wherever possible, that is consistent with the bill. So here we have the high barrier shelter option. So you see this is, again, investing in additional shelter capacity for clients to be served in more appropriate settings. And again, when we say shelter capacity, we also mean the services with that, so 6,000,000 there. Recovery shelter, and you'll hear more from the Department of Health about this. The commissioner will be speaking in a moment about it. There have been some really strong developments into communities around this space. Again, the next one is that shelter like option, utilizing hotel motels, because we have to work with what we have at times, and we can't spend the system on a dime, but utilizing hotelmotels differently to function more like shelters. So a little over $10,000,000 for that, and I've talked about the different services in case management that will be provided for those targeted populations. There is also a component it was on the first slide, the chart to utilize temporary overflow with traditional GIs. So I'd say this is that foundation that you saw on that first slide on the chart, again, with some modified eligibility, to focus on those who have no other option. And then the last item here is for adverse weather conditions, to utilize hotel motels in the traditional sense during cold weather, again, to function like

[Chair Theresa Wood]: shelters. When you say high barrier, can you just, in layperson's terms, describe, just to make sure that we're thinking the same things when we use that term, do you describe what that means to you?

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Well, we pull it out of the bill. So Lily suggested perhaps we don't use that term, but we have reflected it here. High barrier, the way I read it in the bill, is essentially not low barrier.

[Chair Theresa Wood]: So for different specialized populations. So maybe a barrier for shelter for recovery, for families, for those who have severe medical needs. I just wanted, I didn't know if you were using that same definition. Representative Maguire has a question or comment.

[Rep. Eric Maguire]: Or a comment. Think we should explore the term because this is used throughout other continuance of care to address homelessness, what's called program ready. And program ready can be defined as meeting the need in which the person is able to respond to that. I just mentioned there are different levels of family shelter, different levels in regards to recovery shelters. So they're pretty much showing the ability to respond to what's being provided. And that removes this term of high barrier, which is just pretty much the opposite, a low barrier. And when we do hear high barrier, we think of punitive responses, high difficulties to get on end and access those, these significant requirements where it's program ready, provides a more broad definition and more opportunity for people to respond and for those shelters to set up how they would like to go about working with participants.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Thank you, Representative Blanche.

[Chair Theresa Wood]: I

[Rep. Doug Bishop]: think you may have mentioned earlier that you would circle back to it, but the phrase used quite frequently is those who have no other option. I'm wondering if you could share at this point a little more about what's meant by that term.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Yes, would you mind pulling on for two more slides? Actually, we do have a full slide on that. Thank you for the question. Now we'll step through, and we can use a different term if there's a new term, but again, the bill, the low barrier option, we're recommending continuing the emergency cold weather shelters. So you're probably familiar that this past weekend, there are nine that opened up across the state serving with capacity of over 200 beds. So that went very well, and again, serving all Vermonters. Anyone is eligible. And the only criteria is if you are engaging in threatening or violent behavior, you are asked to exit. And here, also recommending that we continue to invest in, again, the low barrier population as well, with additional shelter capacity to be served in more appropriate settings. So we do want to acknowledge both of these line items could potentially utilize some of that GA surplus that we're targeting between $5,500,000 to $6,800,000

[Chair Theresa Wood]: I'll present Donahue who

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: asked the question.

[Emily Haas (Commissioner, Department of Mental Health)]: You.

[Renee B. (Director of Complex Care and Field Services, AHS)]: Is

[Rep. Anne B. Donahue (Ranking Member)]: the intent under the emergency cold weather shelter to retain minus 10 as the threshold?

[Krista McClure (Deputy Secretary, Agency of Human Services)]: So glad you brought that up. So we can talk about where we were last year, where we are now, and plans for the future. So last year, you'd probably recall, the threshold was negative 20. It feels like negative 20. This year, for the state funded shelters, they have the option, if they want to open up at zero degrees, to open at zero degrees again to be funded. But when it's negative 10, they have to open up. It's required. And that's an ongoing conversation of, what would next year look like? Is there a different temperature, a different threshold? And that's something that a conversation we would like to engage both with the community partner that's leading this CIA, but also our community partners too. So it's a great question and it's a conversation we are starting to have, but I don't have an outcome for you at this point.

[Rep. Anne B. Donahue (Ranking Member)]: Just a thought. I mean, that would obviously have budget implications, is a current issue versus longer term discussion.

[Chair Theresa Wood]: So BIA has been a community partner this year in some distinct emergency cold weather shelters, but then also during this last extreme weather, Falcon, I'm sure for whatever other ones that we have that pop up during the rest of the winter, additional emergency shelters popped up really run mostly by municipalities. And so was there any assistance provided to those municipalities in the costs that they incurred to stand those up. It's like you're

[Krista McClure (Deputy Secretary, Agency of Human Services)]: in the meetings with us. So again, we're actively talking about that. For reference, of these nine that I mentioned, six are through BIA that are state funded, and three are more grassroots community driven. And we looking at Lily here, as Lily's watching the numbers very closely we're actively having those conversations because we want to encourage communities to participate, and we don't want funding to be a barrier. Right now, what we're hearing from them is staffing and building availability is the main barrier. But we

[Chair Theresa Wood]: want to keep Vermonters safe, so we don't want funding to be a barrier. So those conversations are happening. And another thing that has cropped up, I know, at least here in Central Vermont and I think in other parts of the state, is coordination with the Division of Fire Safety at the Department of Public Safety. And we'll have them in to testify. But I'm just wondering what sort of groundwork have you laid with them in terms of interdepartmental kinds of conversations? Because to the layperson, it looks like some of the things that they have put out there seem ridiculous. Sorry, fire safety people, but one minute you can have 15, the next minute you can only have eight or nine or six or whatever the number is, and it's the same people running the same thing. It's just the temperature has changed.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: We're familiar with this challenge. And we do work very closely with fire safety, which is one the reasons why we are so familiar with this challenge. And we do recognize the place that they're in. They also want to keep Vermonters safe. They're looking at it from an angle of fire safety. So I'll let them speak to it more, but we absolutely recognize that challenge. And I think it's Brattleboro specifically that communities have. That's the most recent one, but there

[Chair Theresa Wood]: was one in Central Vermont as well. So, okay, yeah, we'll have them in. I guess I was more looking for, are you specifically engaged with them and helping them to understand what it is that we're trying to do? Short answer, yes. Okay. Okay, so then in keeping with the same language, the tier two and tier 2A, We're proposing investing in transitional housing, DOC individuals on community supervision. That's $6,400,000 And then recovery housing, and you'll hear more about that from our partners at the Department of Health. Then permanent and temporary supportive housing, at $3,500,000 combined.

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: So

[Renee B. (Director of Complex Care and Field Services, AHS)]: we got to go see here.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: They will be here this afternoon.

[Chair Theresa Wood]: Okay, yeah, we have a special time for them, so I guess we can wait for them. Sorry, I keep forgetting that we're gonna have special time with all the department staff. Okay. Yes. And then tier three, this is the Vermont Housing Improvement Program, VHIP, and permanent housing rental assistance, 1,400,000.0. And Vermont, the VHIP for those experiencing homelessness, point 1,000,000 with the rapid unit construction. That's a six to eight months to provide more units and low cost, less than approximately $40,000 per unit. So on the rental assistance, is this an additional 1,400,000.0 because there are certain elements of funding now that provide rental assistance. And are you talking about sort of combining those all or is this additional or is

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: it Additional. It's additional. Okay.

[Chair Theresa Wood]: And I didn't really see necessarily, it seemed as though that would be targeted to those, I think to use your risk, but those post mid need or something like whatever that terminology is that you're using, and for what period of time. So right now, HOM has limitations on how long it can be used. And sorry, I've been over to Lily, but

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Yes, no, Lily is the right person.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: Lily, do

[Krista McClure (Deputy Secretary, Agency of Human Services)]: want to talk about this? And one of the key changes is this is also in the base budget. So 1,400,000.0 for rental assistance in the base budget. And Lily, do you want to talk about the time duration?

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: Sure. Thank you. Lily Sojourn, our Director of the Office of Economic Opportunity. So currently, in the Housing Opportunity Program budget, we have some financial assistance. So that's typically short term rentals, so under three months. We also and this is housing and urban development, long term of rapid housing, medium term rental assistance, which tends to be that three to twenty four months. So we do have some

[Chair Theresa Wood]: of those projects around the state.

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: I think with this line item, we're looking to replicate what we've done in spirit, at least, with some of the one time federal or state funds over the past few years. So several years ago, we had emergency solutions grant CARES dollars, which let us do final subsidies for families children.

[Emily Haas (Commissioner, Department of Mental Health)]: We've been able

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: to do one time home voucher. I think we're looking to build on what we've learned from that and create federal assistance that would allow us to go beyond even the twenty four months. But I think what we're seeing is that it just takes longer to move on to, for instance, a housing choice voucher. So we don't want to be restrained by that sort of traffic housing format. I do think we would look to target it to populations, for instance, infants and children or people with complex health needs, that it would allow us to have a little bit more flexibility.

[Chair Theresa Wood]: One of the things, thank you. One of the things that will be helpful going forward as we look at it, because as I looked through this budget book, rental assistance appears in a couple of different places and a couple of different line items. And we're trying to make sure that we're understanding sort of like what the whole picture is. So I think it will be important, depending upon the outcomes of this, to sort of like put our hands around, because rental assistance being one, but their case management is another one that crops up in several different places and as eligible uses for HOT funds and certainly some of the stuff that exists now through the continuum of care funds. So we're gonna wanna try to put our hands around and understand all of what we've got going into rental assistance, because we had ERAP and or HRAP, HRAP, whatever, just ERAP, I don't know, something wrap, I know. And that went away. We knew that was gonna go away and certainly people have been looking to replace that. And so I think in order for us to be able to accurately present any recommendations to the appropriations committee, it will be helpful for us to have a sort of a picture in those sort of major buckets of types of services that you're proposing with a combination of current funding and proposed new funding. That's good to be happy to do that. Thank you. Thank you. Okay, and we've talked about this a little bit, eligibility for emergency housing, refining the eligibility to protect Vermonters who have no other option, and add accountability. So we talked about verification of residency. We talked about that in your committee too, I know it's a touch point, it's touchy for sure, verification of homelessness and verification of income. When we're looking at it, internally when we're talking about residency, we're also talking about people who want to become residents in Vermont, if they're planning to stay and doing that, having those conversations. We want to support people in moving care and increasing our population and expanding the population. But if they're not planning to stay here for any amount of time, then

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: we want to be able to get them where they want to be.

[Chair Theresa Wood]: So I want to understand better, I guess, how you might go about doing that. Because we certainly can verify residency that somebody is here, plans to stay, But I think the limitations that exist about, you can't say that you have to be here for a certain length of time before you receive a benefit or assistance from the state, particularly around this type of service, as we heard from alleged counsel. So I guess we'll be looking to better understand how you might implement something like that and with whom, whether that would be ESD folks or OEO folks, regional people. So it might be referenced.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: You're right. We should probably also underscore that the eligibility we're talking about here is for that emergency housing. So not necessarily for the full shelter spectrum, but for that traditional hotel motel GA. And if I may build off what the commissioner said, I'll share two stories of items that have happened in the recent past, the last few months, just so you're working with the same information that we are around us. And we do work closely with other states. We work closely with the shelter providers in other states to hear, what are they experiencing, what are they doing, how can we learn from each other. And

[Rep. Esme Cole]: in

[Krista McClure (Deputy Secretary, Agency of Human Services)]: one of those calls, they said, we want to let you know that Vermont across the East Coast has developed a reputation of, if you want to be sheltered in the winter, go to Vermont because they'll give you a free hotel room. So this is helping shaping our thinking of how do we better serve Vermonters with no other option. Let me mention the no other option point. This is the second item that happened in the recent past is we're grateful we had someone call us and say, we want to let you know what we've been told. So we just got a job in Vermont. Our family's moving.

[Jill Moore (Housing Program Administrator, Department of Corrections)]: And of course, we're thrilled they got

[Krista McClure (Deputy Secretary, Agency of Human Services)]: a job in Vermont and coming to Vermont. They said, we're having a lot of trouble finding housing here. We recognize workforce housing is very challenging to fund. They said, we were suggested that we call the state because the state will put us up in a free hotel room until we can find a place to live. And unfortunately, the way it is currently constructed with some of the attestation is it fit? And that's not how we view the program as intended. So that's what we mean by those who truly have no other option. So if that helps clarify that.

[Rep. Daniel Noyes (Clerk)]: To an extent, it does.

[Rep. Doug Bishop]: That's anecdotal information. It seems like it'd be challenging to build a policy around. I mean, I'm not saying that isn't true. I'm not saying that didn't happen. But it's hard to build a policy, I guess, around

[Krista McClure (Deputy Secretary, Agency of Human Services)]: We're talking about

[Chair Theresa Wood]: because it used to be done. I'm sorry. I just want to instruct the witnesses to let the representative finish their question. That's all.

[Rep. Daniel Noyes (Clerk)]: Well,

[Krista McClure (Deputy Secretary, Agency of Human Services)]: what used to be done is verifying homelessness, and there is and was a process for doing that. And we certainly can talk about that more in verifying income. We think the verification is an important part versus attestation. And much like this last item here, refining the definition of disabled that's in the bill, we would like to work together on that also to maybe move away from the attestation more to a verification process.

[Chair Theresa Wood]: Representative Donahue.

[Rep. Anne B. Donahue (Ranking Member)]: You somewhat answered my last question, what do you have in mind by Because that's not an area where there wasn't a lot of work and testimony and discussion already on the definition of disabled. So you've somewhat answered that you want

[Emily Haas (Commissioner, Department of Mental Health)]: to ask.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Yes. Thank you. And our counterparts from Dale can talk more about that, probably not today, but could come back if maybe some suggested language, and the community is open for that.

[Chair Theresa Wood]: And I just wanna pick up on Representative Bishop's question. I'm just wondering what is the data showing you about residency? So I know there's been some book about this in the press and some sort of research done about this. I'm just wondering if you can share what data you have on the number or percentage of individuals who have come through the GA

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: program, that

[Chair Theresa Wood]: have had something other than Vermont as their residency immediately prior to coming in. The reason that I ask that is because there's a request for a significant number of additional staffing here. And I'm presuming that part of that is about needing to have sufficient staff to do some of these things on an ongoing basis. And part of our job is to evaluate whether the need is there that justifies the additional staffing. And so when we get to staffing and maybe those folks aren't gonna be working in this area, I don't know. So just trying to figure out sort of the cost benefit of additional qualifications, if you will, or whatever, however you wanna talk about it, and what that would cost in order to implement.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: I think the first part was the data. And yes, we can provide that data. And like I mentioned, we also work with municipalities. And Brattleboro, we encourage you to speak to them directly. They have tracked very good about tracking their data. They have some really good data around this information, and we'll encourage them to reach out

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: to the committee with that. Okay, thank you.

[Rep. Zon Eastes]: Just for the record, I will be speaking with them this weekend about this very subject, so no question. Thank you, Representative Eastes. Representative Maguire? Yeah, just quickly to Doug's point and also here, I think it'd be good also if we can get an interpretation from Katie under Title 33 Human Services Chapter 21 citing 33 DSA 2,107. 2,107 disqualification.

[Rep. Eric Maguire]: When the commissioner or a person designated by the commissioner pursuant to Section 2,104. This title has reason to believe that an applicant or or recipient of general assistance came into the state for the purpose of receiving general assistance, he or she may find the applicant or recipient ineligible for general assistance, notwithstanding its provision of subsection A of the section applicant in immediate need of general assistance for himself or herself or a person dependent upon him or her shall be granted the general assistance on an emergency basis, which may include the furnishing and transportation to the nearest boundary of the state in the direction in which she and she desires to go and leave. It's a good interpretation on that, it's inside the, like,

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: the statute. Question for the witness?

[Rep. Doug Bishop]: Well, yeah.

[Chair Theresa Wood]: I know you kept looking at me, and I'm just like, Oh, it's a question for the witness?

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Think we need it. Our attorney is

[Renee B. (Director of Complex Care and Field Services, AHS)]: to lay it on.

[Rep. Eric Maguire]: That's the question I have. You guys can get interpretation because what you're expressing is already in the statute. I don't know, quality of what's expressed is also the statute. I think we're cognizant of the fact that we do want people to come to Vermont and be successful.

[Chair Theresa Wood]: Absolutely. How can we foster that while at the same time making sure that there are resources available for people who are in Vermont currently and have been, so we're balanced then.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: The next slide, so case management. You'll hear a lot about case management today. You'll hear about case management from the health department, where there are substance use providers. You'll hear about case management from Dale or their AAAs, case management from our community partners, case management from DMH with the DAs and providers, from DOC, from the Vermont Fine Care case management across the board. And we recognize it's a patchwork. That case management is very important. We want that to continue. And we are requesting $1,300,000 to really coordinate case management across the state for all sheltered and unsheltered. And this, we would see as money for community partners to provide that comprehensive coordination of case management, again, for sheltered and unsheltered roles. We have

[Chair Theresa Wood]: a question for Rip Steady. Mine was on the eligibility. Look on the last slide. Can give this to the two d side, just want to know what's changed. Is it correct? Verification for someone who calls after hours and due to, how to say it, the past people calling after hours to get the free hotel, hotel bluff in cold weather and have some suspicious activity. What is your, is there anything new now to verify people after hours? Before it was called CBO, we'll put you in a hotel, but tomorrow you call CBO and get verified. Is there anything new for now?

[Krista McClure (Deputy Secretary, Agency of Human Services)]: I'm wondering if we could phone a friend, but Deputy Kushner,

[Chair Theresa Wood]: that would be great on

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: the phone.

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: Certainly. Good afternoon, Marie. Deputy Kushner, our Economic Services Division. Now we have a Housing Provider two eleven, and so they will have a deadline, so we verify as much

[Chair Theresa Wood]: as we can, but if there's questions then they're infected to call economic services during our normal business hours. Do you

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: have data that shows they don't call the next day, which would raise red flags? I don't

[Chair Theresa Wood]: have that data available. Thank

[Krista McClure (Deputy Secretary, Agency of Human Services)]: you. The accountability piece, we wanted to touch on that because that's a component in the bill as well. And again, this is for the emergency housing, hotel motel component of it. And this is already in statute, but we would like to continue or to remain in statute. If folks decline alternative options and it does happen we do offer folks shelter beds, recovery options, which people don't always take us up on. We would like, again, to reinforce that in statute to exit from the program. Engage in misconduct. This is another important one. You've probably heard about this over the summer. There was a child in Rattleboro that was lured into a guest room. Thankfully, the hotel workers were very attentive, got there very quickly. But we do want to make sure we have mechanisms for situations like that to exit people from the program and to function more like shelter rules, where people can come back in once they've demonstrated that ability to abide by the rules. Again, we also support for the emergency housing for folks to engage in case management as part of the benefit of emergency housing.

[Rep. Esme Cole]: Go ahead, Representative Cole. Yeah, it was my with that specific case that you just brought up in in this context, in general, it's my understanding that that exists.

[Chair Theresa Wood]: There are criteria for that.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: The way it exists currently is it's thirty days that people are exited for. It used to be in rule, and this is going to get into the attorney of mumbo jumbo, it used to be in rule, which then was put into legislation what was currently in the rule, and it's thirty days. So in cases like this, this individual could have come back thirty days later.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: There's a definition for misconduct in rule that's within the last four years or so, something like that.

[Chair Theresa Wood]: Can I

[Krista McClure (Deputy Secretary, Agency of Human Services)]: also just ask Miranda on this? If they're exited from one hotel, could they be placed in another hotel, if they were exited from as co

[Chair Theresa Wood]: placed in the hotel part of the thirty day. However, you were asked to be if it does involve misconduct, then you could be able to go the hotel.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: Represent Noyes?

[Rep. Doug Bishop]: I don't know if you're going to

[Rep. Daniel Noyes (Clerk)]: talk about this, but on case management, are you measuring how case management is provided, whether it's the outcomes or output, like how many times they're meeting with people, and are you going to track that data?

[Krista McClure (Deputy Secretary, Agency of Human Services)]: It's like you fast forwarded two slides. That is one of the key metrics that we are recommending is track the number of folks engaged in these groups.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: Thank you, Representative Steady. I have another number,

[Chair Theresa Wood]: kind of long in this mind. If a family is placed in a hotel, they know they're feeling correctly, and the mother feels it's not safe because her daughter has something, I have to be capable because I don't personally. So, they left the hotel now that they're on the street and their daughter has a severe illness, and they did put them up for the weekend, but they're living in their car. So, what's the penalty when that happens? Is it thirty days to, like, they be able to get back in? Because I do worry for a little girl and not them personally.

[Rep. Esme Cole]: I'm a be a deputy commissioner. I don't like to sit

[Krista McClure (Deputy Secretary, Agency of Human Services)]: about it if you want to know

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: what they choose. So they would be able to, unless it doesn't sound like you can leave a hotel room, right? So it feels like it's not a good fit for you, then there would be a period of eligibility. Okay,

[Chair Theresa Wood]: they did put them off this weekend. Thanks. Deputy Commissioner, I'm not sure I heard the whole, if somebody leaves voluntarily, there's no period of ineligibility, is that what you said? Did not. Okay, thank you.

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: So as we talked about on

[Chair Theresa Wood]: the first slide, and I don't know that we talked about the process and we engaged with partners in the community and looked at the whole system and said, Okay, where can we make changes? How can we improve it? And we recognized the need that there had to be system wide changes across the board. And that's why all the partners at AHS came in and we looked at where there were redundancies, where we can improve, create efficiencies. So we do know that there has to be a system change across the key entities. That's in the agency of human services, as well as other state agencies and departments, community action agencies, shelter providers, municipalities, mental health providers, substance use providers, area agencies on aging providers, skilled nursing facilities, and working as a cohesive unit. And we also talked to emergency departments and hospitals. You'll hear from our other partners how their conversations went and how they plan to address the issue within their scope. But we recognize it needs to be across the board. So I recognize that across all of those systems, people have different ideas necessarily. It's sort of going with what Representative Noyes was talking about, about what case management slide, service coordination, what the definition is and what that means. And so is there an effort to have, I guess, I would say, a common definition for people who are unhoused or who are homeless? Like what's the expectation around that? The expectation of the service provision? Well, the expectation for understanding what's necessary. So if you ask me what service coordination was and you ask somebody else, they might have a different definition. So I'll just give it for instance. People with significant health issues who've been accustomed to being in a hotel for much of the last several years, they may not realize that there might be a residential care home or there might be a skilled nursing facility and that they don't have to be there forever. They can be there, get their, whatever they need taken care of, and then they can be looking for additional housing. But that requires somebody to go physically to them, take them by the hand and take them to a potential placement site where they could see for themselves. You know what I mean? Opposed to, but in addition to being on the phone and saying, well, I'll help you with referrals or things like that. I'm just looking for sort of the depth and breadth of case management slash service coordination that we're looking for in this sort of system wide improvement and additional resources. I would ask you to hold till you hear everyone. From everybody else? Yeah, okay. And if it's still something you wanna hear more about or you think that we should focus more on, then Okay. I guess that very question that prompted the need for consistent and standardized case management and outreach, because it is patchwork and different. We do need to standardize it. And another thing we talked about to encourage collaboration among communities, like identifying specific needs in communities because it's different across the board and encourage collaboration through funding mechanisms. So somehow how we're going to pay for services in certain areas would be dependent on how they collaborate. So there wouldn't be a duplication of funding for the same service in the same area. Yeah, I mean, that's what we're trying to get as the efficient use of resources. So I know lots of people apply for different grants, whether through HOP or funding through Dale or DSU or whatever, and it's kind of based upon what the organization wants to do. And I think we need to have that sort of systemic approach and say, this is what's needed in the community and who is going to do it? Most of the driving the other way around. Yeah, I'm sorry, go ahead. And then we're gonna have to hold on because we're already running behind. So go ahead.

[Rep. Doug Bishop]: So on this point of case management service coordination, would the buck ultimately stop with DCF or AHS to ensure that that's happening? Or is there a vision for contracting for some community partner to lead an effort in a particular area?

[Chair Theresa Wood]: The vision is for DCF to set the policy framework to make sure it's standardized across the state for community partners and for this $1,300,000 that we're suggesting for community partners to receive that money for them to do the case management. Is that helpful? Yes. Thank you. And then just some key performance indicators would be an increase in the number of households engaged in case management, the number of people that exit into permanent housing solution, and then a decrease in the number of days staying in a shelter or shelter like options, the number of deaths in the program or shelter. So based upon the data that we've seen for several years, I would add another one to this, is a decrease in the number of people who reenter homelessness. It's a great one. It's one thing that we definitely need to be tracking. It's going in the wrong direction. Thank you so much. We really appreciate this great overview and sorry for all the questions. Welcome the conversation together. Thank you. Thanks. Okay, health department is up next. Welcome. And I see we have Doctor. Hildebrandt on, oops, where did he go? We had him momentarily. Think he hit a wrong button and he left the Zoom room, but I'm sure he'll be back momentarily. So welcome. I know I have to give it I have to is Doctor. Hildebrand back on? Yes. Okay. Because we made a point of it last time, I have to make a point of it this time that we have a new picture on the PowerPoint. It's a small thing. It's a small It's small thing. Who's driving the show here?

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: Third time's

[Dr. Rick Hildebrand (Commissioner, Department of Health)]: a charm. I think can you guys hear and see me now? I apologize.

[Chair Theresa Wood]: We can. We can.

[Dr. Rick Hildebrand (Commissioner, Department of Health)]: I underestimated my battery percentage and it died just as you had switched to me. I do apologize.

[Chair Theresa Wood]: That's okay.

[Dr. Rick Hildebrand (Commissioner, Department of Health)]: For the record, Rick Hildebrand, Commissioner for the Department of Health. Thank you all for having us. Housing is something that's near and dear to the heart of the health department. Our piece of this puzzle focuses primarily in the substance use disorder realm and a variety of different ways in which we engage individuals who have substance use disorder and have housing needs. Unfortunately, as many of us know, there is a significant overlap between houseless population and those with substance use disorders. It's certainly not everyone, but the folks who have both of those problems are particularly challenged. And we have been working pretty hard to develop a system that helps support those individuals and get them into recovery residences and ultimately into their own independent homes. And that's the system we've been trying to build and what we're gonna speak on today. If you could go to the next slide, please. All right, so Emily Trudor is here as well, and she's gonna give a deep dive into a lot more about this, but one thing we did wanna touch on is the different types of residential treatment that we do support because this system can be confusing. Frankly, it was very confusing to me when I first learned about it. Residential treatment, again, I'm gonna give a 30,000 foot view, but Emily Truter will dive into each of these and give much more granular detail about what they mean. But residential treatment is folks who are in active treatment for substance use disorder and require a medical facility for that treatment. And those we've talked about in the past, the 3.1 beds or 3.7 beds, those are the sort of monikers that are used in that area. Recovery residences are people who are not in active medical treatment. These are facilities that provide housing to individuals who are in recovery and need significant support to continue that recovery as that timeframe can often be measured in years. It is typical that someone who has substance use disorder takes something like two years before they can really be in long term recovery. So recovery residences are an important part of that puzzle. Recovery shelters, and we talked in last presentation about the sort of high barrier, low barrier system. Those are all in this bucket of recovery shelters. These are shelter programs specifically designed for individuals who also have substance use disorder and programming that helps support that. We have a number of them throughout the state and then recovery centers, which we aren't gonna talk too much about in this presentation. That's more outpatient services, intensive outpatient services around folks who have substance use disorder needs. So that's the spectrum of what we provide support for. I'm very excited about the work that's been going on in this round because to your point earlier, Chair Wood, we don't want to see an increase in the amount of homelessness. And this is one area where we can help bend that curve. We can help folks, who are struggling with both homelessness and substance use disorder, get the path back to, you know, employment and housing. And I would like to pass to, if it's okay with you, Emily Trudor, to give you guys a much more granular detail about some of these things. And of course, if there's ever questions at any time, please do not hesitate to interrupt.

[Chair Theresa Wood]: Thank you, commissioner. So, Emily, welcome. And Shaila, welcome. One of the things, I think we have a pretty good understanding about sort of the levels of care. One of the things that would be really helpful as you go through this is to understand what we have for capacity now. And does anything in this proposal and or the governor's budget in your own department increase or decrease that capacity as we go through these levels? That would be great.

[Dr. Rick Hildebrand (Commissioner, Department of Health)]: Yes, that is included in the slide deck.

[Chair Theresa Wood]: Great, all

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: right, floor is yours.

[Chair Theresa Wood]: Thank you. Good afternoon, everyone. My name is Emily Truter. I am the health department's vision director for substance use program. Emily, I'm sorry, but we have a blowing fan behind us. Sure. So if we can do our best to project, that would be great. Will do. So I'm going to speak to four of those blocks that were in that original slide. So I'm going to talk about residential treatment. I'm going to talk about recovery housing and recovery shelters. The recovery centers are there. Part of what we're doing is a little bit of education. The word recovery shows up in a lot of spaces, including the name of an actual organization versus a type of service versus a sort of a state of being. So we do encourage everybody to read all those slides, that would be a little bit about recovery coaching. We'll talk in here, but we'll focus on those first three buckets. So first is SCD residential treatment and talking about expanding care. Our commissioner did speak a little bit about the different levels of care that we have in the state of Vermont. Just for a little additional detail, We speak in clinical ASAM speak, but for us, we have high intensity medically managed treatment, high intensity clinically managed, and low intensity clinically managed. And what those mean are the high intensity, when you hear about length of stay, that's your space of medically managed. You're talking 20 fourseven nursing. You're talking medical detox and stabilization in that space. In a three point the next one down, that clinically managed high intensity, you're talking about a lot of hours, a lot of one on one work, a lot of group work in the facility. So the amount of contact hours with the individual residing there is high. When you step down to the 3.1 level, it becomes a little bit more moderate because they have a lot more work that they're doing in their community to continue to build recovery capital and continue to move through the system. Employment, life skills, and working on other things like that. The individuals that we serve, again, are individuals with substance use disorder. That is determined through clinical assessment and evaluation, and they have to meet medical and clinical criteria. We have some key metrics as part of this. So right now, as far as our inventory, we have 99 active high intensity beds. So again, that's what I'm medically managed and clinically managed, and 49 active low intensity beds. Some of those sort of hot off the presses. We right now serve on average a little over 1,500 unique individuals each year in our residential programming. Our average length of stay at the high intensity levels right now are around fifteen days, and our low intensity for 2024 was thirty seven, with an anticipated 45 plus for 2025. The one hundred percent of individuals that are complete treatment receive an aftercare plan that addresses housing needs. The 2024 homelessness decreased between admission and discharge. So how what was their housing status coming into the residential program and then on departure decreased at all facilities. One exciting fact, I think, for 2025, so that's calendar year, Valley Vista, our Vardis residential provider, did admit two seventy two individuals as homeless. At discharge, two zero eight, so seventy six percent were placed in a residential setting, so did not discharge to homelessness at the end of their treatment stay. I do think it's important to note that residential placements happen across the country, so it's not just placements within state. New Hampshire is a very common partner in that mix, but we have everything from Maine, New York, Delaware, California, California and Florida. As far as expansion efforts, one area that we're excited to talk about in a lot of spaces because we talk about transitions between levels of care and resources. Over the last couple of years, we have started reengagement beds at both facilities, so both Valley Vista and Recovery House. That has two purposes. The first is for individuals who have completed their course of treatment in the higher intensity residential spaces, who now have an aftercare plan that may take a little bit of time, some days, to enact it. So whether that's transitioning to housing, that's finding some other type of space to be and then engaging in their outpatient services as part of that, they're able to stay longer because it's no longer a Medicaid billable space at that point in time. So we have some capacity and funding to make that happen. The other space is that if an individual in a recovery house has a recurrence of use, they are able to transition to one of the reengagement beds at Valley Vista Recovery House and have their bed held for them. Will be assessed when it happens. If a person returns to use, they may be able to return to their bed in the recovery housing space, but they may be at a space where they do need a higher level of care and may return to that high intensity for some particular reason. It's a fluid space. There's not a sort of start here and it's not linear. People can move around as their needs are identified and met. Emily, can I just We have a question from Representative Donahue?

[Rep. Anne B. Donahue (Ranking Member)]: Yeah, quickly. Do you have a breakdown or breakout between high intensity, how many of those are medically managed and how many are clinically managed?

[Chair Theresa Wood]: Is this different level? Yes, I can get that for you. I don't have it off the top of my head right now. Great.

[Rep. Anne B. Donahue (Ranking Member)]: And the other question, and I know any present company excluded, the media doesn't always fine tune their reporting. I heard this big report on the radio driving in this morning about this brand new program called Valley Vista that was going to have that rather than the Medicaid limit of fourteen days, it's going to allow much longer treatment periods and all new program.

[Chair Theresa Wood]: I would say that Valley Vista for Gens just reopened the location back in mid December. They have been actively admitting patients. I think they're at 19 as of today. They are a facility that has 27 beds. As we talk about expansion, we do think that we're able, for the fire marshal, to evolve that to 30, so adding three additional beds in that space. We have had 3.1 beds for several years. So down in Rutland County, we have had McGill and Grace House. So they have been online for a few years. What I would say in regards to length of stay is the length of stay is driven by medical and clinical necessity. The days is an average, and there's an expectation under Medicaid that our state average cannot exceed thirty days. So some people may stay longer, some people may sleep three days. It depends on the individual and their experience. I just want to make sure I'm understanding. We've been meeting with the federal judge for the last couple of years. And is what they're looking at, what you call in this, the 3.1, the lower intensity? So I guess what I'm asking is, because I'm not totally familiar with the ASM categories or levels, is there another level in there that we don't have or are those all three levels and now we're expanding the low intensity? We actually have the full complement right now of the Association of American Society of Addiction Medicine's categories of care. Separate from this presentation, we also, back on July 1, went live with a new standalone clinically managed withdrawal management space so that individuals can do some a la carte depending on their actual needs as opposed to having to do the full high intensity for medical detox. They may just need the withdrawal, then they hop automatically to intensive outpatient. So the difference between intensive outpatient and outpatient literally is about the number of contact hours necessary for an individual in a given time span. So we right now have, from the residential setting and our outpatient, the full comp plan. Okay. Go ahead, Representative Bishop.

[Rep. Doug Bishop]: Last year, we addressed in a bill some confusion that's out there in community with community partners about the length of stay for the high intensity medically managed. And I'm wondering if you, there was a belief that it was capped at 15. Not that that was an average, not that that was the episode that was funded. Do you have any insights as to where community conversations stand now? What your understanding is of how well that is understood, that it's not a hard cap?

[Chair Theresa Wood]: I think we've made some traction. We did host a number of community forums, some of the most familiar faces in the room, through October past year. Had a lot both of our residential programs attended all of those community forums to help with some of those educational pieces. So I think we've made some traction. I still think there's some education to go. Thank you. I'm going to encourage you, just because I'm sort of being mindful of time, I'm going to encourage you, Emily, to not really go through so much the what is it part for this group, because we pretty much know the what is it part and we can read it, but focusing on the metrics, the policy proposals, and specifically about the governor's FY 'twenty seven budget, that would be great. Thank you. So specifically for residential, again, our reengagement beds are active. We've more than doubled our low intensity bed capacity, again, in December with Virginia's opening, and we're seeking to add those three additional beds since the fire marshal has done some new evaluations. So that's where we currently sit with residential capacity and expansion. Is that all within the governor? I'm sorry. Yes. Is that all within the governor's FY27 budget? We were able to accommodate within our current budget. Okay. And I wanna just add that that is meeting demand right now. That is meeting demand? There's no waiting list, is that what you're telling me? There's not, yeah, they are not at 100%. People do not get in instantly, but that's not because of the waiting list or capacity. Thanks.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: The next space, moving on

[Chair Theresa Wood]: to recovery residences. We're excited. As of January 2026, Vermont has eight organizations supporting recovery residences in 30 locations, totaling 155 beds. We did just have a new program open in Essex through the Vermont Foundation of Recovery serving women. So that was 10 new beds that did open in Essex. We right now have 79 beds available for men. Six of those are beds available for men with children. We have 76 beds available for women, 20 of the beds available for women with children. Our policy proposals and expansion efforts for this coming fiscal year, we're looking to, again, we have some funding proposed as part of the opioid abatement settlement. We are seeking $1,200,000 in new funding as part of that effort. And we are also looking to new funding for, as coming as part of Rural Health Transformation Grant. I don't have a lot of specifics about that, but recovery housing is an eligible activity within that award. Our capacity goals, so we did release a needs assessment in December 2024 and a strategic plan in April 2025. Part of that work included doing some assessment in different areas on state need. Our goal is to get to 400 beds statewide. There'll be mixed use as part of that, but we're at 155. There's some room to grow as part of that. They also released a recovery residences report that shows the gaps, and this proposal fills some of the gaps that were identified in that report. So that's on your website as well. I very much appreciate that because it helps us to measure how are we going? What progress are we making or not making? Which is honestly what I'm trying to get from the shelter side of things, where should we be? And so I appreciate that, thank you. The next piece, moving on to recovery shelters. Right now, we currently are part of the agency and support Good Samaritan Haven in Barrie Town. Right now, is in eight double occupancy rooms that have a variety of facilities that are available to guests within that space. Guests must provide their own meals in that space, as well as there's some limited regular transportation to Downtown Berry on a daily basis. Our goals for this upcoming FY '27 is to embed outreach and engagement workers from substance use treatment providers and shelters. Part of the opioid abatement settlement investment, and on onset, provided 26 FTEs across the state in our preferred provider treatment system to engage in outreach and engagement efforts. So we're looking to, as part of their grant agreements, that they do outreach all sorts of communities, and this being one of them. We're looking to embed recovery coaches and shelters. So we do have 12 recovery centers across the state to support those efforts. We're looking to expand the recovery oriented shelter capacity to more areas of the state when appropriate. Areas, for example, could be Burlington and Rutland. We are looking to continue to build strong connections between shelters, our recovery housing programs, and our recovery options. Again, having as much parts of the continuum wrap around individuals' needs as possible. When we talk about expanding and embedding recovery approaches in shelters, are you talking about shelters that are run by other community partners, not the preferred providers or DSU? We would encourage The goal is to reduce the number of individuals that need and are not receiving care. So we want them everywhere and engaging in communities as far and wide as they can reach. And do they go into hotels now? Are they participating in care planning and stuff like that with shelter providers now? It is specifically in the outreach and engagement workers scope of work. I think there may be some variety in regards to the recovery center work. The recovery centers are very well embedded within our communities in a variety of spaces. I wouldn't want to speak as of absolute statewide, but it is an expectation of the outreach engagement workers. Is that part of the grant agreement that goes out in terms of specifics of the Yes. Just a little bit about outreach and engagement. Again, there's 26 positions statewide. There's one in each preferred provider. Certain catchment areas have more than others. For example, in the Burlington area, you would have Lund, Spectrum, Howard Center, Howard's Hub, and UBN Day one program. So there are some higher concentrations in different areas, depending on

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: the number of providers there. Again, their

[Chair Theresa Wood]: goal is to seek out individuals in need of, but not receiving services for substance use disorder. These are positions that are not generally licensed. So workforce is an issue across the board. So we are also trying to be as creative and effective as we can be in utilizing all aspects of our workforce. So this doesn't tend to be a licensed space, but their goal is to build linkages to the wider system. And again, we put a specific note that the workers visit the hotel motel, GA emergency housing sites, shelters today, and as well as people living outdoors. When you talk about not licensed, are we seeing individuals with lived experience who have been through and are still in recovery of providing these types of services? They very well could be. I mean, right now, to be quite honest, it's all hands on deck. And we are seeking peers. Have a new peer certification that became effective back in July. We now are certifying our recovery centers becoming recovery service organizations. So there's a see them in all sorts of different spaces, but certainly in this one as well. Just some key takeaways. Residential treatment has recently expanded. We're going to evaluate it and test it to see what it looks like. Again, we're not at full utilization capacity, and we have enhanced our entrance and our exit strategies as part of that. We have a commitment to continue to expand recovery shelters and recovery housing, particularly recovery housing with more support. So again, looking at life skills and employment, how those support individuals, and a commitment to embed our outreach and engagement workers, as well as recovery coaches in shelters, in addition to where they are now, which is in emergency departments, hotel motels, and outnorthers. People are just having a hard time hearing, I'm sorry, you're doing your best and the room is tricky. Yeah, if there's a way to turn down the heat, that would be okay because it's kind of warm in here. We're used to it being very chilly upstairs in Room 46. Maybe that will turn the fan down, I don't know. These old buildings and having ventilation systems that have been updated don't account for things like hearing people. Okay, are there any other questions for the witnesses? I guess just Yeah, go ahead, Sondheim.

[Rep. Anne B. Donahue (Ranking Member)]: On that last slide, I mean, the commitment to continue to expand, the commitment to embed, embed, and and the commitment to yeah. I mean, that sounds like that's people on the ground and more things being done than now. Is there budget component to doing that?

[Chair Theresa Wood]: We do receive funding to accomplish that. Yes. That's part of our our budget. Correct.

[Rep. Eric Maguire]: But is there an

[Rep. Anne B. Donahue (Ranking Member)]: expansion for the f y twenty seven budget to

[Dr. Rick Hildebrand (Commissioner, Department of Health)]: Can I interrupt a little

[Rep. Doug Bishop]: bit? Do more.

[Dr. Rick Hildebrand (Commissioner, Department of Health)]: Can I answer that, please? The other thing just to say, we had 1,200,000.0 additional in funding, but we are looking at up to 8,000,000 additional for five years through RHDP. So significant increase in funding in the recovery space looking at this exact issue, recovery housing being the primary focus. We recently expanded our treatment. We are going to have shortages in recovery residences and shelters with workers. So yes, significant increase in funding through that program.

[Rep. Anne B. Donahue (Ranking Member)]: Thank you. I misinterpreted the slide on that funding more narrowly as if that was for housing itself as opposed to things like outreach and supports in the housing. Thank you.

[Dr. Rick Hildebrand (Commissioner, Department of Health)]: We actually can't use the RHDP specifically on housing. You can't buy homes or renovate homes with it. So we are going to be looking at all ways in which we can support it, the program.

[Chair Theresa Wood]: Thank you. So I'll be clear that I'm not clear about how BDH is gonna be using the 1,200,000.0 that's in this proposal for jointly administering that with OEO to support shelter services? Is it gonna be specific? Are you gonna expand the number of beds available to individuals with substance use disorder? Are you gonna be working with people with substance use disorder in current shelters? Some combination, I'm not really sure. It's sort of generic in the description here. Not your description, but the one that's in the DCF book. And I'm going to leave you guys. And I'm going phone a friend. Okay.

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: Yeah, thank you. So as Emily mentioned, we're trying to leverage what we've learned with the Recovery Rutland Shelter at the U. S. American Haven. The way that shelter operates is that they receive, and this is intentional to ensure that it's holistic programming. They receive a shelter grant, the Office of Economic Opportunity, and a recovery oriented grant through the health department, and we work with them together for that kind of wraparound approach. And so that's what we're doing and looking to expand, as Ellen said, in targeted areas. So we will be specifically using that funding to help support expansion of that model. We've been able to start next week. We are hoping to start a second project in Burlington, working with Chimney Valley Office of Economic Opportunity. Started out with one time MEMS. This would allow that project to continue. As we also see, if there are other communities where it makes sense, we may be able to expand in the future. But this specifically allows us to double that by opening a second facility and supporting that next year.

[Chair Theresa Wood]: So I think we're just going to need a little bit more detail. So I hear you say, well, CDOEO, you're going to be opening another facility, working with them to open another, I don't know how many spots that is or what kind of expansion that means. I guess I'm also hearing about how that might be expanded in other communities potentially. Is that what you're saying, Lily? At this point, this funding would primarily go to opening the second

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: recovered emergency shelter next year in Burlington, and really maintaining what we're able to start this year. I think while we continue this expansion, we're able to see how is that working, where are other communities, when it makes sense. It really is a higher barrier of shelter. And so wanting to make sure that you have sufficient populations that you're not being beds underutilized, and also ensuring that you have other shelters in your network that as people are progressing in their recovery, they can get into this kind of environment. And if someone has a slip, they're not that much sheltered and they may access a shelter in their shelter beds. At this time, we don't think it's a problem that fits for all communities, but that's what we're going to continue to monitor. Next year specifically would help support the growth of children.

[Chair Theresa Wood]: Thank you. Thank you, Golrang Rey Thank you, Doctor. Gildebrand for being here. Thank you.

[Dr. Rick Hildebrand (Commissioner, Department of Health)]: Thank you for having us.

[Chair Theresa Wood]: Next up, we're going to hear from the Chronic Care Initiative and Complex Care and Field Services with Renee and Angie.

[Renee B. (Director of Complex Care and Field Services, AHS)]: Welcome. Thank you, Chair Wood and committee members for inviting me here today. Angie won't be joining us, but I have Kristen here.

[Chair Theresa Wood]: You've your phone a friend here, yeah. I have your phone

[Renee B. (Director of Complex Care and Field Services, AHS)]: a friend here. For the record, I'm Renee B. Director of Complex Care and Field Services for the agency. I've been in the state for four years. And prior to that, I worked for a community organization overseeing shelter services and community services for unhoused Vermonters. Today, I was hoping to talk and share with you a little bit about the services of the Vermont Chronic Care Initiative and some of the framework that we're trying to promote in communities to help the patchwork of case management services that are being offered to people who are experiencing homelessness work collaboratively together so that we're not duplicating services and care. Do we have your presentation? Have you emailed that to Lori?

[Rep. Eric Maguire]: I will get it over after his time, not sent yet.

[Chair Theresa Wood]: Okay. We don't have it, in other words. Okay. Okay. So if you're looking for a committee member, it's not there. Okay. Thank you.

[Renee B. (Director of Complex Care and Field Services, AHS)]: So for those of you who aren't aware of the Vermont Chronic Care Initiative program, it's a program that sits within AHS central office within our health care reform teams. We are comprised of 60 nurse We case also have some Medicaid outreach coordinators, a nurse administrator, and an admin support person. We meet with Vermonters in the community. So if they are in a hotel, we're going to hotels to meet them. We meet with them in their homes, in shelters, and just wherever they're comfortable being served. We serve people who have complex health and social health care needs. And we typically focus on those who are disconnected and disengaged from services, so they're not already working with other providers in the community getting services. Our goal is to provide the short term intensive to get them connected to services they need and identify the care coordinator and then step out of that role once they're engaged with the services that they need. We typically serve people who are really at the highest risk for poor health outcomes and are high utilizers of the crisis care systems in our state. A new piece of work that's embedded within our program is the Vermont Medicaid Reentry Care Coordination, and that's a program that we just launched January 2. So that's just getting off the ground. That's a new one for me. I'm not sure what that is. Can you describe that just briefly? Sure. So that's under the new Medicaid waiver program, a program to provide care coordination to sentence people in the justice system who are incarcerated. So we'll be able

[Rep. Eric Maguire]: to

[Chair Theresa Wood]: provide Reentry back into the case. Yes. Okay. I didn't know which term reentry was referring to. Okay, I got it now.

[Renee B. (Director of Complex Care and Field Services, AHS)]: Okay, any other questions? No, trying. Thank you. The core functions of the Vermont Chronic Care Initiative are to do a health related social needs screening and assessment on individuals we serve to assess their needs for health care and then social health needs, such as housing, food, transportation, mental health, substance use, housing, all those things that can be barriers to folks and contribute to poor health outcomes. We connect people to medical homes if needed and any other services or benefit programs in the community they need. We help them to navigate complex system of care that we offer as a state, And we continue to provide ongoing assessment of their needs and update their plans of care. The model we use is a team based care approach. And we use different care coordination tools to help people identify who they're connected with in the community, both from a support framework and from a provider framework, and bring that care team together so that the individual can talk about their goals. And we can identify the roles and responsibilities of each care provider to support the individual in reaching their goals.

[Chair Theresa Wood]: Do you have data on the number of people who are homeless who have received your services? That's on the next slide, actually.

[Renee B. (Director of Complex Care and Field Services, AHS)]: And we can go to that right now.

[Chair Theresa Wood]: Yep, we can do

[Renee B. (Director of Complex Care and Field Services, AHS)]: that, yep. So at this point in time, this is a point in time count. We're serving three eighty Vermonters statewide. And we're down three staff right now, so we're still recruiting. Out of those, fifty four of those are in the general assistance emergency hospital program, and twenty one are in other unsheltered situations, such as sleeping in their car or in a tent or campers.

[Chair Theresa Wood]: We receive referrals from other community partners. Can think of I know End Homelessness Vermont serves a number of very medically fragile individuals. Do you coordinate services with community providers like that?

[Renee B. (Director of Complex Care and Field Services, AHS)]: Do you receive referrals from them or vice versa? Referrals from End Homelessness Vermont. And when we do outreach, if people are wanting them as part of their care team, we would have them sign a release and invite them in to be a care team member with our other AHS partners and community partners. We've seen an increase over the years in the number of people experiencing unsheltered homelessness that we serve.

[Chair Theresa Wood]: Well, we've seen an increase in the number you In general. Yeah. Do you know out of that 75 folks are, in terms of the sort of general percentage of those folks who are older

[Renee B. (Director of Complex Care and Field Services, AHS)]: Vermonters? I don't have that breakdown with me, but I can can get it to you.

[Chair Theresa Wood]: I know a number are We're hearing continually about the increase in the numbers of older Vermonters who are unsheltered or homeless, so that would be helpful to know what proportion that would be. Thank you. I can

[Renee B. (Director of Complex Care and Field Services, AHS)]: get that to you. I wanted to talk also on the last slide that I have today more broadly about some of the work we've been doing over the past couple of years, which is really to work with our community partners and state partners around promoting team based care as a philosophy and practice to embed regionally within the community so that we're working together to serve our people with the highest, most chronic needs. We have some systems level meetings happening in communities that help identify people who need outreach and support. One of those is the coordinated entry meetings that our housing providers do. We're at the table to take referrals there so that we can outreach people and get them care coordination. We attend the local interagency teams, and we have community providers there to work together around outreaching folks and getting them connected and problem solving any barriers or access issues to care in the community. And then more recently, we have, with our public safety partners, situation tables, which are in several communities and have been highly effective in connecting people to services and supports. Some of the work that we're continuing to do as well as learning collaboratives at the community level for community providers. And we have free trainings up for any provider in the community, as well as state partners on how to use team based care in serving people with chronic health and social health needs so that we're all speaking the same language and can support each other in care team meetings. Thank you so much for being here this afternoon. Thank you. Appreciate it.

[Chair Theresa Wood]: Do you have a question? I'm sorry, didn't

[Rep. Esme Cole]: hear you. Sure. I'm Wondering if we have a sense of how many what percentage of our hospice population were especially those who have engaged in the JH program and otherwise such programs that

[Emily Haas (Commissioner, Department of Mental Health)]: are available, how many we have been

[Rep. Esme Cole]: in contact with through your specific ECCI program or ECCI, sorry. Is that the right acronym? Yeah, ECCI. And also, the comparison between your direct engagement versus referrals from outside or other organizations that I know we want to work together as a whole complex unit. But yeah, that breakdown of where we directly being in touch with versus who are we hearing about. And those two combined, what percentage are we reaching people? Because I think as we get in our data, a huge percentage would benefit obviously from this. I see on your website in the very top, it's like, you're going to get delays, don't have much capacity. And I

[Chair Theresa Wood]: think you mentioned staffing, but it

[Rep. Esme Cole]: seems like a really integral piece of this puzzle for long term solutions. So it's a lot there.

[Renee B. (Director of Complex Care and Field Services, AHS)]: And I'm wondering what time frame you're looking at to have an understanding of the numbers of people that we've served. That was a point in time that I gave you. But are you looking for us to go back a year and tell you how many people in the GA housing program specifically that we've worked with or experiencing homelessness in general?

[Rep. Esme Cole]: I think the main point of my question is just to figure out how to catch people who haven't had interaction or engagement with this service who would greatly benefit. And so, I see this number of people have engaged, I just curious if we're missing people, which I think we might be, and how do we better address that?

[Renee B. (Director of Complex Care and Field Services, AHS)]: How many have been outreached versus actually engaged?

[Rep. Esme Cole]: Outreach too. Engagement is obviously critical, but it's outreach. Because I think not everyone, the folks who

[Chair Theresa Wood]: I know who benefited

[Rep. Esme Cole]: from this, who were involved in the VA program, I don't think there was an opportunity for them to learn about this. And so that exposure, how to amp that to the best of our ability and how to support that in the budget and also on the back end, how to carry it out, carry out the way you're doing effectively in a timely way.

[Chair Theresa Wood]: So just to amplify what Representative Cole was saying, we have heard over and over and over again from shelter providers, from DCF themselves, from other community providers about the complicated medical history that people have. And it seems like 'seventy five, I realize that was just a sort of point in time, but even

[Rep. Esme Cole]: as a

[Chair Theresa Wood]: point in time, that seems low for the number of individuals that we hear about from community providers as having complex medical issues that they don't feel equipped in handling. So I'm just trying to figure out, do you receive referrals from shelter providers? Do they know about you? I think they know about Dale in general. But I know that you're not housed in Dale. But do you hear from shelter providers? Do you hear from community action agencies? We do.

[Renee B. (Director of Complex Care and Field Services, AHS)]: Yeah, we get referrals from partners, tripled the area agencies I'm aging, from shelters, from primary care physicians, designated agencies, and then also self referrals. People can also self refer into the program. They don't need to be referred by a provider or get a referral. And I could get that breakdown for you as well.

[Chair Theresa Wood]: Yeah, thank you. Thank you very much for being here this afternoon. Appreciate it. Thank you. Gail? And so, committee members, because we're running behind schedule, we're not going to take a break. If you need to get up, just make sure we have a form before you leave. Welcome. Hi, how about you? Just gonna share. One second. We do have this one committee members on our website.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: Are there those you want?

[Chair Theresa Wood]: It's been a little slow today. There you go. You'll see that we and

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: Dale have drunk the SteraTemp plate Kool Aid.

[Chair Theresa Wood]: I see that, I see that. I did notice that.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: So this

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: morning when we met with you as part of AHS, I kept thinking when you were asking what's an example or somebody asked what's an example, this is like the perfect example, this work, of how we are working collaboratively. I should say, for the record, I'm Doctor. Jill Bowen. I'm the commissioner for Department of Disabilities, Aging and Independent Living, Dale.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Angela Smith Jain, deputy commissioner.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: So the work that AHS is doing to address homelessness is a collaborative across all the departments in AHS. Angela, Deputy Commissioner Smith Jeng, is our lead and has been part of the ongoing conversations. Can you hear me?

[Chair Theresa Wood]: I usually talk loud. I can hear you, but again, I don't know about people on, we can hear you around the table. Angela might have to speak up a little bit more.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: But it is a collaborative effort, and Dale has been very much at the table. So we want to take you through the work that we have been focused on and how it aligns with what you've been hearing from everybody today. So next slide, please. So all of the work that we are doing that addresses the needs of older Vermonters, we put under the umbrella that is age strong Vermont. And that's really critically important because nothing actually exists outside of a system or is a one off. It all flows through the continuum. And from the Older Vermonters Act of 2020, Vermont communities should be designed, zoned and built to support the health, safety, and independence of older Vermonters, and that includes older Vermonters who may be experiencing some sort of shelter need or housing instability. Next slide, please. So let's just look for a moment at the housing and sports continuum for older Vermonters. Most of the folks who we are working with in the homeless system, the GA system, but our older Vermonters, very few have developmental disabilities. I just want to say that there were approximately twenty five with developmental disabilities specifically in the course of a year, all of whom were connected through the designated agencies. And so we're not on the street, so to speak, in any way. So we are gonna focus this conversation on the older providers who are in the

[Chair Theresa Wood]: system. I'll just share with you the testimony we received yesterday indicated still high number of people with developmental disabilities receiving services in shelters. To be fair, I don't know if that meets the department's definition of developmental disability or people who might be a little slower in learning or understanding.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: They may be in some form of shelter or some form of temporary housing, less likely to be in the GA motel, but they could be in some setting like that, but they're connected through the designated agency in receiving services. One of our first steps into this was how do we get the people who are already connected and are in the GA system out of the GA system and bring them into the services that we have already available if, one, they're already a part of the services but not being connected appropriately, or two, are eligible but haven't been coming. So that was the first thing we did. And that brought a lot of people who otherwise maybe would have been languishing into a system that has the ability to provide some services, which also goes back to there are some alternatives for those folks that maybe aren't available to others because they meet the criteria of some of the care systems that we have in place. So here's the housing and support continuum for older Vermonters being served in their own home, downsizing living with family or home sharing, age specific housing, supportive housing models, residential care homes, assisted living residences, skilled nursing facilities, adult family care homes, and then the specialized skilled nursing facilities beds. Anywhere in that continuum is better than being in, you know, a a GA system or being on the street. So next slide. Just in terms of our current data, you've asked a lot about data, and we do have some. So this tells you that we have been tracking Vermonters in our adult services division programs who are also in the GA emergency housing. So most recently, just like last week, there were 27 individuals who were also served by the ASD programs who were accessing the program. There have been 66 unique individuals served by ASD who are housed in the GA emergency hotels since state fiscal year '26. So we're tracking them and and have very up to date data, but we're looking longitudinally as well. And in addition, there were two thirty nine Vermonters categorized as medically vulnerable, many of whom are older Vermonters.

[Chair Theresa Wood]: So I have a question about So those are people who are served by the adult services division, so either through choices for care or one component or other of choices for care, I'm presuming. So I guess my question is, why are they still in hotels? Maybe you're gonna get to that. Yeah, I'm gonna get to that. Okay. And then, so that's great that you know the number of people who are identified and you know where they are if they're already a recipient of Adult Services Division. What about those folks who are not already receiving services through

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: the Adult Services Division, but who in fact are eligible for those services? If they're eligible so in many ways, that's where the AAAs and others come in. For people who are 60 and over, but they're not on Dale or ASD's programs, that coordination happens at the local level between the coordinated entry agency and the AAAs. And if they meet the criteria, then they can, they can get an intake. They're also receiving services that they're eligible for while they're in GA to try and get them out of GA. So, for example, the 27 that are in GA as of January 19, so just like last week, six of them intend to private pay at motels, that's their choice. Two have ERC referrals in process. One has an AFC referral in process. One has a SNIP referral in process. Two are working with case managers on plans to move out of state. And 15 are working with case managers and housing organizations for apartments. They're not interested in the choices for care options. So that gives you an idea of what kind of activity is going on for those that are identifying.

[Chair Theresa Wood]: I'm just trying to reflect back on really the testimony that we heard yesterday from a variety of different shelter providers and community partners who, they report seeing an increasing percentage of the people who are coming to them and both not just in the GA, hotel motel, but also in their shelter services. And the numbers just don't kind of add up to what we were hearing yesterday. So I'm just trying to understand how, so for instance, maybe you could give us an example about how the AAAs do outreach to the shelters, do outreach to

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: the hotels, do outreach to people in general who meet the criteria for older Vermonters service. I do want you to know that we work pretty closely with the shelter providers. We work with Brenda, for example. So we may get a call, like, Is this person eligible? Is there something that we can be helpful with? Sometimes that means, yes, we can. Kurtz will check. The person is in our system, and we will move in there. Or the person's not in our system, we will contact the AAA so that they know that they're there. Our whole plan is to have this be as a system. So you know, because we told you about the collaborative that we it was like a learning collaborative. It's a retreat. We had the AAAs in there. We did it twice. They're working pretty intensively on the ground, the triple a case managers. I know that you have mentioned in the past that they don't do enough of that. And when it comes to working in the GA system, they're doing a fair amount of that. And we're trying to work with them so it's coordinated and that they have best practices and that they have the contacts they need. So any way in which we can support that and support the connections, we're doing. That being said, there's more work to be done. There's certainly more people who meet those criteria than are in our system. Some of them don't meet the criteria for our system, that doesn't mean they don't need some support. I'm going to turn it over to Angela now. She has more specific details and information and data to share. What happened to our PowerPoint? I said, I'm going to turn it over to her. I know that's We're done with it. You

[Chair Theresa Wood]: can keep going in. You know what you're going to say, because we have it here. It'll come back in a moment.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: I'm sorry,

[Chair Theresa Wood]: go ahead.

[Rep. Doug Bishop]: Before we might move on to the next slide, on this slide, there's reference to two thirty nine Vermonters categorized as medically vulnerable per the executive order. What's the connection, if any, or crosswalk over to Vermont Chronic Care Initiative to see if those individuals may be eligible?

[Chair Theresa Wood]: And choices for care.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: So that two thirty nine people who were in that category, that was in the period of April to June. And some of them were on Choices for Care. So that is inclusive of people on Choices for Care, inclusive of people who were receiving the CCI services,

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: and then others who weren't receiving those services. It encompassed them all. But more work needs to be done for the medically vulnerable because you can see these numbers and so can we. And that's part of what you heard the big secretary and commissioner who opened today to talk about in FARC was the medically vulnerable. So we have more we would like to share with you.

[Rep. Doug Bishop]: I'm sorry to stay on this point, but some people receiving the Chronic Care Initiative may be part of that two thirty nine, but have all of those two thirty nine been screened, if you will, to see if they're eligible? Because I would think many of them would lack a medical home, which seems somewhat central to what can be offered through the Chronic Care Initiative.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: I don't know the answer. But

[Renee B. (Director of Complex Care and Field Services, AHS)]: our team is very well versed in eligibility criteria for choices for care.

[Rep. Eric Maguire]: And

[Rep. Esme Cole]: if that's an identified need,

[Renee B. (Director of Complex Care and Field Services, AHS)]: then we're connecting that individual to their local area agency on aging to get that application process started. And they become part of the care team until that person is fully engaged with them, and

[Chair Theresa Wood]: then you would step out. So I'm going to follow-up on Representative Bishop. So I appreciate, Commissioner, you gave us an update of the 50 or so people or whatever that number total out about, like where they're at now. What would be wonderful, because we know who those people were, is how many of, I guess a similar breakdown and that would Okay, that wouldn't just be for you, but of those two thirty nine people who meet the governor's definition of medically vulnerable per that executive order. How many of those are in permanent housing? How many have been referred to as SNP? How many people remain homeless? How many people are getting coordinated chronic care services. And this isn't all on you. You happened to highlight this for us.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: Yeah, I do. Because it's important for us. Is transparent. What you're going to see is the data and how we're tracking what you're talking about, which may be a narrower view in, but you'll see we're talking about the same metrics. So when we

[Krista McClure (Deputy Secretary, Agency of Human Services)]: get there, okay. Okay. So just really briefly, this gives you a sense of who mostly choices for care is also in the GA program at any given time. So we track that on a weekly basis. We started in July 2024 sharing data between DCF and Dale to be able to do this. So there have been 118 people served since then, 68 so far in state fiscal year '26. '27 currently, as Commissioner Bowen mentioned, are currently in both on choices for care and in the GA system. You'll see there's a dip in the summer, and then it goes back up as the winter has come.

[Chair Theresa Wood]: We

[Krista McClure (Deputy Secretary, Agency of Human Services)]: did a deep dive looking at state fiscal year 'twenty five. At the end of the fiscal year, anyone who had been on choices for parent and in GA that year, there were forty eight people that had left GA. Where did they go? So the graph on the screen shows where people went following GA. So nineteen percent secured an apartment. About seventeen percent were no longer clinically or financially eligible for choices for care or the other programs.

[Chair Theresa Wood]: Occasionally, we

[Krista McClure (Deputy Secretary, Agency of Human Services)]: have someone on the brain injury program or attended services or modern needs. Seventeen percent moved into a facility, a nursing facility, or a residential care home or assisted living. Fifteen percent decided to private pay at the motel. And then you'll see smaller numbers for other categories.

[Chair Theresa Wood]: That's exactly what I was talking about. So thank you. And really talking about for that larger cohort that the governor included in his executive order. So it would be great to work with whatever community partners that we could have an update of that, not just right then here, but

[Krista McClure (Deputy Secretary, Agency of Human Services)]: this is great. Great. And the next slide just shows you that breakdown in actual real numbers. So you can see nine secondured an apartment of the 48 total, for example.

[Chair Theresa Wood]: I'll move on

[Krista McClure (Deputy Secretary, Agency of Human Services)]: to current Dale and ASD efforts to support unhoused participants. So one of the things that we do is we do that data sharing, and then we communicate with the AAA's management directors on a weekly basis to inform them of the individuals on choices for care and in GA, offer support as needed, and ensure that they're prioritizing case management for those individuals. Regular communication, ongoing. As Commissioner Bowen shared, we held two retreats, all day retreats, with the AAAs in 2025, one in the spring and one in the fall, to really deep dive on this issue. We included executive directors, case managers, options counselors to really talk it through what was working, what wasn't working, what could we do better, what are the processes we could improve, What resources were they needing or the training that they were needing? Those have been really helpful conversations. Got another one scheduled this spring as well to continue that work. For example, one thing that came out of that first retreat was they were saying, we're spending a lot more time on case management with unhoused individuals than a typical Choices for Care participant. Normally, under Choices for Care, you have a maximum of forty eight hours a year of case management. You're spending forty eight hours in a month or two with someone who might be unhoused. Definitely have heard that. So we created a simplified and expedited variance process so they could easily request additional hours and be authorized to be able to bill for those hours to make it a lot easier to be able to continue to provide that service.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: But I think this is exactly what you have been talking about, the intensity with which they need to be out there and with them, and to find out there's sort of a barrier to that, and we could break

[Chair Theresa Wood]: it down. That's Yeah, that's great. I mean, is all really good and it's for those people who are on CFC already, they've already gone through an eligibility process. Because that's how we started. Right, so mostly concerned, because I know you guys are tracking these folks. Do you provide the same kind of information or how does the AAAs find out about other people who might be eligible for choices for care or other ASD services that haven't been recognized yet?

[Krista McClure (Deputy Secretary, Agency of Human Services)]: It might be the next slide, is it? Well, we don't track that at a statewide level. That's really that connection at the local level that we were talking about is where the folks that are not on our programs are most likely connecting between the shelter and the AAA. I think there's more we could do there.

[Chair Theresa Wood]: Yeah, I mean, I

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: think it's great, the

[Chair Theresa Wood]: information flow between the department and AAAs around people who've been determined eligible for choices for care. I think that the real concern is those folks who haven't yet reached that stage. I guess I'd be interested, and maybe we'll hear from the AAAs to hear directly from them maybe about how they're doing the outreach in hotels, in local shelters, for those folks who the community providers, other community providers are seeing as needing more services than they're able to provide. But they may be, as you pointed out, Commissioner, they may be eligible for something where we actually do have funding. That missing link, don't think we feel like we have quite gotten there yet. Representative Noyes.

[Rep. Daniel Noyes (Clerk)]: Thank you. Thank you for your work, helping the Vermonters end up in this situation. I was wondering if you track, or actually it'd be helpful to hear, about how long people are interacting with case management before they have moved out of GA housing. So in other words, are you tracking the individual from when they first present in GA housing to when they find a more stable housing situation? And how long does that last? Just the individual, like, you know, I can see people being in a shelter for an extended period of time. And I'm just wondering, like from start to finish.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: Yeah, I'm gonna let Angela answer that with specificity, but let me say that so much of it depends on what the person is willing to accept and what is available at that moment. So somebody could pretty quickly be connected up to alternative option. They become eligible for it. They become accepted for it. And what we would like is that they actually take advantage of it, because that opens up a space for somebody else who might not have another option. So it's so variable. But maybe you have more specific data.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: I know at the Adult Services Division, they're looking at, in choices for care, they're looking at every individual every week. Are they still in the shelter or in GA? What is the situation? Touching base with that case manager and seeing how long that person is there over time. It can vary really significantly. If that person is interested in a facility placement, immediately that work towards admission begins as soon as they've talked to their case manager. Sometimes it takes much longer to work with people.

[Rep. Daniel Noyes (Clerk)]: Do you have that data you could share from first over time? I'm interested to see what the timeframe is of receiving case management, how long? Some people it might be first interaction. Other people, like you said, might be a lot longer with no conclusion at the end. They might decide to miss on one of your things to live outside.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: So just an example, just to put a sort of human based example on it. One case manager put in one hundred and twenty hours of case management in four months, which was thirty hours per month with one individual. He was using substances for a long time. When he finally decided that he would accept the case management assistance to set him up with a rep payee so he would no longer spend his money on substances. He owed a lot of back rents and unpaid utility bills because he was running out of DA time. Finally, he was willing at that point to have referrals made to both nursing homes and assisted family care. So it was four months

[Chair Theresa Wood]: of extensive work with that institution. Until he got to

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: the point where he trusted the case manager enough and recognized his limitations and his challenges and said, I'm ready. So you just never know when that moment's gonna happen, you never give up.

[Rep. Daniel Noyes (Clerk)]: And I was just looking at your report from December and the number of individuals, 65 plus is 119. This is the report that came out on the twenty second. And I'm just like each month, it's, you know, there's, I keep an eye it, it's like 8,100. And I'm just wondering how many new people are coming in and how many people are leaving GA housing to a more secure And then also, anyone coming back? Like, you placed them and it didn't work out and they end up back in that situation.

[Chair Theresa Wood]: So I'm going to thank you for all the information about all the training that's being provided to the AAA case managers, but I'm gonna move us a Yes, bit past where would you like me to speak? I think that if we know about Sash and the Bell family and shared living, the residential care homes, it's helpful to know that 81, and it's 81 out of how many except Medicaid?

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: The

[Krista McClure (Deputy Secretary, Agency of Human Services)]: total, I'm not sure.

[Chair Theresa Wood]: Okay, that would be helpful to know. We're obviously trying to encourage people to accept Medicaid and ResCare by increasing those rates. And thank you for talking about how to support those homes to be more flexible. Let's move to nursing home.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: We do have from the other side, from the different receiving facilities, how many people they have taken. So it's interesting to see it for both

[Chair Theresa Wood]: Yeah, yeah. No, that definitely is one of

[Krista McClure (Deputy Secretary, Agency of Human Services)]: We just wanted to show the work of thoughts that contain.

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: Exactly. Yeah, I appreciate that. So current nursing home data,

[Krista McClure (Deputy Secretary, Agency of Human Services)]: let's touch on that slide briefly. So right now, have 30 I pulled out Green Mountain nursing homes. I think that's closing in April. So not counting that one, we have 32 nursing homes that accept Medicaid, 2,814 licensed beds. Almost 2,500 of those are occupied. So that's an occupancy rate of 88%. It's been increasing since the pandemic. And about two twenty seven unoccupied beds with an availability rate of 8%.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: Some of which are short term beds.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: So yes, to just unpack that a little bit, it's really common for a nursing home to have some unoccupied beds. We only have a small number of them that have a significant number of unoccupied beds. And we're working with that. Are a variety of reasons for that. It could be quality issues or financial issues or workforce issues at that facility. We're working with them on that. But as we've talked about, some unoccupied beds are not actually really available for a variety of reasons. They could be short term rehab, private pay, male or female, for incoming admissions that are already in process, or a resident who's left to be hospitalized and is coming back, a variety of reasons. But we do know we want to maximize all of the beds that we do have. So what are we doing to increase access to nursing homes? We're really doing a multi year planning process right now to stabilize and sustain our nursing homes, to build capacity and infrastructure needed to be able to serve more people at that level of care. So we're focusing in five to four areas: capacity building and infrastructure, workforce recruitment and retention, financial stability and viability, quality of care, and access to complex care. These are all really connected. And so we are working on a planning process with strategies under each of those goal areas and bringing in stakeholders to really work together with the nursing home industry to increase access. Right now, we're also doing a deeper dive into barriers, specific barriers to those unoccupied beds. Because sometimes, even with staffing, nursing homes deny admission to people with complex needs. We know this. It's often due to needs that involve severe mental illness, active substance use disorder, behaviors like combativeness, or really acute medical needs beyond what a SNF can manage. So we're really working to try to identify all of those barriers, and then including sometimes that includes people who are unhoused or coming from homelessness, to better understand those and then address them on a more systematic way.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: Right, we really want to get to that. Let's go to the next slide for a second.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Okay, just that innovation, it's just

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: such a sweet story. I just want to So two individuals in a hotel this year became friends, and one became the informal caregiver for the other. And with support from the AAA taste manager, they found a department together supporting each other to heal and grow. So they made friends and then they could be okay, it was

[Chair Theresa Wood]: That's nice. So those are the kinds of informal kind of support systems that- Of course, would love to have promising opportunities like that for people. Maybe they just need a little bit of support in order for that to happen.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: Exactly. Let's talk about what is So being as part

[Chair Theresa Wood]: of the EHS housing initiative Can we just back up a little There's particular interest in Rutland County, so I don't want to gloss over the partnership example that you gave. So would you mind just talking a little bit about that? Absolutely. And in talking with the Southwestern Vermont Council on Aging, they're really proud of the work with Rutland Regional on this project,

[Krista McClure (Deputy Secretary, Agency of Human Services)]: which really involves increased communication and collaboration and team meetings to support people who are presenting in the emergency room who aren't homeless. And it shows that they did a research project looking at before they were doing this intensive collaboration and after. And they were able to reduce ER usage over the course of the year through that collaboration. It just

[Chair Theresa Wood]: Get them out faster. And it's managed specifically for older Vermonters? Specifically for older Vermonters, yes. And of course, we know that ER is one of the most expensive places to be. Exactly.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: But it's kind of teaming to have that kind of outcome. That's the

[Chair Theresa Wood]: kind of data that's helpful to sell the story. Exactly.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Relationship and trust building between the hospital and the AAA really helped make

[Rep. Eric Maguire]: that successful.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: We've been working on that. Hospital by hospital by hospital, we've been out there meeting with the CEOs and working with them on support for doing those sorts of teamings and to be to think of this as a system with your community health partners.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Okay, so last but not least.

[Emily Haas (Commissioner, Department of Mental Health)]: Are you going to

[Chair Theresa Wood]: use the $2,600,000

[Rep. Esme Cole]: Yes, we're going to use the $2,600,000

[Krista McClure (Deputy Secretary, Agency of Human Services)]: We're going to use the $2,600,000 to try out a new model of a specialized care shelter.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: Or two.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Or two, yes. The idea would be to create specialized shelter capacity for people who are medically vulnerable. They don't necessarily have to be older Vermonters, but many would be. Starting out with one in the North and one in the South, building this capacity in this next fiscal year. And the shelter would have embedded services right there on-site for people, whether that's personal care needs or skilled nursing for wound care. And obviously, case management would be a part of that as well. It would need, in order for this model to be successful, it will need to be a really strong collaboration between a shelter provider and a health care provider, a home health agency, FQHC, that type of collaboration. This doesn't negate all of the work we need to do to support people in all the shelters in GA and across the system. But we have been hearing as well that this is a really unmet need of people not getting the appropriate care that they need in our hotels or our shelters as they're currently laid out. They need a safe place, an accessible place, and a place that has the services.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: And this would start with 30 in each?

[Chair Theresa Wood]: 30 in each? So we have a lot of questions about that, and I'm just trying to be aware of we have floor time at 03:30 and we're definitely running over, but I have a lot of questions about this. And we're gonna have you in for budget. So I'm gonna ask folks to hold their questions on this and we will ask further questions about it when we have you in for your budget presentation.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: You wanna send them in advance so that we can No, I can not. Okay. I'm just kidding.

[Chair Theresa Wood]: What we could say? One of the biggest is understanding how the development of these shelters or expansion may be at current shelters with specialized services might work in concert with nursing facility beds that we already budget and pay for. So that intersection will be important to understand and sell us on. So thank you both for being here, we really appreciate it. Thank you. And we're gonna switch things up a little bit, and Emily, I think you're gonna be on next with whomever you want to bring with you. All right, welcome. I see everybody's gotten the word about the PowerPoint.

[Emily Haas (Commissioner, Department of Mental Health)]: Stuff.

[Chair Theresa Wood]: Great. So let's focus on those things that you're currently doing. And then also how that might change through this proposal.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: Okay, perfect. And we'll start with introductions. I'm Samantha Sweet, Deputy Commissioner at the Department of Mental Health. Hi, everyone. I'm Kristen Briggs, Director of Mental Health Services at the Department of Mental Health. Welcome. Thank you. And Kristen is going to take the lead, and I am color, side cancer.

[Rep. Esme Cole]: I don't know. Filling

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: gaps. Yes,

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: thank you. So we'll start with some of the things that we're doing and, of course, acknowledging that we need system improvement. So we'll see what is needed in addition to that. So in terms of DMH specifically, for housing support programs, we have multiple services through multiple programs providing mental health and case management services for folks who are unhoused or experiencing housing stability in the same way that anyone would be receiving those supports, but also there are additional needs with folks who are unhoused. Some of the other support that is offered is through direct financial assistance. And we'll go more in-depth in further slides, but we've got the pre tenancy and tenancy supports the PATH program, Pathways Vermont, the designated agencies, and then the housing support funds and subsidy and care program. So go to the next slide, get into the details. So the projects for assistance in transition from homelessness, otherwise known as PATH, We've listed the agencies that we're referring to at the bottom here, in addition to how many outreach staff there are at each of those, for ease of reference. And these PATH agencies or providers are serving individuals with serious mental illness who are experiencing homelessness and typically not otherwise engaged with mental health services in the system of care. And SAMHSA provides funding for the services specifically for individuals with, serious mental illness who are unhoused. These services include outreach, screening, diagnosis, habilitation and rehabilitation, community mental health and substance use disorder treatment, referrals for primary care, job training, education services, and housing. And there's some specific housing services, public health, because of the Public Health Service Act. Once folks are engaged with the PATH provider agency, they are then referred to community affordable housing opportunities and long term supported services. So there's some folks who are served longer than others under this programming. And then once they're engaged, the PATH provider agency refers them to the community affordable housing opportunities and long term supportive services. We're highlighting the number of staff here because it's probably not a surprise to folks that, as you've mentioned earlier and has been talked about in earlier testimony, the number of unhoused individuals continues to rise. And even though there's a lot of success stories around the folks moving through that system, there's folks returning to being unhoused and higher numbers. And so what we've discussed and have heard about from these PATH providers is that these staff are very busy doing this outreach. And of course, there is more outreach needed than what is currently being provided. So we just wanted you to see, this is what's actually happening in terms of the amount of staff that each are providing that outreach. There were a total of three ninety two people contacted by PATH funded staff in sorry, I should say that there's a report link right at the bottom there. And it's fiscal year 'twenty three because that is the most recent completed report. And in that report, which you could click into, it says that there's three ninety two total people who were contacted by PATH funded staff. Two fifty one of them were with active enrolled PATH status at any point during that reporting period. Sixty nine percent of the contacted unhoused folks with serious mental illness who became enrolled in services, and then the sixty one people who were actively enrolled in PATH as PATH clients receiving community mental health services through any funding source at any point during that reporting period. I know I went through that quickly because of time. Right. Can The report is fair. So, committee members,

[Chair Theresa Wood]: I just want you to know that I have asked the speaker to be excused from floor time today, but I'm waiting to hear. I understand. I think it's important that we get the full picture. We still have another department. And I don't want to short it for anybody on timing because particularly we want to understand better this because those numbers that you just shared, that's great for those small number of individuals. Think you know that the numbers are much larger than that for people who have serious mental illness who are accessing shelter and or GA services. This doesn't, can you give us a sense when somebody is outreached and you talk about the services that they get, what's the length of time that they receive those supportive services? How long do the PAP providers follow them? We don't have that data in front of me,

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: but I can certainly, we can get back to you with that. But I can share that there are multiple supports that happen for a specific individual through the length of time that they're on house. I can get some more specific data to certain people.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: Okay. And can I fill in, too? The hope is that the PATH outreach provider is doing the outreach and then identifying someone needs ongoing supports and making the referral. So we're hoping it's just a few times and then warm handoff to either pathways or one of the designated agencies for ongoing services.

[Chair Theresa Wood]: And one of the things and maybe you'll sorry, I haven't looked at the head. Maybe you'll address this. But I'm not seeing it. One of the things that we really heard a need for is specific housing and programs related to or for individuals with mental health challenges. And Matt, could you talk a little bit about that as you move through? And if you cover that, then we'll all wait till you get to it. I just wanted to highlight that as something you cover, because we definitely heard that in yesterday's testimony that many of our shelter providers and people in the hotels really are not feeling equipped to provide the supports and services and are really looking for the specialized supports that DMH is responsible for. Yes, we do speak to

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: that in a further slide of what our approach to getting supports to those individuals.

[Chair Theresa Wood]: Yeah, okay.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: You. Pathways Vermont, we're highlighting here.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: Can we go to

[Chair Theresa Wood]: the back one?

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: There you go.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: Yes, Pathways Vermont. You'll see the map here. The blue is the counties that they serve, most recently Bennington being added to that list. So they provide services for adults with high acuity mental health needs, including, of course, individuals with serious mental illness who are experiencing homelessness by HUD definition. Folks, the individuals are served through the specialized service agency pathways and might be referred from designated agencies for appropriateness of fit for what Pathways can offer. They could also be referred from hospitals, other various community partners, or somebody could self refer to Pathways for our services. There are minimal service requirements for individuals to allow them to preserve their choice and, of course, self determination or autonomy in what their individual goals are. And then Pathways supports with permanent supportive housing program, which is funded by DMH. This serves the counties that are highlighted on the map. And they also I know we said there's referral sources there, but they partner with also other designated agencies where there might be needs for individuals where there's identified gaps.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: And I'll just add that to speak to your point just a minute ago, pathways, we do rely heavily on pathways to be an agency that is housing first. And so finding housing, working with landlords to provide the housing. And oftentimes, what we see is pathways, leases, and clients sublease out of pathways. And so that model has worked for them.

[Chair Theresa Wood]: We have a question here. Yeah, just to share a point earlier, what is the timeline for the case management? So a limit for the timeline in Pathways program? Is it something like two years?

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: So there isn't a limit on that timeline for case management. When somebody is engaged in their services, they continue to work with them while they're engaged, similar to other service providers, I guess I'll say. But the frequency or intensity with which people are receiving those supports depends on where they're at and what supports they're needing.

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: What's the base shuttle? How many people is one case manager support? How

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: many clients does one case manager serve? Great question.

[Emily Haas (Commissioner, Department of Mental Health)]: Yeah, that's a great question. I

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: could get

[Krista McClure (Deputy Secretary, Agency of Human Services)]: back to you

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: on that. Don't have that in front For

[Emily Haas (Commissioner, Department of Mental Health)]: the record, Emily Haas, Commissioner for the Department of Mental Health. I'm wondering when the both of you were in, myself included, when I did case management, the average caseload was around 26 folks working with, and then depending on how many of that are weekly or once a month, or just depending on what's the treatment plan is developed with that particular individual, what that need is. Yes. And how

[Chair Theresa Wood]: many people, so through Pathways, is Pathways the only place where you're

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: providing residential services? So Pathways doesn't provide specific residential. And so that's more our designated agencies, which we'll get into. Pathways really is about finding permanent housing in the communities that

[Chair Theresa Wood]: they serve. So connecting them to housing. I guess I'm going to follow-up on a question that somebody else asked. Because we're seeing just a recurrence into homelessness after people have been in permanent housing. And what we hear anecdotally, I don't know what the data is, but that those folks have significant mental health challenges. And so what's the length of time that people follow folks once they have been placed into permanent housing for that follow along? As

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: they long meet medical necessity to receive the services, then they're ongoing. So there's no time limit as long as Pathways, the person needs the services, Pathways will continue working with them. So it's based on their medical need, whatever their

[Chair Theresa Wood]: needs are based on their mental health diagnosis. So there's no time limit. You have any range? For instance, of people who, I mean, this is a provider that really kind of focuses on people who are homeless with mental So health

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: you have any range? It's long term because they work with serious mental ill individuals with serious mental illness. So oftentimes what we see length of stay in services for those individuals is a longer term. Yes. So years.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: Years. And we'll go into what the supports, pre tenancy supports and tenancy supports look like in the next slide, which might speak to some of how that differs. And does the department have any

[Chair Theresa Wood]: intentions, or is it in the FY 'twenty seven budget to expand Pathways access into unserved areas now? No, we do not.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: So this slide highlights, again, what services or supports an individual would receive prior to finding that permanent housing, and then when they're in housing, what supports. So it could be helping with identifying and assessing barriers to the individual for housing, credit challenges, if they have criminal history, rental debt from the past. Also individualized supports as necessary around securing documentation, like IDs, proof of income, applications, and obtaining vouchers. Finding units, of course, available units to apply the vouchers to would be things that are all in place or should be in place for services prior to someone getting housing. I know earlier, we're not going to spend time talking about whether or not the units or vouchers are there. We spoke to that in the earlier testimony, but that's the design of what would be happening pre tenancy for supports, in addition to the case management that addresses the other needs, which Deputy Commissioner was speaking to with

[Chair Theresa Wood]: the medically necessary I was looking ahead, sorry. Did say so this is with voucher use. But are any of these resources available to use for short term rental assistance or longer term rental assistance in the absence of a voucher? Yes.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: So we do speak to that in just a few minutes. You'll see that housing support funds we use for short term rental assistance. So definitely recognizing vouchers are needed. But in the short term, we do use housing support funds. And all 10 designated agencies and pathways receive housing support funds. Yes. Thank you. Yep.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: And then once somebody has housing, supports could be continuing to collaborate with landlords to address any concerns that would hopefully help an individual remain in that housing. The case management that we spoke about, partnering with other organizations and community partners to provide the wraparound services, continuing to check-in on that landlord and tenant relationship, again, positively or trying to proactively address the issues that could come up, connecting ongoing rental subsidies or, sorry, rental cost needs and also any emergencies that could come up that could be some sort of higher build than usual or something like that related to the housing where they could get a one time support for that. And anything that could help somebody sort of mitigate the risk for being evicted from a unit, really. And then also supporting in either directly providing training or access to training for household management things, financial literacy, conflict resolution, things that help individuals be more set up for success to remain in that community setting. So how many are sort of done on

[Chair Theresa Wood]: an annual basis through different ways? And are there any waiting lists for the services? Oh, you have that up already. There we go. Their website says two twenty two with an 85% housing retention rate. That's just for permanent supportive housing. That's just permanent supportive housing.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: Yes. And we could get back to you with the specific data on the other question of just generally how many people they're supporting.

[Chair Theresa Wood]: Well, I mean, obviously we know that the need is surpassing the people who are being served. And so understanding sort of what the, I can't think of the right term and graduation rate is not what I'm thinking, but the sort of turnover rate of people who move through the system and don't need the supports anymore, or don't desire them anymore. What is the capacity, I guess, of the system on an annual basis of the system that you have right now to assist individuals and recognizing that it's voluntary, that people are not, if they're not interested, does it sometimes matter how much outreach you do, they may still not be interested. Get that. And that's for everything, for all the people that we've talked to today, I get that. So we're just trying to get a sense of capacity of the existing system around homelessness supports and then how this proposal impacts the existing system. Absolutely.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: I'll just add before we move on. There is no wait list. So for anyone that needs the services in the, what we formerly used to call CRT, it's now called SMI, serious mental illness. We are not allowed to have waitlists. And so all the DAs and pathways can serve individuals as they come in and need those services.

[Chair Theresa Wood]: Okay, thank you. Yep.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: And then we'll get into some of the other pieces of what you were speaking to in further slides. Switch to the next slide. So again, we have a map highlighting which agencies are in which locations across Vermont, the designated agencies. This is the housing supports that folks could expect to receive. So for each designated agency, clients with, again, high acuity mental health needs, including individuals with serious mental illness, receive case management, and that may include intensive housing supports. I think you spoke to this a moment ago, but depending on how much somebody is wanting those supports and what their goals are and informs the treatment plan for how expensive the supports are specific to housing or whatever other needs individuals might have. And is that available in all 14 counties? Is that, it's provided by designated agencies, so I know it's And

[Chair Theresa Wood]: what's the capacity for that type of housing

[Dr. Jill Bowen (Commissioner, Department of Disabilities, Aging & Independent Living)]: in the For

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: the type of housing?

[Chair Theresa Wood]: Well, with high acuity mental health needs that I guess, I'm trying to figure out. We've heard that people need specific housing related to not just the fact that they're homeless, but related to their mental health challenges and that they may need it for a longer term, and some may need it for an extended period of time. And I'm trying to figure out how this all comports with, I know that there's changes happening in residential right now around how payments are made and some of the longer term stuff. I don't know, at least I know in Waterbury, I know there's change happening. So I'm trying to figure out what do we have for capacity for people who need specialized mental health residential support. And I mean, a place. Talking about.

[Emily Haas (Commissioner, Department of Mental Health)]: And I don't think you're meeting, maybe you are, but like group home living with staff. Are you?

[Chair Theresa Wood]: I'm meaning any type of variety. Okay, great. That would in group

[Emily Haas (Commissioner, Department of Mental Health)]: I think that's helpful to narrow down that it's the whole scope, not just independent living with mental health supports. Exactly. It's different than a residential setting. Yes. So I think that's what you're asking is the whole gamut.

[Chair Theresa Wood]: Yes. Don't need to talk to the psychiatric care hospital. We know that's separate. Yes. I'm talking about the community based

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: supports. So residential treatments that somebody could be engaging with. Sort of along the continuum. I mean,

[Chair Theresa Wood]: what I'm hearing you say is that you could support people in their own apartments with mental health supports, but also yes, residential treatment per se, and maybe just longer term group or small group living, looking for the capacity. So I can speak

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: to that a little bit while you're pulling it up. And so eight out of 10 of the designated agencies have residential beds in their system. And so we also in order to utilize those beds, someone needs to meet the need to live in a residential. So it cannot be just that someone is unhoused and then we give them a residential bed. It needs that they meet that level of care to move into the residential, to gain skills of independent living, whatever the skills may be to gain and then hopefully move out into whatever the next step may be. So we have a number of residential beds in our system. And we have July 1 this past year, we needed to move from HCBS waiver into the state plan, which means that everything needs to be rehabilitated. And so in the past, we have had individuals living in residentials for long, long term, using it as permanent housing. We can no longer do that. So what we're expecting to see is more turnover of those beds. And so individuals gain the skills that they need and move either into independent living, nursing home, whatever the next step may be, but that we'll see those beds turn over so that more people can utilize that level of care.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: And there are residential programs not funded in this way through us that exist in communities as well. So that might be a longer term option for individuals also.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: So this is our pyramid, which may help a little bit. So the very top tier is our most intensive, most acute system, which is inpatient hospitalization, all the way to the bottom level, which is our community based services, which we take pride in that most of our services are out in the community, right? We don't want to see people in the hospital if that's not what they need. We want people receiving services in their community, and that includes residential care beds. And that's really small from here. I can't tell you how many beds. There you go. Thank you. So this is how many beds we have in our current system. You'll see that we have crisis beds, which is not long term, right? Someone goes into a crisis bed, which all 10 designated agencies have crisis beds in their system. And so we have 38 beds across the state, and then we have adult intensive residentials, which is 42. Those beds are intended to step people out of the hospital. That's not to say that we don't see individuals going from the community into intensive residential, but most of them are coming out of the hospital and needing that intensive residential before they move back into their own community. And then we do have peer service agencies that also provide crisis beds, which two beds for a list of and adult intensive residentials, which is out of pathways. And then we do have secure residential, which is River Valley, and that's 16 beds. And that is a locked facility.

[Chair Theresa Wood]: So it's not surprising to me, I guess I would say, that what we are hearing from shelter providers and other community partners is honestly something that doesn't fit into most of this up here. That is, I guess, something that feels like it's missing in the system if is what Well, what's not on this slide is our residential beds. So we don't have that.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: We should add that. We don't have the number of adult residential beds in our system. We know eight out of 10 designated agencies have residential beds and it's around

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: 50 beds 100 are residential. Statewide, yes. So that's not a

[Chair Theresa Wood]: requirement to have I'm just surprised that only eight out of 10, not all 10, have that. So, actually, it would be great if you could add that figure to this and then send us this slide. Would be great.

[Emily Haas (Commissioner, Department of Mental Health)]: And there's a variety of reasons why an agency may choose or not choose to do residential. In this climate, they're very, very difficult to staff any 20 fourseven service. And so most of the residentials that are happening that are less intense than our intensive residential program still do 20 fourseven staffing, but they might not have as much medical oversight or nursing oversight, but those some agencies, you know, aren't able to do that. And our residential system is not necessarily community specific. An individual can go to an intensive residential in the Washington County area if they're from Chittenden or Rutland, there is some choice there.

[Chair Theresa Wood]: Thank you. That's helpful. I guess I would say still points to what we're yeah. Getting that we're hearing about.

[Rep. Esme Cole]: So, Garof,

[Emily Haas (Commissioner, Department of Mental Health)]: what we need to think about when looking at these services is what's Medicaid eligible and what's cash. And so, part of the residential shift and transition is related to DMA residential programs needing to be rehabilitative, which means that an individual can recover from mental illness and move to independent living. And we separated out from the HCBS requirements, which were habilitative, which doesn't require somebody to move on. So in order for us to keep those programs, Medicaid eligible, they need to be rehabilitative, so folks are moving through that system. Okay.

[Chair Theresa Wood]: Thank you. So, what I'm gonna ask a little bit is if you can focus your comments on, I'm looking for your portion of this. Maybe you don't have a portion. You don't have a portion on this. The place where we see the most need is a place that's not addressed in this plan. Okay. That's just Yeah, there's something I'm not sure

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: what you're looking at. So I'm looking at the DCS. Yes,

[Chair Theresa Wood]: we do have some I thought that there was something here, but I was having a hard time seeing it.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: So just to share a data point briefly, because I know it's we've been focusing on the amount of people who are utilizing the emergency housing GA program. So as of the January 21, there were thirty five clients with serious mental illness who were utilizing that specific program, which was a decrease from one from the week prior.

[Chair Theresa Wood]: And you know that how?

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: Similar to the other AHS departments, there's a data collection point where we're able to see the qualifying criteria of how somebody was able to utilize that program. And though it's not called CRT anymore, it's individuals with SMI, that is still criteria that we're able to track and then ultimately work with the designated agencies and pathways around what work is happening with those individuals who are utilizing the emergency housing GA program to help move them on from that program.

[Chair Theresa Wood]: I think it's gonna be important and helpful for the committee to be, I guess, trying to reconcile what we hear from the other community partners with what we're hearing from AHS. And sometimes they align and sometimes they don't align, and trying to figure out how we improve the system with the resources that we have, and I guess where the flex points are and where they're not. Because we definitely, even though we're hearing about lots of wonderful things that happen across AHS, we're also hearing about all of the challenges that exist for 4,500 people out there, which is not insignificant for a state this size. So that's more of a comment, not necessarily particularly directed at DMH, but I see places in this proposal where they intersect and then other places where it doesn't quite capture the need. And I appreciate that, and I would also should add that, of course, somebody could have a mental health need or a mental health diagnosis that might not meet the threshold for serious mental illness. They could, the same time, have a family, be an older Vermont or have another need where they might be tracked a different way or have multiple needs at once.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: And so we're certainly not the methods that this is the total of individuals with kind of Yeah, I can't in that program. Do

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: you want to move to the proposal now? And we'll do that. That would be great.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: I'm just going to take yours. Thank you. So our proposal is to embed mental health services into shelters. We feel that it makes sense for individuals to be able to remain in the community in which they're accessing the services to address the housing needs, and also be able to get the mental health support. So in order to strengthen access to services for folks who may not be otherwise engaged in services or to help fill the gap of needs that may not be addressed either by shelter staff or the designated agency or SSA agency system that they're involved with. So our proposal is to embed mental health staff for ten hours a week into the shelter, again, to help fill that gap. And the times would be determined by when are the most people actually in the shelter, because we know that there are often after hours times where people aren't in the shelter. So working individually at the local level to figure out when are these the most needs, where most people could be engaged with these folks. This wouldn't be supplanting whatever services and supports that they'll provide or what services and supports the designated agencies would be providing. It's again to help fill the gap and engage folks and encourage them to access services that they might not be involved with. This would help to expand outreach assessment referral capacity, again, for those who aren't yet connected. And it would allow for a closer look at what gaps continue to exist and maybe what some of the barriers are to accessing those services. And again, would allow people already engaging in services to continue with their current team and not need to move away from what services they are getting to be located someplace specifically because of a mental health need.

[Chair Theresa Wood]: So Sandy or Kristin, you're gonna have to help me identify where that is in here, because I don't see it in here, but it probably is here someplace, it just has a different name than, and I don't see DMH mentioned here. If you all are going to need to help us now. Can I ask? Completely fine. Yeah, go ahead. Have a follow-up. So is this proposal, is this being absorbed in your current budget, Or is there a request for an appropriation to kind of cover this additional service? This would be a part of a request for an appropriation to help cover this service. So I guess that's the piece that I can't find. I don't find any. Go ahead, Deputy Secretary.

[Krista McClure (Deputy Secretary, Agency of Human Services)]: So you can segment that out separately. We wouldn't say shelter, station services, that's how we have it together, but we

[Chair Theresa Wood]: can segment that out separately. Thank you. I think it would be helpful because it's just one of the things we hear over and over and over again about the mental health needs of people, and so a recognition that's trying to be addressed in this way would be helpful. Okay.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: Any last questions? I know we skipped a few slides about what's currently done in the system. But I know we're up against time, so any last questions?

[Chair Theresa Wood]: Thank you. I think you've definitely provided us with some background, and we'll be able to go back and look at this stuff. One of the things you didn't mention is your Chittenden County outreach program, which is slated to be cut. And I know I mentioned that earlier, but for this crowd this afternoon, we just hear over and over again how helpful that is in Chittenden County, obviously because it's for Chittenden County, but how many sort of, I guess I would say non housing providers and non shelter providers, but also including shelter providers that access that service in Chittenden County. So that's a real concern for us in terms of- We can speak to that if you would like. Just That would be great.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: Yeah, we're proposing to cut it because we are trying to streamline and look at all our services and what is duplicative. That's a word. So we're trying to We have enhanced mobile crisis all throughout the state. We've put a lot of effort, a lot of funding into enhanced mobile crisis. It's a two person response, a clinician and a peer 20 fourseven. And so right now with community outreach, we have five to six staff hired by Howard Center that's providing services to nine towns. Of those nine towns, two in one quarter received single digit outreaches. 35% of those in the quarter were face to face. The rest were either on the phone or collaborative, so with reaching out, making referrals, things like that, talking to other professionals. So that is something that we see that Enhanced Mobile Crisis can do. Move those staff over to Enhanced Mobile Crisis. It's 20. The towns will receive the same level of services. We have nine eighty eight that actually can provide the service of the phone. So there's 20 as well. And we're actually implementing behavioral health link where someone could call 988 and 988 can dispatch mobile crisis through behavioral health link. So that's coming in this year. And so we have a lot of services in our crisis system of care that can provide actually more coverage to those towns.

[Chair Theresa Wood]: Can I add on that, Yeah,

[Emily Haas (Commissioner, Department of Mental Health)]: absolutely? Along with Behavioral Health Link program, Vermont is also one of the first in the nation to adopt 911 to 988 protocols, which empowers 911 folks to transition the call over to 988, and so that those professionals can work with the caller to determine whether or not an outreach can happen. With community outreach, which is only in existence in Chittenden County, we do believe that to be a historical program that served what it needed to serve when it was implemented. And we've innovated the system into a more efficient and collaborative approach to serving our communities. And so our goal would be that those nine towns don't feel that they don't have the community outreach that we have in place, the communication plan, and the ability to engage with enhanced local crisis at 988.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: Is 98820 It sure is.

[Emily Haas (Commissioner, Department of Mental Health)]: And Vermonters are one of the highest utilizers of 988 nationally.

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: That's great for cap.

[Chair Theresa Wood]: It's great to hear that we're getting that information out there and it's I feel like I'm inclined to. You

[Emily Haas (Commissioner, Department of Mental Health)]: might see them on bridges or in sandals,

[Rep. Esme Cole]: I don't know, once we try

[Chair Theresa Wood]: to sign We them can put a sticker and help somebody A to still shed

[Emily Haas (Commissioner, Department of Mental Health)]: location for someone who is experiencing a need for additional help and also someone who may be sitting with somebody or seeing it, they can call as well. That centralized dispatch is really what we want

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: to take of. So you

[Renee B. (Director of Complex Care and Field Services, AHS)]: made a point of saying

[Chair Theresa Wood]: the connection between 211 and 988. 911. I mean, 11. At 911. Yes. I was just going ask that question.

[Emily Haas (Commissioner, Department of Mental Health)]: And so representative, what ultimately that means is that law enforcement is responding less to people in a mental health crisis and that mental health professionals, two person response, person with lived experience are the folks who are responding to those individuals in the community.

[Chair Theresa Wood]: Yeah, I'm just thinking that people who are experiencing homelessness and are having mental health issues aren't necessarily going to be thinking about, oh, I can dial 9880.

[Emily Haas (Commissioner, Department of Mental Health)]: They can chat it, they can text it.

[Chair Theresa Wood]: They can, yeah.

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: The shelter staff, absolutely.

[Chair Theresa Wood]: Or the library can We've as also

[Unidentified Committee Member (possibly Vice Chair Golrang “Rey” Garofano)]: worked a lot to communicate with state, county and local professionals in the law enforcement side, and actually first responders in general, to make sure they're aware that any of them can call 988 about a situation to see what might be available for an individual and to help that person make the connection. And we have seen an increase in that. We have schools where teachers are reaching out to 988 during a class to demonstrate to kids how that call could look if they were in crisis and needed to reach out for the support. So we are continuing to really try to push the message of it's available like 911 is available when you're

[Chair Theresa Wood]: in Texas for mental health or substance use.

[Emily Haas (Commissioner, Department of Mental Health)]: And so with community outreach and with most of those interactions being phone, it does make sense to shift that to 988 who has the capability dispatching a team to that person.

[Chair Theresa Wood]: Okay, well, that's helpful to know. I don't know if I'm 100% convinced yet, but it's helpful to know that I understand what you're saying in terms of the systems have evolved, and we'll see how that gets torn out in actual real life on the street interactions for people if they feel like they are receiving as much support as they did before. Okay, thank you very much. We appreciate it. You hanging with us through the whole afternoon. And certainly last and definitely not least is Department of Corrections. I'm just kidding. There's only two of you on my list, so you're gonna Excuse me, yes. We're only very detailed. Okay, so just introduce yourselves for the record, that

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: would be wonderful. Thank you. Kristen Calvert, Deputy Commissioner.

[Rep. Eric Maguire]: Good afternoon, my name is Travis Denton. I am the Chief of Operations for Moncton Park of Corrections.

[Jill Moore (Housing Program Administrator, Department of Corrections)]: My name is Jill Moore. I'm the Housing Program Administrator for

[Chair Theresa Wood]: the Department of Corrections. Great. Thank you so much. Welcome. Appreciate it, and thank you

[Samantha Sweet (Deputy Commissioner, Department of Mental Health)]: for emphasizing not least. Appreciate that. Absolutely not. So I'm going to walk

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: you through just a high level DOC overview to level set since we're not in your committee often or at all. DOC is housed within the Vermont Agency of Human Services. We are a unified system, which is relatively unique nationally in that we serve pretrial supervision, detained individuals, sentenced individuals, and the full gamut of community supervision statuses. We have six facilities in state, five for men, one for women, and one contracted out of state facility that serves men only. We have 12 probation and parole offices throughout the state and about 1,100 staff. 2025, we had two fourteen new hires. But as many folks are, we are experiencing staffing difficulties. We have an overall 12% staff vacancy rate, facilities being higher due to the nature

[Renee B. (Director of Complex Care and Field Services, AHS)]: of that work, and at 14.6%

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: currently. Field is at 8.7%. So a very high level about our population, we serve sixteen seventy five folks who are incarcerated. That's detained and sentenced individuals. Total releases from incarceration in 2025 was over 4,000. Total returns was eight fifty five and just over almost 4,800 individuals under community supervision, the large amount being 3,800 on probation. So now I'll pass it to Jill, who is our housing expert.

[Jill Moore (Housing Program Administrator, Department of Corrections)]: So, in speaking about DOC transitional housing, caseworkers help sentence individuals find housing placements prior to release through our transitional housing grants. Our policy is that one year prior to the projected release date, they can start applying transitional housing. It's available to all individuals on field statuses, and what that means is the people on furlough, probation, and parole are served in our transitional housing. It's not just furlough. Transitional housing programs provide wraparound services to our individuals. We really like to stress that our transitional housing are programs, not just beds. People don't just sleep there for the night. They provide wraparound services, case management services, and they really like to do that in individualized support based on specific needs and not taking the one size fits all approach to our individuals and our population. In addition to transitional housing, we also have housing supports that we call stabilization funds. So, that can be a two piece. It could be that an incarcerated individual has identified an apartment that they can move into, but they really just need first, last, and security in order to help them move in there, so they can request those funds and move into that apartment with the help of those stabilization funds. Or that could be somebody that's in transitional housing, let's say up to two years, and they really just need that security deposit and first fund's rent in order to move into that permanent housing, and

[Chair Theresa Wood]: they can request those funds as well too, through that stabilization fund. Can I just ask the question? Because we, again, we're just trying to reflect back what we hear in testimony. Of what we hear in testimony is people being released from correctional facilities to the GA housing program, emergency housing program, and trying to access an emergency hotel room. It doesn't seem as though, from what you're talking about, that that would be part of the person's discharge plan.

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: Is that accurate? No, it would not intentionally be part of the plan. There are situations where folks aren't able to secure housing prior to release. And if they have a max out date, you can't hold them beyond that. And so there are times when folks do go into that program, sir.

[Chair Theresa Wood]: Do you have any idea about, on an annual basis, what those numbers look like?

[Krista McClure (Deputy Secretary, Agency of Human Services)]: I don't have it on hand, but we're happy to follow-up with that. Okay, thanks.

[Chair Theresa Wood]: My question? Go ahead, Representative.

[Rep. Esme Cole]: Thank you. My questions are related as well. My type of data is an interesting term I hadn't known about because I don't know. I know there are some circumstances where folks are held longer than they would have been had they had a place to go. So, learning about the details and sort of the nature of how that process works and the rules around when and when we can release you and when we cannot release you, regardless of what you did, but rather because of the housing related issue.

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: I'm going to guess that that situation is applying to someone who's eligible for release prior to their maximum sentence. And that is possible where they might be held past that date, which is not a guarantee, to secure approved housing. Whereas if someone maxes out and apology for that terminology that's the total end of their incarcerated sentence. So we're not able to

[Chair Theresa Wood]: pull them past that legally.

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: Does that help verify?

[Chair Theresa Wood]: It does.

[Rep. Esme Cole]: And there are, of course, very valid reasons that somebody wouldn't serve the whole length of their sentence as determined by judges, by courts and lawyers. So on our end, doing everything that we can to reduce the amount of time that we're holding people for longer than they necessarily have to be there because we know it's happening as a result of them not having a place to go. And this seems like a critical, the transition program, a critical piece of that puzzle. I'm also curious if that one year allowance to start the process at one year ahead of time. Is that enough? Has that been working?

[Chair Theresa Wood]: Yeah, more on what we can do

[Rep. Esme Cole]: to fill the gap and prevent people from overstaying.

[Jill Moore (Housing Program Administrator, Department of Corrections)]: Yeah, so two pieces to that. One, the lack of housing that we're talking about if somebody can't be released to housing. We do a lot of quality control that are on the wait lists for our transitional housing, and we can pull those wait lists at any moment if we want to, to be able to say, why do you have just 10 individuals on your waitlist, do you have four open beds right now, what's the plan to move these people in to help that quality control and flow of the waitlist, making

[Lily Sojourner (Director, Office of Economic Opportunity, DCF)]: sure our beds are going

[Chair Theresa Wood]: be brought to the best of the ability,

[Jill Moore (Housing Program Administrator, Department of Corrections)]: and not keep people incarcerated for lack of housing because we don't want to see that either. Part A of your question. Part B is the policy actually used to be six months before their protective release date they could apply and it wasn't enough time,

[Chair Theresa Wood]: which is why we extended it to a year. That feels good, better? Yes, I think that provides enough time. Okay, thank you. Thank you.

[Jill Moore (Housing Program Administrator, Department of Corrections)]: So speaking of the stabilization funds, we also participate in local probation and parole offices, we find the nice, with sit tables, situation tables, and specifically that's usually around people that are too high level of need of our population for our transitional housing to say to the Department of Mental Health, maybe please help us. We can't serve this individual. Maybe you can. Is there a reentry plan that we can come up with so we can house this individual? Also working with Vermont Medicaid Reentry Program in partnership with BCCI. We are hopeful that our population will really take advantage of that, especially in the transitional housing space, which will just help without funds for our housing as well, too. So currently, DOC funds two fifteen transitional housing beds statewide. That's with 13 grantees, but that provides coverage to every single Prohibition and Parole site. So every probation and parole site has at least one transitional housing grantee they can release to or apply to. If that incarcerated individual doesn't want to return to their county or can't return to their county for public safety or victim concerns, they can certainly apply elsewhere. It doesn't mean that they have to release to Bennington County or they have to release to Rutland County. Whatever makes sense for their reentry plan is where they can apply. Underneath that, we have just a list of what our grantees provide as a range of services, earlier speaking about how we're not just housing, it's transitional housing programs and case management services, And this is just a really short list that our grantees provided us in our annual report of things that they provided to our population. So for accompanying participants to appointments, PCP, maybe probation and parole, maybe to their COSA, community justice centers, medical appointments, job coaching, a lot of tenancy education is provided by our grantees. And then below that is our public listing. So that's by county, how

[Chair Theresa Wood]: many beds we had with one program.

[Jill Moore (Housing Program Administrator, Department of Corrections)]: So our data for state fiscal year '25, we collect a lot of data. We do results based accountability data. So it's how much, how well, and if our participants were better off. So this is what that is. In state fiscal year '25, four zero three individuals were served in our DOC transitional housing, which was 58,111 beds, days that were utilized. 86% of our referrals were accepted by our transitional housing programs, and 89% of participants who exited transitional housing in that year were not charged with a new crime, and seventy one percent of those participants were employed or enrolled in education or training programs at the time of exit. And we had eighty seven individuals exit to permanent housing last year.

[Chair Theresa Wood]: So there's quite a difference between four zero three and eighty seven. What happened to the other three hundred people?

[Jill Moore (Housing Program Administrator, Department of Corrections)]: So they're either still in the program, they haven't exited the program, or we have about eight, we have eight options in total to choose when they are exited from the program. That could be re incarceration, that could be homeless, at risk for homelessness, hospital, other transitional housing programs. But the exits to permanent housing was the highest individual exit. So it would be helpful to know out of

[Chair Theresa Wood]: that four zero three, how many are exited to homelessness or at risk of homelessness? Because obviously that's a group of people that we're talking about. And just on average of 403,058 bed days, that's around six months, but I would imagine that there's a range. What's the range of time that people generally utilize the transitional housing programs? So our utilization is based on the day that the body is physically in the bed and then the day that the body is physically out of the bed. And that's why our target is 80%, not 100% utilization. So for state fiscal year, our utilization was 71%, which is below target for sure. But again, keeping in mind that our utilization target is 80%, not 100%. Yeah, I get that. I'm just trying to figure out how long do people stay. Yeah,

[Jill Moore (Housing Program Administrator, Department of Corrections)]: that really depends. That depends on their sentence. In order to be in DOC, transitional housing, you have to be under supervision of DOC. Some of our programs require a ninety day commitment. Some of our programs require a year commitment. So that really depends. Yeah. Thank you. And we had 31, so we had two fifty one people exit in state fiscal year '25, thirty one of them were homeless or at risk.

[Chair Theresa Wood]: Thirty one? Thirty three. Do you know if they ended up at a GA motel or do you know what follows, because they're not They wouldn't be covered by probation and parole at that point in time? They may or may not have, most likely. They were not under DOC supervision, but there is a possibility that some of those 31 individuals still were. It's just that maybe they were terminated from the program or no one wanted to participate in the program. Okay, thank you. Go ahead, Representative Cole. Thank you. I'm curious on the

[Rep. Esme Cole]: new crime piece. Does that include technical violations? No. Okay. Yes, but it does include misdemeanor or no. Sounds good. Thank you. And then love to see the 71 enrolled in participating in educational and otherwise programs. Yeah, hopefully we can increase the program as a whole and get more people involved. Thank you, Esme Cole.

[Chair Theresa Wood]: That's all we have for you.

[Kristen Calvert (Deputy Commissioner, Department of Corrections)]: Okay.

[Chair Theresa Wood]: But we're here for questions, So my main question is, I didn't see a specific proposal for DOC as part of this initiative. Is it another one of those DMH buried ones, or is there anything in particular? Okay, I understand she'll have shake her head. Don't have one.

[Rep. Esme Cole]: Okay,

[Chair Theresa Wood]: alrighty. Any other questions for these witnesses? Thank you so much. We appreciate you sticking with us for the afternoon. Thank you to everybody who is still here for sticking. I know it's been a marathon. Thank you for being here. Thank you for helping us to understand this overall proposal. And obviously we have a lot of work to understand the ins and outs of it and how it intersects not only with the governor's budget, but with the bill that we're working on and how that will all sort of hopefully come together in the end. So I think that, unless anybody has any final questions from committee members,