Every other week, Shana Halliday meets with a 70-year-old whose wife died last year. He had been struggling with isolation and didn鈥檛 have anyone to talk to 鈥� he said he didn鈥檛 want to burden them. He made an appointment with his primary care provider in Rutland, who referred him to Halliday.
She鈥檚 seen hundreds of patients since she started working at the practice last year 鈥� helping them write advanced directives, fill out applications for food and fuel assistance and connecting families with therapists who can help with medication management and substance abuse treatment. She also provides coping skills for anxiety and depression and grief counseling, like for the 70-year-old man.
鈥淚f they're in for an appointment, they can come and see me,鈥� she said.
鈥淲e can round out their medical help with their mental help. And so it's kind of the whole package.鈥�
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She鈥檚 one of more than 110 staff funded through a state program aimed at boosting support at primary care offices across Vermont. But that funding is set to run out by March or April of next year. The Agency of Human Services requested $6.5 million to keep the program going, but it wasn鈥檛 included in the state budget.
That means practices won鈥檛 have funding to pay for social workers, licensed counselors, and other mental health professionals like Halliday.
鈥淭his was a hugely impactful way to get mental health services to everyone who goes to one of these primary care practices,鈥� said Jessa Barnard, the head of the Vermont Medical Society.
鈥淎nd it worked,鈥� said Barnard. 鈥淚t wasn鈥檛 just something that felt good.鈥�
Data from Medicaid claims last year show patients at participating practices were more likely to go to a psychiatrist or counseling and less likely to get mental health treatment in emergency departments than in prior years 鈥� the proportion of patients who got mental health care in a hospital fell by 6.6%. Meanwhile, at practices that weren鈥檛 part of the program, the proportion of patients who received mental health care in an emergency department increased by 5.2%.
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鈥淭his showed, at least preliminarily, the initiative鈥檚 ability to help patients with mental health needs access less expensive, less crisis-based care,鈥� said Dr. John Saroyan, who oversees the program at the Agency of Human Services and leads a state team called Blueprint for Health.
The program was also aimed at reducing burnout for primary care providers so they are not solely responsible for connecting patients with community resources, like at the practice in Rutland.
鈥淚f I鈥檓 sitting with a patient, we can make phone calls here in the office,鈥� Halliday said.
State officials are hoping other funding will become available to keep paying these community health workers, but they didn鈥檛 have any specifics to offer.
Barnard, with the Vermont Medical Society, is advocating for some of $11 million earmarked to support primary care in a settlement between the state and the University of Vermont Medical Center to go towards supporting these positions.
鈥淚t鈥檚 not dead yet,鈥� she said.
