This Scorecard demonstrates the programs and performance measures from across the Agency that have been included in the Agency of Administration's Performance Budgeting Exercise.

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What We Do

Prevent and eliminate the problems caused by alcohol and drug misuse.

Who We Serve

We serve all Vermonters: prevention services to those of all ages, intervention services to those misusing substances, treatment services to those with substance use disorders, and recovery services to any Vermonter needing support to sustain healthy behaviors.

How We Impact

Alcohol & Drug Abuse Programs:

  • Improve access to prevention, intervention, treatment and recovery services to address substance use in Vermont.
  • Increase understanding of substance use disorders.
  • Employ evidence-based practices and strategies.
  • Fund services, provide technical assistance and encourage collaboration in communities.

Together with population indicators, the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

Total Program Budget FY 2018: $53,335,922


PRIMARY APPROPRIATION #: 3420060000
PROGRAM # (if applicable): N/A

Total FY2018 Appropriation $53,335,922


TOTAL PROGRAM BUDGET 2018 $53,335,922
Performance Monitoring Plan

The Vermont Department of Health will monitor this plan in two ways:

  1. The Performance Management Committee will review all investment programs and associated performance measures annually.
  2. Commissioners and Division Directors will review selected measures at bi-weekly leadership meetings.
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What We Do

The Vermont Department of Health Immunization Program provides over $16 million in vaccines to provider practices, educates health care providers and the public regarding immunizations, implements the state immunization regulations, and conducts ongoing assessments of population health status to identify populations at risk for vaccine-preventable diseases. Program activities are developed based on best practices to ensure access to affordable vaccines, support vaccination in the medical home, and provide the public with information needed to vaccinate with confidence.

Who We Serve

The Immunization Program serves all Vermonters with targeted efforts for parents, health care providers, provider practices, and school nurses.

How We Impact

The Immunization Program ensures adults and children have access to all recommended vaccines at their medical home and works to effectively limit vaccine preventable disease. Together with population indicators, the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Investment objective: Encourage the formation and maintenance of public-private partnerships in health care, including initiatives to support and improve the health care delivery system.

Budget Information

Total Program Budget FY 2018: $10,138,629

PRIMARY APPROPRIATION #: 3420021000
PROGRAM # (if applicable): N/A

Total FY2018 Appropriation $85,483,688
Budget Amounts in Primary Appropriation if not related to this program $75,345,059

TOTAL PROGRAM BUDGET 2018 $ 10,138,629
A portion of the total vaccine purchase of $16 million is provided in the form of direct support from the Centers for Disease Control and Prevention under the Vaccines for Children and Section 317 programs.


SFY15 Global Commitment Costs: $253,245

% allocated to Global Commitment investment: 100%

Performance Monitoring Plan

The Vermont Department of Health will monitor this plan in two ways:

  1. The Performance Management Committee will review all investment programs and associated performance measures annually.
  2. Commissioners and Division Directors will review selected measures at bi-weekly leadership meetings.
PM
2015
4.6%
5.0%
2
PM
2015
59
15
1
P
Time
Period
Actual
Value
Target
Value
Current
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What We Do

The Vermont Chronic Care Initiative (VCCI) identifies and assists Medicaid beneficiaries with chronic health conditions and /or high utilization of medical services to access clinically appropriate health care information and services. DVHA care coordinators are fully integrated core members of existing Community Health Teams and are co-located in provider practices and medical facilities in several communities. The population are the top 5% utilizers of the healthcare system, accounting for 39% of healthcare costs.

Budget Information
Total Program Budget FY 2017: $2,608,703.46
How We Impact

VCCI is focused on utilization measures with documented reductions in all areas, including for ambulatory care sensitive (ACS) inpatient hospital admissions, readmissions and emergency department use. Staff are embedded in multiple high-volume hospital and primary care practice sites to support care transitions as well as direct referrals for high risk/cost members. The VCCI continues to receive national recognition for its model and results including by CMS and the National Academy for State Health Policy (NASHP).

Action Plan

VCCI will continue to be an integral component of healthcare reform efforts given the initiative’s focus on holistic case management and the required expertise in human services necessary for successful case management and care coordination of a high complexity population, including those with significant social needs. The Unit has taken a leadership role in the enterprise level MMIS/Care Management system procurement process, with an anticipated go live date of early SFY 2016. VCCI has developed collaborative relationships with contracted Medicaid ACO partners and will continue strategic efforts to leverage limited resources toward common goals. Inherent in this, VCCI is active on the payment reform Care Management and Care Models (CMCM) workgroup and has a leadership role in the care management learning collaborative planning and implementation to assure service integration.

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What We Do

Tobacco use is the number one preventable cause of death, but about 800 Vermonters still die each year from tobacco-related diseases. Given this morbidity and mortality, three goals guide the work of the Tobacco Control Program: prevent youth smoking; reduce adult smoking; reduce exposure to second-hand-smoke. The Health Department Tobacco Control Program employs Centers for Disease Control and Prevention best practice in four key areas to address these goals:

  • Cessation services help Vermonters quit smoking through the Quitline, Quit Partners, or Quit Online as part of 802Quits. These services are evidence-based and greatly increase the changes a smoker will quit successfully. The program also partners to provide nicotine replacement therapy
  • Mass Reach Media, including hard-hitting ads, is shown to be effective in reaching those who smoke and inciting them to reach out to 802Quits. This includes television, radio, and social media efforts.
  • State and community interventions raise awareness on the actions decision makers can take to reduce the toll of tobacco. These include educating decision makers about passing smoke-free policies at local parks and playgrounds, which reduce secondhand smoke exposure and create positive social norms around tobacco use, and changing the tobacco retail environment, where exposure to product and advertising causes youth tobacco initiation. The Vermont Department of Health and the Agency of Education fund two youth tobacco prevention groups – Our Voices Xposed (OVX) in high schools and Vermont Kids Against Tobacco (VKAT) in middle schools.
  • Surveillance and evaluation ensure the program stays on track and uses data to drive programmatic decision making. The Tobacco Control Program invests in data collection, analysis, and dissemination to partners in and outside of government.

Who We Serve

The Tobacco Control Program is committed to serving all Vermonters seeking to reduce and quit their tobacco use. Some populations, including pregnant smokers, Medicaid-insured, those with mental illness or substance abuse disorders, less education, and lower income, are a focus of the Health Department. Additionally, supervisory unions with a higher burden of tobacco use are a targeted sector supported by this program. Tobacco use and the morbidity and mortality it causes disproportionally impact those with fewer resources and results in large health disparities.

How We Impact

By employing CDC Best Practices for Comprehensive Tobacco Control Programs with fidelity, the work of the Tobacco Control Program and partners should, over time, impact the number of Vermonters who smoke and therefore reduce deaths from tobacco-related diseases. Quitting tobacco has beneficial short and long term health impacts no matter one’s age. Three behaviors - no physical activity, poor diet, and tobacco use - lead to cancer, heart disease, diabetes, and lung disease accounting for more than 50% of premature deaths in Vermont. Reaching Vermonters that want to quit and supplying the needed cessation support will reduce, over time, the number of Vermonters suffering and dying from chronic disease.

Together with population indicators, the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

Total Program Budget FY 2018: $3,626,26
PRIMARY APPROPRIATION #: 3420021000
PROGRAM # (if applicable): N/A

Total FY2018 Appropriation $85,483,688
Budget Amounts in Primary Appropriation if not related to this program $81,857,419


TOTAL PROGRAM BUDGET 2018 $ 3,626,269
Performance Monitoring Plan

The Vermont Department of Health will monitor this plan in two ways:

  1. The Performance Management Committee will review all investment programs and associated performance measures annually.
  2. Commissioners and Division Directors will review selected measures at bi-weekly leadership meetings.
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What We Do

The DVHA strives towards the Institute for Healthcare Improvement’s “Triple AIM":

  • Improving the patient experience of care (including quality and satisfaction)
  • Improving the health of populations
  • Reducing the per capita cost of healthcare

One of the strategies the DVHA has adopted to move towards the “Triple AIM” is utilization management of our most intensive and high-cost services, which include inpatient psychiatric hospitalization. Inpatient psychiatric services, which include detoxification, are paid on a per day basis, unlike hospitalization on traditional medical inpatient units. This per day payment methodology has the potential to create a dis-incentive for providers to make efficient use of this high cost, most restrictive level of care. While CRT members’ hospital costs are included in their case rate payment to the Designated Agencies (DAs), which creates an incentive for the DAs to work efficiently with the inpatient units to transition their members back to their existing community services and supports, no such incentives exists for children or non-CRT enrolled adults.

Partners
  • Department of Mental Health Adult and Children and Families Units,
  • Department of Disabilities, Aging and Independent Living,
  • Department for Children and Families,
  • Integrated Family Services,
  • Designated Hospitals,
  • Designated Agencies,
  • Special Service Agencies,
  • Vermont Chronic Care Initiative
How We Impact

Historically, as a part of an acute care management program that was developed in response to the 1115b Waiver, children’s inpatient admissions at the Brattleboro Retreat were managed through a concurrent review process, however this oversight ended in late 2006 and during this “unmanaged” period the average length of stay and inpatient costs grew substantially. In 2010 the Department of Vermont Health Access began a utilization management (UM) system for children and adolescents, adults ages 18-22 admitted to the Brattleboro Retreat, and all adults admitted to out of state facilities. In 2011, the DVHA added inpatient detoxification admissions and adult psychiatric admissions (excluding CRT and Involuntary) to the UM program. In 2012 the Department of Mental Health (DMH) and the Department of Vermont Health Access (DVHA) collaborated to create a unified utilization management system for all Medicaid funded inpatient psychiatric and detoxification services. The goals for the utilization management system are as follows:

- Clinical care is provided only as long as necessary for safety and/or other acute needs.

- There are standardized criteria for admission, continued stay and discharge throughout the system of care.

- Care is continuous between the ongoing community treatment teams and episodes of inpatient or residential care. Ideally the hospital or residential facility and community teams develop and share a common treatment plan developed in partnership with the individual and their family, beginning within 24 hours of admission.

- Resources of the public system are effectively and efficiently used.

- The system of care will ensure access to effective, appropriate, recovery-based services that promote an individual’s health, wellness and resiliency and will support successful integration into the community.

Collaboration between VCCI and DVHA utilization review staff helps ensure timely communication with inpatient facilities and supports beneficiaries being able to successfully re-integrate with outpatient supports and services.Collaboration between DVHA and DMH UR staff and DCF, DAIL and DMH adult Care Managers and DMH CAFU Care Managers helps to ensure that active and appropriate aftercare planning is facilitated between the Designated Hospitals and the outpatient providers, this allows for aftercare services to be in place and ready to receive beneficiaries as soon as they are ready to be discharged and return to their communities. Our Agency partners are also invaluable in holding their preferred providers accountable to the tenets of the “Triple AIM”.

Together the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

Total DVHA Program Budget SFY 2018: $987,810

PM
SFY 2016
5.55
1
PM
SFY 2016
4.60days
2
PM
SFY 2016
$2.44Mil
1
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What We Do

The Vermont Blueprint for Health is a state-led, nationally-recognized initiative that helps health care providers meet the medical and social needs of people in their communities. The Blueprint’s aim is constant: better care, better health, and better control of health care costs.

The Blueprint encourages initiatives to support and improve health care delivery. It promotes innovative initiatives aimed at improving health outcomes, increasing preventive health approaches, addressing quality of life concerns, and increasing access to quality care through patient-centered medical homes and community health teams.

Who We Serve

The Vermont Blueprint for Health serves all Vermonters.

How We Impact

The activities of the Blueprint serve as the foundation for strengthening primary care and expanding the ACO programs. This initiative is especially focused on building the links between community and medical services, so that patients have better coordinated care across the spectrum of services.

Together the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

Total DVHA Program Budget SFY 2018: $897,820

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Budget Information

Budget Information

Total Program Budget FY 2018: $600,000

PRIMARY APPROPRIATION #: 3440100000

PROGRAM # (if applicable): 608640

Total FY2017 Appropriation: $600,000

TOTAL PROGRAM BUDGET 2018: $600,000

What We Do

Family Supportive Housing helps families who are homeless move into affordable housing and provides them with home-based case management and service coordination to help them maintain permanent housing.

Who We Serve

The program serves homeless families with children. Families with children under the age of 6 who have had multiple episodes of homelessness or engagement with Family Services are given priority.

How We Impact

The program helps families to achieve stability through affordable housing and employment.

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What We Do

BARJ is a balanced and restorative justice approach to juvenile justice that emphasizes:

Reducing the number of youth involved with juvenile justice system;

Repairing the harm caused by the delinquent behaviors; and

Giving victims and community members a voice in the process.

Who We Serve

BARJ serves youth who are on juvenile probation, at risk of becoming involved with the juvenile justice system or truant from school.

How We Impact

BARJ help youth take responsibility for their delinquent behavior and build skills and competencies that reduce and eliminate further involvement in the juvenile justice system.

Budget Information

Total Program Budget FY 2018: $984,779

Primary Appropriation #: 3440020000

Program # (if applicable: 37515

Total FY 2018 Appropriation: $984,779

TOTAL PROGRAM BUDGET 2018: $984,779

PM
2016
657
1
P
Time
Period
Actual
Value
Target
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Current
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Budget Information

Budget Information

Total Program Budget FY 2018: $1,657,898

PRIMARY APPROPRIATION #: 3440030000

PROGRAM # (if applicable): 603600

Total FY2018 Appropriation: $1,657,898

TOTAL PROGRAM BUDGET 2018: $1,657,898

What We Do

Strengthening Families Child Care provides grants to 40 community child care programs throughout Vermont to ensure affordable access to high quality comprehensive early care and education and afterschool programs for children and families challenged by economic instability and other environmental risk factors.

Who We Serve

These grants serve:

  • Children/families eligible for and participating in the CDD Child Care Financial Assistance Program (at least 25% of enrolled children).
  • Children/families who are receiving specialized child care services: including children with an open case with the Family Services Division of the Department for Children and Families (including foster children), children in families participating in Reach Up, refugee children and teen parents.
How We Impact

The following impacts on intended by these grants:

  • Documented use of the Center for Social Policy Strengthening Families Program Assessment tool through submission of outcomes and related program plan.
  • Continuity of care improves as measured by attendance records and compared to participants in CCFAP including specialized care in other non Strengthening Families programs.
  • 70% of parents report positive family experiences (protective factors) as part of their overall experience of having an enrolled child in the program.
PM
HY2 2016
1,816
3
PM
HY2 2016
1,178
1
PM
2016
94%
1
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Time
Period
Actual
Value
Target
Value
Current
Trend
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2011
45.0%
2
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Time
Period
Actual
Value
Target
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Current
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What We Do

Correctional Services administers for the courts eight Legal Sanctions:

Probation: An offender found guilty of a crime upon verdict or plea, is released by the court without confinement, subject to the conditions and supervision by the Commissioner of Corrections. This is a contract between the offender and the court, to abide by conditions in return for the court not imposing the sentence. Violation of this sanction requires due process, with a court hearing, counsel, and proof beyond reasonable doubt. Within the probation sanction is the reparative probation program, which allows citizens on community panels to determine the quality of restitution made to the victim and repair of harm to the community, consistent with 28 VSA Chapter 12.

Supervised Community Sentence: Based on a law passed in 1990 that provides the legal framework for the intermediate sanctions program. The judge sentences, with prior approval of the Commissioner, to a set of conditions, minimum and maximum time frames and an intermediate sanctions programs. The offender is under the supervision of the Department of Corrections. The Parole Board is the appointed authority and violations are resolved through a Parole Hearing. When the offender reaches his minimum sentence the Parole Board may continue on SCS, convert to Parole, or discharge from supervision completely.

Pre-approved Furlough: The offender is sentenced to a term of confinement, but with prior approval of the Commissioner, for immediate release on furlough. Furlough status is a community placement, but the revocation is administrative, and the rules for behavior more stringent.

Home Confinement: A type of Pre-Approved Furlough that is determined either by the court at sentencing or the Commissioner of Corrections that restricts the offender to a pre-approved place of residence continuously, except for authorized absences, enforced by appropriate means of supervision, including electronic monitoring and other conditions.

Incarceration: The sentence is confinement to a correctional facility, under the care and custody of the Commissioner. Release is by the Parole Board, upon completion of the minimum term or placement on conditional reentry by the Commissioner.

Conditional Reentry: At the completion of the minimum term of sentence, the inmate may be released to the community, still under confinement, subject to conditions of furlough.

Reintegration Furlough Reentry: Up to 180 days prior to completion of the minimum term of sentence, the inmate may be released to the community, still under confinement, subject to conditions of furlough.

Parole: On completion of Conditional Reentry, or during the term of incarceration, on petition of the State or the inmate, the Parole Board may release the inmate on Parole, subject to the rules of the Board, supervised by Corrections.

Home Detention: A program of confinement and supervision that restricts a defendant to a pre-approved residence continuously, except for authorized absences, and is enforced by appropriate means of surveillance and electronic monitoring by the Department of Corrections.

Who We Serve
How We Impact
Budget Information

Total Program Budget FY 2018: $146,346,897

PRIMARY APPROPRIATION #: 3480004000

PROGRAM # (if applicable):Multiple programs: 45126 - Transitional Housing, 45563 - SRRIP, 45125 - Tapestry, 45127 - Community Rehabilitative Care, 45128 - Women’s Programs, 45530 - Residential Substance Abuse Treatment (RSAT), 45561 - FABRIC, 45590 - Prison Rape Elimination Act (PREA), 45800 - Governor’s Highway Safety

Total FY2018 Appropriation

$146,346,897



TOTAL PROGRAM BUDGET 2017

$146,346,897

PM
2014
6
1
PM
2014
45
1
PM
2016
9,809
1
P
Time
Period
Actual
Value
Target
Value
Current
Trend
What We Do
Who We Serve
How We Impact
Budget Information

Total Program Budget FY 2018: $5,036,949

PRIMARY APPROPRIATION #:3480004000

PROGRAM # (if applicable):45126

Total FY2018 Appropriation

$5,036,949


TOTAL PROGRAM BUDGET 2018

$5,036,949

PM
Q4 2016
57
1
P
Time
Period
Actual
Value
Target
Value
Current
Trend
What We Do

The Community Rehabilitation and Treatment (CRT) programs provided at Vermont's Designated Agencies help individuals and their families to develop skills and supports important to living the life they want for themselves.

Who We Serve

Vermont’s Community Rehabilitation and Treatment (CRT) programs assist adults that have been diagnosed with a severe and persistent mental illness. Symptoms may be mild or substantially disabling, and long-term or short term.

How We Impact

Together the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

Total Program Budget FY 2018: $73,872,446

PRIMARY APPROPRIATION #:
PROGRAM # (if applicable):
Total FY 2018 Appropriation$225,703,851
Budget Amounts in Primary Appropriation
if not related to this program
$151,831,405
TOTAL PROGRAM BUDGET 2018$73,872,446


VDMH
How_Much
PM
SFY 2016
2,718
2,700
1
PM
SFY 2014
73%
80%
1
P
Time
Period
Actual
Value
Target
Value
Current
Trend
What We Do

The Vermont Psychiatric Care Hospital provides excellent care and treatment in a recovery-oriented, safe, respectful environment that promotes empowerment, hope and quality of life for the individuals it serves.

Who We Serve

The Vermont Psychiatric Care Hospital (VPCH) serves adults who require a hospital level of care and who are held involuntarily by a civil or a forensic order. VPCH is considered a Level 1 inpatient facility, meaning it serves those who are highly acute and require additional services and supports.

How We Impact

Together the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

Total Program Budget FY 2018: $21,381,003

PRIMARY APPROPRIATION #:
PROGRAM # (if applicable):
Total FY 2018 Appropriation$225,703,851
Budget Amounts in Primary Appropriation
if not related to this program
$204,322,848
TOTAL PROGRAM BUDGET 2018$21,442,125
PM
SFY 2016
0.40
1.30
2
PM
SFY 2016
100
50
1
P
Time
Period
Actual
Value
Target
Value
Current
Trend
What We Do

The Department of Mental Health is a major partner in the Agency of Human Services Integrating Family Services initiative. IFS brings together different programs and funding streams within AHS to create a single, flexible service delivery and payment system for services and supports to children, youth and their families so that practice and planning better match their needs.

DMH has two participating providers: Counseling Services of Addison County (CSAC) and Northeast Counseling and Support Services (NCSS). These providers work with the Parent Child Centers in their respective regions.

Who We Serve

This initiative provides supports and services to children, youth and families (prenatal to age 22).

How We Impact

Bringing these programs and funding streams together the following performance measures focus on whether Vermonters are better off as a result of this initiative. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

Total Program Budget FY 2018: $9,850,128

PRIMARY APPROPRIATION #:
PROGRAM # (if applicable):
Total FY 2018 Appropriation$225,703,851
Budget Amounts in Primary Appropriation
if not related to this program
$215,853,723
TOTAL PROGRAM BUDGET 2018$9,850,128
PM
FYQ4 2016
1,624
1
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