Annual Report design

Annual

2020 Report

Making a difference, changing lives

Table of Contents LETTER TO THE COMMUNITY FROM CEO DICK COURCELLE............................................................ 03 OUR TEAM: LEADERSHIP, BOARDS OF DIRECTORS, STAFF............................................................. 04 PERSPECTIVE: PROVIDING ESSENTIAL SERVICES IN A PANDEMIC . . ............................................05 - 07

BEHAVIORAL HEALTH . . ...................................................................................................... 05

DEVELOPMENTAL DISABILITIES SERVICES......................................................................... 07

TELEHEALTH : CREATING REMOTE CONNECTION WHEN PEOPLE NEED IT MOST. . ............................. 10 LIFESTEPS: PIVOTING TO ONE - ON - ONE SUPPORT......................................................................... 11 RSVP & THE VITAL ROLE OF VOLUNTEER WORK.............................................................................12 STRONG START: AGENCY SUPPORT FOR STAFF SEEKING LICENSURE . . .............................................13 FACILITIES UPDATE: CRUCIAL WORKSPACE FOR CRISIS SERVICES.. .................................................14 STAFF PHOTOS...........................................................................................................................15 FINANCIALS.............................................................................................................................. 16 SURVEY DATA. . ........................................................................................................................... 17 CCN SERVICES AND PROGRAMS.............................................................................................. 18 - 19

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2020 ANNUAL REPORT

Community Care Network | rmhsccn.org

Letter to the Community It is with pleasure that we present the 2020 Annual Report for Community Care Network and its two agencies, Rutland Mental Health Services and Rutland Community Programs.

This has not been a normal year- by any stretch. We entered 2020 as with any new year, with plans and hopes. At no time in the early months of 2020 did I think that life would become so disrupted, so isolated, so uncertain- so fast.

But on March 13, 2020, CCN had to rapidly pivot to life under COVID-19. And nothing has been “normal” since.

Both CCN organizations were working on new initiatives when the year started that then came to a screeching halt. There was, and is, no playbook for this. We made some mistakes and had some successes, as we navigated through this unprecedented time. We rapidly pivoted to remote care and work models. Our buildings became very quiet, as we directed most staff to work from home if they could; others anxiously waited for “normal” to return. As of this writing, it still hasn’t. Our residential and child care programs adopted stringent health and safety protocols and restrictions, which changed regularly based on public health directives. Some in-person services continued under strict health protocols.

Personal Protective Equipment was a phrase foreign to most of us before the pandemic. Obtaining scarce cleaning and sanitizing supplies, and retrofitting work spaces for social distancing, required great coordination, negotiation and dispatch. The pandemic forced, or accelerated, the closure of some programs such as InterAge Adult Day Services, which served the region for 30 years.

Difficult choices had to be made; none were easy.

Despite this, or perhaps because of it, I have witnessed great creativity, resilience and commitment of our staff at Community Care Network. They rose to the occasion, and continue to do so. And they too were experiencing isolation and the stressors of the pandemic. Time and again, they made sure that supports and services, however they could happen, remained in place for the most vulnerable of those we serve. Nothing was easy. I am indebted to them and am in awe of their dedication.

This year our report focuses on how Community Care Network responded in this unprecedented time. Our mission is to enhance the health and well-being of our communities, individuals and families through responsive, innovative and collaborative services. We did just that.

Dick Courcelle Chief Executive Officer Scan to watch a video message from our CEO, Dick Courcelle.

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Our Team Senior Leadership Team Dick Courcelle, Chief Executive Officer

Jim DiCosimo, Chief Financial Officer

Lorraine Jenne, Chief Operations Officer

Laura Kass, Chief Services Officer

Dr. Judith Tietz, Medical Director

Boards of Directors 2020 RUTLAND COMMUNITY PROGRAMS Jay Slenker, Chairman Betsy Glynn, Vice Chair Tim O’Connor, Secretary Jim DiCosimo, Treasurer Dick Courcelle, CEO

Renee Bousquet Susanne Engels Kate Thomas Vanessa Tufts

RUTLAND MENTAL HEALTH SERVICES Laird P. Covey, Chairman Michael McClallen, Vice Chairman Ron Holm, Secretary Jim DiCosimo, Treasurer Chris Keyser, Past Chair Coral Stone Rick Hildebrant, M.D.

Lillian Jackson Brian Kilcullen Cynthia Taylor-Patch Deborah Quirk Thelma Stoudt Scott E. Tanner

We thank our staff for their years of service and dedication.

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years

OF SERVICE

Kate Herrera, Behavioral Health Darlene Kelly, Developmental Services Kristin Brogren, Developmental Services Melissa Mahoney-Carvey, Developmental Services Lorraine Jenne, Administration Laura Kass, Behavioral Health Leo Guariglia, Behavioral Health Scott Folmsbee, Developmental Services Jacqueline Eddy, Behavioral Health Peter Chilos, Developmental Services Donald Jenks, Developmental Services Rachel Fillioe, Developmental Services Seana Lewis, Behavioral Health Emily Knust, Behavioral Health Robert Bride, Behavioral Health Danielle Payton, Behavioral Health Patricia Luther, Administration Devin Tarbell, Administration Heather Brouillard, Developmental Services

10

years

15

years

25

years

OF SERVICE

Naomi Ross, Developmental Services Lynn Bosworth, Volunteer Service Programs Kimberly Capps, Head Start: Early Care and Education Holly Rich, Developmental Services

OF SERVICE

Danielle Bergeron Ingram, Developmental Services Brett Myhre, Behavioral Health Tammy Brown, Volunteer Service Programs Georgette Haviland, Behavioral Health Angela Goepel, Head Start: Early Care and Education

OF SERVICE

Kelli Wilson-Young, Behavioral Health Eva Dickinson, Behavioral Health

30

years

40

years

OF SERVICE

Daniel Leblanc, Developmental Services

OF SERVICE

June Ward, Developmental Services

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Perspective: Behavioral Health

Providing Essential Services in a Pandemic The COVID-19 pandemic has affected the delivery of essential mental health services in every way imaginable. Throughout Rutland Mental Health Services, staff are learning new ways of doing their jobs, demonstrating tremendous creativity, resilience, and sheer determination – all while dealing with the same fears and uncertainty as their clients. Leaders from across the agency share their thoughts and insights on a year like no other.

Usually, in agency life, change tends to take a long time; and yet, here we were completely changing everything we did overnight.

It was an immediate pivot. Staff really rose to the occasion – literally everything had to be reinvented, without any reduction in service. In fact, the demand was even greater.

We found pretty early on that telehealth with young kids and families could work – kids love devices. The fact they could see their case manager was really helpful. People had to work hard to be engaging over technology. We tried all kinds of crazy stuff – singing, dancing – anything to be more interesting. We had a lot of families in the middle of PCIT treatment (Parent-Child Interaction Therapy), and we had to find new ways of doing that over ZOOM, so kids couldn’t hear the coaching. It was messy, but somehow it worked out. I think staff discovered they are much more capable than they knew.

One of the benefits of being school-based is that we have access to kids – we can pop into classrooms, and we know exactly how they are doing. When the shutdown happened, we lost that access. I think I was most impressed with how quickly everyone mobilized. We very quickly figured out what we needed to do, with a lot of creativity and as few disruptions as possible.

Fortunately, most families were able to engage with us remotely – either by video, phone or Google Voice. We very quickly adapted to using Doxy & ZOOM, and found that remote works well for some kids. We did have some families we had to troubleshoot, and in some cases, the school was able to drop off computers for families to use.

Our staff does a range of things -- from parent support and individual therapy to case management and skill building. We don’t always have access to families, and the push to telehealth provided a new way to connect with them remotely.

It’s interesting – this month we have started to feel and see the impact of everything. There is such a need right now -- no

We’ve started a new program for parents called Circle of Security™ which teaches how to be a secure base for your child.

We are starting to run these groups on ZOOM, and it’s working.

People are getting used to doing things remotely.

My team is very close-knit, and it’s been hard to be separated – to not be able to bump ideas off each other. Also, young kids rely on hugs, lap-sitting, and being close to grownups. It’s been hard clinically, to collaborate with the families and be as helpful as we want to be.

LAUREN NORFORD, LICSW Program Manager, Early Childhood Services

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Scan to hear staff

one realized this pandemic was going perspectives on to go on for so long. The stressors resilience. just keep piling up, and the numbers are increasing. I think the hardest part has been seeing how overwhelmed our systems are, and not having enough resources to meet the need. In Rutland, we’re experiencing huge truancy issues – kids are supposed to be learning remotely and aren’t showing up. This is hard to address remotely.

This pandemic has forced us all to be intentional with our own self-care; our own mental health, so we can help our clients more. Our team is trying to get outside more, exercise more, and be more mindful. I can’t underscore enough the creativity of my team, and how much they support each other.

HEATHER HILDEBRANT, LICSW Supervisor, School-Based Services

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Behavorial Health Perspective continued

We were able to switch to telehealth pretty quickly, but it has really been a mixed bag. Our census has fallen off the cliff, for any number of reasons. For some it’s the absence of face-to-face services; others don’t have connectivity or equipment. We also have a lot of court-mandated clients who don’t want to be here.

The pandemic gave them an excuse to get out of treatment.

Alcohol sales have gone through the roof. People are drinking at home and they are drinking more heavily at home. This behavior would cause problems under even the best of circumstances. Now, people are dealing complex situations at home and compounded levels of stress and anxiety. We’ve noticed that 2-1-1 (Information & Referral) has been getting a lot of calls from a new population – one we’ve not heard from before. These folks aren’t accustomed to seeking help, and don’t really know where to go.

When the stimulus checks went out, we immediately saw an increase in substance use, and some overdoses. A lot of people we work with are not good at handling large amounts of money – it goes right to their addiction. One of my female clients actually expressed anger at the government for putting more drug money in her hands.

We have been able to resume our Impaired Driver Rehabilitation Program, and ZOOM works really well for that program. The response has been good – we have a fair amount of folks dealing with their DUI’s now.

I think the hardest part is not knowing where we’re going, or how long this is going to last. I do think we are going to see aftershocks of this pandemic, and the need for our services is going to continue to increase.

CLAY GILBERT, LADC Director, Evergreen Recovery Services

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Initially we were very concerned with the idea of some of our families isolating themselves. For families with challenging kids, the parents need that break that school provides, and school can be a safe and stable environment for the kids. We expected the phones to blow up. We did see an increase of crisis calls, but not what we expected. We saw families really rise to the occasion.

My outdoor adventure program had to stop in their tracks.

Counselors spent time individually connecting with kids, and got super creative. They took facetime hikes, and kept the interest going that way. Staff did a phenomenal job rising to the challenge. This is much more taxing on all of them than anything I’ve experienced in 28 years here.

Our biggest challenge with remote work has been to see that people who are seeking our services are getting what they need. In mental health, the most important aspect is your relationship with the therapist, and so much of our work centers around making a strong connection right from the beginning. Distance makes it much harder to establish those relationships, and make assessments.

This is really intense work, and it can creep up on you. We have to be able to put our own stressors behind us so we can focus on the families and kids we’re working with. With 90 staff working out of their homes, it’s been a lot harder to support each other.

Generally, it’s very awkward for kids to come to therapy. We’ve found that in some cases kids are much more comfortable with telehealth – video is their preferred way of communicating. They tend to open up more when they are in their own environment.

As providers, how do we identify the kids that might do better through telehealth? Nothing would prevent us from offering this in the future as an alternative strategy.

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Telehealth certainly has its place, and looking ahead it will be really advantageous in winter when the weather gets bad.

Some of our clients have a lot of anxiety around getting to an appointment –no transportation or child care – for them, telehealth has been a big plus. For group therapy, it’s not always as effective – screens freeze, people struggle with audio – it can be intimidating for some.

2020 ANNUAL REPORT

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Seeing clients is only part of our job. Because we’re a designated agency, most of our funding comes with a lot of regulatory requirements, and managing all of that becomes much harder when you are not in the office. How do you get the answers you need? It has been tremendously challenging.

DOUG NORFORD, LICSW Director, Child & Family Services

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Behavorial Health Perspective continued

Normally our clients meet once a week with their individual therapist for 90 minutes. Moving those sessions online was a struggle in itself for our clients – determining whether they had the right technology and the cognitive ability to utilize telehealth.

Fortunately, the introductory calls that took place prior to each session took a lot of pressure off the clinical staff – we didn’t have to teach.

I thought we adapted really well. There was virtually no delay in services, we just had to pivot and adapt. I was one of the first to roll out telehealth using DOXY – I used it almost immediately. It was clunky at first and a bit frustrating, but I was adamant about getting back to work. After about a month I switched to ZOOM. We’ve noticed that the group member dynamics are not the same. Sharing becomes more difficult. Attendance is good, people are participating via ZOOM, but as far as the interaction goes, it is diminished.

Doing psychotherapy on ZOOM presents a whole list of challenges.

It is more difficult to get a read on someone’s emotional state of mind. Sometimes there’s a little delay, sometimes you can’t hear people, and some don’t like to be on camera. It can be clunky, and

it can be trying. When you can’t read facial expressions, it makes it tough for both client and therapist. That is also true of in-person sessions when we are wearing masks.

Working from presents its own set of challenges. As psychotherapists we deal with a lot of heavy stuff all day. To do so in your home feels a lot different than in the workplace. I’ve had to create some boundaries, and reorganize things in my mind.

Not being able to see co-workers also contributes to daily stress.

This is not the time to rally against change. With no end in sight, I’m now working on putting my DBT (Dialectical Behavior Therapy) online. Everything will be uploaded into an app. Clients will be able to access the manual, submit homework and manage their diary cards, all through the app. Everyone has had to be creative, and some real innovation has happened. You just do what you have to to make things work.

CATHY MCMULLIN Clinician, Adult Services, Community Rehabilitation and Treatment Program

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Perspective:

Developmental Disabilities Services Overnight, we went from being very person-centered to having to do everything from a distance. We – along with the people we support – were definitely not used to that. Because we are a long-term service provider we like to spend time with folks and get to know them. The pandemic has made that really difficult.

The directive to stop all non-essential supports brought a level of panic – how do you determine what is essential, and more importantly, how do you keep people safe? It ultimately came down to this -- If losing services put someone’s health and safety at risk those services were deemed essential.

There has definitely been innovation around telecommuting and finding new ways to interact with people remotely. We’ve had

specific brainstorming groups to identify best practices and look for sustainability, as this is likely to be our future.

This is a field that is rooted in personal connection. We’re used to being around people -- walking down the hall and saying hi to co-workers. Right now, our whole world is pretty disconnected.

As we navigate through this and adjust to doing everything from a distance, increasing our communication and compassion with each other is going to be essential.

DUSTIN REDLEIN Director, Developmental Disabilities, Services Systems

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Developmental Disabilities Services Perspective continued

The pandemic made us stop and ask ourselves, what is essential about providing remote services? It immediately became clear that it was up to us to remain essential in a remote world – that we would need to perform constant re-evaluation to ensure the work we do continues to be relevant, even from a distance. If families aren’t accessing our services, how are we troubleshooting?

There is no single answer, and everyone is finding their own way.

We’ve been surprised at how well some have engaged with our telehealth, and have had quite a bit of success.

Some services were interrupted at the beginning, guided by state-mandated safety precautions. Service coordinators who continued to provide in-person supports had to stay outside, and had to keep a safe social distance from their clients. In our search for best practices, we encouraged our staff to explore different platforms, and make their own decisions about going remote.

We looked for ways to incentivize direct-support work. And we empowered our teams to be creative, to embrace change, and to share their ideas with one another.

Kids with Autism tend to be rigid in their thinking, and they do not enjoy change. Some kids just closed their laptops, which was their

CAP currently provides shared living supports to 145 individuals in 130 homes, and normally we are an in-person, in-home service.

In mid-March, a lot of those services shut down. We were not able to physically be in homes, or even at homes initially. Like the rest of the world, we scrambled to figure out how to monitor homes remotely.

People have been pretty resilient in figuring out how to coordinate weekly meetings through telehealth. The whole virtual connection is very new. I think some people have really liked that connection, and for some it’s just a little too abstract or confusing. Fortunately, the majority of our staff already had iPads, so it was a matter of IT activating camera capabilities and getting us hooked up with ZOOM and Doxy. There was definitely a learning curve.

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way of walking away. A couple of practitioners found a way to stay engaged by using a dollhouse-building app and a shared screen.

They put furniture in the wrong rooms to prompt a response.

It tackled the same treatment goal, and it was really creative.

Another staff member found a way to engage a very young child in an imitation exercise through the living room window. It continues to be an exciting challenge, and people are really rising to the occasion.

I think the hardest part of this pandemic is the loss of structure across the board. I’m continually struck by how passionate this staff feels about the people they serve, wanting desperately to do the best they can. I applaud all of the efforts to embrace telehealth. The most exciting piece is that everyone is onboard to explore remote. I think new services will come out of this, and I’m very excited to see where it takes us. Why would anybody not embrace change right now?

MARY- GRAHAM MCDOWEL, BCBA, LBA Director, Developmental Disabilities, Autism Services

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Getting our hands on PPE was tough at the beginning. Fortunately some of us are sewers.

We’ve all had to get creative about how best to connect and support our teams. The reality is we spend more time at work than we do at home, and it’s been very hard for people to lose those social connections. We have some staff who have never met in person. It’s just a strange dynamic.

We have three nurses that work with us, and the shutdown of medical offices shifted them to remote work as well. This has made our advocacy role that much more challenging. Since we can’t be there in person, there’s a lot of time spent playing phone tag with medical professionals.

In the first few months, I think all our contacts were via phone and virtual visits. Around the end of June, the guidelines allowed us to do in person, socially-distanced, masked outside visits. To be able to connect personally with folks again -- that eased a lot of tensions. I think people are concerned about losing that again.

Our home providers have really risen to the occasion. They’ve provided crucial support through a really confusing time, and it’s miraculous that none of our individuals or providers have contracted the virus. This is a true testament to their commitment and dedication.

Masks have been a struggle -- many of our folks are sensory challenged to begin with. The whole idea of wearing this thing on your face took a lot of work and required some creative solutions.

MICHEL KERSTEN Manager, Community Access Program, Shared Living Services

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Developmental Disabilities Services Perspective continued

I came into the program as a service coordinator just three weeks before the pandemic arrived. In-person visits stopped, and I still hadn’t even met the individuals I would be working with. It was a very stressful experience. Remote introductions were difficult. It’s very hard for individuals with developmental disabilities to grasp the whole concept of a pandemic. They don’t understand what’s happening.

When we started working from home, I actually really enjoyed that. Somehow, I felt I had more flexibility to have more down-to-earth, relaxed conversations with the people I was handling. There’s more time to get to know people, without the distractions that exist in a workplace. On the other hand, being home alone for that long is exhausting.

We continued with virtual visits until mid-April, until we were given guidance that we could resume in-person, and only if people were comfortable on both sides. We did daily phone check-ins for a while, and that at least offered a sense of routine. I was pen pals with a couple of individuals, and that was really fun.

Before Covid hit, I was doing community work with two individuals – one had Autism and was non-verbal, the other had communication issues and had violent tendencies at home. We would go out into the community and enjoy all sorts of activities like bowling, swimming, playing basketball – but the pandemic shut all of those activities down and I lost most of my community hours. I did continue to work with one individual for a couple of months. We found things to do outside, and when the weather was bad, we just took long drives in the country. Sometimes we would drive up to Pond Hill Ranch in Castleton and look at the horses. It was going ok, until his behavior made it unsafe for us to continue.

Now I’m working with an individual in the Employment Services program who works for Meals on Wheels. Meals on Wheels had to ramp up production during the height of the pandemic because so many more people

Community supports were completely suspended, and employment supports for most individuals. The loss of LifeSteps was heartbreaking. This was a place where individuals in the CAP program could hang out with their peers. In some cases it was the only peer-socialization they received. For a lot of people, this was their life. This loss has been really devastating to their overall routine and sense of purpose, and it’s going to have a long-lasting impact. It makes me want to cry.

It’s hard not to get emotional when you see that certain individuals aren’t able to understand why this is all happening.

Their whole world is upside down. Just watching them struggle -- it’s really hard. We think this is hard for us to endure – to be a person with a developmental disability, I just can’t imagine.

AMELIA ASHLEY- SELLECK CAP Service Coordinator

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needed meals – they went from 1200 meals per day to 5000. D.J. came in every day, right through the pandemic. You could say he contributed in large part to keeping Rutland fed. It’s a real feather in his cap.

The environment at Meals on Wheels has gotten a lot busier and a lot more hectic. D.J. gets nervous in crowded areas, so I’ve had to provide much more emotional support. The pressure to produce meals can be very intense at times, so we take breaks and do deep breathing. Wearing masks in a hot kitchen is no fun.

I think the hardest part has been dealing with the fear that my individuals have. D.J. lives in a home with vulnerable family members, and he is constantly worried about bringing the virus home to the people he lives with and loves. We take great precautions with mask-wearing and hand-sanitizing, and over time he has gotten more comfortable.

There has also been so much misinformation floating around, he has a hard time processing what is true and what isn’t. I just have to keep filtering information in a way he can process.

Hear from other service providers...

Scan to hear more staff perspectives on Community Care Network’s crucial work.

MIKE HUNDT Direct Support Professional

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Telehealth: Creating Remote

Connection When People Need It Most As the coronavirus crisis continues to wreak havoc on our daily lives, the need for mental health support is more important than ever. Anxiety is flooding our lives as we worry about loved ones, health, finances, stability, and how to best navigate a new normal.

For individuals and families who grappled with behavioral health and mental health issues before the pandemic, the economic and social upheaval brought on by this crisis has compounded their struggles.

Amid this extraordinary time of social-distance, isolation and limited human contact, telehealth has provided a lifeline, delivering critical care at a distance.

some clients caught on very well, and preferred the remote access. It increased the level of parent engagement in some cases, and turned out to be very successful.”

“We found that, more than expected, families had the correct technology,” says Louiselle. “If that was an issue, we were able to bring them into designated conference rooms at the agency, to connect with their clinicians that way. We accommodated them anyway we could.”

Hillary Ward is the Director of Adult Services on the Behavioral Health side. She says technology has been a struggle for many adults in her programs – particularly the CRT population -- and staff has had to find “Before the pandemic, we were just starting to have conversations innovative ways to connect with them. Some have spent long hours about telehealth,” says Scott Louiselle, who oversees outpatient teaching clients how to use technology. But despite the difficulties programs for Child & Family Services. “We were looking at ways to for this population, Ward says telehealth has accommodate our families in any way we been essential to providing service during could. The coronavirus kicked this up to O U R G OA L WAS TO the pandemic. “The ability to lay eyes on our light speed. An initiative like this could easily M A K E T E L E H E A LT H clients has made a huge difference. We can have taken a year, and we were looking to only do so much over the phone. The ability A N D L I V E V I D E O implement in a matter of hours or days -- as to see facial expressions, body language, and quickly as possible so our families would not go BASED INTERACTIONS even their environment gives you that added without our service during lockdown.”

WITH OUR CLIENTS connection.”

A N O R M A L PA RT O F A telehealth consultant was hired shortly after Some adult groups offered through telehealth the pandemic hit, to help the agency ramp-up R M H S O P E R AT I O N S . brought unexpected insights. “We noticed their effort and do it the right way for both fewer no-shows,” says Norford. “It really providers and clients. Issues of infrastructure, - Dick Courcelle, CEO worked better for some participants. To compliancy, security and etiquette all needed be able to just walk into a room is a real time saver for that person. to be addressed. “Our goal was to make telehealth and live videoMoving forward, nothing prevents us from offering both.” based interactions with our clients a normal part of RMHS operations,” says CEO Dick Courcelle. “The result has been a telehealth protocol Nine months into this pandemic, the demand for mental health that is managed well and is thus far performing well.” services is still growing. Intakes are up across the agency, along with

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The quick pivot to telehealth within Rutland Mental Health Services was due to an extraordinary effort by the IT team, led by Jit Singh.

They first had to ensure that staff – working from home -- had the equipment, software and internet access to connect remotely to the agency. iPads had already been issued to all community-based staff as part of last year’s EMR rollout. “The fact that we had iPads out there that could easily convert to use for ZOOM put us ahead of the game,” says Singh.

the level of intensity. Continual access to health care services is critical at any time, but especially now when stress and anxiety are running high “Mental health is woven into every aspect of this pandemic,” says Louiselle. “Whether it’s working with someone who is having issues directly related to the pandemic, or someone with underlying needs that have been intensified by the pandemic, in both situations we’ve really had to take a look at what we’re doing, and make sure we’re doing it the right way.”

Jit’s team worked round the clock to troubleshoot issues as they arose – everything from staff comfort levels, to increased bandwidth in the office, to expanded WiFi coverage into the agency’s parking lot for clients to access. Zoom, Doxy, and multiple other screen-sharing platforms were vetted, monitored, and pushed out to staff.

Singh says that currently, about ninety percent of the agency’s services are being done through telehealth. And although everyone is anxious to return to Covid-free life and more human connection, he acknowledges that telehealth is here to stay. “Knowing that you don’t have to put staff in harm’s way; knowing you are fully capable of doing your job remotely; offering flexibility to those we serve – these are some of the great advantages of telehealth.”

“It was like a crisis response,” says Doug Norford, Director of Child & Family Services. “Within about a two-week span, we went from doing very little or no telehealth, to it being our primary mode of service.”

Norford says one of the biggest challenges for Child & Family Services was connecting with their existing client families, and helping them find the right equipment, or connectivity. “We quickly found that

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“It’s important to mention that telehealth is not one size fits all, says Louiselle. “What we’re realizing is that we really need to create a shared position around an individual or family, and offer flexibility to meet their given need. In some situations, we can get better outcomes through the use of telehealth.”

Abe and Linda enjoy regular walks on the trails of Northwood Park.

LifeSteps: Pivoting to One-on-One Support

The ten-year-old program discontinued its group model in favor of more individualized community supports.

In the age of COVID-19, the opportunity to congregate in groups is a rare luxury. But for LifeSteps, a group community support program for individuals with developmental disabilities, the forced end of group gatherings has been an opportunity.

“The initial closure was due to COVID-19, but then that discussion transformed,” says Jess Nadeau, Employment and Transitional Support Program Manager at Community Access Program.

LifeSteps began nearly ten years ago as a community support service that allowed individuals with developmental disabilities to join their communities and work towards individual goals in a group setting.

Now, the LifeSteps group model has been discontinued in favor of the one-on-one community support service model, which Nadeau says achieves both safety and greater individual success. Now, individuals receive one-on-one services, and can engage more directly in what they want to do. Their experience with community support is modeled after their individual goals and their own pace.

Darlene Kelly, a Service Coordinator, says she’s seen a difference in Abe, an individual she serves who has moved to the one-on-one support model. Abe has been able to do more of what interests him, like swimming and volunteering. “Going one-on-one has been really good for him because he can help design the services he wants,” says Kelly.

activities during the pandemic, but she and Abe are adapting well.

“Our days are packed,” she says, “We go for walks, we go swimming, we hike, and we visit different stores when it’s safe.” Abe is an avid swimmer and has a goal to do more volunteer work. He says he has more time to pursue those things with the individual support model.

Of course, it wasn’t an easy decision or transition to make. There were initial concerns about clients being able to maintain relationships with peers from the group and continue to work with familiar staff.

“Every client continues to work with staff who they have a relationship with. And service coordinators have been instrumental in keeping individuals connected to their peers,” says Nadeau. Service coordinators have been able to help individuals connect to their peers from the LifeSteps group by setting up safe outings and helping them exchange contact information.

Supporting individuality in a one-on-one model is a crucial step for helping former LifeSteps participants thrive long-term and discover new connections. “Providing these services in a group model can be limiting of individuality. When we think about accessing a community and developing friendships…those things happen out in the community.

At work, running errands, and doing things you enjoy.”

Linda Henderson is a Direct Support Professional who is helping Abe achieve his goals. She says it’s taken some creativity to find safe 2020 ANNUAL REPORT

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RSVP volunteers prepare to distribute 15,000 gifts and toys to approximately 1,200 kids throughout Rutland County.

RSVP & The Vital Role of Volunteer Work When living in a global pandemic became the new reality in March, RSVP & The Volunteer Center adapted and met the needs of the moment. Signature programs like Bone Builders took workout classes online and recorded at PEG TV. Operation Dolls and More volunteers pivoted quickly to sew and distribute thousands of masks throughout Rutland County, then continued to restore dolls, toys, and books at home. One-2-One transportation program temporarily discontinued some transportation services, but still ensured safe, reliable transportation for critical care patients to and from doctors appointments.

In some cases, volunteer participation has actually increased despite the challenging times.

“In RSVP we have more volunteers reading virtual stories for classrooms than we did previously,” says Alix O’Meara, Director of Volunteer Programs at Rutland Community Programs.

RSVP and its signature programs offer individuals ages 55 and up the opportunity to volunteer for non-profit organizations in Rutland and Addison counties. Volunteer opportunities are diverse, interesting, and speak to individuals of all skillsets. This variety of volunteer options has been crucial for keeping volunteers engaged at a time when social distancing is a must.

“Most of our volunteers want to keep doing something.

For a lot of them, this is their social connection. Many of them live alone or have spouses who are ill—this is how they stay connected and find purpose in their lives,” says O’Meara.

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2020 ANNUAL REPORT

Community Care Network | rmhsccn.org

While the pandemic has presented many challenges, those challenges have also revealed volunteers’ steadfast commitment to their work.

“Most of the (One-2-One) drivers said, ‘Well, they have to get there. It’s not an option,’” says Tammy Brown, Program Coordinator for One-2-One. “We’ve continued to provide transportation for critical care patients. There have been very few cases where I’ve had to tell someone we couldn’t take them where they needed to go.”

When it came to meeting the needs of the moment, RSVP’s mask-making effort was a force to be reckoned with. “Our mask-making efforts started small to begin—we were sewing and providing masks for Rutland Regional Medical Center. Then we branched out to helping all over Rutland County,” says Maryesa White, Program Coordinator at RSVP. The effort involved 22 volunteers who spent 2,268 hours sewing over 4,000 masks in their own homes. Masks were distributed everywhere from Castleton to Killington, and will go out to 13 schools during RSVP Operation Dolls sociallydistanced, drive-through event on November 18.

For many struggling with the toll isolation has taken on their mental health, RSVP’s socially-distanced volunteer opportunities could provide a sense of purpose while serving the community. O’Meara wants to be clear that no effort is too small.

“We want people to know that there are safe options for volunteering that they can do from home. It doesn’t have to be a huge time commitment—no matter what you can contribute, your efforts always make a difference.”

RSVP & The Volunteer Center by the numbers: Fiscal Year 2020 (July 1, 2019 through June 30, 2020)

761

volunteers PROVID ED

170,052

hours of service

to their communities

Based on the Independent Sector National Value of a Volunteer Hour, this equates to

$4,625,414 of service to the

counties we serve

The Strong Start Team from left to right: Kristina McKeighan, Paul Black, Karen Grimm, Tom Cox

Strong Start: Agency Support for Staff Seeking Licensure Recently, the conversation around mental health has moved from a buzz to an open, fearless dialogue. As more individuals seek mental health support, the demand for mental health professionals of all disciplines has risen. But the road to becoming a licensed, practicing mental health professional isn’t easy. Even after the ink has dried on that hard-earned degree, those pursuing careers in mental health still have clinical hours and licensure exams to complete.

true veteran of the rigorous licensure exam process, Paul Black now facilitates weekly virtual study groups with the 19 members of Strong Start’s pilot group.

“The process is tough. It couldn’t be more layered,” says Paul Black, a licensed clinician at Rutland Mental Health Services. In the process of becoming licensed, he struggled to balance his work as a child and family clinician at Rutland Mental Health Services and find time to study. Ultimately, Black received the support he needed from Karen Grimm, Manager of School-Based Services. “I was given a few hours each week to study during my work day, and it made a big difference in how I studied and found support.”

“We’ve been talking for years about developing a foundational series of trainings to enhance education on topics child & family staff come across in our work,” says Tom Cox, a child and family outpatient clinician, “This became part of Strong Start because we realized newer staff might be looking for additional information that would enhance their knowledge base of their work, the agency, and those we serve.”

This gesture of support became the cornerstone of Community Care Network’s new Strong Start program, which launched in September 2020 after months of research, proposals, and preparation. Strong Start is a career springboard for emerging mental health professionals that helps them balance employment with study and find community among their peers. It was launched by Karen Grimm, Paul Black, Thomas Cox, and Kristina McKeighan.

“To see staff experiencing so much frustration with the licensing process...really made us wonder how our agency could help new clinicians find resources and not feel so defeated during this process,” says Grimm.

Strong Start participants have access to robust licensure exam prep materials, attend monthly mental health trainings, and find peer support at study groups built into their workweek. As a tried and

Strong Start also integrates monthly mental health trainings to help staff build competence and confidence to work through common issues clinicians face.

But it’s more than just a study group—it’s a study in how an agencysupported licensure process creates cultural change that builds community and ultimately strengthens services to the community.

The impacts of clinicians obtaining licensure touch every aspect of the work done at Community Care Network.

“From a recruiting standpoint, we’ve been looking at how to attract the talent of new graduates and out-of-staters and how to we keep them,” says Kristina, McKeighan, an HR Business Partner and recruiting expert for the Strong Start leadership group. “It’s a great thing to start the (licensure) conversation early with new hires, and then support the process as an agency.”

The Strong Start founders are now in the thick of collecting feedback and refining the program, and are excited about the possibilities.

“We created this out of thin air, and there are some growing pains. We have some data, some ideas, and some thoughts about how to move forward—and we are ready to iron them out,” Cox says.

2020 ANNUAL REPORT

Community Care Network | rmhsccn.org

13

Facilities Update:

Crucial Workspace for Crisis Services Crisis Services will soon have its own home, in the space at 230 North Main Street in Rutland City vacated by InterAge Adult Day Program.

It’s a silver lining in the cloud of this pandemic-related closure.

“The loss of InterAge was an unfortunate casualty of Covid-19,” says Chief Financial Officer Jim DiCosimo. “You can’t provide in-person services to seniors and high-risk individuals during a pandemic. When the decision was made to close permanently, we started looking around at the best use of the space.”

“When one door closes, another one opens,” says Chief Services Officer Laura Kass. “We’re very sad that the agency had to close InterAge – it was a wonderful, wonderful program. On the bright side, Crisis Services has never had its own home. They have always been bounced around from room to room and have had to look for space.

Base camp for them has always been the hospital’s Emergency Room, and that has been upended by COVID. This was an opportunity for the team to come together under one roof.”

with four hotline desks with phones, a larger space to do assessments for kids and families, two smaller offices and a director’s office. There will also be ample space to conduct groups, for that time in the future when in-person groups are allowed again. The location on the main bus line will make it easy for people in the community to access.

“Right now, everyone is so separated,” says Kass. “When someone answers the hotline, that person has to call for help or support. The support that we will now be able to give each other, that will help with morale and team building. I couldn’t be more excited about this.”

The transition to centralized emergency services comes just as pandemic-related crisis calls are on the rise. “We’re seeing people we haven’t seen before, and they are dealing with isolation, depression and other trauma. We’re also seeing more children. With schools being so disrupted, it’s been a real challenge for children and families.”

Renovations are scheduled to begin in December, with hopes of an early 2021 move-in date.

The Crisis Services team consists of clinicians, case managers, peer support and crisis hotline staff. Their new workspace will be configured

CRISIS SERVICES MOVING TO 230 NORTH MAIN STREET IN 2021

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2020 ANNUAL REPORT

Community Care Network | rmhsccn.org

Staff Photos

Top: Karim Chapman and Lyss Eaton represent Community Care Network's Zero Suicide team by offering suicide prevention education to the community.

Doug N orf to a gro ord, Directo ro u Netwo p of high sch f Child & Fam rk's se rvices ool students ily Services, and th e ment about Comm speaks un al healt h syste ity Care m.

Right: Peggy Bathon provides crisis support during a National Guard Food Distribution event in Rutland, Vermont.

Scan to hear staff discuss finding success and joy in their work.

s mble wellnes partners asse unity Care m HR Business m Co g rin oyees du ellness Week. bags for empl 20 Virtual W Network's 20

Community k's Care Networ Pilot Strong Start s ld ho m ra og Pr y a Zoom stud y week session ever r fo e ar ep to pr s. licensure exam

l, Devin Tarbel Medical Assistant, & Heidi Lipka, RN, sanitize and prepare c the shot clini for clients at .

Court Square

Employee as recognition w nt a little differe got this year. We creative with r staff honoring ou lly cia so a in . distanced way cially eers with a so ent. lebrate volunt ev ce n aff tio st ia ec VP RS lunteer appr distanced vo

2020 ANNUAL REPORT

Community Care Network | rmhsccn.org

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Financials

from July 1, 2019 to June 30, 2020 Revenue

RUTLAND MENTAL HEALTH SERVICES

8%

88%

State Grants and Contracts

Medicaid

3%

Private Insurance, Self-Pay, Misc.

1%

Other Contracts and Town Giving

Expenses

19%

58%

Community Rehabilitation & Treatment/ Crisis Services

Developmental Disabilities Services

18%

3%

Substance Use Disorders

Behavioral Health Child and Family Services

2%

Behavioral Health Adult Services

RUTLAND COMMUNITY PROGRAMS Revenue

59%

Federal Grants and Contracts

27%

State Grants and Contracts

7%

Medicaid

3%

Local Contracts and Support

3%

Other Fees

1%

Miscellaneous and Town Giving

Expenses

72%

Head Start/ Early Childhood Education and Care

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2020 ANNUAL REPORT

Community Care Network | rmhsccn.org

11%

InterAge Adult Day Program

8%

Green Mountain Foster Grandparents

5%

Retired Senior Volunteer Program

4%

One-2-One

Survey Data from July 1, 2019 to June 30, 2020 87%

C&F services = 88%

received the help they needed

CRT Services = 81%

School Based Services = 97% Developmental Services = 94%

said they

Emergency Services = 81% Adult Mental Health Services = 88%

(899 out of 1028 Agreed or Strongly Agreed)

Substance Use Disorder = 80%

84%

C&F services = 81%

services were right for them

CRT Services = 78%

School Based Services = 85% Developmental Services = 94%

said the

Emergency Services = 80% Adult Mental Health Services = 87%

(875 out of 1039 Agreed or Strongly Agreed)

Substance Use Disorder = 78%

92%

C&F services = 87%

treated them with respect

CRT Services = 86%

School Based Services = 97% Developmental Services = 98%

said that RMHS Staff

Emergency Services = 91% Adult Mental Health Services = 93%

(928 out of 1010 Agreed or Strongly Agreed)

Substance Use Disorder = 90%

80%

C&F services = 76%

improved their quality of life

CRT Services = 77%

School Based Services = 82%

said the services made a difference and

Developmental Services = 95% Emergency Services = 64% Adult Mental Health Services = 81%

(807 out of 1006 Agreed or Strongly Agreed)

430

CNN Workforce Total Full-time and Regular Part-time

Substance Use Disorder = 79%

377

Rutland Mental Health Services

53

Rutland Community Programs

2020 ANNUAL REPORT

Community Care Network | rmhsccn.org

17

About Community Care Network Community Care Network is comprised of Rutland Mental Health Services and Rutland Community Programs. The mission of CCN is to enhance the health and well-being of our communities, individuals and families through responsive, innovative and collaborative services. The programs of Community Care Network serve more than 3,000 people each year throughout Rutland County. The dedicated 400-plus staff of Community Care Network are focused on improving the health and well-being of Rutland County residents and their families living with mental illness, developmental disabilities and substance use disorders. A list of programs appears below. For more information about the wide range of comprehensive services at CCN, please visit our website at www.rmhsccn.org.

BEHAVIORAL HEALTH Adult Services Community Rehabilitation and Treatment: Comprehensive services using a multi-disciplinary treatment team approach for adults with severe mental illness. CRT offers a wide range of support options to help people remain integrated in their communities, while building strategies to live more independent and satisfying lives.

Welcome Home: A joint program of Rutland Mental Health Services (RMHS) and The Homeless Prevention Center (HPC) of Rutland County, providing housing and support services utilizing the Housing First model to people who experience chronic homelessness.

Vocational Opportunity Works: Supported employment services to individuals with mental health and co- occurring disorders.

Child and Family Services

Outpatient Treatment: Individual and group therapy includes daily stabilization group, women seeking safety group, weekly aftercare group and anger management group, psychiatric evaluations and medication management.

Early Childhood: Mental health services and supports for children (birth to age 6), adolescents and families that promote mental health; prevention services to reduce risk factors and increase resiliency and protective factors; and comprehensive intervention and treatment services to children and youth with serious social, emotional and mental health needs.

Eldercare: Outreach mental health services to homebound elders, including clinical assessment and case management.

Emergency Crisis Services: Available 24-hours-a-day, 7-days-aweek, providing emergency supportive counseling by telephone or in person.

Integrated Clinical Case Management: Provides mental health services to adults experiencing emotional or behavioral distress severe enough to disrupt their lives, who are medical patients at the Community Health Centers of the Rutland Region, but who do not meet eligibility criteria for Community Rehabilitation and Treatment services.

Substance Use Disorders Services: Substance abuse treatment services, including alcohol and drug assessments for individuals age 12 and older. Includes Outpatient treatment, Intensive Outpatient Program-Adult (Quitting Time), Impaired Driver Rehabilitation Program (Rutland County and weekend program in White River Jct.), Case Management, Rocking Horse Program, Rutland County Treatment Court(Federal Drug Court), Collaboration with Reach Up, Healthy Women’s Program and Elder SUD Services.

Crisis Stabilization and Inpatient Diversion: Short-term stays for adults with acute psychiatric symptoms to help avoid the need for a higher level of care such as an inpatient psychiatric hospital or to serve as a step-down from inpatient psychiatric care to prepare for a return to community-based support.

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MapleWood Recovery Residence: Supervised and supported recovery intervention services in a residential location for adults in the early stages of recovery.

2020 ANNUAL REPORT

Community Care Network | rmhsccn.org

School-Based: In-school clinicians provide mental health services including family therapy, case management, substance abuse counseling, and daily one-on-one behavioral intervention and skills building in many Rutland County schools to support academic success.

Outpatient and Case Management: For children birth to age 18 and their families, psychotherapy (individual, family, group), case management, psychiatric evaluation, and medication management for mental health, substance abuse, and co-occurring disorders.

Intensive Family Based Services: Intensive, home-based services to children at risk of removal from their home due to emotional or behavioral problems and also when there is a reunification of a child back home from an out-of-home placement.

Respite: Short-term support and relief to families of children and adolescents with significant mental health issues.

Vermont Outdoor Adventure Program: Therapeutic skill-building and experiential learning activities provided in a wilderness setting.

J.O.B.S. (Youth Transitional Services): Youth ages 14-26 are helped to overcome employment barriers, sustain healthy relationships, and manage the issues of day-to-day living.

Rapid Response: Immediate community- based supports to children returning home following a crisis assessment or a hospital/ residential placement.

Wraparound and ABA Program: Applied behavior analysis services for children on the autism spectrum.

DEVELOPMENTAL DISABILITIES SERVICES The Community Access Program (CAP) provides an array of comprehensive, person-centered supports and services to children and adults with developmental disabilities and their families.

Service Coordination: Assists individuals in planning, developing, accessing, coordinating and monitoring supports and services.

Home Supports: Supervised Living: Supports provided to individuals who live in their own home/apartment or that of a family member.

Staffed Living: 24-hour supports provided to one or two adults living in their own home/apartment.

Group Living: 24-hour supports for four adults living in our licensed group home.

Shared Living: Supports provided to one or two individuals living in the home of a shared living provider.

Clinical Services: Access to psychiatric services, therapies, behavioral consultation, and other clinical supports.

Crisis Services: Support for individuals who are experiencing a psychiatric, behavioral, emotional, or medical crisis.

Transportation: Reimbursement for mileage to access community supports. Assistance for individuals requiring an accessible vehicle to acquire and maintain accessible transportation.

Bridge Care Coordination: Support for families to access and coordinate needed services and resources for children up to age 22.

Family Managed Respite: Provides families with a break from caring for their child with a disability up to age 21.

Flexible Family Funding: Available to families to support their child or adult family member to live at home.

Specialized Services in a nursing facility: Services for individuals 18 years old and older living in a nursing facility who need additional social, behavioral, or communication supports related to their disability beyond the scope of the nursing facility.

Choices for Care Adult Family Care: A 24-hour shared living option for individuals at least 18 years old who meet clinical criteria for nursing home level of care.

RUTLAND COMMUNITY PROGRAMS

Health Services Coordination: Nurse Consultants help coordinate and monitor health care for individuals receiving staffed, group, or shared living supports.

One-2-One: Volunteer drivers provide essential services transportation to adults 60+. More information at www.volunteersinvt.org/service/ rsvp-telecare-program.

Respite Supports: Provide family members and shared living providers a break in caring for an individual.

Green Mountain Foster Grandparents: Volunteers provide mentoring and role modeling for children of all ages in a variety of educational settings throughout Rutland, Bennington, and Addison Counties. These intergenerational relationships enrich both the volunteers and the children they serve. More information at www. volunteersinvt.org/green-mountain-foster-grandparent-program.

Community Supports: Assist adults to develop skills and social connections through volunteering, recreation, leisure, and educational opportunities.

Employment Services: Assist adults to obtain and sustain competitive employment and achieve career goals.

Project SEARCH: Workplace immersion program for students with intellectual disabilities in last year of high school or young adults that helps them learn skills and obtain competitive employment through collaboration with CAP, the Rutland School district, Rutland Regional Medical Center, and Voc Rehab.

College Steps: Supports students living with social, communication, or learning challenges to make successful transitions into college life at Castleton University while learning new skills and preparing for meaningful careers. College Steps Residential program provides a unique support model to select students. Two students are supported by a professional roommate in a 3 bedroom apartment to develop independent living skills while attending Castleton University.

RSVP and The Volunteer Center: Provides individuals of all ages with a variety of interesting and diverse volunteer opportunities throughout Rutland and Addison County in over 150 non-profit agencies. Our locally-designed Signature Programs, RSVP Bone Builders and RSVP Operation Dolls and More, also respond to the needs of our communities. More information at www.rchsccn.org.

Early Care and Education / Rutland County Head Start: Our 5-STAR, NAEYC-accredited, early care and education programs prepare children and families for a successful school experience through comprehensive, integrated, family-centered services.

Comprehensive programming integrates successful learning, medical, dental and mental health support; social services; and parent engagement for income-eligible, preschool-age children and their families. More information at www.rchsccn.org.

2020 ANNUAL REPORT

Community Care Network | rmhsccn.org

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Maryesa White, RSVP Program Coordinator, and Volunteers load a vehicle with donated toys and gifts during the Operation Dolls & More Drive-Thru donation event.

Vision

To be the provider and partner of choice, advancing services that transform and empower lives.

Mission LEARN MO R E AT:

rmhsccn.org

To enhance the health and well-being of our communities, individuals and families through responsive, innovative and collaborative services.

P.O. Box 222 | 78 South Main Street | Rutland, VT 05701 | 802.775.2381

Community Care Network

CCN is a member of:

Community.Care.Network

2020 Annual Report PHOTOGRAPHY Caleb Kenna Photography, CCN Staff GRAPHIC DESIGN Lyz Tomsuden VIDEOGRAPHY Andrew Wilson, Westview Digital