One cut, a microcosm of state's dilemma

Article published Feb 1, 2010 One cut, a microcosm of state's dilemma By Louis Porter VERMONT PRESS BUREAU MONTPELIER – Heather Sheppard and her husband didn't know what they were going to do. Their daughter was in what Sheppard called a "crisis scenario." She'd been drinking, running away from home and having some run-ins with the police. Then, under court direction, Brandalia, now 18, went to the Valley Vista inpatient adolescent substance program in Bradford last year. Actually, in a way the whole family did, Sheppard said. While Brandalia stayed at the facility the rest of the family made the long trip at least twice a week from the northern Vermont town of Cambridge to participate in the program and work things out. "The program was intense," Sheppard said. "She really worked hard and we did as a family. I don't think we would be OK without it." Like other parents or guardians, Sheppard has a high opinion of the Valley Vista program: "I don't know if my daughter would be alive today without it." While state officials and parents agree on the value of Valley Vista's programs for children and young adults, the state's budget crisis has left the future of the program unclear – and parents worried whether they are losing a vital option for troubled kids. This year in the budget proposed by Gov. James Douglas' administration there are a variety of cuts and changes in the funding of state grants and programs, part of the state's effort to meet a severe state fiscal crisis that has left a $150 million budget gap. One of those, which illustrates just how difficult and painful the process is turning out to be, is a proposed reduction in the $1.5 million appropriation Valley Vista has received in past year. Roughly $500,000 of that amount would, if the budget is approved by lawmakers, be spent for the same services, but it is unclear where those services would be given and what Valley Vista's part in them would be. The goal, state officials say, is to stop paying the program for state-funded beds which are not always used to capacity. But Jack Duffy, the program's executive director, says the state is simply not buying anything like that much unused capacity at Valley Vista. A $1 million cut will effectively mean that although Valley Vista will keep running and providing care for patients with private insurance, the state will no longer be paying for – or getting - any space there. "The adolescents who are served at Valley Vista have serious addiction and mental health problems that require inpatient treatment. Many of them have had serious physical or mental trauma and about a third of them are in state custody," Duffy said. "If there is not state funding for this program the next closest inpatient facility would be in New York State, approximately three hours away from most locations in Vermont." That is where Vermont kids with those substance abuse problems used to go, and the problem, some worry, is that it may be difficult or impossible for families to get there to participate in the kind of intense and difficult treatment their children need. Barbara Cimaglio, director of the Division of Alcohol and Drug Abuse Programs for Vermont's Department of Health, is a fan of the program. But the state budget – with less revenue than was brought in a half-decade ago despite inflation – is simply too tight not to make tough calls, she said. "The need clearly is there for substance abuse treatment," she said. "This was an area we just weren't able to continue to fund at the level we have been funding at the past." "We are all making very difficult choices now," she said. The state does not plan on sending the children who would have been at Valley Vista out of state. Instead the plan is to re-negotiate a new contract with the program to more closely fit the need with the spending, she said. Meanwhile outpatient treatment for the same kids has been improved in the state in the last five years, she said. "We have been making a concerted effort to enhance the community treatment that is available," Cimaglio said. "This has really been a tough decision. I think Valley Vista has done an excellent job with the children they have cared for," she said. "This was not an easy decision to come to." Administration budget writers and the governor have repeatedly said that there simply have to be cuts made in human services programs somewhere and they are ready to listen to alternative ways to save money It would be an easy decision for Scott Warner of Rutland City. His daughter Lauren was in trouble with drugs and alcohol like Heather Sheppard's. She also ended up at Valley Vista last year, and the program kept her on even after their private insurance ran out rather than discharging her before her work was done, Warner said. "We were dangling by a thread," he said. "It gave us part of our lives back." "My daughter was really in a self-destructive situation," Warner added. "I truly believe they saved her life." Warner said one of the most surprising things was meeting other parents in the program of all walks of life who had no idea how deeply their children were involved in drugs or alcohol – including a long-time police officer. "This is something that affects everyone," he said. Warner said he came to believe that in the long run the program saves money by keeping kids out of the criminal justice and court system. Valley Vista, along with the support groups his daughter has gone to since, was essential, Warner said. "We really needed this to work," he said. "It has. I can't tell you how wonderful it is to have her back." The state's involvement in Valley Vista came about in part because it was realized the old approach of sending those who need inpatient treatment out of state was not working, said Ken Libertoff of the Vermont Association for Mental Health. He worries the changes in funding could result in a return to that old system of trying to treat kids out of state. "It is the policy of the state to treat Vermont kids in Vermont. One of the priorities we have is to maintain that structure," he said. "It is possible we are going to drift back to the policy of 10 years ago." Putting those patients in out-of-state facilities is not the state's intention, but the state wants to align service needs with what they cost, Cimaglio said.