Community Rehabilitation and Treatment

Community Rehabilitation and Treatment Option

  • The Vermont Agency of Human Services (AHS) would make administrative policy changes to Vermont’s Medicaid mental health services.

    Almost all Community Rehabilitation and Treatment (CRT) services would be delivered as rehabilitation services instead of as home and community-based services. This is a technical change, not a change to services.

    • This change would allow Designated Agencies and Specialized Services Agencies (DA/SSAs) to continue providing mental health case management (service coordination) and still provide most CRT services to eligible people.
    • To avoid conflict of interest, a small subset of CRT home and community-based services, such as supported employment, would need to be delivered by other direct service providers (not DA/SSAs).
    • This option would minimize change for people receiving CRT services and CRT providers. It would support continuity of existing therapeutic relationships.
  • ProsCons
    • Maintains DA/SSA structure with minimal disruption of CRT services for individuals and families.
    • Maintains close coordination/integration of CRT case management and direct services within same agency.
    • Will need to develop additional separate HCBS provider capacity for the mental health HCBS (such as supported employment) that cannot be defined as Medicaid Rehabilitation Services.
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