Several community mental health centers serving the Upper Valley and surrounding regions will soon be included in a new payment model designed to offer more flexibility in treating patients with mental illness. Announced this month by the Vermont Department of Mental Health, the program will use a monthly payment structure rather than traditional billing, allowing providers greater freedom to use funds and tailor services to individual needs.
Known as the Certified Community Behavioral Health Clinic (CCBHC) model, the approach is part of a federally supported initiative already implemented in 13 other states. Vermont is among the first new states joining an expansion led by the Centers for Medicare and Medicaid Services. The aim is to address workforce shortages and rising demand for mental health and substance use treatment.
For Upper Valley residents, the change means that local designated agencies such as Health Care and Rehabilitation Services (HCRS), which serves Windsor and Windham counties, will have broader discretion in how to deliver and fund services. This could include adding peer counselors, expanding same-day access to care, and increasing outreach to underserved populations.
Barbara Morrow, executive director of HCRS, said in a statement that the new model “better aligns funding with our current approach,” which emphasizes team-based care and early intervention. HCRS and other participating agencies will receive monthly payments based on enrolled clients, rather than billing separately for each service rendered.
Advocates for the model argue that this change reduces administrative burdens and allows agencies to respond more quickly to patients in crisis. Traditional billing often limits providers to reimbursable services, which can leave gaps in care when patients need help that doesn’t fit into a coded category.
The organizations taking part in the program must meet federal standards for service delivery, including 24/7 crisis care, collaboration with law enforcement, and integration of physical and behavioral health. The Vermont Department of Mental Health expects participating agencies to begin implementing the model later this year.
State officials say the shift is intended to stabilize the mental health care system and improve outcomes in rural areas, where workforce shortages and long wait times have strained access. According to the department, Vermont saw a 30 percent increase in demand for mental health services during the COVID-19 pandemic, a trend that has not reversed.
Agencies like HCRS are already working to recruit new staff and expand capacity ahead of the transition. The organization has added crisis clinicians and telehealth capabilities in recent months, and Morrow said the funding model will help sustain those efforts.
While the state has emphasized the pilot nature of the program, it hopes to eventually expand the model to all ten designated mental health agencies across Vermont. Officials say the success of the initiative will be measured by reduced wait times, fewer emergency interventions, and improved patient satisfaction.
Though implementation is still underway, local providers see the new model as a way to address longstanding challenges in rural mental health care. For patients in the Upper Valley, the shift could mean faster access to support and more consistent follow-up at a time when mental health needs remain high.
As agencies prepare to adopt the new approach, health officials and community leaders say they will monitor progress closely to ensure that flexible payment leads to meaningful change on the ground.
