The Vermont Statutes Online

Title 18: Health

Chapter 207: Community Mental Health and Developmental Services

• § 8901. Purpose

  The purpose of this chapter is to expand community mental health and developmental disability services; to encourage participation in such a program by persons in local communities; to obtain better understanding of the need for community mental health and developmental services; to authorize funding for the program by State aid, local financial support, and direct payment by people who receive services who have the ability to pay; and to provide services to persons with a mental condition or psychiatric disability, persons with a developmental disability, and children or adolescents with a severe emotional disturbance. (Added 1967, No. 305 (Adj. Sess.), § 1, eff. Oct. 1, 1968; amended 1979, No. 108 (Adj. Sess.), § 1; 1987, No. 264 (Adj. Sess.), § 10; 2005, No. 174 (Adj. Sess.), § 47; 2013, No. 96 (Adj. Sess.), § 115.)

• §§ 8902-8906. Repealed. 1979, No. 108 (Adj. Sess.), § 9.

• § 8907. Designation of agencies to provide mental health and developmental disability services

  (a) Except as otherwise provided in this chapter, the Commissioners of Mental Health and of Disabilities, Aging, and Independent Living shall, within the limits of funds designated by the General Assembly for this purpose, ensure that community services to persons with a mental condition or psychiatric disability and persons with a developmental disability throughout the State are provided through designated community mental health agencies. The Commissioners shall designate public or private nonprofit agencies to provide or arrange for the provision of these services.

  (b) Within the limits of available resources, each designated community mental health or developmental disability agency shall plan, develop, and provide or otherwise arrange for those community mental health or developmental disability services that are not assigned by law to the exclusive jurisdiction of another agency and that are needed by and not otherwise available to persons with a mental condition or psychiatric disability or a developmental disability or children and adolescents with a severe emotional disturbance in accordance with the provisions of 33 V.S.A. chapter 43 who reside within the geographic area served by the agency. (Added 1979, No. 108 (Adj. Sess.), § 2; amended 1987, No. 264 (Adj. Sess.), § 11; 2005, No. 174 (Adj. Sess.), § 47; 2007, No. 15, § 15; 2013, No. 96 (Adj. Sess.), § 115; 2023, No. 6, § 218, eff. July 1, 2023.)

• § 8908. Local community services plan

  Each designated community mental health and developmental disability agency shall determine the need for community mental health and developmental disability services within the area served by the agency and shall thereafter prepare a local community services plan that describes the methods by which the agency will provide those services. The plan shall include a schedule for the anticipated provision of new or additional services and shall specify the resources that are needed by and available to the agency to implement the plan. The community services plan shall be reviewed annually. (Added 1979, No. 108 (Adj. Sess.), § 3; amended 2005, No. 174 (Adj. Sess.), § 47.)

• § 8909. Boards of directors of nonprofit corporations designated as community mental health and developmental disability agencies

  (a) The board of a nonprofit corporation that is designated by the Commissioner of Mental Health or of Disabilities, Aging, and Independent Living to be a community mental health and developmental disability agency shall be representative of the demographic makeup of the area served by the agency. A majority of the members of the board shall be composed of both individuals who are or were eligible to receive services from an agency because of their disability, and family members of an individual who is or was eligible to receive services because of his or her disability. The board president shall survey board members on an annual basis and shall certify to the Commissioner that the composition of the board is comprised of a majority as required by this section. This composition of the board shall be confirmed by the organization’s annual independent audit. Annually, the board shall determine whether or not this disclosure shall be made available to the public on request. The board shall have overall responsibility and control of the planning and operation of the community mental health agency.

  (b) The board shall direct the development of the local community services plan and shall consult with the Commissioners, with consumers, with other organizations representing persons receiving services, persons with developmental disabilities, and children and adolescents with a severe emotional disturbance, and with other governmental or private agencies that provide community services to the people served by the agency to determine the needs of the community for mental health and developmental disability services, and the priority need for service. The plan shall encourage utilization of existing agencies, professional personnel, and public funds at both State and local levels in order to improve the effectiveness of mental health and developmental disability services and to prevent unnecessary duplication of expenditures.

  (c) For the purpose of this section:

  (1) “Disability” means, with respect to an individual,

  (A) a physical or mental impairment, including alcoholism and substance abuse as defined by the Americans with Disabilities Act, that substantially limits one or more of the major life activities of the individual;

  (B) a record of such an impairment; or

  (C) being regarded as having such an impairment.

  (2) “Family member” means an individual who is related to the individual with a disability by blood, marriage, or adoption, or considers himself or herself to be family based upon bonds of affection, and who currently shares a household with the individual with a disability or has, in the past, shared a household with that individual. For the purposes of this section, “bonds of affection” means enduring ties that do not depend on the existence of an economic relationship.

  (3) “Commissioner” means either the Commissioner of Mental Health or the Commissioner of Disabilities, Aging, and Independent Living, or both, depending on the circumstances and subject matter of the issue or issues being addressed. (Added 1979, No. 108 (Adj. Sess.), § 4; amended 1987, No. 264 (Adj. Sess.), § 12; 1989, No. 187 (Adj. Sess.), § 5; 1995, No. 174 (Adj. Sess.), § 3; 1997, No. 113 (Adj. Sess.), § 1; 2005, No. 174 (Adj. Sess.), § 47; 2007, No. 15, §§ 16, 22; 2013, No. 96 (Adj. Sess.), § 115.)

• § 8910. State aid; fees

  (a) Upon application to the Commissioner by a designated community mental health and developmental disability agency, the Commissioner of the appropriate Department may grant to the agency funds to be used for carrying out its mental health and developmental disability services. Such grant of funds shall be based on a program plan and program budget developed by the agency and submitted to and approved by the Commissioner or Commissioners. The budget plan must indicate cost per unit of service and anticipated fees for services and must represent a balanced plan of anticipated receipts and expenditures.

  (b) No State funds shall be distributed to a community mental health agency unless the Commissioner determines that the agency has a reasonable cost per service unit and has established a uniform and reasonable schedule of fees for services provided to those persons who can afford to pay. A policy statement regarding fees, instructions for payment of fees, and fee collection procedures to be used by the agency shall be prepared and updated annually.

  (c) Nothing in this section should be interpreted to preclude anyone from receiving the services of the agencies due to inability to pay nor to preclude an agency from bringing an action as provided by law to recover fees due. (Added 1979, No. 108 (Adj. Sess.), § 5; amended 2005, No. 174 (Adj. Sess.), § 47.)

• § 8911. Powers of the Commissioners

  (a) If the Commissioners after discussion with the board of a community mental health and developmental disability agency determine that the local community services plan required by section 8908 of this chapter is inadequate to meet the needs of persons with a mental condition or psychiatric disability or with developmental disabilities or children and adolescents with a severe emotional disturbance in accordance with the provisions of 33 V.S.A. chapter 43 in the area served by a mental health and developmental disability agency or that an agency has, for reasons other than lack of resources, failed or refused to implement an otherwise adequate plan, the Commissioners shall take one or more of the following steps:

  (1) Offer technical assistance to the agency.

  (2) Actively seek out and designate another agency to provide the needed services.

  (3) Directly provide or arrange the needed services if it appears that the services will not otherwise be available within a reasonable period of time. The remedies specified in this subsection shall be in addition to any other rights and remedies that are available to the Commissioner under State or federal law.

  (b) Until May 1, 1998, no agency that has been designated as a community mental health agency may lose its designation without first being provided with notice and an opportunity for hearing in accordance with the provisions of 3 V.S.A. §§ 809-813. After May 1, 1998, no agency may lose its designation except in accordance with new rules adopted for that purpose under the provisions of this subsection. Notwithstanding any other provisions to the contrary in 3 V.S.A. chapter 25, the Commissioner shall, in consultation with the designated provider system and consumer groups, develop proposed rules setting forth the standards and procedures for designation, redesignation, and loss of designation, and provide for six months’ notice of intent to revoke an agency’s designation. The proposed rules shall also provide standards with measurable performance-based criteria and a streamlined appeals process. On or before December 31, 1997, the Commissioner shall file and hold public hearings on the proposed rules as provided in 3 V.S.A. §§ 838, 839, and 840 in accordance with 3 V.S.A. chapter 25. The Commissioner shall file the final proposed rules with the General Assembly on or before January 15, 1998. Unless disapproved by act of the General Assembly on or before April 1, 1998, the Commissioner may adopt the rules by filing with the Secretary of State, which rules shall take effect on May 1, 1998.

  (c) The board of directors of a community mental health and developmental disability agency will be given a six-month notice of any intent on the part of the Commissioners to terminate its designated status. The Commissioners shall provide a written notice that outlines the performance based rationale associated with such intent. The board of directors shall have six months to review the Commissioners’ stated concerns and implement a corrective action plan. The board of directors shall also be informed, in writing, of current standards and procedures regarding appeal processes. (Added 1979, No. 108 (Adj. Sess.), § 6; amended 1987, No. 264 (Adj. Sess.), § 13; 1997, No. 61, § 140a; 2005, No. 174 (Adj. Sess.), § 47; 2013, No. 96 (Adj. Sess.), § 115.)

• § 8912. Contracts with nondesignated agencies

  The Commissioners may enter into agreements with local community mental health and developmental disability agencies or with any public or private agency for the purpose of establishing specialized services that are needed by persons with a mental condition or psychiatric disability or with developmental disabilities or children and adolescents with a severe emotional disturbance and are not available from designated community mental health agencies. (Added 1979, No. 108 (Adj. Sess.), § 7; amended 1987, No. 264 (Adj. Sess.), § 14; 2005, No. 174 (Adj. Sess.), § 47; 2013, No. 96 (Adj. Sess.), § 115.)

• § 8913. Minimum program standards and other regulations

  (a) The Commissioners shall establish minimum program standards for services provided by community mental health and developmental disability agencies. Minimum program standards shall specify the basic activities and resources that are necessary for the implementation of such programs.

  (b) The procedure for establishing such standards shall be in accordance with 3 V.S.A. chapter 25. (Added 1979, No. 108 (Adj. Sess.), § 8; amended 2005, No. 174 (Adj. Sess.), § 47.)

• § 8914. Rates of payments to designated and specialized service agencies

  (a) The Secretary of Human Services shall have sole responsibility for establishing the Departments of Health’s, of Mental Health’s, and of Disabilities, Aging, and Independent Living’s rates of payments for designated and specialized service agencies that are reasonable and adequate to achieve the required outcomes for designated populations. When establishing rates of payment for designated and specialized service agencies, the Secretary shall adjust rates to take into account factors that include:

  (1) the reasonable cost of any governmental mandate that has been enacted, adopted, or imposed by any State or federal authority; and

  (2) a cost adjustment factor to reflect changes in reasonable costs of goods and services of designated and specialized service agencies, including those attributed to inflation and labor market dynamics.

  (b) When establishing rates of payment for designated and specialized service agencies, the Secretary may consider geographic differences in wages, benefits, housing, and real estate costs in each region of the State. (Added 2017, No. 82, § 11, eff. June 15, 2017.)

• § 8915. Provision for agreements with case management entities

  Notwithstanding any provision of law to the contrary, the Commissioner of Disabilities, Aging, and Independent Living may enter into agreements with case management entities to support local communities. The Commissioner may develop rules setting forth the standards and procedures for the case management entities it contracts with. (Added 2023, No. 113 (Adj. Sess.), § E.300.1, eff. July 1, 2024.)