April 22, 2025
To Whom It May Concern:
I am writing regarding the present condition of Vermont’s substance abuse treatment system of care.
Vermont’s present model is funded via an “episodic rate,” which often results in short-term stays (14-17 days) at the highest level of care in one of two primary High-Intensity Residentials: Valley Vista or Serenity House. While low-intensity residential treatment is available, individuals are often discharged to their communities for treatment in their home geographic area, usually with options that range from living at a Sober Home and outpatient care, recovery supports at the local Turning Point Center, or both.
This unfortunately places them back with the very people, places and things which fed their addiction to begin with. Relapse is almost a certainty, and they are eventually sent back for another 14-17 day stay at a High-Intensity Residential.
This is what is called a Wash-Rinse-Repeat cycle, and we are doing exactly that in Vermont. The system we have in place may have worked somewhat well when we were in a Heroin crisis. But we are in a Fentanyl/Xylazine crisis, which is very different and requires a different approach.
As the executive director of Spectrum Youth and Family Services, one of our main programs is the provision of outpatient counseling for those suffering from mental health and/or substance use disorders. Eighteen months ago, I started meeting with judges, staff from Probation and Parole, and with providers from treatment programs such as Jenna’s Promise. We were all reporting seeing the sad, same phenomenon. We did our research and learned that other states, including nearby New Hampshire, have a much longer and more comprehensive system for treating those suffering from substance use disorder. We learned that we are missing that “middle piece,” that part of treatment that links an individual from a Valley Vista/Serenity House, to at least 30 days of coordinated care, and then refers people to the Sober Homes and Turning Point Centers which are, in fact, an indispensable component of treatment.
Creating this “middle piece” is supported by the scientific literature which states that the longer an individual is drug-free and has an opportunity to practice sobriety, the more likely he or she will engage in a sustainable, sober lifestyle.
It also makes financial sense for our taxpayers. The High-Intensity Residential is the most expensive component of the system of care. By treating an individual there for 14-17 days, sending them into the community, having them quickly relapse, and end back up at that Residential, this Wash-Rinse-Repeat cycle is costing the taxpayer dearly. It makes far more sense dollar-wise to continue to keep individuals in the system of care longer where the likelihood of their staying sober increases, and the cost to the taxpayer is less.
Another factor to consider is that under our present system, some of these individuals are relapsing and then becoming homeless and ending up in hotels and shelters, all of which are expensive. Some become involved in crime, at the cost of public safety and with a fiscal cost as well. The fact is that a person who is stable in their recovery is much more likely to obtain and maintain employment and secure permanent housing.
It took our group over a year, but we convinced the Scott administration to include funding for this “middle piece” in the Governor’s recommended budget. The administration has done so, proposing $1.5M which will create 15 beds.
It is now up to the Vermont Legislature to decide whether or not to proceed with this plan, and I am imploring them to do so. It would be nothing less than tragic to remove this money from the budget for some other purpose. We cannot wait for another biennium to address this issue. People are dying from overdoses of Fentanyl and Xylazine now. We need to catch up to the science and to what other states are doing. Vermont was not long ago the standard for the nation in terms of the provision of Medically Assisted Treatment, and the Hub-and-Spoke model, for the treatment of heroin addiction. But this is a different time, with much more dangerous drugs, requiring a different approach.
I am asking the Vermont Legislature to do the right thing and move ahead with the administration’s proposal. This has nothing to do with left versus right politics. It has to do with science, saving money , and, most importantly, saving lives.
Sincerely
Mark Redmond
Executive Director
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