House Human Services Testimony – Rep. Ann Pugh, Chair


Cyrus Patten

President, Vermont Coalition of Residential Programs

Director, HowardCenter Comprehensive Care Programs


My thanks to the committee for your time today and for your commitment to evaluating the progress of Integrated Family Services.  The Vermont Coalition of Residential Programs is a collective of 21 Vermont organizations that provide high end services for Vermont children and families.  They provide services ranging from foster care to inpatient psychiatric hospitalization.  As stakeholders, we have been watching the implementation of Integrated Family Services since its inception.

The intention behind IFS is an honorable one: to shift human service resources from expensive, high-end levels of care for children and families to earlier, less intense and less expensive interventions.  The unfortunate reality is that despite the best efforts of many, the resistance of a few is preventing IFS from being realized.

The vision of IFS was one in which families receive the services they need without needing to experience a crisis and without consideration of arbitrary criteria.  It is a vision of children being served in a family centered, strengths based paradigm.  It is a vision of adherence to best practices and evidence based interventions that result in simple, early and effective treatment.  And lastly, it is a vision of streamlined funding and increased collaboration between state offices which time and time again has been proven to be better for families.

Rather than funding early interventions in order to prevent the need for high level intervention, the state has adopted an approach of cutting high end system with hopes it will result in decreased need for early interventions.  At great cost to children and families, the cart has absurdly been put before the horse.

For the past four years, residential programs have been level funded, while expenses have risen consistently.  I speak for residential treatment programs when I say that we are seeing children and families in crisis to a degree we have never seen before.  Children in need of specialized services are getting younger, more acute and their family systems more complex.

Although there are many causes for this rise in acuity, the most significant is lack of action and resources by those charged with care for this population.  If the measure of our humanity is how we treat those in need, I am scared for my daughter’s generation.

This is a gentle narrative compared to the real impact on Vermonters.  Children are being left in abusive homes.  Families are raising children they are neither resourced nor equipped to nurture.  The high end of the system is bursting at the seams while resources allocated to it shrink.  Children are being harmed by a system unable to keep them safe.

Words that cannot be used to describe Vermont’s system of care include: Streamlined. Continuum.  Responsive. Collaborative. Efficient and Effective.

Words that can be used to describe Vermont’s system of care include: Fragmented. Distressed. Desperate. Crisis.

The reality of the IFS implementation can best be understood by comparing it to spring roads in Vermont.  It is fraught with barriers and potholes.  It is taking much longer to reach our destination than originally intended.  And many stakeholders are left wondering whether or not we really can get there from here.

There is no quick solution, but there are simple ones.

1)      Fund the system fully and consistently.

2)      Direct AHS commissioners and their deputies to endorse IFS as the future of human service delivery in Vermont.  They’ve done it publicly, but they must do it operationally.

3)      Set a deadline for true integration on a fiscal and operational level and hold them to it.

Thank you again for your time.

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