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Agency of Human Services Programmatic Performance Budget (FY21)

This Scorecard demonstrates the programs and performance measures from across the Agency that have been included in the Agency of Administration's Performance Budgeting Exercise.

Vermonters are healthy
O
Time Period
Current Actual Value
Current Target Value
Current Trend
P
Time Period
Current Actual Value
Current Target Value
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What We Do

The Department of Health Division of Substance Use Programs is made of many programmatic elements that collectively prevent and eliminate the problems caused by alcohol and drug misuse. Our mission is to prevent, reduce and eliminate the problems caused by alcohol and drug use.  Strategies used by the various substance use programs include education, prevention, treatment, and recovery. The programs also collaborate with healthcare providers, community partners, and people with lived experience to end stigma and increase opportunities for treatment and recovery. 

Some of the specific programs and activities, many of them jointly implemented with valuable partners, include:

  • ParentUpVT
  • Prevention Consultants
  • Do Your Part
  • Impaired Driver Rehabilitation Program
  • Community Coalitions
  • Hub & Spoke System of Care
  • Recovery Centers
  • School-based Substance Abuse Services
Who We Serve

We serve all Vermonters of all ages, not only those who are directly experiencing substance misuse or directly serving them. We provide prevention services to those of all ages, intervention services to those misusing substances, treatment services to those with substance use disorders, and recovery services to any Vermonter needing support to sustain healthy behaviors. We also support people, organizations, and entire communities working to reduce substance misuse in Vermont through funding, media and promotion campaigns, and coalition building.

How We Impact

Substance Use Programs:

  • Improve access to prevention, intervention, treatment and recovery services to address substance use in Vermont.
  • Increase understanding of substance use disorders.
  • Employ evidence-based practices and strategies.
  • Fund services, provide technical assistance and encourage collaboration in communities.

Together with population indicators, the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

 Program

 FY23 Actual

 FY24 Projected

 FY25 Governor Recommended

 Substance Use Programs

 $55,647,669

 $67,806,887

 $61,355,605

This program includes the entire appropriation #342006000

P
Time Period
Current Actual Value
Current Target Value
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What We Do

The Vermont Department of Health Immunization Program provides vaccines to provider practices, educates health care providers and the public regarding immunizations, implements the state immunization regulations, and conducts ongoing assessments of population health status to identify populations at risk for vaccine-preventable diseases. Program activities are developed based on best practices to ensure access to affordable vaccines, support vaccination in the medical home, and provide the public with information needed to vaccinate with confidence.

Who We Serve

The Immunization Program serves all Vermonters with targeted efforts for parents, health care providers, provider practices, and school nurses.

How We Impact

The Immunization Program ensures adults and children have access to all recommended vaccines at their medical home and works to effectively limit vaccine preventable disease. Together with population indicators, the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Investment objective: Encourage the formation and maintenance of public-private partnerships in health care, including initiatives to support and improve the health care delivery system.

Budget Information

 Program

 FY23 Actual

 FY24 Projected

 FY25 Governor Recommended

 Immunization Programs

 $22,406,521

 $23,893,027

 $24,488,708

This represents a portion of the Public Health appropriation #3420021000

PM
2022
6.0%
5.0%
1
P
Time Period
Current Actual Value
Current Target Value
Current Trend
What We Do

Tobacco use is the number one preventable cause of death, but about 800 Vermonters still die each year from tobacco-related diseases.

Given the high level of morbidity and mortality related to tobacco use, three goals guide the work of the Tobacco Control Program: prevent youth smoking; reduce adult smoking; reduce exposure to second-hand-smoke. The Health Department Tobacco Control Program employs Centers for Disease Control and Prevention best practice in four key areas to address these goals:

  • Cessation services help Vermonters quit smoking through the Quitline, Quit Partners, or Quit Online as part of 802Quits. These services are evidence-based and greatly increase the chances a smoker will quit successfully. The program also partners to provide nicotine replacement therapy
  • Mass Reach Media, including hard-hitting ads, is shown to be effective in reaching those who smoke and inciting them to reach out to 802Quits. This includes television, radio, and social media efforts.
  • State and community interventions raise awareness on the actions decision makers can take to reduce the toll of tobacco. These include educating decision makers about passing smoke-free policies at local parks and playgrounds, which reduce secondhand smoke exposure and create positive social norms around tobacco use, and changing the tobacco retail environment, where exposure to product and advertising causes youth tobacco initiation. The Vermont Department of Health and the Agency of Education fund two youth tobacco prevention groups – Our Voices Xposed (OVX) in high schools and Vermont Kids Against Tobacco (VKAT) in middle schools.
  • Surveillance and evaluation ensure the program stays on track and uses data to drive programmatic decision making. The Tobacco Control Program invests in data collection, analysis, and dissemination to partners in and outside of government.
Who We Serve

The Tobacco Control Program is committed to serving all Vermonters seeking to reduce and quit their tobacco use. Some populations, including pregnant smokers, Medicaid-insured, those with mental illness or substance abuse disorders, less education, and lower income, are a focus of the Health Department. Additionally, supervisory unions with a higher burden of tobacco use are a targeted sector supported by this program. Tobacco use and the morbidity and mortality it causes disproportionally impact those with fewer resources and results in large health disparities.

How We Impact

By employing CDC Best Practices for Comprehensive Tobacco Control Programs with fidelity, the work of the Tobacco Control Program and partners should, over time, impact the number of Vermonters who smoke and therefore reduce deaths from tobacco-related diseases. Quitting tobacco has beneficial short and long term health impacts no matter one’s age. Three behaviors - no physical activity, poor diet, and tobacco use - lead to cancer, heart disease, diabetes, and lung disease accounting for more than 50% of premature deaths in Vermont. Reaching Vermonters that want to quit and supplying the needed cessation support will reduce, over time, the number of Vermonters suffering and dying from chronic disease.

Budget Information

 Program

 FY23 Actual

 FY24 Projected

 FY25 Governor Recommended

 Tobacco Control

 $4,304,731

 $4,088,918

 $4,088,918

This represents a portion of the Public Health appropriation #3420021000

P
Time Period
Current Actual Value
Current Target Value
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Budget Information

Appropriation ID - 15000 Global Commitment

What We Do

The Clinical Integrity Unit (CIU) is responsible for the utilization management of mental health and detoxification services. The team works toward the integration and coordination of services provided to Vermont Medicaid members with substance use disorders and mental health needs. The team performs utilization management activities; including concurrent review and authorization of mental health, eating disorder treatment, and substance use detoxification services. The CIU also administers the Team Care program, which locks a member to a single prescriber and a single pharmacy. In addition, the Autism Specialist authorizes applied behavior analysis (ABA) services for children.  The CIU also engages in Medical Record Reviews to support quality initiatives.

Partners
  • Department of Mental Health Adult and Children and Families Units,
  • Department of Disabilities, Aging and Independent Living,
  • Department for Children and Families,
  • Integrated Family Services,
  • Designated Hospitals,
  • Designated Agencies,
  • Special Service Agencies,
  • Vermont Chronic Care Initiative
How We Impact

The CIU serves Vermont Medicaid members who require mental health inpatient and detoxification services, eating disorder treatment, and ABA services.

PM
SFQ2 2024
5
3
P
Time Period
Current Actual Value
Current Target Value
Current Trend
Budget Information
What We Do

The Vermont Blueprint for Health is a state-led, nationally-recognized initiative that helps health care providers meet the medical and social needs of people in their communities. The Blueprint’s aim is constant: better care, better health, and better control of health care costs.

The Blueprint encourages initiatives to support and improve health care delivery. It promotes innovative initiatives aimed at improving health outcomes, increasing preventive health approaches, addressing quality of life concerns, and increasing access to quality care through patient-centered medical homes and community health teams.

Who We Serve

The Vermont Blueprint for Health serves all Vermonters.

How We Impact

The activities of the Blueprint serve as the foundation for strengthening primary care and expanding the ACO programs. This initiative is especially focused on building the links between community and medical services, so that patients have better coordinated care across the spectrum of services.

Together the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

P
Time Period
Current Actual Value
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Budget Information
What We Do

The Vermont Chronic Care Initiative (VCCI) provides holistic, intensive and short-term case management services to Vermont residents enrolled in Medicaid, including dually eligible members. VCCI works with non- ACO members identified using claims-based methodology and members identified by health care providers and community partners in need of complex care management. VCCI case managers are also welcoming new members to Medicaid, by outreaching and asking questions about primary care provider, health conditions and other supports that would assist them in maintaining or improving their health as well as housing, food and safety. The VCCI team works to connect members with medical homes, community-based self- management programs, and local care management teams.

The VCCI utilizes common tools and processes adopted by the local community care teams as part of the complex care model to include eco mapping, identification of lead care coordinator, facilitating care teams, and shared care plan development.

Licensed case managers trained in the complex care model, deliver services in communities throughout the state.

How We Impact

The VCCI case managers are community based; and are stationed within the communities they live in. They work closely with their community health care and social service providers; collaboratively working with each other and the member on the member identified priorities. The case managers are closely linked with their AHS Field Directors – which has proven vital when working with members that may be involved with DCF, DOC, DMH, DAIL, and VDH. VCCI case managers meet with members in varied locations- homes, PCP offices, homeless camps, hospitals, shelters- successfully engaging members that have been historically ‘hard to find’.

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Time Period
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What We Do

The Community Rehabilitation and Treatment (CRT) programs provided at Vermont's Designated Agencies help individuals and their families to develop skills and supports important to living the life they want for themselves.

Who We Serve

Vermont’s Community Rehabilitation and Treatment (CRT) programs assist adults that have been diagnosed with a severe and persistent mental illness. Symptoms may be mild or substantially disabling, and long-term or short term.

How We Impact

Together the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

Budget Description: Adult Services to include Emergency Services Investment, CRT (all expenses), Adult Case Rate, Homeless, MISC Adult Grants, Emergency Outreach, Case Management, Workforce Training, Forensic System of Care

FY 22 Actual FY 23 Budget FY 24 Draft Governor Recommend
$93,927,952 $99,771,295 $101,648,524
PM
SFY 2023
2,220
5
P
Time Period
Current Actual Value
Current Target Value
Current Trend
What We Do

The Vermont Psychiatric Care Hospital provides excellent care and treatment in a recovery-oriented, safe, respectful environment that promotes empowerment, hope and quality of life for the individuals it serves.

Who We Serve

The Vermont Psychiatric Care Hospital (VPCH) serves adults who require a hospital level of care and who are held involuntarily by a civil or a forensic order. VPCH is considered a Level 1 inpatient facility, meaning it serves those who are highly acute and require additional services and supports.

How We Impact

Together the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

DMH Program budget (summary level)

FY 22 Actual FY 23 Budget FY 24 Draft Governor Recommend
$28,065,553 $24,833,519 $31,355,689
Vermont's families are safe, stable, nurturing, and supported
P
Time Period
Current Actual Value
Current Target Value
Current Trend
What We Do

The Family Supportive Housing (FSH) Program provides intensive case management and service coordination to homeless families with children and helps house families through partnership with housing providers. The program's goal is to reduce the incidence and duration of homelessness through supports for families as they transition to and sustain permanent housing over time. Service coordination and case management focus on the root causes of a family's homelessness; promote resiliency for parents and their children; and help households build financial capability. FSH staff take a holistic, two-generation approach using non-judgmental, positive, and trauma-informed communication and engagement in their support of families.

Who We Serve

Families with children under the age of six who have had multiple episodes of homelessness or engagement with Family Services are prioritized for the program. OEO administers funding which supports Family Supportive Housing at seven community-based providers: Barre, Bennington, Brattleboro, Rutland, St. Johnsbury and White River Junction.

How We Impact

Service Coordinators provide customized home-based case management; financial empowerment coaching; life skills support and referrals; tenant education; parent and child resiliency support; and support of addiction recovery. FSH Service Coordinators align and coordinate these services with existing Agency of Human Services programs and initiatives.

Budget Information

FSH

SFY23 Actual

SFY24 Projected

SFY25 Governor Recommended

Program Budget

$1,399,208

$3,086,351

$3,086,351 (not final)

PM
2023
62%
1
P
Time Period
Current Actual Value
Current Target Value
Current Trend
What We Do

The BARJ program is an arm of the youth justice system that provides support to youth who are at-risk for involvement in the justice system, or have been adjudicated and may or may not be on probation with DCF - Family Services.  The primary goal of the BARJ program is to support youth involved in, or at risk of becoming involved in the justice system by providing restorative interventions that reduce or eliminate further involvement in the system.

Who We Serve

BARJ serves youth who are at risk of becoming involved with the justice system, have been adjudicated or truant from school.

How We Impact

The purpose of this contract is to provide restorative services that focus on accountability and competency development of the youth, and community safety, while including the victims and the community in repairing the harm caused.  The Balanced and Restorative Justice (BARJ) program is successful because it offers a variety of supports and services that vary depending on the individual needs of the youth and family.  The BARJ program works with youth to support them in:

  • Building upon their protective factors; 
  • Building upon their self-regulation in natural settings; and
  • Not committing new offenses.
Budget Information
BARJ

SFY23 Actual

SFY24 Projected

SFY25 Governor Recommended

Program Budget

$942,295

$1,704,798

$2,038,051 (not final)

 

P
Time Period
Current Actual Value
Current Target Value
Current Trend
What We Do

Strengthening Families Child Care provides grants to community child care programs throughout Vermont to ensure affordable access to high quality comprehensive early care and education and afterschool programs for children and families challenged by economic instability and other environmental risk factors.

Who We Serve

These grants serve:

  • Children/families eligible for and participating in the CDD Child Care Financial Assistance Program (at least 25% of enrolled children).
  • Children/families who are receiving specialized child care services: including children with an open case with the Family Services Division of the Department for Children and Families (including foster children), children in families participating in Reach Up, refugee children and teen parents.
How We Impact

The following impacts on intended by these grants:

  • Documented use of the Center for Social Policy Strengthening Families Program Assessment tool through submission of outcomes and related program plan.
  • Continuity of care improves as measured by attendance records and compared to participants in CCFAP including specialized care in other non Strengthening Families programs.
  • 70% of parents report positive family experiences (protective factors) as part of their overall experience of having an enrolled child in the program.
Budget Information

Strengthening Families Child Care

SFY23 Actual

SFY24 Projected

SFY25 Governor Recommended

Program Budget

$978,676

$726,091

$1,110,000 (not final)

 

PM
HY1 2023
849
1
PM
HY1 2023
602
1
P
Time Period
Current Actual Value
Current Target Value
Current Trend
What We Do

The Department of Mental Health is a major partner in the Agency of Human Services Integrating Family Services initiative. IFS brings together different programs and funding streams within AHS to create a single, flexible service delivery and payment system for services and supports to children, youth and their families so that practice and planning better match their needs.

DMH has two participating providers: Counseling Services of Addison County (CSAC) and Northeast Counseling and Support Services (NCSS). These providers work with the Parent Child Centers in their respective regions.

Who We Serve

This initiative provides supports and services to children, youth and families (prenatal to age 22).

How We Impact

Bringing these programs and funding streams together the following performance measures focus on whether Vermonters are better off as a result of this initiative. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

Budget description: Childrens Community Services to include Emergency Services, Childrens case rates, peer services and Misc. Grants

FY 22 Actual FY 23 Budget FY 24 Draft Governor Recommend
$53,176,860 $58,881,465 $58,981,662
PM
FYQ2 2024
1,071
2
Vermont is a safe place to live
O
Time Period
Current Actual Value
Current Target Value
Current Trend
I
2019
42.40
1
P
Time Period
Current Actual Value
Current Target Value
Current Trend
Budget Information
FY20 PROGRAM BUDGET  
Primary Appropriation # 3480004000
FY 2020 Appropriation $$$ $139,982,309.00
Portion ($$$) of Appropriation Dedicated to Program $139,982,309.00
TOTAL PROGRAM BUDGET FY 2020 $139,982,309.00
   
FY18 PROGRAM ACTUALS  
FUND: GF (Code: 10000) $136,132,643.67
FUND: SF (Code: 21870) $777,327.99
FUND: FF (Code: 22005) $801,816.91
FUND: GC (Code: 20405) $5,166,089.00
TOTAL ACTUAL FY18 $142,877,877.57
What We Do

Correctional Services oversees individulas placed on the following legal statuses:

Incarceration: The sentence is confinement to a correctional facility, under the care and custody of the Commissioner. Release is by the Parole Board, upon completion of the minimum term or placement on community supervision furlough by the Commissioner.

Home Detention: A program of confinement and supervision that restricts a defendant to a pre-approved residence continuously, except for authorized absences, and is enforced by appropriate means of surveillance and electronic monitoring by the Department of Corrections.

Community Supervision Furlough: At the completion of the minimum term of sentence, the inmate may be released to the community, still under confinement, subject to conditions of furlough.

Pre-approved Furlough: The offender is sentenced to a term of confinement, but with prior approval of the Commissioner, for immediate release on furlough. Furlough status is a community placement, but the revocation is administrative, and the rules for behavior more stringent.

Parole: On completion of Conditional Reentry, or during the term of incarceration, on petition of the State or the inmate, the Parole Board may release the inmate on Parole, subject to the rules of the Board, supervised by Corrections.

Supervised Community Sentence: Based on a law passed in 1990 that provides the legal framework for the intermediate sanctions program. The judge sentences, with prior approval of the Commissioner, to a set of conditions, minimum and maximum time frames and an intermediate sanctions programs. The offender is under the supervision of the Department of Corrections. The Parole Board is the appointed authority and violations are resolved through a Parole Hearing. When the offender reaches his minimum sentence the Parole Board may continue on SCS, convert to Parole, or discharge from supervision completely.

Probation: An offender found guilty of a crime upon verdict or plea, is released by the court without confinement, subject to the conditions and supervision by the Commissioner of Corrections. This is a contract between the offender and the court, to abide by conditions in return for the court not imposing the sentence. Violation of this sanction requires due process, with a court hearing, counsel, and proof beyond reasonable doubt. Within the probation sanction is the reparative probation program, which allows citizens on community panels to determine the quality of restitution made to the victim and repair of harm to the community, consistent with 28 VSA Chapter 12.

Who We Serve
How We Impact
PM
2018
8,691
2
P
Time Period
Current Actual Value
Current Target Value
Current Trend
Budget Information
Transitional Housing FY23 Actual FY24 Budget FY25 Governor Recommended
Program Budget $ 5,848,810.87 $ 6,364,748.00    $ 6,511,864.00
(Appropriation #3480004000)

*FY22 and FY23 Budgets include Community Justice Centers and VNADSV.

What We Do

Through grants to community partners, the DOC supports the provision of transitional housing, rental assistance, housing search and retention, and other supportive services for individuals released to the community from Vermont's correctional facilities. The primary purposes of the program are to:

  1. Promote housing stability of individuals returning to the community from incarceration;
  2. Supervise and support individuals in the least restrictive environment (conducive with public safety); and
  3. Provide opportunities for reintegration and connections to community and services.

With a safe, stable place to live, participants are able to find employment, engage in substance abuse and mental health treatment, pursue education or training opportunities, and connect to services that will support their long-term stability in the community. 

Who We Serve

Priority is given to individuals being released to the community from incarceration, as well as individuals who are supervised in the community and are at risk of being (re)incarcerated due to lack of appropriate and stable housing. Most participants are on furlough/conditional reentry status, and all participants are under some level of Department of Corrections (DOC) supervision.

The individuals we serve have multiple and complex needs often related to mental health, substance abuse, employment, transportation, rental history (or lack thereof), and education, just to name a few.

How We Impact

The DOC works in partnership with Designated Agencies, Public Housing Authorities, Community Justice Centers, affordable housing providers, private landlords, municipalities, and non-profit organizations. 

To gauge whether participants are "Better Off" after having participated in transitional housing programs, we measure the following:

  • % who were not charged with a new crime while in the program;
  • % of participants who were employed, enrolled in an educational or training program, or receiving benefits (TANF, SSI, VA, General Assistance, etc.) at exit; and
  • # (and %) who exited to permanent housing (included in this report).

Additionally, program activities support community connections and integration.

PM
Q4 2023
71%
80%
2
PM
Q4 2023
212
268
1
Vermonters with disabilities live with dignity and in settings they prefer
O
Time Period
Current Actual Value
Current Target Value
Current Trend
Why Is This Important?
P
Time Period
Current Actual Value
Current Target Value
Current Trend
Budget information

Brain Injury Program (TBI)

FY22 Actual

FY23 Budget

FY24 Governor Recommend

Program Budget

(Appropriation ID 3460070000)

$5,598,179

$6,163,669

$6,321,928 not final

What We Do

The Vermont Brain Injury Program supports Vermonters with a moderate to severe brain injury, diverting or helping them return from hospitals and rehabilitation facilities to a community-based setting. This program is focused on rehabilitation and driven by participant choice, supporting individuals to achieve their optimum level of independence and to return to work.

Who We Serve

The Vermont Brain Injury Program serves Medicaid eligible Vermonters with a moderate to severe brain injury.

How We Impact

The Vermont Brain Injury Program helps Medicaid eligible Vermonters with moderate to severe brain injuries to achieve their optimum level of independence and to return to work.

P
Time Period
Current Actual Value
Current Target Value
Current Trend
Budget information

Division for the Blind and Visually Impaired

FY22 Actual

FY23 Budget

FY24 Governor Recommend

Program Budget (Appropriation ID 3460030000)

$2,026,989

$1,761,457

$1,907,604 not final

What We Do

The Division for the Blind and Visually Impaired (DBVI) is the designated state unit to provide vocational rehabilitation and independent living services to eligible Vermonters who are blind and visually impaired. DBVI's Mission is to support the efforts of Vermonters who are blind and visually impaired to achieve or sustain their economic independence, self reliance, and social integration to a level consistent with their interests, abilities and informed choices.

Who We Serve

DBVI serves Vermonters who are blind and visually impaired.

How We Impact

DBVI supports Vermonters who are blind and visually impaired to achieve or sustain their economic independence, self reliance, and social integration to a level consistent with their interests, abilities and informed choices.

PM
2023
53.2%
43.7%
1
PM
2023
55.4%
50.0%
2
PM
2023
56.7%
49.8%
1
PM
2023
56.0%
53.5%
1
PM
2023
$6,153
$4,800
4
P
Time Period
Current Actual Value
Current Target Value
Current Trend
Budget information
Project Search

FY22 Actual

FY23 Budget

FY24 Governor Recommend

Program budget

$315,199

$315,199

$315,199 not final

In addition, each school district listed above contributes a per pupil tuition via Special Education funding which, in collaboration with the DAIL budget, covers the expense of the program.

What We Do

Project SEARCH prepares student-interns during their last year of high school or transition age adults with technical skills taught through several training rotations within a host business which lead to competitive employment upon high school graduation.

Who We Serve

Transition age youth age 18 to 26 who are eligible for developmental disabilities services.

How We Impact

The Project SEARCH model assures a smooth transition into the Vermont workforce for transition age youth by providing marketable technical skills and person-centered job placement.

O
Time Period
Current Actual Value
Current Target Value
Current Trend
Why Is This Important?
P
Time Period
Current Actual Value
Current Target Value
Current Trend
What We Do

Emergency (or Crisis) Services are time-limited, intensive supports provided for individuals and families who are currently experiencing, or may be expected to experience, a psychological, behavioral, or emotional crisis.  Services may also be provided to the individual's or family's immediate support system. These services are available 24 hours a day, 7 days a week.

Who We Serve

Any person in Vermont is eligible to receive support through the Emergency Services (ES) program.

How We Impact

Together the following performance measures focus on whether Vermonters are better off as a result of this program. They do so by looking at the quality and efficiency of these programs and services.

Budget Information

There is no budget information specific to Emergency Services. It is emeshed in the following budgets:

  • Suicide Prevention
  • Childrens Community Services to include Emergency Services, Childrens case rates, peer services and Misc. Grants
  • Adult Services to include Emergency Services Investment, CRT (all expenses), Adult Case Rate, Homeless, MISC Adult Grants, Emergency Outreach, Case Management, Workforce Training, Forensic System of Care
PM
SFY 2023
10,340
1

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Scorecard Container Measure Action Actual Value Target Value Tag S A m/d/yy m/d/yyyy