A record staffing shortage has led the Howard Center to reduce the number of “crisis beds” in Burlington and combine programs in a move some say will leave vulnerable people seeking support for substance use disorder and mental health issues in the lurch.
The Act 1 program — a temporary detox facility on Pearl Street with six beds — will no longer provide beds. Instead, it will only screen walk-in clients and refer them to other programs. Three other Howard Center programs have cut bed capacity in half, according to Bob Bick, the organization’s chief executive officer.
“It’s the worst it’s ever been,” said Bick, of the staffing crisis at the state’s largest social services agency.
The organization, which has a staff of 1,600 when fully staffed, is trying to fill 197 full-time and part-time positions and 220 substitute vacancies — the highest since the start of the pandemic.
On March 18, the center eliminated three of the six beds at its Bridge program, which complements Act 1 by providing short-term stabilization, detoxification and withdrawal management.
Assist, a stabilization program for adults experiencing a psychiatric crisis, and Jarret House, a stabilization program for children and youth ages 5-13 who are experiencing an acute mental health emergency, are also down from six beds to three each, according to Bick.
He said the programs affected require a minimum of two staffers per shift to remain open 24-7 — or 16.6 full-time staff positions and six to eight subs — but there just aren’t enough employees.
“I recognize and appreciate that when we talk about the numbers of beds or numbers of clients, every one of those numbers represents a person — an individual with loved ones and family and friends who are struggling,” Bick said.
“It is dispiriting for us here and for our staff who remain to know that we are not in a position right now to be able to meet the needs of individuals when they need those needs to be met,” he said.
Kashka Orlow, who worked as a residential counselor in the Act 1/Bridge programs, told VTDigger the programs, especially Bridge, are “critical to the community.”
“One of the issues is, once clients complete their detox at the Bridge program, they can become discouraged when we are unable to find them a bed at a longer term rehab center. They want so badly to be sober and to continue working on their sobriety but there are simply not enough spaces available to accommodate the huge needs we face,” Orlow said. “If no one else is waiting at the end of that ‘bridge,’ clients then have no choice but to return to their toxic environment where the cycle of addiction begins again.”
To preserve services, the Bridge program has moved from Pearl Street to the Assist program’s location on Pine Street in the city’s South End. Once 24/7 Jarrett House has been running 5.5 days a week since September due to staffing issues; Act 1 is operating from 8 a.m. Wednesday through 8 a.m. Monday; the Bridge and Assist programs remain open 24/7, according to Bick.
The situation is not unique to the Howard Center. Across Vermont, programs providing mental health and substance use services are facing a “hugely significant” staffing crisis, Bick said.
“I’ve talked with colleagues across the state. They are closing programs for days or weeks at a time. We are in a horrible situation,” he continued. “And our jobs are not the easiest jobs to do.”
Howard Center has a budget of $132 million, of which about 95 percent is state-funded. Funding has largely remained level for years, said Bick, though the state increased reimbursement rates this year. The Act1/Bridge program has a budget of $1.2 million this fiscal year and is running on a roughly $330,00 loss to date, he noted.
“We hope the community understands this is not a choice we looked forward to making but it was necessary in order to keep at least some of the services available during the staffing challenge,” Bick said.