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In 2012 the Vermont Legislature passed Act 79 following the significant loss of inpatient mental health care beds from Tropical Storm Irene. Act 79 provided resources to expand the state’s community-based approach to mental health care, including peer counseling services. This report provides an in-depth analysis of Vermont’s community-based programs, specifically the Community Rehabilitation Treatment programs, focusing on client outcomes, peer counseling providers, costs, and policy changes from Act 79. It first assesses existing research on the effectiveness of peer counseling and community-based programs in improving mental health outcomes. Since housing stability is associated with mental health outcomes, housing programs available for Vermont residents with severe and persistent mental health conditions are examined. The report also considers the changes in peer counseling services resulting from Act 79 and services in several other states (Maine, Connecticut, and New Hampshire). The analysis highlights potential options for Vermont in improving its provision of mental health services, and peer counseling programs in particular.