Nearly 20 years ago in his landmark Vineyard book People and Predicaments, Island psychiatrist Milton Mazer recalled the beginnings of Martha’s Vineyard Community Services. He wrote:

“The venture to provide human services for the Island was begun in 1960 by a small group of Island physicians and clergymen. Their almost daily experience with the many Islanders overwhelmed by human predicaments had led them to look for remedies, and a psychiatric service seemed a good place to begin.

“There was no precedent for so small, so unaffluent, so isolated a community to start its own community mental health clinic. The difficulties of the proposal argued loudly for themselves. Would a traditional, rural New England community accept the presence of a psychiatric clinic in its midst? Would people be willing to consult a psychiatrist in numbers sufficient to justify his presence? What sorts of therapy could be feasible where anonymity is absent and a knowledge of the lives of one’s neighbors is a part of the gruel of life? And above all, how could such a service be supported in a county with the lowest median income and the highest rate of poverty in its state?”

Hard questions, all. Today, more than three decades after it began, Community Services, with its unique model as a multi-service agency, has a stronger presence than ever on the Vineyard. Community Services, which experienced trouble with finances and leadership several years ago, today finds itself on sound financial footing with a solid endowment and five successful social service programs. And now Community Services stands at a new crossroads.

This week leaders at Community Services announced the completion of a year-long strategic planning project. The report strengthens and clarifies the mission of Community Services, and lays out a detailed plan for the future. Among other things the plan calls for:

•Continuing the five successful health and human service programs;

•Strengthening Island-wide coordination and continuity of care in the programs and establishing partnerships with on and off-Island providers;

•Participating in the development of regional systems of care, anchored in the needs of Islanders while at the same time anticipating future funding changes at the local and regional levels;

•Establishing new services in response to community needs.

Community Services is a multi-service agency whose five programs include the Island Counseling Center, the Visiting Nurse Service, Early Childhood Programs, Women’s Support Services and Special Needs Support Services.

The report has been approved by the board of directors and concludes with a strategic work plan for the years 1995 to 2000 which lists 10 specific areas to be addressed by the staff and the board. The work has already begun, putting Community Services at the forefront of goal planning and change among social service and health care providers on the Vineyard.

“The committee recognizes this report is truly a beginning — not an ending,” declares the introduction to the strategic planning project report. “It is dedicated to the residents of Martha’s Vineyard, who comprise our board, staff, volunteers and most especially our clients to whom the plan is devoted.”

The strategic plan was prepared by senior program staff and members of the board for Community Services, assisted by consultants from Integrated Health Strategies Inc. of Cambridge. Among other things, the year-long planning project involved an intensive review of 30 years of operations at Community Services. It also analyzed industry trends, assessed each program area in detail and developed a far-ranging five-year plan for the continued delivery of services on the Island.

High marks went to Early Childhood Programs for its family day care and Head Start programs, to the Island Counseling Center for its youth services and to Women’s Support Services for its hotline, advocacy and counseling services.

The report also recounts the history of Community Services, tracking the evolution of its services and bluntly acknowledging the rough spots encountered over the years.

“The late 1980s were particularly troubling....The financial condition had so badly deteriorated, the very survival of the agency seemed in question,” the report noted.

Today, thanks in large part to the skilled leadership of director Ned Robinson-Lynch, Community Services is emerging from a five-year fiscal reorganization program in sound financial shape. And the view to the future is both bright and enterprising. With state and federal monies rapidly disappearing for health and social services, many agree that an increasingly creative approach is needed. Phrases like “integrated health management systems” now occupy the language of the business, and groups which are organized and can demonstrate clear long-range goals will likely get first crack at the shrinking dollars.

“Money is going to make the future decisions, not whether it is what you and I need,” said Mr. Robinson-Lynch. Mr. Robinson-Lynch and board vice president Arthur Wortzel met with the Gazette this week to talk about the strategic plan and the new platform it will give Community Services.

“The original concept is still sound; our greatest strength is the multi-disciplinary model and now we need to buff that up,” said Mr. Robinson-Lynch. “We have all cylinders working,” he added.

Community Services today has a $3.5 million budget and employs a staff of 110 (about 70 are full-time). Half the budget is funded through state and federal contracts; about 10 per cent of the other half comes from fund raising while the balance is made up by user fees. “We have grown in the last five years in terms of our budget and finances,” Mr. Wortzel said.

And while it is not the only multi-service agency in the state, Community Services is still unique in its model and community base. “It is a unique organization in many ways — and it’s Martha’s Vineyard again. Without the kind of support we have I don’t know if we could pull it off,” said Mr. Robinson-Lynch, adding: “The Vineyard is a little laboratory where we can say, ‘Let’s make this work.’<\q>”

The executive director said the next step includes reaching out to the Island community, as the agency addresses gaps in services and looks at possibly adding services. “Our next step is to go to the community; the public voice is going to have to be there again,” Mr. Robinson-Lynch said.

And addressing the report, Mr. Robinson-Lynch concluded: “I would want this to be a vision of leadership for health care on the Island.”