A lot of the
work that is being done at the Statehouse this year has been focused on
addressing problems created by tropical storm Irene. At the end of January, a few weeks into this
session, a 10 year old problem was finally tackled as a direct result of
Irene. Irene
did suddenly what the legislature has wanted to do for many years: it closed
the Vermont State Hospital in Waterbury. This caused severe disruption to the
State’s ability to provide services to Vermonters who need acute inpatient care
for mental illness. The silver lining: it forced the legislature to act and
provided a capital funding opportunity that was not available before.
Since the
flood, the reorganization of the mental health system has been under discussion
by several committees in the House with hearings being held throughout the
state. Caregivers, hospitals, patients
and their families gave testimony. The House finally passed H.630, entitled Reforming
Vermont’s Mental Health System.
The bill strengthens Vermont’s existing mental health care
system by offering a continuum of community and peer services, as well as a
range of acute inpatient beds throughout the state based on the principles
developed by the Mental Health Oversight Committee. These principles include:
- meeting the needs of individuals with
mental health conditions, including such individuals in the Corrections
system, while reflecting excellence, best practices, and the highest
standards of care;
- providing a coordinated continuum of
care to ensure that individuals with mental health conditions receive care
in the most integrated and least restrictive settings available, honoring
individuals’ treatment choices to the extent possible;
- performing long-term planning to
design programs that are responsive to changes over time in levels and
types of needs, service delivery practices, and sources of funding;
- ensuring that the mental health system will be integrated
into the overall health care system, including the location of any new
inpatient psychiatric facilities adjacent to, or incorporated with a
medical hospital;
- distributing facilities based on
demographics and geography to increase the likelihood of treatment as
close to home as possible;
- ensuring that the legal rights of
individuals with mental health conditions are protected; and
- ensuring that Vermont’s mental health
system will be adequately funded and financially sustainable to the same
degree as other health services with oversight and accountability built
into all aspects of the system.
A key
strategy of the bill is the development of a distributed system of care in
order to provide services closer to where patients live while at the same time
providing facilities that offer safe and secure environments for patients that
require them. The services that were provided
at the Vermont State Hospital will be provided at acute inpatient hospitals
throughout the state including a 14-bed unit within the Brattleboro Retreat and
a 6-bed unit within Rutland Regional Medical Center, and also by temporarily
contracting for 7 to 12 inpatient beds at Fletcher Allen Health Care, by
providing acute inpatient services at another temporary location, and by
building a 25-bed hospital in central Vermont.
Funding for these facilities will come
mostly from insurance payments for the Waterbury Complex and from FEMA
Relocation and Replacement assistance.
In addition, since the State Hospital, which had been decertified by the
federal government due to repeated problems, no longer exists, $10M per year in
federal funding is again available for operations. This will help the state absorb the
additional expenses of the temporary arrangements. The bill is now in the Senate.
