The Word in the House - 2/11/2012 - Irene's Influence on State Mental Health System

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.