Gov. Peter Shumlin, Feb. 22, 2012. VTD/Alan Panebaker
The triangulation continued on Tuesday between the Shumlin administration, the Senate and the employees’ union over the size of the facility that will replace the Vermont State Hospital.
Gov. Peter Shumlin wants a 16-bed facility; the Vermont State Employees Association is pushing for a psychiatric hospital with 50 beds; and the state Senate will take up amendments this afternoon that range from 25 to 50 beds.
The vehicle for the legislation, H.630, under consideration in the Senate today, originally included 25 beds as approved by the House a few weeks ago. The Senate version of the bill has 16 beds, with no option to increase that number.
At his weekly press conference on Tuesday, Shumlin insisted that a larger psychiatric hospital would not be eligible for Medicaid funding. The governor said he met with officials from the Centers for Medicaid and Medicare in Washington last week. They said, according to Shumlin, that they would not support a 60 percent federal match for an institution for mental disease larger than 16 beds.
“I made very clear the discussions going on in this Legislature about whether we could build 16 beds or 25 beds or 30 beds,” Shumlin said. “All I can tell you with certainty is this: It is incredibly likely that should this Legislature vote for more than 16 beds, Vermont taxpayers will be paying $10 million every single year out of their pockets that should be paid for by the federal government. I was very specific with them about our situation and what they said was, ‘Governor, you have to know there’s no example in the country where if you build more than 16 beds in a new facility that you’ll get reimbursed from federal government.’”
That $10 million is a reference to the current reimbursement rate from the Centers for Medicaid and Medicare for patients now placed at regional hospital facilities around the state in the wake of the Aug. 28 flood that destroyed the Vermont State Hospital. Before the Tropical Storm Irene disaster, the state had been ineligible for the 60 percent Medicaid match from the feds because the state hospital was decertified by CMS in 2003. For at least eight years, the state lost about $10 million a year in federal funding for the psychiatric facility.
Shumlin wants to preserve that federal funding going forward by moving toward a decentralized mental health system that relies on private hospitals like Rutland Regional Medical Center, Brattleboro Retreat and Fletcher Allen Health Care.
“We are running a business here in the respect that government is an operation that has to be fiscally responsible,” Shumlin said. “All I can say is our plan has found the balance between the best quality with the patients who come first and the best deal for Vermont taxpayers. This debate’s important. I need a bill on my desk that allows the administration to build a 16 bed facility not a 17 bed facility.”
The governor, who originally asked for a bill on his desk by Feb. 17, urged lawmakers to move as quickly as possible.
“I think what the Legislature must understand is that we are in crisis,” Shumlin said. “People’s lives are at stake here. Get me a bill. This crisis will not get better with time. Every day a bill is not on my desk it’s more likely that a tragedy is going to come to Vermont.”
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He may be running it like a business, but government is not a business.
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The Senate is scheduled to be on the floor at 3:30 PM this afternoon. View the amendments via the following:
Senate Calendar for Wednesday, February 29, 2012:
http://www.leg.state.vt.us/docs/2012/calendar/sc120229.pdf
View House passed version of H. 630 as well as Senate Health and Welfare Committee “strike all” amendment:
http://www.leg.state.vt.us/jfo/vsh_replacement_plan.aspx
Listen to audio of senate proceedings (beginning at 3:30 PM this afternoon):
http://www.vpr.net/news/vermont_legislature/
via Vermont Public Radio (VPR)
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That $10 million a year could be used for community treatment that would keep people from deteriorating to the point where they need hospitalization. Maybe the members of the Legislature who vote for a larger hospital should pay that $10 million out of their own pockets.
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In addition to what it could cost the state to continue what would be considered by the feds as an IMD (Institute of Mental Disease) and, even if the state managed to fudge their way around such regulations as they once did before VSH was decertified once again and and then for years prior to the Irene flooding), BGS has stated the cost at building anew at $1 per bed and so these monies will also take away from the needed investments in building a much more robust community services system, including providing the needed additional housing opportunities and also providing more in the way of peer-run services and supports; the reason also given before why these things could not be done was due to their being no money available, because nearly $24 Million in general fund Vermont taxpayer dollars was being spent on an annual basis on keeping VSH operating and also was part of why when they needed to cut they did so to community-based services and which is why there was growing demand since people did not have wanted they needed within the community and not just in the way of mental health services either, but across the board, including housing and the like.
On top of this is how there were and would continue to be those who could be better served in least restrictive settings in the community, including within housing of their own and not in institutional settings; this has gotten other states, including New Hampshire, into trouble with the U.S. Department of Justice (DOJ) as a result of ADA/Olmstead violations and Vermont had a huge liability on its hands in these regards when VSH was still open due to holding people within institutions who could be better served elsewhere and are not because the resources are not being provided for them to do so.
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i.e., … BGS has stated the cost at building anew at $1 Million per bed …
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Governor Peter Shumlin’s Executive Order regarding Vermont State Hospital (VSH) Employees who have been subject to the recent Reduction In Force (RIF):
http://governor.vermont.gov/sites/governor/files/executive_orders/EO%2004-12%20Protection%20of%20VSH%20Employees.pdf
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Vermont State employee RIF rights are generous in helping laid off workers find other state jobs. There may not be enough jobs for displaced employees now, but there will be in the future. Recall Rights continue for two years. Recall Rights are mandatory rights to a permanent classified position with State government.
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RIF Rights Info Sheet (via VSEA):
http://www.vsea.org/rif-rights-info-sheet
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SMART MOVE!!! The union needs to back down and give in! We need to invest in community based services for our most vulnerable citizens. Smaller facilties are better. VSH workers should be given priorty on open positions. Keep the new facility at 16 beds.
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The Waterbury stae complex is now able to be reused. The governor is playing the people of Waterbury as a political pawn in his game. There’s a current underneath that the governor doesn’t want anybody to see. Could be a new building will make him some money on the side. The future of the Waterbury complex is laying in wait for the right people to come along and point out the good of having the state complex where it is.
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The Waterbury complex is on a flood plain a hundred yaeds from the river. The parking lot flooded every few years. It will probably flood again soon.