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.”