Despite $80 million of uncertainty hanging in the air, the state is going full speed ahead on its ambitious overhaul of the mental health system, Shumlin administration officials said Tuesday.
“We can’t afford to slow the process down,” Secretary of Administration Jeb Spaulding told a special legislative Health Oversight Committee at the Statehouse, citing the continuing crisis in mental health caused by the closure of the Vermont State Hospital by Tropical Storm Irene a year ago, eliminating all 54 acute care beds.
But he admitted the state was in a “delicate situation” as it awaits word from the Federal Emergency Management Administration on how much money it will provide to rebuild the system.
“We need their help in order to achieve what we want to achieve,” Spaulding said. Vermont hopes to build a new $27 million, 25-bed state hospital next to Central Vermont Medical Center in Berlin and is on track to add six acute-care beds in Rutland and 14 in Brattleboro as the state moves to a more community-based, regional care system.
Mental Health Commissioner Patrick Flood stressed the same point, saying, “We are nowhere out of the crisis yet,” and the state could not afford to delay planning for the new hospital, which is on a tight schedule with plans to open in January 2014. Flood said patients are still finding themselves stuck in emergency rooms waiting for beds to open up for treatment.
FEMA officials gave the state a shock several weeks ago by indicating they may fund much less than the hoped-for $80 million to help replace the flooded Vermont State Hospital in Waterbury and to restore the Waterbury state office complex. The state has proposed a new state-of-the-art office building at the complex, along with some reuse of buildings, a new power plant and some demolition, all as part of its plans to bring back around 1,000 state office workers to the historic complex about 10 miles from Montpelier.
Spaulding said that what happens at the Waterbury complex depends on how much FEMA eventually decides to chip in. The governor said at a press conference Tuesday that decision is now going to come at the end of the month instead of this week as first indicated.
According to Spaulding, the state expects to purchase the land next to Central Vermont Hospital “in a matter of days” after working out a series of complications that have delayed the process. Flood said construction was planned to begin around Thanksgiving.
Spaulding said of the plans to build a new mental health hospital in Berlin: “We haven’t slowed down now, we do not anticipate slowing down.” But if FEMA money falls short, he said there would likely be “repercussions” with the plans for the state complex in Waterbury and the state would have to re-evaluate what it can do.
“The governor is committed to bringing state employees back to Waterbury. The question is, can we afford to do it,” he said in light of the FEMA issue. Spaulding said the state may have to scale back its plans for a “high quality workplace of the future” to something “maybe not state of the art.”
Flood gave legislators a rundown on the state’s efforts to overhaul mental health based on the comprehensive legislation passed by the Legislature this spring in Act 79, citing both progress and delays.
Overall, he said the new state hospital effort “was moving along extremely constructively, and at a good clip.” A final design for the hospital, which will have a 16-bed and nine-bed wing around a central core, is expected to be finalized later in August. A public hearing on the plan is set for Aug. 20, he said.
According to Spaulding, the state expects to purchase the land next to Central Vermont Hospital “in a matter of days” after working out a series of complications that have delayed the process. Flood said construction was planned to begin around Thanksgiving.
Flood said the state’s plan for eight temporary acute-care beds in Morrisville have been delayed several weeks by discovery of asbestos during renovation of space at the Lamoille Community Connections offices. The beds are expected to be ready by the end of September.
“We need those beds and the sooner we have them the better,” he said. “In this environment, eight beds are huge.”
Those needing acute care currently are being treated in hospital psych wards and in 14 beds at the Brattleboro Retreat, but a crunch for acute care continues in the state, affecting availability of in-patient treatment crisis beds for those needing lesser levels of care as well.
According to Flood, renovations for a six-bed acute care ward at the Rutland Regional Medical Center will begin in September and renovations for a new 14-bed ward at the Retreat are under way. Both are expected to open in February 2013, he said.
“At the end of the year you’re going to see a lot of resources come on line,” he said.
The overhaul also provided funding for new residential facilities for mental health treatment called “step-down” facilities and Flood cited progress in that arena. One is open in southern Vermont in Westminster, another is planned to open this fall or early winter in Westford in Chittenden County and a third is in the planning stages in the Rutland area. A fourth is planned with seven beds in Franklin County.
A “Soteria” house five-bed facility, a model designed for those who desire mental health treatment without medication, is being planned in Chittenden County as part of the state’s community-based approach. Its projected opening is set for July of next year.
The one place the state remains somewhat stymied is in building a secure treatment facility to house those under court order, he said. According to Flood, the state is still exploring options, including locating a modular housing unit at the site of a flea market on Route 2 north of Waterbury and another potential site in central Vermont. Flood said the state is again looking at a building in Windsor it owns but the renovation costs are likely too high there. Flood said the state has been told if it found a site, a simple secure modular unit could be built in as little as 30 days.
Four patients are currently housed at the state’s correctional center in Springfield as a temporary solution following the closure of the state hospital. Flood said he was hopeful that they could all find placement in other settings and use of the jail block at Springfield could be ended by September.
