The state’s new 25-bed psychiatric hospital will cost $20 million a year to operate, according to the Department of Mental Health (DMH).
The annual price tag came as an unpleasant surprise to some legislators, since the state paid only slightly more — $23 million a year — to operate the Vermont State Hospital, which had twice the capacity.
“That’s about what we were paying for a 52 bed hospital,” Appropriations chairwoman, Rep. Martha Heath, D-Westford, observed. “Why?”
DMH’s financial director, Heidi Hall, responded, “It’s a completely different staffing model, so most of those costs are staffing costs.”
DMH Commissioner, Paul Dupre, said the department plans to hire 106 new employees to run the facility.
Heath said the committee will need a “more complete explanation” when department officials return to make the case for their Fiscal Year 2015 budget.
The Vermont Psychiatric Care Hospital in Berlin will be one of four facilities providing Level 1 mental health services for acute care patients in Vermont. The state’s post-Irene, decentralized system currently includes beds at Rutland Regional Medical Center, the Brattleboro Retreat, Fletcher Allen Health Care and the 8-bed Green Mountain Psychiatric Care Center in Morrisville. The latter two facilities will be phased out when the Berlin facility opens. The total current expenditures for Level 1 beds for acute care is about $10 million in fiscal year 2014, according to documents from the department. In addition, it costs $4 million a year to run the 7-bed Middlesex Secure Residential Facility.
The committee also gleaned more details about the timeline for opening the new hospital during a House Appropriations Committee meeting on Wednesday.
Dupre said the hiring process will wrap up by June 15, and the hospital will open on July 15. He doesn’t expect to fill the 25 beds until a month after the opening date — August 15.
“It’s very ambitious,” Dupre told lawmakers. “We try to give you the best case scenario but even under the best case scenario we cant open at 25 [beds] in July.”
The Mental Health Oversight Committee voted to endorse 25 beds (the Shumlin administration has advocated for 16 beds in the past) and exhorted the administration to use the “quickest legislative route” to get the beds in place as early as possible in fiscal year 2015. Lawmakers on the committee advocated for a July 1 opening day for all 25 beds.
Sen. Sally Fox, chair of the oversight committee, said the authorization from the Legislature needs to be expedited because it takes time to hire and train staff. If the Budget Adjustment Act doesn’t pass quickly, she says lawmakers may need to pass a standalone bill.
“We want this decision to be made considering all of the people needing beds, and not based upon budgetary concerns,” Fox wrote in an email.
In a report to the Legislature, the oversight committee said lawmakers had hoped that strengthening the community system statewide would reduce the number of Level 1 beds needed in the mental health system and that wait times for Level 1 beds “would no longer exist.”
“However, the committees do not have enough data to show which community programs warrant a greater investment and which do not,” according to the authors of the report.
The authors go on to say the mental health system is fragile and “too many people are waiting too long in emergency departments or correctional facilities for level 1 admissions.”
In all, the state has 32 level 1 beds. From March to October this year, the average daily census of patients needing intensive psychiatric care has exceeded the number of beds available by as many as 16 patients.
Editor’s note: Anne Galloway contributed to this report. The story was updated at 5:46 a.m. Dec. 5.