[E]arlier this month Middlesex Town Clerk Sarah Merriman received a routine call from a woman interested in registering to vote.
The caller asked if someone could come to the Therapeutic Community Residence because she could not leave the secure psychiatric facility.
She introduced herself as “Betty Teague,” according to Merriman, the same Teague that was found incompetent to stand trial for a deadly workplace shooting spree in 1991.
Teague has spent the intervening years institutionalized at psychiatric hospitals. The Department of Mental Health received a judge’s permission to transfer her to the Middlesex facility last October.
The secure residential facility is meant to be a transitional home for psychiatric patients who don’t need acute care, yet aren’t ready to return to their community, due to legal issues or treatment needs.
The Middlesex residence is part of the state’s decentralized mental health treatment system, which was put in place after the Vermont State Hospital was damaged by Tropical Storm Irene, and it is meant to be a temporary placement for patients until the state opens a permanent facility by January 2018.
Officials say the state is still on track to do that, and are considering a new potential location in Essex County.
Northeast Kingdom Human Services wants to partner with the state to build a 16-bed secure residential facility.
The nonprofit, which already contracts with the state to provide social and mental health services wants to eventually build a “social services campus” that would provide a wide array of services in Essex County on a 729-acre property in Bloomfield, a town of roughly 260 near the New Hampshire border.
The state is seeking another location in part because Middlesex residents initially opposed the seven-bed temporary residential facility located next to the Vermont State Police barracks. Last summer a patient escaped for a brief period during a community outing.
In 2012, state officials told community members the secure facility would be temporary. Until now, the state has made little progress on finding a new location for the patients.
Merriman said Teague’s arrival renewed her own safety concerns. During the planning process, Merriman said she doesn’t recall any mention of potentially dangerous criminals being housed there.
“In fact, my memory is that they specifically denied such,” Merriman said in an email.
Paul Dupre, the outgoing commissioner of the Department of Mental Health, said he could not comment on Teague’s case. As for what officials told residents when the residence was being planned, he said, that was before his tenure.
“I know a lot of things were probably said in the midst of a crisis,” he added.
Generally, however, DMH assesses the risk of “people doing something harmful to the community” at any of its facilities, and uses its best judgement to ensure both patient safety and public safety, Dupre said.
In Teague’s case, a judge granted the transfer, despite concerns raised by Brattleboro State’s Attorney Erica Marthage.
The Bloomfield Ridge project proposal
Dupre said the state is still determining the exact number of secure residential beds it believes will be needed to shore up the state’s decentralized mental health system.
DMH and the Department of Buildings and General Services drafted a prospectus for lawmakers calling for a 14-bed facility that would cost roughly $11 million.
Northeast Kingdom Human Services proposes a 16-bed facility in Essex County that could be built for $7 million, according a business plan.
DW Bouchard, the nonprofit’s executive director, said in an interview Friday that figure was a “very preliminary guess,” and recent discussions with engineers show it would likely cost more.
The need for the project and the wisdom of placing it in underserved and economically depressed Essex County are real and the animating force behind the NKHS proposal.
Bouchard points to a psychiatric service “bottleneck” that leaves patients stranded in hospital emergency rooms or in higher security psychiatric hospitals when a lower level of care would be less costly and more appropriate.
It costs $1 million per patient per year to be housed at the Vermont Psychiatric Care Hospital, which opened last July. According to NKHS, care could be provided in Bloomfield to patients with “similarly complex high needs” at the proposed facility for a cost of $500,000 per year.
It could also reduce the number of patients awaiting a placement at VPCH or the three other hospitals the state contracts with for hospital secure inpatient services. Often those waiting are held in emergency rooms at a cost of $2,000 per day, according to the NKHS planning document.
NKHS says it would create a subsidiary to construct and operate the facility with money secured through bonds from the Vermont Economic Development Authority and a grant from DMH.
The state’s investment would be paid back with interest over 20 years using patient revenue. NKHS believes the project will generate enough money to pay back the state and allow it to bolster the array of services it already offers in Essex, Orleans and Caledonia counties.
Frank Reed, deputy commissioner of DMH, said his department is aware of the proposal and will review it as part of a legislative report on the size, need and possible location of a secure residential facility. That report is due to lawmakers in February 2016.
Once the report is complete, the Department of Finance and Management can release $50,000 in planning funds appropriated in the year’s capital bill for siting and design work.
State officials first learned of the proposal at the end of the legislative session, when NKHS brought it to DMH and several lawmakers that represent districts in the Northeast Kingdom, according to Reed.
“We’re not opposed to considering that, it’s just so early in the process that we have to keep all of our options open,” Reed said.
Essex County State’s Attorney Vince Illuzzi, who was not aware of the proposal until contacted by VTDigger, said he thought it an odd choice given the distance to a hospital or other support services (the closest hospital is Upper Connecticut Valley Hospital in Colebrook, New Hampshire, approximately 15 miles from the property).
That’s a “reasonable” concern, Bouchard said, but one he thinks can be appropriately addressed.
The concept of a secure residential facility as the flagship for a larger “human services campus” is most important to his organization, Bouchard added, noting they they’re not “wedded” to the Bloomfield location.
He would like to locate in Essex County, though, to bring jobs to the sparsely populated region and improve services available to people in the Northeast Kingdom. Preliminary estimates suggest the secure residential facility alone would need 70 FTEs
There are 10 properties in Essex County of more than 100 acres that are currently for sale, Bouchard said, and at least three people have called with ideas for alternative locations.
Still, there is much that is appealing about the $550,000 Bloomfield property, Bouchard said, not least because he believes there would be therapeutic benefits of the property’s natural beauty.
The amount of space would allow for the other elements of the project Bouchard hopes to develop, though the first phase would only include the secure residential facility and an on-site public safety facility, likely involving the Essex County Sheriff.
Ultimately, NKHS wants to build freestanding transitional housing for patients who can be treated in a less restrictive setting; an on-site learning center staffed through a partnership with Lyndon State College; a primary care facility staffed through a partnership with a Federally Qualified Health Center in the region; residential programs for parolees with mental health needs through a partnership with Department of Corrections; and residential programs for elderly people with mental health needs through a partnership with the Department of Aging and Independent Living.
The plan calls for hiking and biking trails that would be for patients and the public on the massive property. The buildout of other services and facilities would happen over a four-year period, according to the proposal.
In a recent meeting with Bloomfield town officials, Bouchard said they asked “tough and appropriate” questions, but said their attitude toward the project was overall positive.
Bouchard acknowledged there are “thousands of ways this project could wither on the vine,” but he added that if it can work it has the potential to “address a wide array of different issues that in so doing would benefit the Northeast Kingdom.”
