The hamburger grill at the Vermont State Hospital Canteen may be fired up again on July 1, thanks to a last-ditch effort by mental health advocates to bring the snack bar back.
Last Friday, the House Appropriations Committee rejected a Senate provision mandating that the Canteen be reinstated as a budget-neutral program of the Department of Mental Health. Though no money was attached to the Senate amendment for the Canteen, it was interpreted as a potential cost to the General Fund by the Douglas administration and members of the House committee.
The Department of Mental Health closed the Canteen on Dec. 5 because officials said it would save approximately $80,000. Advocates, former patients and Vermont State Hospital workers fought the decision last fall because they said state officials had inflated the Canteen’s costs, added an unnecessary staff position and refused to allow the snack bar to raise prices. They asked Sen. Vince Illuzzi, R-Essex-Orleans, to propose legislation to reinstate the snack bar.
Advocates argue the facility offers the only reprieve for mental health patients who have earned the right to leave the wards of the Vermont State Hospital.
The former Canteen coordinator, Curtis Sinclair, said he was able to run the operation at a small profit until the department refused to let him modestly raise prices for food a few years ago.
The Senate language, which called for the Canteen to reopen as a budget-neutral program, was stripped from the House Appropriations Committee’s version of the budget adjustment bill last week, and came to a vote on the floor of the House Chamber on Tuesday morning.
The vote was presented as a double negative: A “no” vote would reinstate the Canteen without an appropriation; a “yes” would cut it altogether.
The language, as posed, was confusing to members, and in frustration, Speaker Shap Smith, who tried to explain it, resorted to telling members: “You want to vote ‘no’,” shortly followed by titters from the members and a correction: “That was inappropriate.”
In short order, however, that’s what they did: House members voted (115-6) against the House Appropriations Committee’s proposal to eliminate the Canteen. Three members — two from Barre – Paul Poirier, an independent, and Tom Koch, a Republican – spoke in favor of the Senate’s proposal to enable the Canteen to continue as a budget-neutral program.
Committee Chair Martha Heath, D-Westford, said they had not heard from mental health advocates at public hearings for the budget adjustment bill.
Heath said Mental Health Commissioner Michael Hartman testified that the State Hospital had installed vending machines in the former Canteen and patient activities might be held in the space.
“They felt to keep the Canteen open would cost $80,000 in General Fund dollars,” Heath said on the floor.
Heath said the committee felt Hartman’s time would be better spent helping the designated mental health agencies determine how to save $5.2 million under the state’s new restructuring initiative, “Challenges for Change.” In addition, the department is charged with developing the Vermont State Hospital Futures Project, which is designed to provide alternatives to the Waterbury facility for severely mentally ill patients, and making sure the Vermont State Hospital is recertified by the Centers for Medicare and Medicaid Services. Recertification would make the state eligible for approximately $9 million for fiscal year 2011 in federal Medicaid funding.
Heath said the committee considered taking the bill back and revising it, but “since the amendment is budget-neutral, we don’t feel we have the time to do it.”
“This morning … you have received a flier in your mailbox (from advocates) and we understand that there will be a motion to defy this amendment and to take up this issue separately,” Heath continued. “We will be recommending that people vote based on the info they have.”
Rep. Poirier, I-Barre City, who said he has served as a public advocate for the Vermont State Hospital, was the first to speak on the issue.
“I oppose this amendment,” Poirier said. “You earn your way when you’re a patient at Vermont State Hospital. You have to demonstrate to staff you are not a threat to yourself or others. For many people the Canteen is the stimulus for people to change their behavior. It’s a place to order a hamburger that isn’t on the hospital menu.
“The canteen is the biggest carrot the hospital can offer a patient,” Poirier said. “There are many patients who agree to voluntarily to take medications in return for the promise they can access the Canteen.”
Poirier said under the Senate proposal, a plan will be developed to allow patients access to the cafeteria “with the caveat that the Canteen is privately run” and “cost neutral.”
He pointed out that the Canteen is an extension of the Legislature’s commitment to mental health parity. No hospital, he said, is without a restaurant where patients and family members can get together.
“One of the best gifts we can give the patients at the Vermont State Hospital is the ability to maintain their Canteen and give them the same rights people in a private hospital receive,” Poirier said.
Rep. Tom Koch said there’s no reason not to reopen the snack bar. “If we’re not going to save money by closing the Canteen, why are we closing it?” Koch asked. “If it’s not going to cost us, let’s keep it open. I will be voting no on the proposal before us that would strike the Senate language.”
Rep. Anne Donahue, R-Northfield, said Canteen privileges help patients manage their psychotic behavior and prepare them for community placement.
“This is not just about having a little R&R,” Donahue said. “The canteen is the most normalizing experience patients have, and closing it will have a clinical impact.”
She cited a statement from Terry Rowe, executive director of the Vermont State Hospital, who wrote to department personnel: “I think we are on dangerous grounds arguing this cost issue. We could raise prices, cut back on staff and provide limited services.”
Donahue said the proposal asks for the development of a plan by March that would put the Canteen operation in the black for the next fiscal year.
The Senate amendment reinstating the Canteen passed the House by an overwhelming majority.
