VTDigger is posting regular updates on the coronavirus in Vermont on this page. You can also subscribe here for regular email updates on the coronavirus. If you have any questions, thoughts or updates on how Vermont is responding to COVID-19, contact us at coronavirus@vtdigger.org
The Brattleboro Retreat — Vermont’s largest mental health facility — won’t accept out-of-state inpatients until further notice to help itself and surrounding hospitals reduce bed counts during the coronavirus crisis.
“Each time we admit a patient who would otherwise be stuck in a hospital emergency department suffering from acute psychiatric distress, we free up valuable medical resources needed to combat COVID-19 in Vermont,” Brattleboro Retreat President Louis Josephson said this week.
The private not-for-profit psychiatric and addiction treatment center is licensed for 149 beds, although it recently reduced its capacity to 93 and currently has 60 patients.
State leaders project the number of Vermont coronavirus cases will peak in mid-April to early May and could require more intensive care beds and ventilators than currently available.
The Retreat, which has yet to report a coronavirus case but has one quarantined patient awaiting test results, is preparing space on its campus to serve as an isolation unit for people with both psychiatric and non-life-threatening symptoms.
“When we take psychiatric patients out of emergency rooms as quickly as possible, we are able to open capacity for hospitals and best use health care resources,” chief nursing officer Meghan Baston said.
The nearby Brattleboro Memorial Hospital will offer medical support for presumed positive or mildly symptomatic coronavirus patients so only people who require higher levels of care have to be transferred out.
“No one quite knows how it’s going to unfold — at the moment we can only plan for tomorrow and the next day,” Retreat chief medical officer Gaurav Chawla said. “Depending on the peak, we may have to think about alternative solutions.”
“It evolves so quickly,” Baston added, “we have to be fast in our ability to pivot.”
In other measures, the Retreat is screening all potential inpatients for coronavirus, suspending public visits and bolstering its inventory of personal protective equipment.
It is increasing its cleaning protocols, closing its onsite school and outpatient programs that involve face-to-face group counseling and canceling its spring continuing education conference series.
It also is plugging in with outpatients by telephone and audiovisual technology and providing people with drug use disorders with enough buprenorphine medication so they don’t have to visit daily.
The Retreat — Windham County’s largest employer with more than 850 employees — has provided more than half of the state’s inpatient psychiatric treatment beds and all of its youth treatment beds since Tropical Storm Irene flooded the Vermont State Hospital in Waterbury in 2011.
“We are beyond impressed with our staff,” Baston said. “They are not only incredibly committed but also incredibly courageous.”
“We will do everything we can,” Chawla added, “to provide them a safe environment to the fullest extent possible.”
Before the current challenge, the Retreat was losing money because it’s treating a high number of Medicaid patients whose public insurance pays less than private insurance. The facility threatened to close in January unless it received more government help, leading Gov. Phil Scott to pledge his support in his 2020 State of the State address.
“This health care provider is simply too critical for us to let fail, especially without an alternative,” Scott said in the speech.
The Retreat has yet to furlough or lay off any employees during the current crisis.
“The Retreat has never been more essential to the state’s overall health care system,” Josephson said. “I don’t have a crystal ball to tell me when this pandemic will be over, and at what cost. We remain focused on our core mission to provide quality mental health and addiction services.”
