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The state will provide Brattleboro Retreat $7.3 million in cash to sustain the beleaguered psychiatric facility.
The Covid-19 pandemic has sent Vermont’s largest mental health provider spiraling into a “dire” financial situation, said Secretary of the Agency of Human Services Mike Smith. The number of patients has plummeted; 50 of the Retreat’s 870 staff members have left, according to CEO and president Louis Josephson.
Josephson said the cash would provide a short-term lifeline for the institution, which includes half the state’s inpatient mental health beds and the only unit for youth and adolescents. “What the Retreat needs to do to stay open through the crisis,” said Josephson. “Bigger questions about our financial sustainability moving forward I think we’ll get to in a few months.”
The money, about half of which was delivered to the Retreat last week, does come with strings attached. The Retreat must repay roughly $3.3 million of the total, and also send the state $500,000 of a CARES Act loan it received from the federal government. The Retreat will keep $3.5 million as a grant.
Smith has also convened two teams, one from the state, and one from the Retreat, to study the long-term financial viability of the facility. They’ll look at a variety of options, including restructuring the organization, reducing the number of patients and, Smith said, even receivership, where a court-appointed entity is put in control. The groups will report back their findings by the end of May.
“We need to make sure the health care system stays viable,” Smith said. The state also recently bailed out Springfield Hospital with a $1.3 million emergency loan, he pointed out. “Without relief it was clear that the financial viability of the Retreat was in jeopardy during a time when the state could ill afford to lose a major health care facility.”
For the Brattleboro Retreat, the virus is the latest addition to a growing tally of financial challenges. In January, Josephson told Smith that if the state didn’t provide the Retreat $2 million in cash, he would consider selling or closing the facility. Josephson also said he may have to close a quarter of its beds.
Ultimately, the state provided the money and has been meeting regularly with Retreat officials to plot out the future of the facility.
The aid wasn’t enough to stop the hemorrhaging. In March, the Retreat paused the construction of 12 new inpatient beds, which were scheduled to be completed this summer. The Retreat’s bank, Citizens Bank, has set limits on the facility’s borrowing: Retreat leadership must consult with the bank before drawing on its line of credit, according to Brattleboro Retreat spokesperson Konstantin von Krusenstiern. In a statement, the bank said it recognized the importance the institution plays in Vermont’s mental health system and vowed to continue “working in a diligent manner with the Retreat and its leadership.”
The total number of patients has dropped by 40%, from about 100 to 60, according to Josephson. That was partly intentional; earlier this month, the Retreat stopped accepting patients from out of state, so that Vermonters who needed treatment wouldn’t have to wait in hospital emergency rooms for a bed to become available.
The low patient numbers aren’t unique to Brattleboro. Since the pandemic hit the state, fewer Vermonters have also sought treatment, said Department of Mental Health Commissioner Sarah Squirrell. Between March and April 8, the total number of people receiving inpatient mental health treatment dropped from 191 to 113, Squirrell said.
Squirrell said it’s not yet clear why patient numbers have dropped. Some may not be seeking mental health treatment to avoid the risk of being exposed to Covid-19, she said. Others may be getting care through their local mental health providers rather than seeking out inpatient treatment.
The number of staff has also dwindled. Since March 1, about 27 Retreat staff have exited because of risks from the virus, said von Krusenstiern, as well as others for separate reasons.
Between 15% and 30% of the 170 staffers at the state-run Vermont Psychiatric Care Hospital in Berlin have also been unable to work, due to self-isolation, child care demands, or because the risks of the coronavirus caused them to leave their jobs entirely. “Our workforce is also grappling with the pressures and impact of Covid-19,” Squirrell said.
That pressure is part of the reason both the Retreat and the state have been intent on keeping the facility open. “Brattleboro Retreat and the Agency of Human Services have been partners for many years,” Squirrell said. “Right now, the tone and spirit of the discussion is one of problem solving.”
