An unexpectedly high price tag will delay construction of a proposed 25-bed psychiatric facility at the Central Vermont Medical Center in Berlin.
Estimates for the project, which included upgrades to the hospital, came in at $150 million.
At a stakeholder meeting last week, leaders from Central Vermont Medical Center offered a detailed description of the 55,600-square-foot renovation, which was to include a parking garage, roof gardens, and relocated emergency rooms. They concluded the presentation by announcing that they would be redesigning those plans.
That decision sets the project back nearly two years with an anticipated open date of 2024. A significant portion of the $1.2 million in planning costs will also go by the boards.
John Brumsted, CEO of the University of Vermont Health Network, described the setback as a normal part of the development process. “What has come forward is a plan that’s too expensive,” he said. “So like almost every building project I’ve ever been in, it’s at a point where we have to go back and match up what’s been designed with what’s affordable.”
The beds are meant to help ease pressure on the state’s overburdened mental health system.
Psychiatric patients are held in emergency rooms for hours or days until a mental health bed becomes available. Last month, patients admitted involuntarily waited an average of 59 hours for a bed, according to the Department of Mental Health.
The $150 million price tag was the first cost estimate presented publicly for the project. On average, constructing a psychiatric facility costs about $1 million a bed, according to Mourning Fox, deputy commissioner of the Department of Mental Health.
Fox urged Central Vermont Medical Center officials to continue the construction planning. “This is something that’s needed, and it needs to move forward,” he said.
Jack McCullough, director of Vermont Legal Aid’s Mental Health Law Project, responded to the news with a combination of disappointment and frustration. “What this really means is that they have no plan,” he said, of the hospital’s leadership.
Brumsted attributed the high cost to “unforeseen building site conditions, complex interfaces with the existing hospital, [and] patient access into the building,” among other issues, he said in a report submitted to the regulatory Green Mountain Care Board.
Still, Brumsted defended the project timeline.
The 21-month construction planning period was “like a world record pace for quickness,” he said. “We’re trying to design this building and get it filled because of the patient needs. Any project this complex if we get it over the finish line in a single-digit number of years, that really is a remarkable feat.”
Anna Tempesta Noonan, president and chief operating officer of Central Vermont Medical Center, was not available for an interview, according to spokesperson Annie Mackin. Noonan and other hospital representatives will present the updates to the Green Mountain Care Board this week.
The psychiatric facility plans have been in the works for close to two years. After the University of Vermont Medical Center booked a surplus of $38.5 million in 2017, state regulators ordered the hospital to invest $21 million of that total in mental health beds for the state’s most acutely ill patients.
UVM Medical Center ultimately decided to locate 25 additional beds at its affiliate hospital, Central Vermont Medical Center, which already had 15 beds.
Noonan originally said a proposal would be submitted to regulators by the end of 2019 and the facility would open in 2022. But now that the hospital is months away from a formal certificate of need submission, the slated open date has been set back to 2024, according to Fox.
Originally, the plan was centered around just building the new beds, said Rep. Anne Donahue, R-Northfield, a mental health advocate who serves on the stakeholder committee. That planning expanded, as the hospital incorporated longer-term building projects, such as relocating the front entranceway, moving a power line, and moving the psychiatric portion of the emergency room.
Donahue says the estimate came in high because of hospital-wide improvements that were part of the proposal. “I think people were sort of told ‘start planning something in the way that good planning happens,’” Donahue said. “That started, bit by bit, until all of sudden the frog discovered the water was boiling.”
The delay comes at a time when other parts of the state’s mental health system have faced scrutiny.
The Brattleboro Retreat is in the process of constructing an additional 12 beds, which are scheduled to be completed this summer. But the Retreat has also announced fiscal challenges; last month, its leadership said it may close the facility if it doesn’t receive additional state funding.
It’s all the more important that the Central Vermont Medical Center move forward quickly, Kevin Mullin, the state’s head health care regulator. “It’s a lose-lose for everybody the longer it drags out,” he said.
