Lawmakers: Vt. slow to close state hospital
Toolbox
By JOHN ZICCONI Vermont Press Bureau - Published: July 13, 2005
MONTPELIER — A panel of legislators charged with overseeing mental health issues harshly criticized state officials Tuesday for taking too long to close the troubled Vermont State Hospital.
The frustration was aired just four days after the Department of Justice issued a scathing report that concluded the hospital during 2004 failed to protect patients from harm, often did not develop adequate care plans and used restraint and seclusion excessively.
The federal agency is threatening legal action unless improvements are made.
"The Department of Justice told us things we already know: The rooms are like prison cells and people are not treated like patients," Rep. Patricia O'Donnell, R-Vernon, pointedly told Paul Blake, the state's deputy commissioner of mental health.
"I don't understand why the (closure) process should take so long," O'Donnell said. "I really expected to be building a new facility this summer."
Lawmakers on the state's Mental Heath Oversight Committee peppered Blake and other state officials with questions for more than two hours. They expressed anger that four years after they first concluded the 113-year-old Waterbury facility should close, the Douglas administration is still an estimated five years away from opening a new facility.
Administration officials for the first time this winter circulated a draft plan to replace the 54-bed hospital with a new 28-bed facility and transfer about 22 patients to other hospitals, community mental health facilities and a secure residential facility slated for somewhere in the Northeast Kingdom.
The annual cost to run such a system is estimated at $21.8 million, nearly $7 million more than the current state hospital budget.
Mental health officials told lawmakers Tuesday that community facilities in Chittenden, Addison and Caledonia counties might be ready this winter to take about a dozen patients, but that building a new facility for the state's most severely mentally ill patients likely won't happen until 2010.
Earlier estimates said a new facility could be built in as few as three years, but that goal has been all but abandoned, Blake said.
"This is a massive project," Blake said, referring to the overhaul of how the state cares for its most severely mentally ill residents.
Although lawmakers first expressed concern four years ago, the state hospital did not come under heavy scrutiny until two patients committed suicide in 2003, an event that caused the hospital to lose its federal certification.
The U.S. Centers for Medicare and Medicaid Services restored the hospital's good standing about a year later. But last winter, it pulled the mental health facility's certification for a second time due to continuing concerns about patient safety.
The state is not seeking recertification.
The Justice Department's report, based on a 10-month inspection of the hospital, revealed deficiencies like patient misdiagnoses and improper drug use that other investigations did uncover.
State officials immediately dismissed many of the lawmakers' criticisms Tuesday as old news. But Sen. James Leddy, D-Chittenden, warned at the meeting about becoming "numb" to criticism.
"If we become willing to accept the situation, we have all become part of the problem," Leddy said. "We need to move beyond where we are and have to move beyond the numbing effect of saying 'oh, this is just another report.'"
The Justice Department expects immediate improvements to protect patient's civil rights and will not accept merely a long-term plan to replace the hospital with a new facility, Leddy said.
Wendy Beinner, director of the mental health division of the Vermont Attorney General's Office, would not disclose details of her conversations with Justice Department officials, saying they must be kept secret due to the threat of a lawsuit.
Hospital officials also were vague, telling lawmakers only that some concerns have been addressed — a new contract with Fletcher Allen Health Care provides additional psychiatric oversight — while other problems still require attention.
Beinner would say only that she is negotiating with federal officials and expects the two sides to develop a reform plan that the hospital must follow. As long as the state abides by the plan and agrees to regular inspections, no lawsuit will be filed, she said.
"These negotiations are generally very detailed and take about a year to work out," Beinner said.
Lawmakers are powerless to reform clinical procedures, but said they could ensure that physical changes to make the hospital a more comfortable place are done as quickly as possible.
A year ago, lawmakers suggested that air conditioning and "quiet rooms" for out-of-control patients be installed in all wards.
So far, only one quiet room has been constructed and air conditioning has been delayed until October. Lawmakers expressed their contempt for the delays and, on a day when temperatures hovered around 90 degrees, ordered that temporary air conditioning be installed immediately.
"Do it," Leddy said, pointing to Blake. "Bring immediate relief."
Contact John Zicconi at john.zicconi@rutlandherald.com.
20