Intensive 16-bed psych unit proposed at VA campus
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By JOHN P. GREGG VALLEY NEWS - Published: January 30, 2010
WHITE RIVER JUNCTION — Officials with the state of Vermont, Veterans Affairs Medical Center and Dartmouth-Hitchcock Medical Center are discussing the possibility of building a secure 16-bed acute-care psychiatric unit at the VA's 64-acre campus that would serve Vermont residents and veterans needing intensive mental health care.
Although the proposal is still in its conceptual stage, the state-owned facility, if built, might be staffed by Dartmouth physicians and would be part of an evolving plan to replace the problem-plagued Vermont State Hospital in Waterbury.
Dartmouth already has an affiliation with the VA for a variety of medical services, and also provides mental-health care services for the states of New Hampshire and Maine.
"This is an interesting concept," said Vermont Department of Mental Health Commissioner Michael Hartman. "Dartmouth has really quite a bit of experience doing this level of care."
Hartman said the proposal is still being formulated, and nothing hard-and-fast is on paper yet, including how much the state would spend to build the facility.
"Everybody has agreed that we can continue to explore this," Hartman said.
Robert Walton, the director of the VA hospital, said the VA has surplus land it might either donate, sell or lease to the state. Walton said the VA is interested in revenue potential from providing meals, property maintenance and possibly security for the new facility, while also obtaining a nearby alternative for more intensive psychiatric care that would also be available to veterans.
"It's something we are pursuing with them," Walton said. "Provided it's to the benefit of veterans by increasing our revenue and having more local medical care, I think it's something that would be beneficial. It would help the state of Vermont, as well."
The VA currently has a 10-bed unlocked mental-health unit at its White River campus.
"Anybody who would need more secure care due to a more acute condition, normally we would have to send them out of state to another VA, or to the state hospital," Walton said.
Walton said his idea would be for the state to use land that could have its own, separate entrance off the VA Cutoff Road, across from Interstate 89. Before any transfer of land could take place, Walton would have to obtain permission from VA headquarters in Washington.
The plan also has been helped along by Dr. Alan Green, the chairman of the psychiatry department at Dartmouth Medical School.
Dartmouth manages psychiatric care at New Hampshire State Hospital in Concord and provides similar care at Riverview Hospital in Augusta, Maine, part of the Maine state hospital system.
Frank McDougall, DHMC's vice president of government relations, said Dartmouth is working on "various options to see if we can be helpful.
"The work is ongoing, and it's got a long way to go, but we are engaged," McDougall said. "Our main interest is serving our patient population. That's our mission. We also have a lot of experience in this."
The 54-bed Vermont State Hospital lost its certification in 2003, regained it briefly, but has been struggling for years to regain certification, and the millions of dollars in federal Medicare or Medicaid aid that comes with it. A federal report last May denying recertification cited building safety hazards and lapses in patient care, among other problems, in Waterbury.
A 2007 "Futures" commission plan recommended that the main hospital be replaced by a new rehabilitation treatment center, with other services moved into community hospitals and facilities.
Hartman, the mental health commissioner, said the state has a 14-bed "subacute" care facility known as Second Spring in Williamstown and just opened a six-bed subacute facility known as Meadowview in Brattleboro, tied in with the Brattleboro Retreat.
The state plans to build a 15-bed secure residential facility in Waterbury to handle the most severe, long-term psychiatric cases. This year's capital budget has about $1.5 million to start the certificate of need process for the new Waterbury facility, but no funding as of yet to build the $15 million project.
State officials are also talking with Rutland Regional Medical Center to develop a 12-bed acute care facility, similar to the proposal on the VA campus, as well, Hartman said.
Vermont Gov. James Douglas mentioned the proposal for White River Junction on Monday, noting the slow progress since the Futures committee report was issued more than 26 months ago.
"It's frustrating," Douglas said. "It seems like the future never comes."
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