A proposal to convert some Vermont psychiatric hospitals into adult forensic facilities was approved by the Senate last month and is currently being debated in the House.
The plan is S.89, plans to remove two units with a total of nine beds from an acute psychiatric hospital in Berlin from 2024 to create a safe residential treatment facility. That part of the building is reserved for those charged with the most serious crimes, if deemed incapable of standing trial or acquitted on the grounds of insanity.
Administrative officials told the House Medical and Judiciary committees this week and last week that part of the mental hospital should be repurposed — a place where that small group of people can now stay legally and safely. Because there is no
“You can’t put them in a hospital if they don’t need hospital-level care,” Emily Hawes, commissioner of the Vermont Department of Mental Health, told the Judiciary Commission last week. have gaps to adequately serve those people.”
Under Vermont law, a person who is determined to be incapable of fully participating in his or her own defense cannot be held by the Department of Corrections for more than 15 days from the date of discovery, said a mental health department attorney. One Karen Barber said in testimony this week.
However, courts often place those individuals under the national custody of either the Department of Mental Health or the Department of Senior Independent Living through various types of legal proceedings.
Even within that group, forensic facilities are appropriate only for those charged with crimes that would otherwise be detained without bail.
“We’re talking about a very small number of people who have a very high need,” Barber said.
Vermont is one of the few states that does not operate a forensic facility.
The forensic side of the building will require a lower level of clinical staff than the hospital side, but will be locked and provide 24-hour care, Hawes said. Staff can also unknowingly detain someone and, in accordance with court proceedings, require them to take psychiatric medication.
The River Valley Therapeutic Residence, a new 16-bed state residential mental health facility that will soon open in Essex, is a need because state law does not allow involuntary procedures to be performed there. , Barber and Hawes explained.
“We initially wanted the ability to do these things in River Valley, but the decision of Congress was not to allow us to do it,” Barber told the Health Commission on Wednesday. “So there’s a limited number of people who can get in there.”
The amendment “Facilities shall not use emergency involuntary procedures” was derived from House Health Care and added to 2021 Capital Billprovided some of the funding for the $25 million project.
Public advocates and advocates disagree about the need for new facilities, who belongs to them, and the process used to determine them.
“Vermont desperately needs a forensic facility,” Pentagon General Matt Valerio told the Judiciary Committee, adding, “We’ve committed very serious crimes, and we’re trying to get a small group of very serious people to be really properly treated.” There is currently no place to treat mental illness. “That’s been true since Tropical Storm Irene flooded Vermont State Hospital in Waterbury in 2011,” he said.
But Jack McCullough, director of mental health legal representation at Vermont Legal Aid, said there was no need for a separate facility for people accused of crimes.
“This bill is a solution to a problem,” he told the judiciary committee last week.
People who receive treatment through the criminal justice system and those who are involuntarily raped by courts because they are a danger to themselves or others without criminal charges need the same kind of care, he testified. said in
Furthermore, he said the current proposal would reduce capacity for people who have not been charged with a crime when there already isn’t enough space to meet their needs.
is currently 57 Acute Psychiatric Hospital Hawes told the Judiciary Commission about hospital beds in the state, which are located at state hospitals, the Rutland Regional Medical Center and the Brattleboro Retreat. Plans in Berlin are to reduce that number to 48.
“This proposal will shut down nine beds in the hospital, but there are still people in the emergency department waiting to enter the hospital, both voluntary and involuntary patients,” McCullough said. I’m here.
When asked by House Health Care whether the change would increase pressure on emergency rooms, Barber said he didn’t think it would.
Patients waiting there usually receive treatment voluntarily and require less serious hospitalization programs, Barber said. The Department of Mental Health testified that there are now seven hospitals across the state capable of providing such care, with a total of 142 adult beds.
The department hopes the forensic unit will actually open up acute care hospital beds more quickly.
Hawes and Barber also explained that by 2027, the federal Medicaid program will reimburse states only for care provided in independent mental hospitals with 16 or fewer beds. By relicensing nine beds as a forensic treatment facility, Vermont Psychiatric Hospital is eligible for these funds.
Rachel Seelig, who directs representatives of people with disabilities for legal aid, and other advocates told the Judiciary Committee this week that it would not be appropriate to consider placing the group in a forensic facility.
After the Brandon Training School closed in 1993, she said, the Vermont government committed to serving people with developmental disabilities who were sheltered in the community.
“We would be taking a big step by saying that we cannot serve these people in our community,” Seelig said.
Stuart Schull, an attorney with the Department of Aging and Independent Living, told the commission that the option would only be considered in rare cases where less restrictive housing arrangements are not possible for safety reasons. rice field.
“There are individuals who are at risk of serious harm, not just to the community, but to the staff working with them,” Schurr said.
