Midyear administrative budget adjustments that soak up the first few weeks of each session of the Vermont Legislature typically include requests for money transfers between existing programs. It usually takes a hospital several years to launch a new service.
This year, those norms have been turned upside down.budget adjustment package Released late last weekGovernor Phil Scott’s administration sought approval to reallocate $9.25 million from this year’s budget to support the rapid development of the inpatient youth psychiatric unit at Southwestern Vermont Medical Center. .
However, Bennington Hospital is not yet involved in the project. Vermont Department of Mental Health administrators say they want to broaden the wording of the law so that funds can be moved elsewhere if SVMC leadership decides not to move forward.
“We know there’s a need, but we don’t have the capacity at this time,” Vermont Department of Treasury Commissioner Adam Grethin told the House Appropriations Committee on Friday.
Because the project involves remodeling an existing ward at Southwestern Vermont Medical Center, it is likely to open sooner than projects involving new buildings, Grethin said, with a goal of January 1, 2024. added that the bed is to be made available to Amid budget adjustments to try to keep the momentum going,” he said.
If Congress approves the request for funds as part of a budget adjustment, the funds will be available to hospitals during the current fiscal year before next year’s budget begins on July 1.
Even lawmakers and hospital leaders are skeptical about the possibility of such a rapid rollout.
On average, six children and their caregivers are awaiting day two inpatient mental health care in emergency departments across the state. That number has been consistent for the past two years, according to a weekly survey by the Vermont Hospitals and Health Systems Association.
A broader study tracking the number of adult and adolescent patients admitted to hospital emergency departments seeking mental health care is set to be submitted to legislature next week. last year’s versionlooking at discharges in the year before 30 September 2021, found 1,438 young cases during that period, with an average length of stay of 2 days.
Emily Hughes, commissioner of the Vermont Department of Mental Health, told the House Appropriations Committee on Tuesday that a major gap in the current system is the lack of hospital beds, especially for young people within health care settings.
Currently, the Brattleboro Retreat is the only facility designated to provide acute psychiatric care to adolescents, but is ill-equipped to serve patients with “complex medical needs”. Hughes said.
Complicated medical needs can mean conditions such as pregnancy, type 1 diabetes, epilepsy, developmental disabilities, or acute problems such as severe dehydration associated with self-inflicted wounds or eating disorders. Young people in psychiatric crisis with these additional medical needs are now often admitted to emergency departments, making it difficult to provide them with the mental health care they need.
The department has been actively seeking partners to open the facility since February last year. UVM Health Network initially expressed interest in adding services to its children’s hospital in Burlington. retreated After suspending all new construction due to a large annual budget deficit.
Southwestern Vermont Medical Center said it expressed interest after the agency issued a second request in June for proposals for up to 12 juvenile psychiatric beds and agreed to investigate the feasibility of new services. said Jim Trimarchi, director of planning at Bennington Hospital.
“We are excited about it and glad that Governor Scott is recognizing the challenges and moving the budget forward,” said Trimarchi. However, when it comes to the project, “it’s actually pretty early on.”
Bennington County’s United Counseling Services, the area’s designated social and mental health services agency, has discussed the project with hospital leaders, executive director Lorna Matern said in an email. staff work daily with the psychiatric needs of patients and have agreed to help staff the inpatient facility, she wrote.
Trimarchi said the feasibility study should be completed in late March. The next step is approval of the project by the hospital’s board of directors and the Green Mountain Care Board, the state’s hospital regulatory agency, through the issuance of a “certificate of need.”
A January 2024 opening could be achievable from a purely construction standpoint, barring significant supply chain issues, but he said he didn’t “want to get ahead of the board and other regulators.”
Regulatory issues were also on the minds of lawmakers. According to the application form for the required certificate is not registered in the project. care board website.
Clearing that hurdle itself could propel the project into the next budget cycle, D-Middlebury MP Robin Scheu told the committee during Greshin’s testimony. “I appreciate your kind response, but I need to see if it’s possible or if there’s anything wrong,” she said.
Nicole Distacio, director of policy for the Vermont Department of Mental Health, said in an email that administrators should work with legislators to create budget allocation language that is not unique to Southwestern Vermont Medical Center. The department will likely reissue the RFP for a third time if the hospital decides against the project, she said.
But the department hopes to set aside funds from this year’s budget adjustments for that purpose, Distacio said. Federal American Relief Plans Act funding offsets the need for significant state spending this year and the previous year and provides an opportunity to invest to help bring hospital-based juvenile inpatient psychiatric units into service it was done.
“There is a continuing need to be able to serve this youth population in the state, especially those with concurrent medical needs that require connectivity with the hospital environment,” Distacio said. increase.
do not miss it. Sign up here to receive VTDigger’s weekly emails about Vermont hospitals, healthcare trends, insurance and state healthcare policies.
