New psychiatric facility opens, others in early stages

Front entrance to the newly constructed River Valley Therapeutic Residence in Essex.Photo Credit: Troy Parr/Vermont Department of Mental Health

Several Vermonters with complex mental health needs were moved last week to a new locked residential facility in Essex, an official with the State Department of Mental Health told lawmakers.

“We are staffed and ready,” Secretary of State Emily Hawes told the House Medical Committee on Wednesday. “We are really excited that people will be able to participate in that therapeutic environment.”

The newly constructed River Valley Therapeutic Residence is on the state’s long journey to rebuild safe mental health options after the historic flooding caused by Tropical Storm Irene in August 2011 closed Vermont State Hospital. It’s a milestone. In addition to this project he will add nine residential beds.

Yet another change is likely to come with bill S.89, which is in the final stages of parliamentary approval, to establish a separate nine-bed “forensic” residential facility in the building housing Berlin’s Vermont Psychiatric Hospital. It allows

Also, although not certain, a new 12-bed inpatient psychiatric unit for adolescents ages 12 to 19 is also underway at the Southwestern Vermont Medical Center in Bennington, which was recently completed. Studies have shown that it is feasible.

In an emailed statement, Hawes said all three projects “will create a comprehensive system that will enable Vermonters to get mental health care on their terms, when and where they need it.” is part of the ministry’s goal of

Analysts pointed to a shortage of hospital beds as one of the reasons for the large increase in the number of adults and adolescents waiting for psychiatric care in emergency departments of state general hospitals.

According to the Vermont Hospital and Health System Association, the average number of people waiting in emergency departments for care has decreased in the past six months, and so has the percentage of people waiting in emergency departments for 24 hours or more. This group represents all 14 nonfederal hospitals in the state and collects weekly data from those hospitals.

“This is good news for those in need of care and for emergency departments and hospital floors,” the group said in a written statement. “But no matter what day it is, there are still many Vermonters awaiting treatment in inpatient care facilities, so we remain committed to continued progress in this area.”

No more FEMA trailers

Hawes told lawmakers the new 16-bed River Valley Therapeutic Residence opened after a low-key ribbon-cutting last Friday. This facility is located off of Highway 15 on the site of a now demolished state juvenile detention center.

A ministry spokesman said five residents were there on Wednesday. The goal is for project personnel to stay an average of 18-24 months, according to planning documents, allowing them to return to a less restrictive community setting.

This adult-only facility is a psychiatric hospital in Berlin and the two other most demanding, so-called level 1 wards of the Rutland Regional Medical Center in the state, a “step” for people who were mostly involuntarily patients. intended as a “down” option. Center and Brattleboro Retreat.

At a cost of about $19.3 million and more than $5 million in estimated bond costs, the new building will replace the seven-bed temporary facility that opened in 2013. The site is a cobblestone combination of two Federal Emergency Management Agency trailers next to the state police barracks. In Middlesex, it was intended as a three-year stopgap solution, but remained in use for almost ten years.

In the new building, each resident has more personal space, a larger bed, a private bathroom, and more areas for indoor and outdoor activities. Hawes told lawmakers that residents seemed “very excited” about the renovation.

“Just seeing the look on people’s faces when they walked in was really nice,” Hawes said.

Another safe abode on the horizon

A proposed new “forensics facility” would change the designation of nine beds in one wing of a Berlin building from being part of an inpatient hospital to a treatment residence. This is primarily a reduction in the types of medical equipment and staffing levels required.

The space will serve as a long-term safe haven for Vermont residents involved in the criminal justice system. Specifically, those charged with the most serious crimes but deemed incompetent to stand trial or acquitted due to insanity.

After gaining approval in the Vermont House and Senate, the bill will be presented to Gov. Phil Scott’s desk to exempt the project from routine “Certificate of Need” review by the Green Mountain Care Commission. It is content. It would also require both the Department of Mental Health and the Department of Aging and Independent Living to undertake a separate and joint public rulemaking process to determine standards and procedures for institutional involvement.

For advocates of Vermont residents with intellectual disabilities, the question of whether forensic facilities were appropriate for them was a concern. In response, the law now establishes a working group to assess the issue, and requires that group to have the standards approved by the legislator.

Mental health activists fear that the new facility will reduce the number of hospital beds for critically ill patients by more than 15% to 48.

The department originally requested that the court design the River Valley facility for use by individuals who might request to take the drug involuntarily. An amendment that “facilities may not use emergency involuntary procedures” originated in House Health Care and was added to the 2021 Capital Bill to rule out that possibility.

Hawes said the change “will inevitably have some impact.” However, although some cases are currently in prison, it is necessary to provide a place for those who are best served in a therapeutic setting.

“We need to consider vulnerable people who are less than competent, involved in the criminal justice system and suffering from mental health, substance abuse and intellectual disabilities,” she said in a statement. .

Also, the majority of Vermonters who need inpatient care will not be served at critical level 1 hospitals. The Care System currently has 142 general admission beds for adults in 7 different hospitals and 30 beds for children and adolescents only in Brattleboro Retreat. In the Bennington Project, the latter number increases to 42.

Bennington Hospital recently completed a study that concluded that a new youth psychiatric project would be feasible if the state provided multiple layers of support. SVMC was the sole respondent to a request for proposals initiated by the ministry last year.

The youth facility will require $1 million in start-up operational support and a commitment of $9.2 million to renovate the old records building, plus $2,000 per day for Medicaid-funded patients. fee is required. Funding for this renovation was included in the latest 2024 budget proposal.

Southwestern Vermont Medical Center, which recently became part of Dartmouth Health, will partner with Dartmouth-Hitchcock Medical Center to provide psychiatric staff, Hawes told the committee.

Medical Commission Chair Lori Horton said the advances in inpatient facilities along with the expansion of several community-based crisis response programs were “all really exciting.”

“All of this should help ease[the pressure on]hospitals,” she said.

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