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An act relating to planning and evaluating options for inpatient psychiatric hospital services

The House proposes to the Senate to amend the bill by striking all after the enacting clause and inserting in lieu thereof the following:


(a)  The general assembly recognizes that there are some regulatory and legislative constraints on the department of health’s planning efforts related to developing new inpatient psychiatric services.  Nevertheless, the general assembly finds:

(1)  There has been inadequate evaluation of the options available to the state regarding the provision of inpatient psychiatric hospital services which are now provided at the Vermont state hospital (VSH).

(2)  The projected costs to plan, construct, and privately operate a 40‑ to 60‑patient bed facility on the main campus of Fletcher Allen Health Care (FAHC) in Burlington have not been adequately analyzed and compared with the projected costs of a publicly operated state facility or several smaller private or public facilities across the state.  Furthermore, FAHC has not made the necessary 50‑year commitment to host and operate the facility.

(3)  As found by the Public Oversight Commission (POC) in its recommendation dated January 10, 2007 concerning the VSH Conceptual certificate of need (CON), the construction cost for new inpatient services approaches $100 million which, the POC suggested, is beyond the fiscal capability of the state if the overall components of the Futures Project, including necessary expansions to the community mental health system, were to be implemented and adequately funded.

(4)  No operating cost estimates of the proposed FAHC inpatient psychiatric facility or any other facility have been developed.

(5)  No determinative analysis has been made of the costs and policy implications that will be required to meet federal funding requirements associated with partnering or not partnering with a general hospital. 

(6)  Issues of concern to potential host communities have not been adequately addressed, including governance, accountability, and sustainability; design and development of the facility; public safety; the impact on municipal services, housing, community mental health programs, other community resources, and reimbursement to the host communities for the costs associated with such impacts.

(7)  The state’s community mental health system may be threatened by the cost to operate psychiatric inpatient services that are not adequately planned within the budgetary context of the full continuum of necessary mental health services.

(b)  The general assembly reaffirms its intent as stated in Sec. 141a of No. 122 of the Acts of the 2003 Adj. Sess. (2004) that all mental health programs, services, and supports, including inpatient psychiatric services, be provided to individuals with psychiatric disabilities or diagnoses or emotional disorders in a holistic, comprehensive continuum of care, that consumers be treated at all times with dignity and respect, that public resources be allocated efficiently and produce the best positive outcomes, and that direct services overseen and provided by the agency of human services and its community partners be client- and family-centered and -driven, accessible, and culturally competent, and it furthermore reaffirms the guiding principles identified therein for purposes of the Futures Plan.

(c)  Notwithstanding any provision of law to the contrary, the remaining balance of the $1 million appropriated in Sec. 271(a)(3) of No. 215 of the Acts of the 2005 Adj. Sess. (2006) shall remain subject to the requirements as directed in Sec. 4 of  No. 147 of the Acts of the 2005 Adj. Sess. (2006), subdivisions (a)(2)(A)(ii) and (a)(2)(B), for use by the department of buildings and general services for the agency of human services to continue planning, designing, and permitting associated with the creation of a new inpatient facility to replace the current Vermont state hospital, except such funds expended for consulting services described in subsection (d) of this section.

(d)(1)  The committee on committees of the senate and the speaker of the house are authorized to retain one or more consultants to:

(A)  compile, analyze, and review the planning that has been done to date for replacing the services now provided at the VSH, including a review of the feasibility of recertifying the existing state hospital and obtaining authority to secure federal funding to support its operations;

(B)  investigate and make recommendations on the necessary steps to secure federal funding for the development of one or more regional or satellite psychiatric facilities in conjunction with other general hospitals and institutions for mental diseases, or stand-alone facilities, or both;

(C)  review and make recommendations regarding the feasibility of all the options available to the state for providing inpatient psychiatric services, taking into account the capacity needed; the time required to achieve the delivery of services; projected capital and operational costs; assurances of quality of care; the extent to which there will be integration with the chronic care initiative and integration of mental health care with overall health care; and the alternatives of public, private, public-private partnership, or other combination of operation and ownership structures; and

(D)  analyze the impact of the population involved in the criminal justice system on the needs, services, and costs of inpatient psychiatric hospitalization.

(2)  The committee on committees of the senate and the speaker of the house are authorized to spend up to $100,000.00 from the appropriation referenced in subsection (c) of this section to accomplish the purposes of this subsection. 

(3)  The consultant or consultants shall report preliminary progress on or before September 1, 2007  jointly to the chairs of the House and Senate Appropriations and Institutions Committees, the Senate Health and Welfare Committee, and the House Human Services Committee.  A final report shall be submitted to the above mentioned committee chairs, and to the Joint Fiscal Committee, the Mental Health Oversight Committee, the Secretary of Administration, and the Secretary of Human Services no later than November 1, 2007.


This act shall take effect from passage.

Published by:

The Vermont General Assembly
115 State Street
Montpelier, Vermont