|BILL AS INTRODUCED||2007-2008|
Introduced by Committee on Appropriations
Subject: Vermont state hospital; legislative evaluation
Statement of purpose: This bill would provide for an independent evaluation by the general assembly of the options available to the state regarding the provision of inpatient psychiatric services now provided at the Vermont state hospital.
AN ACT RELATING TO PLANNING AND EVALUATING OPTIONS FOR INPATIENT PSYCHIATRIC HOSPITAL SERVICES
It is hereby enacted by the General Assembly of the State of Vermont:
(a) 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 a new FAHC inpatient facility approaches $100 million which, the POC suggested and the general assembly finds, 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 have been developed.
(5) No analysis has been made of the costs and policy implications that will be required to meet federal funding requirements associated with 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 strong community mental health system may be threatened by the cost to build and operate a $100 million psychiatric hospital on the FAHC campus, thereby reducing already limited funds available for mental health services.
(b) 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) and the expenditure of which was directed in Sec. 4 of No. 147 of the Acts of the 2005 Adj. Sess. (2006) 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 shall not be spent unless authorized by the joint fiscal committee of the general assembly, or for expenditure of funds authorized for consulting services in subsection (c) of this section. The general assembly shall review the planning efforts described in this section, including a review of the feasibility of recertifying the existing state hospital, and obtaining authority to participate in federal funding to support its operations, with or without a regional or satellite facility in one or more geographic locations around Vermont in conjunction with other general hospitals and institutions for mental diseases.
(c) The president pro tempore of the senate and the speaker of the house are authorized to retain one or more consultants to assist with the planning review and to pursue the necessary steps to meet conditions of participation or waivers from the Centers for Medicare and Medicaid Services and the United States Congress to enable the participation of the existing state hospital in federal funding or the development of a regional psychiatric facility, or both, and they are authorized to spend up to $100,000.00 from the appropriation referenced in subsection (b) of this section to accomplish this purpose no later than June 30, 2007.
(d) The review of the options available to the state, as required by this act, shall take into account the time required to achieve the delivery of services, projected capital and operational costs, assurance of quality of care, the extent to which there will be an integration with the chronic care initiative and integration of physical and mental health care, and whether the facility will be publicly or privately operated, or operated as a public-private partnership.
(e) The review shall also include consideration of the impact of the offender population on the needs, services, and costs of the inpatient psychiatric hospital services.
Sec. 2. EFFECTIVE DATE
This act shall take effect from passage.
The Vermont General Assembly
115 State Street