State officials began the new fiscal year by opening the new 25-bed psychiatric hospital in Waterbury. The facility replaces the 54 bed state hospital, opened in 1891, that was flushed away by Tropical Storm Irene. The governor and others made the important point that the new facility would bolster community-based services and reduce the reliance on hospitalization. Another seven-bed facility in Middlesex is moving toward completion.
Sen. Jane Kitchel, D-Caledonia, was present for the ribbon cutting. In an interview with VT Digger, the Senate's appropriations chair revealed that the many mental health programs approved in 2012, including the new hospital, are now cumulatively $50 million over budget from what was originally proposed.
How can this happen?
The "global commitment," first obtained from Washington by Gov. Jim Douglas, allows the state to receive a predictable amount of Medicaid funding and use it according to state priorities, with numerous conditions.
Morgan True, of VT Digger, explained that Vermont's "mental health system now vacuums up much of the global commitment money Vermont receives through its federal [Medicaid] waiver." Senator Kitchel says, "This basically obligates all of our global commitment money."
Critics of the state's extensive mental health programs have long said that persons suffering from mental illness should, whenever possible, be helped in community settings with the participation and support of other patients and families - as opposed to being the charges of uniformed state employees. Obviously in some acute cases patients must be confined to prevent them from hurting themselves or others, but in lower intensity chronic cases there should be attractive -- and less expensive - opportunities for patients, with help, to regain their equilibrium in non-institutional settings.
The Vermont State Employees Union has always opposed this approach. It wants a large mental hospital with state employees managing mentally ill people for as long as possible. They didn't get the large new hospital they wanted, but you can bet that they'll manipulate the system in ways that maximizes the earning potential for VSEA members.