Mental Health

The Legislature passed S.133, which looks at the Vermont’s entire mental health care system that has been struggling due to a lack of resources, inadequate staffing in community programs, insufficient community programs, and inadequate supply of housing since Tropical Storm Irene flooded the Vermont State Hospital in 2011. The most obvious symptom of this problem is that people in mental health crisis linger for days in hospital emergency rooms because of limited resources for crisis support, hospital diversion and inpatient care for children and adolescents in Vermont.
This bill addresses the present crisis by directing the Secretary of Human Service, in collaboration with the Commissioner of Mental Health, the Green Mountain Care Board, providers, and persons who are affected by current services to come together and provide an analysis and an action plan to the legislature by Sept. 1, 2017. A comprehensive evaluation of the overarching structure for the mental health services within a sustainable, holistic health care system in Vermont will then follow.

The bill:

  • Requires an analysis of the role of involuntary medication treatment and psychiatric medication play in inpatient emergency department wait times;
  • Requires the AHS and the Chief Superior Judge to report the role of involuntary treatment and medication in emergency department wait times, including concerns arising from judicial timelines and processes;
  • Charges the Department of Mental Health to collect and analyze data on why a person is being referred to a hospital emergency department, the rates at which patients brought to an emergency department for an emergency evaluation are in need of inpatient hospitalization, and the trends in inpatient length of stay and admission rates (data for persons under 18 will be analyzed separately);
  • Compels the AHS to develop a plan to integrate multiple sources of payments for designated mental health agencies and specialized service agencies and to increase efficiencies and reduce administrative burdens;
  • Requires the AHS to evaluate the potential benefits and costs to develop regional navigation and resource centers to improve access to appropriate levels of care;
  • Directs the Secretary of the AHS and hospitals with psychiatric units to evaluate opportunities for achieving parity for individuals presenting at hospitals regardless of whether for a psychiatric or physical condition; and
  • Requires the examination of facility options, such as nursing homes, forensic facilities, and a 23-hour bed evaluation center to prevent or divert individuals from the need to access the emergency department.