MONTPELIER -- Gov. Peter Shumlin outlined a plan Tuesday to replace the Vermont State Hospital heavily damaged by Tropical Storm Irene with a new 15-bed hospital in Berlin and expand existing facilities in Brattleboro and Rutland.
The expansions would create another 20 beds for the state's psychiatric patients in need of the most intensive care. An area of the minimum security state prison in Windsor would be outfitted to securely hold another five patients who don't need the level of services that could be provided in Berlin, Brattleboro and Rutland.
Mental health care would be improved outside those facilities by providing transitional beds for people moving out of the acute care system, improving emergency and individualized services and providing housing vouchers and additional support to people moving back into the community, Shumlin said.
The total cost of the new and renovated facilities and the improved community services would be about $42.6 million, although only a portion of that cost would come out of the state budget.
"We have an opportunity in Vermont as a result of Irene to ensure that we rebuild this state better than the way Irene found us," Shumlin said.
"We also have a golden opportunity to deliver to Vermont's most vulnerable citizens -- our mental health patients in Vermont -- the best quality care of any state in the country," he said. "We all know that the facility that we were using for the state hospital pre-Irene, the bricks and mortar, did not dignify or allow for quality recovery because the buildings were so dismal.
The governor was joined at a Montpelier news conference Tuesday where he outlined the plan by members of his administration who helped make the plans and mental health advocates.
Not everyone agreed with the plan.
"This goes back 10 to 20 years in state-of-the-art care by removing it from direct integration with medical care," said state Rep. Anne Donahue, R-Northfield, who has long taken an interest in mental health issues.
"The vast majority of people with acute psychiatric needs also have acute physical needs -- that's well-established medically," she said. "Building any new facility, rehabbing any new facility, without it being integrated with medical care goes backward not forward."
But Shumlin said no plan to replace the state hospital would make everyone happy.
Even before Irene inundated the state office complex in Waterbury officials had been trying to decide what to do about the antiquated state hospital, which held about 50 patients until they were evacuated during the flood. The patients were spread across the state into other hospitals and the state prison in Springfield. But that solution has overtaxes those facilities, and the administration has been working to come up with a long-range plan.
The new construction would be in Berlin, near the Central Vermont Hospital, although the exact location has not been chosen. It would be a state-of-the-art facility for 15 individuals. It is expected to cost $15 million and it would be built in such a way that, if needed, it could be easily expandable.
The 14 beds at the Brattleboro Retreat would require a $4 million capital improvement. The changes at the Rutland Regional Medical Center would require $6 million in improvements.
"The new hospital, the Brattleboro Retreat, and Rutland will all be able to provide the same level of care," Shumlin said. "All of the other pieces of the puzzle will be for less acute patients, and we're going to move out patients from acute care and into the community... as quickly as we know how."
The goal is to renovate a small building on the grounds of the state prison in Windsor to create a secure, long-term residential setting for patients, said Patrick Flood, the deputy secretary of the Agency of Human Services.
"There is a need for certain people from time-to-time to have a secure setting for a longer period of time. They don't need the hospital anymore," Flood said.
Officials hope much of the cost would come from insurance payouts, disaster assistance from the Federal Emergency Management Agency and other federal funds. The governor's office estimated $7 million would need to come from the state's general fund.
The Legislature must approve the plans.
"Three-quarters of the plan, roughly, can be executed as soon as the Legislature gives us the green light," Shumlin said. "The rest will be done as quickly as possible."