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Retreat limits inpatients to Vermonters only

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BRATTLEBORO — The Brattleboro Retreat is limiting its in-patient clientele to Vermont residents only. This is to make sure that someone in Vermont requiring mental health care can be immediately sent to the Retreat instead of having to wait in an emergency room somewhere for a space to open up, said President and CEO Louis Josephson.

"Each time we admit a patient who would otherwise be stuck in a hospital emergency department suffering from acute psychiatric distress, we free up valuable medical resources needed to combat COVID-19 in Vermont," he said.

The Retreat is licensed for 149 beds. Before the national emergency, the Retreat held open 105 beds for inpatients. The Retreat has reduced its capacity to 92 beds and now has 72 patients.

The Brattleboro Retreat currently has one patient under quarantine as it awaits testing results to determine if that person has COVID-19.

"This is a recent development," said Meghan Baston, the Retreat's chief nursing officer and senior vice president of Patient Care Services.

Nonetheless, the Retreat had been planning for such an eventuality.

"We have assessed and prepared a clinical space that can serve effectively as an isolation unit suitable to meet the needs of patients with both psychiatric and non-life-threatening symptoms of the Coronavirus," Josephson wrote in a message to the community. "The Retreat is also partnering with Brattleboro Memorial Hospital to help us provide medical support for presumed-positive or mildly symptomatic coronavirus patients should that become necessary."

Since Tropical Storm Irene wiped out the state hospital in Waterbury in 2011, the Retreat has served as a contracted arm of the Agency of Human Services, providing more than half of all of Vermont's inpatient psychiatric treatment beds, 100 percent of Vermont's child/teen treatment beds and 150 suboxone slots as part of the state's hub and spoke treatment program.

Other changes the Retreat has made in reaction to COVID-19 include: Suspension of visitation on all inpatient units; an increase in cleaning and disinfection protocols in all areas; initiation of COVID-19 screening protocols for all potential inpatient admissions; closure of its on-site school programs; closure of outpatient programs that involve face-to-face group counseling; cancellation of this spring's continuing education conference series; closure of the facility's cafe and employee fitness center; and limited staff movement between buildings.

This is a big challenge for the Retreat and its more than 850 employees, said Josephson.

"I really cannot say enough about the great work that continues to take place at the Retreat under difficult circumstances," he said. "COVID-19 has impacted everyone in the community in so many ways. But in spite of the personal and professional upheaval caused by this pandemic, the Retreat's care providers have truly been an inspiration to us all as they manage to constantly put our patients first. We know we have some tough weeks ahead of us, but the staff has been great."

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"We are very fortunate to have the staff we do," said Dr. Gaurav Chawla, the Retreat's chief medical officer. "The level of commitment, the flexibility and the adherence to our mission that is displayed by our staff despite the uncertainty and anxiety is heartwarming."

Josephson said another reason for reducing the Retreat's capacity is to make sure its employees have the time they need to take care of themselves and their families.

"We need people to get rest and take days off," he said. "At the same time, we remain focused on our core mission to provide quality mental health and addiction services."

And when the Retreat eliminated face-to-face contact with out-patients, it turned to technology, using telehealth. Baston said the Retreat has been using telehealth for a while now, so many of its patients are very comfortable with the technology.

"We have also adopted measures to ensure that patients receiving daily dosing of buprenorphine [for opioid use disorder] can have enough of the medication at home so as to eliminate the need to come to our HUB program each morning," said Josephson.

The Retreat is also keeping a close eye on its stock of personal protective equipment, said Baston.

"PPE is in very short supply around the world," she said. "We are trying to be responsible in how we deploy it. We want to reserve it for the time that it's really needed."

Baston also said that even with a reduction in programming at the Retreat, most staff members are working, while a few are taking earned time off.

"At this moment, we have not laid off or furloughed anyone," she said. "There is work available for the majority of the staff who have been displaced."

Josephson said the Retreat and other health organizations around the state are hopeful that they will be getting funding through the various packages coming out of Washington, D.C. But sorting out who gets what and how much might not be done until into May.

Bob Audette can be contacted at raudette@reformer.com.


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