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Vt. Updated on State Of Brattleboro Retreat

Montpelier — A top official at a private psychiatric hospital taking state patients promised improvements yesterday as lawmakers reviewed a series of deficiencies reported by a federal agency.

Peter Albert, vice president for government affairs at the Brattleboro Retreat, briefed members of the House Human Services Committee on a series of deficiencies reported March 11 after a state inspection done at the behest of the federal Center for Medicare and Medicaid Services.

That came after a series of complaints by patients at the Retreat, where the state has been sending some of its most acutely mentally ill patients since the former Vermont State Hospital in Waterbury was forced to close due to flooding from Tropical Storm Irene in August 2011.

Albert said the Brattleboro facility was not in danger of following Waterbury in losing federal certification. The Waterbury hospital had been without it for about a decade, costing the state about $8 million a year in lost federal matching funds under the Medicaid program.

“We are not on an immediate jeopardy or termination track, but I do not want to minimize in any way the level of seriousness of the work that we need to do,” Albert told the committee.

A March 11 letter from CMS to Retreat CEO Robert Simpson said the “deficiencies have been determined to be of such a serious nature as to substantially limit your facility’s capacity to render adequate care” and be in compliance with regulations.

Recent incidents covered in the report that resulted in the deficiencies included a patient who reported having sex with another patient, and wanted immediate follow-up treatment. The patient asked for “a specific medical intervention” the morning after the incident, but was not seen until the afternoon.

The inspection report said the patient reported “increasing fear that because of the delay in time, the medical intervention s/he had requested would not be effective.”

Albert agreed with lawmakers that the incident should have been reported to the state division of Adult Protective Services, but said that did not happen in a timely manner. Rather, he said, staff on the unit decided to assess the complaint.

A staff note said the patient “reports recent sexual activity. Unclear if (patient) claim is real or delusional.”

Albert said staff were told, “It’s not your job to assess.” Instead, the report should have been referred for assessment by state inspectors, he said.

A second incident involved an adolescent patient who threw something at a mental health worker and was taken by the arm and led into a seclusion room.

Referrals for seclusion should be made by more senior personnel, Albert said. He called the worker’s reaction “more of a knee-jerk reaction than actually anything clinically appropriate to help de-escalate the situation.”

A third incident noted in the deficiencies involved a patient with both physical and mental health problems who was given medical treatment against his or her will.

Albert said the hospital was working on a corrective action plan, but could not provide a specific date when it would be complete.

Some committee members expressed displeasure at what they said was a lack of complete information.

“We always get the (public relations) person from the Retreat and not the clinical people, which is what other hospitals send when there are issues about clinical treatment,” said Rep. Anne Donahue, R-Northfield.

Albert said in a later interview that while he is the Retreat’s vice president for government relations, he also is a trained clinical social worker.