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Editorial: While desperate patients wait for a new psychiatric facility, UVM Health squanders two years planning a boondoggle

Published: 3/4/2020 10:10:17 PM
Modified: 3/4/2020 10:10:09 PM

The severe shortage of inpatient psychiatric beds for Vermont’s most acutely ill patients is among the state’s most pressing problems, and it is beyond disappointing to see the issue being treated so cavalierly by those charged with helping to solve it.

That certainly is a harsh judgment, but it’s hard to reach any other conclusion after learning that the University of Vermont Health Network has squandered two years in planning for a new 25-bed psychiatric facility at its affiliated Central Vermont Medical Center in Berlin.

The planning process yielded a $150 million plan that was not merely unaffordable, but ludicrously so. By way of comparison, the average cost for constructing a psychiatric facility is about $1 million a bed, according to Mourning Fox, deputy commissioner of the Department of Mental Health.

Not to worry, says John Brumsted, chief executive of the UVM Health Network: “What has come forward is a plan that is too expensive. So like almost every building project I’ve ever been in, it’s at a point where we have to go back and match up what’s been designed with what’s affordable.”

We’re pretty sure his equanimity is not shared by acutely ill patients languishing in hospital emergency rooms waiting for a psychiatric bed to become available. Or their families. Or health care providers who have been assaulted or otherwise traumatized in dealing with distraught patients. For them, and the state as a whole, addressing this issue demands a sense of urgency that appears to be sadly lacking among UVM Health leaders.

In 2018, state regulators tasked UVM Health with investing $21 million of a $38.5 million surplus in developing inpatient psychiatric capacity. The health network spent 21 months and $1.2 million designing a 25-bed facility at Central Vermont Medical Center that would supplement the 15 psychiatric beds already on the campus there. UVM and hospital executives attributed the $150 million construction estimate to unforeseen challenges such as the need to move a power line and building on sloping terrain.

But, as VtDigger reported last month, the plans also incorporated other projects including a parking garage, roof gardens, a new hospital entryway and an emergency room renovation. To all appearances, hospital executives larded up the plans for a psychiatric facility with a rich menu of other priorities.

So now it’s back to the drawing board, the effect of which will be to push back the projected completion date for the badly needed facility by two years, to 2024. Meanwhile, patients admitted involuntarily wait an average of 59 hours in emergency rooms for a mental health bed to become available, according to the Department of Mental Health.

Among those exasperated by the situation is Kevin Mullin, chairman of the Green Mountain Care Board, the state’s health care regulatory body. “Here we are two years out and everyone’s overwhelmed at a cost that’s way beyond what anybody had envisioned,” said Mullin in admonishing representatives of the UVM Health Network and Central Vermont Medical Center when they provided the board with an update last month.

Expressing displeasure is not enough. The board itself needs to assume more direct oversight for the project and provide direction to an organization that sorely needs it. It ought to define the parameters of what’s needed and what’s possible, including setting a price tag that’s reasonable and defining a time frame for planning and construction. And the regulators should hold the leaders of the UVM Health Network and Central Vermont Medical Center accountable for coming back with a workable plan without unnecessary delay.

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