BERLIN, Vt. — The University of Vermont Health Network says planning for a new inpatient psychiatric facility is “on track,” and a formal proposal will be submitted to state regulators later this year.
But the facility, to be built on the Berlin campus of Central Vermont Medical Center, likely is still about three years away from completion.
Anna Tempesta Noonan, Central Vermont’s president and chief operating officer, said a certificate of need application with the Green Mountain Care Board will be “really the start of the process.”
“As heavy as this lift has been to date, the heavy lift is to come,” Noonan said.
UVM Health Network has spent more than a year developing plans for 25 new adult inpatient beds that would join 15 beds already on the Central Vermont property. While those plans have not been finalized, Noonan said that “ideally, we would like to see this entire (psychiatric) population colocated” in a 40-bed facility.
“Moving the beds we have to be (adjacent) to this additional capacity would be ideal, so that we can flex staff, so that providers have ease of moving from one of these tiers to another,” she said.
The project was spurred by the care board, which last year ordered UVM Medical Center to set aside $21 million in “surplus” operating revenue for a project that would “measurably increase inpatient mental health capacity in Vermont.”
Officials hope the project will ease pressure on the state’s overburdened mental health system, in which psychiatric patients often are stuck in hospital emergency rooms due to a lack of available mental health beds. That situation has led to regulatory violations at several hospitals.
“Our focus for this whole project is to make sure that no Vermonter is waiting for extended periods of time in our emergency departments, because there just isn’t the capacity for those therapeutic inpatient psychiatric beds,” Noonan said. “We’re really committed to that mission.”
While a UVM Health Network study found that the state may need up to 35 new psychiatric beds, the network eventually settled on building 25 beds in order to not run afoul of federal Medicaid-funding regulations.
The Brattleboro Retreat also is adding mental health capacity via renovations that are expected to be complete next year.
UVM’s project will take longer than the Retreat’s, in part due to its size and also because the project involves building an entirely new mental health facility. Administrators also have taken a deliberative approach to the project, holding a series of meetings with various interested parties and the public.
The most recent meetings, held over a 12-week period, were designed “to complete the facility planning, operational and space programming effort,” John Brumsted, the health network’s president and chief executive officer, wrote in a May 15 letter to the care board.
In addition to gathering opinions from “front-line caregivers,” the network’s planning consultant met with representatives of the state’s designated mental health agencies, the National Alliance on Mental Illness, Vermont Psychiatric Survivors and “patient and family advisors” from Central Vermont Medical Center.
Noonan said the hospital project needs to be shaped by those with “lived experience” in mental health care.
“I can’t underscore enough the importance and the value of that lens being applied to this kind of work,” she said. “I think it really enriches the programming, design and development, and gives us insights that we may not have as clinicians.”
Brumsted’s letter also says some of those who are participating in the planning process visited the state-operated Vermont Psychiatric Care Hospital in Berlin as well as Lancaster General Hospital in Lancaster, Pennsylvania, and Regions Hospital in Saint Paul, Minnesota.
Noonan said she put out a request among a national network of academic medical centers to tour inpatient adult psychiatric space that had been built or significantly renovated within the past five years.
“This type of benchmarking is not unusual for us – we do this work a lot,” she said.
While the health network has not yet finalized programming and staffing decisions, Brumsted’s letter says a certificate of need application to the care board is anticipated in December 2019. If the board OKs the project sometime in 2020, the project is expected to extend into 2022.
The health network in 2018 projected a three- to four-year schedule for the project, and “we are committed to trying to hit that time frame,” Noonan said.
Brumsted’s letter also shows that, at this point, the health network has used less than $95,000 of the $21 million set aside for the project by the care board. Noonan said administrators are “trying to be really prudent with these resources,” especially since the project is expected to cost more than the amount in the care board’s order.
In the coming months, “we’ll be really looking at the financing and the capital spend, operational costs, those sorts of things,” she said.