Tag Archives: Tropical Storm Irene

Let's Not Fix the Mental Health System and Say We Did

Oh, great. The state’s Department of Mental Health is finalizing a ten-year plan to improve the state’s inadequate mental health care system. The highlights, errrrr lowlights, include:

  • It doesn’t appear to address the system’s biggest shortfall, i.e. the lack of resources for the worst cases.
  • It echoes the approach promulgated by the Shumlin administration and legislature after Tropical Storm Irene. Which, for those just joining us, failed to do what it promised.
  • There seems to be nothing about the lack of resources in the prison system.
  • There’s nothing about providing more funding to put the plan into action.

So there’s that.

The report focuses on linking treatment of mental and physical illness, “eliminating stigma around mental health and expanding community-based treatment programs.” That’s nice. But meanwhile, people with profound mental illnesses continue to be stuck in hospital emergency rooms in greater numbers and for longer periods.

That has nothing to do with “stigma” or “community-based treatment programs.” It has everything to do with Vermont’s lack of capacity to treat our severely mentally ill. That’s been a problem since Irene damaged the state hospital at Waterbury.

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The Bourgoin reverberations

I imagine Vermont’s psychiatric community is nervously anticipating the fallout from the horrible wrong-way crash on I-89 that killed five high school students. Lawmakers will be looking to assign blame and prevent future tragedies, and they’ve often used the psychiatric community as a whipping boy.

There are things the Legislature and administration could do, but based on past performance, I have little faith they will come to the right conclusions.

A couple of points. First, the Howard Center is in deep shit. Second, here’s the lesson I hope is drawn from this: when you have an under-resourced mental health system with a chronic shortage of inpatient beds, you foster a bias against hospitalization.

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Minter airs general election TV spot for the primary, hm.

Following in the footsteps of Matt Dunne, Sue Minter has put out her first TV ad for the gubernatorial primary. And following in the footsteps of Matt Dunne, her ad raises strategic doubts in my mind. (Not counting the missed opportunity to use “Minter Fresh” as the tagline.)

(Gee, why am I not a campaign manager?)

The ad focuses on her work as Irene Recovery Officer, which strikes me as a questionable place to start her TV effort.

First of all, Irene was a traumatic event, but it was five years ago already. It’s been front and center in her campaign since day one. Doesn’t she have anything more recent to brag on?

Second, the ad is misleading on a key point: she was the second Irene Recovery Officer. She succeeded Neale Lunderville, who occupied the post during the critical first few months of the operation. Irene happened in late August 2011; Minter took over in January 2012.

(This is the same convenient omission made on Minter’s Wikipedia page by FourViolas, an editor who’s made 13 changes to the page since mid-March.)

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More Wiki-intrigue: Who is “FourViolas”?

Recently, I’ve written a couple of posts about Peter Galbraith’s Wikipedia entry and the extremely assiduous pro-Galbraith editing activity of two anonymous persons — Devotedamerican and Westencivil.

Well, now I’ve got more intrigue to report, and it involves one of Galbraith’s competitors for the Democratic gubernatorial nomination.

Those who’ve been following the Galbraith story way too closely for proper maintenance of mental health will recall that the activity of Devotedamerican was brought to attention by another Wikipedia editor.

The plethora of edits was flagged to VTDigger by FourViolas, a Wikipedia editor from Vermont who reported having stumbled upon Devotedamerican’s work while inserting policy positions on the pages of all the Vermont gubernatorial candidates.

In an email, FourViolas asked to be identified only by Wikipedia username, saying the community appreciates anonymity.

Yeah, well, here’s the thing. FourViolas has been extremely busy editing Sue Minter’s Wikipedia page. FourViolas’ first edit came on March 17; after that, s/he was inactive until May 21. Since then, FV has been responsible for 12 more edits. Most of them add biographical detail fleshing out Minter’s experience and qualifications.

One of FourViolas’ edits conveniently omitted an important fact. See if you can spot it:

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The budget mess, again

One of the annual features of the Shumlin Era is the battle to close a budget gap*. There are reasons for this: the rising costs of (1) operating a government (mostly health care), (2) operating public schools (mostly health care), and providing social services (mostly health care).

*To be fair, it was also a feature of the Douglas Era, but the dynamic was different: Republican governor versus Democratic legislature. 

And then there’s the revenue side. Vermont is suffering from a creaky tax system that doesn’t reflect current economic realities, and is bringing in less and less money over time.

The Legislature is now in the throes of dealing with Budget Gap 2016, which has many of the features of past editions. Cries of doom, unexpected revenue upgrades, patently unworkable/unpopular money-raising ideas from Shumlin’s crack policy staff, and lawmakers trying to find alternatives. This year, we also have a significant difference between administration and Legislature over the size of the budget gap; per VTDigger, House budget writers say the administration omitted more than $9 million in basic government operations from its proposed budget…

…including a pay increase for state workers (estimated at $2 million to $6 million, depending on the results of a fact finder’s report and ongoing contract negotiations), pay increases for child care and direct care workers ($1 million each), and funding for the Low Income Home Energy Assistance Program ($4 million).

Shumlin’s modest proposals for new spending have already been killed by the House Appropriations Committee, whose first priority is closing the gap between current obligations and state revenue.

It’s a depressing Rite of Mud Season that has drained the energy of the Democratic caucus, party, and electorate.

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Our mental health sandcastle, part 1

And every one that heareth these sayings of mine, and doeth them not, shall be likened unto a foolish man, which built his house upon the sand:

— Matthew 7:26

Here’s something that close observers won’t find surprising at all: fresh signs of trouble in Vermont’s mental health care system. In my next post: staffing shortages and other troubles in the system’s crown jewel, the Vermont Psychiatric Care Hospital. This time: Again with the Brattleboro Retreat.

The Vermont attorney general’s office is conducting a criminal investigation into the Brattleboro Retreat following a whistleblower’s complaints about alleged Medicaid fraud at the private psychiatric hospital, The Associated Press has learned.

Ruh-roh. The AP’s Dave Gram quotes AG Bill Sorrell as characterizing the probe as “not narrow in scope,” and that it goes beyond the whistleblower’s complaint into other areas.

As for that complaint:

[Former Retreat staffer Thomas] Joseph alleged a yearslong pattern of instances in which, if overcharges showed up in patient accounts, Retreat staff would not make refunds but instead would change the account to reflect a balance of zero.

If the accusations are true, the Retreat would be in deep shit with Medicaid, which (according to Gram) supplies the Retreat with roughly one-fourth of its total funding.

Yeah, that’s not an enemy you want to make.

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Shumlin identifies the real culprit: “Anonymous blog sites”

In response to the killing of social worker Lara Sobel and three other women, Governor Shumlin has issued a plea for change. But he’s not calling for tougher gun laws or even better enforcement of the ones we have*. He’s not calling to boost staffing to make the Department of Children and Families more effective. Heck, he’s not even calling for better security arrangements for state workers — although he has “ordered a full review of our security procedures,” so we’ll see where that goes.

*Reportedly, Jody Herring should not have been able to acquire the gun used in the murder spree.

The real problem is “hateful speech” delivered on “anonymous blog sites and unfiltered social media.”

I realize the Internets provide an easy target in times like these, especially for a politico capable of writing “anonymous blog sites” without a trace of irony. But even aside from that inelegant phrase, there’s a real “You kids get off my lawn” feel to the whole piece.

Yes, “anonymous blog sites” can be wretched hives of scum and villainy. But is this our real problem? Was Lara Sobel’s death triggered by “anonymous haters who use vicious language to incite public ill-will toward others,” as Shumlin seems to argue?

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