Well, that didn’t take long. In fact, it couldn’t have happened any faster.
Two weeks after public comment forced the Green Mountain Care Board to defer cancellation of a plan that might have led to a badly-needed increase in inpatient mental health beds, the Board came right back and went ahead with the deal today with minimal amendment. It stands essentially as it did before: it lets the University of Vermont Health Network off the hook for designing a new inpatient facility, thus closing the door on the best opportunity to resolve our 12-years-old-and-counting* crisis on inpatient mental health care.
*That’s the generous count, starting the clock with Tropical Storm Irene. If you want to include the dilapidated, outdated old state hospital, well, the crisis goes back a lot further.
The revised plan requires UVMHN to invest $18 million in boosting “capacity of mental health services in the state.” Not “inpatient,” mind you, but “mental health services” of any sort. The Board then punted review of UVMHN’s plan to the Department of Mental Health because, as Board member Jessica Holmes put it, “we’re not the experts” and DMH is.
It also allows the GMCB to wash its hands of the whole mess, but that’s just a bonus.
Our health care guardians at the Green Mountain Care Board are trying to sneak through a bit of business that combines bad policy with questionable procedure.
Well, I guess that explains the “sneak through” part. They can’t be proud of this.
Six years ago, the GMCB ordered the University of Vermont Medical Center to take $21 million in surplus revenue and spend it on developing a plan to boost inpatient mental health care, which has been abysmally lacking since Tropical Storm Irene wiped out the old state hospital in 2011. We’re now in our twelfth year of inadequate inpatient care that has left severely mentally ill patients languishing in emergency rooms and frontline providers dealing with the consequences.
The failure to address this situation ought to be a source of embarrassment if not shame to Our Political Leaders.
Anyway, it seemed like a decent idea: Let UVMMC use the surplus to tackle a challenge that nobody else would.
Well, now the GMCB is about to let UVMMC off the hook, further delaying any meaningful response to the shortage of inpatient care. And the Board trying to rush it through with the least possible fanfare.
Did you know that the Scott administration Covid policy isn’t aimed at reducing illness? Nope, they don’t care about that. The governor himself has said, over and over, that his goal is to prevent Vermont’s health care system from being overwhelmed. As long as the caseload is manageable, he’s fine.
Well, yeah, he’s fine.
But there’s a problem with that “set the bar low and jump over it” policy goal. It’s already failing. The health care system is already in crisis. It just hasn’t completely blown up yet.
And that’s only because of heroic and unsustainable efforts by health care workers and staff. The administration is desperately trying to patch things together and prevent a total blowup, and that’s all it cares about. Human Services Secretary Mike Smith has taken to giving weekly updates on efforts to add more subacute inpatient beds (to hustle patients out of the hospital as quickly as possible) and ICU beds — and the state is paying God knows how much to staff those extra beds.
I’ve also heard that the University of Vermont Medical Center is relying heavily on temporary nurses because it’s so short-staffed. If that’s the case at our crown jewel, imagine what’s happening in smaller facilities. Temporary nurses are in such high demand that they can almost write their own tickets, and the temp-staff agencies are making out like bandits. (Those agencies charge up to 100% of the staffer’s salary.)
The administration is willing to do anything, at any cost, because they don’t want to see Covid patients parked in emergency rooms or triaged for lack of resources. It’s not about quality of care of public health, it’s about avoiding a PR nightmare.