The University of Vermont Health Network wants to build a mental health urgent care clinic to take some of the heat out of its emergency departments, which often serve as de facto shelters for patients experiencing mental health crises.
The $2.85 million clinic is just part of an $18 million proposal Health Network presented, in partnership with the Vermont Department of Mental Health, to the Green Mountain Care Board last week to address the crisis state mental health.
The largest single expense in the proposal is $4.5 million to reconfigure the psychiatric unit at Central Vermont Medical Center in Berlin to “increase bed usage and improve patient experience.” The reconfiguration involves converting six beds from shared rooms to private rooms to give psychiatric patients more privacy, calm and tranquility.
“This will help reduce the number of patients waiting in the emergency room and provide a better environment for healing,” a news release said.
Also in the proposal:
- Expand resources for eating disorders and transgender care clinics for youth. Hire additional staff, including a doctor, dieticians, social workers, psychologists and support staff for young people with eating disorders or transgender care needs.
- Expand the schedules for ambulance transportation at Brattleboro Retreat. This will be a pilot program offering ambulance transport to collection from 5-11pm to determine patient benefits.
- Continue to integrate primary care and mental health care. The network has made “significant investments” to expand access to mental health services at its primary care sites, according to a news release. Based on initial success, the plan is to add these services at even more clinics.
- Develop and implement protocols to prevent suicides, with a particular focus on service members, veterans, and their families.
- Expanding access to innovative treatments for patients with major depression. This involves the creation of esketamine and transcranial magnetic stimulation programs at the University of Vermont Medical Center. Dr. Robert Althoff, chair of psychiatry at UVM Health Network, explained in an email that esketamine is a nasal spray that can be used with an antidepressant in “treatment-resistant depression and suicidal depression.” Transcranial magnetic stimulation is a noninvasive treatment that uses magnetic fields generated on the scalp to improve symptoms of treatment-resistant depression and obsessive-compulsive disorder, according to Althoff.
The good old days of budget surpluses are over
The $18 million to pay for mental health care programs has been held by UVM Health Network since 2018, when it was ordered by the Green Mountain Care Board to use the budget surplus generated by the network in 2017 to help remedy to the Vermont mental health care crisis.
Before the COVID-19 pandemic hit in 2020, the network routinely brought in millions of dollars more than its regulated revenue goals, and the board dictated what to do with those overages. As the Network notes in a press release, the Board “tightly regulates” Vermont’s hospital budgets.
The pandemic, coupled with inflation, ended the days of budget surpluses for UVM Health Network and ushered in an era of financial hardship. Last July, the network asked the Green Mountain Care Board to approve an additional $142.3 million in payments from Vermont’s BlueCross BlueShield and other commercial insurers to help bail it out of an unprecedented financial crisis.
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Chief Financial Officer Rick Vincent told the board last year that the total size of the hole in the network’s budget for the following year was $164.6 million. Vincent said the network was facing the toughest financial position it had seen in its 20 years of health care.
The Green Mountain Care Board denied the request for additional insurance payments, which would have required double-digit commercial rate hikes, of nearly 20 percent for UVM Medical Center alone. The network also includes Central Vermont Medical Center in Berlin and Porter Medical Center in Middlebury, as well as three hospitals in upstate New York.
“Along with hospitals nationwide, UVM Health Network has faced well-documented financial challenges, but remained committed to using (the $18 million surplus) to improve access to mental health care,” he said a press release.
Contact Dan DAmbrosio at 660-1841 or firstname.lastname@example.org. Follow him on Twitter @DanDambrosioVT. This coverage is only possible with the support of our readers.
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