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Vermont State
Hospital closure plans
make progress
(October
2005 Issue)
By Sean Smith
Vermont's long-running efforts to replace its much-criticized state
psychiatric hospital continued to nudge forward in late summer,
with the appointment of a new administrator assigned to directly
oversee the process.
The Vermont State Hospital (VSH), which twice in recent years has
lost its federal certification because of safety concerns, is slated
to close and the state is seeking to reduce the patient census as
it continues to develop plans for replacing the hospital's services.
On Sept. 2, Deputy Health Commissioner for Mental Health Services
Paul Blake named Beth Tanzman, MSW, as director of Vermont's Mental
Health Futures Initiative. According to the press release announcing
her appointment, Tanzman will provide leadership as project manager
for developing a new inpatient facility to replace VSH and for implementing
the array of new community capacities described in the Vermont
State Hospital Futures Plan. Her first task will be to assemble
a project team within the department that will be dedicated to this
project.
Tanzman, who was Vermont's Mental Health Adult Services director
for more than nine years, has "been recognized in Vermont and nationally
for her leadership in program development, administration and systems
planning in the field of mental health," according to the release.
Among the achievements for which Tanzman is credited is helping
to oversee the downsizing of a unit at VSH and the development of
a number of new community capacities. She also was the lead developer
of the Community and Treatment Services case-rate payment methodology
that introduced greater flexibility for mental health providers.
The week following Tanzman's appointment, Vermont Health Commissioner
Paul Jarris, M.D., M.B.A., offered an update on the VSH situation.
Jarris says plans for replacing the hospital's services are "moving
rapidly, with dozens of stakeholders involved in the process," and
that the state hopes to have alternative facilities in place by
late winter to provide 16-20 sub-acute beds, operated by local agencies.
"We also are moving ahead toward an ambitious goal of constructing
one or more small inpatient hospital facilities within three years,"
says Jarris.
The Tanzman appointment and Jarris' statement came after Vermont
mental health advocates had publicly called on the U.S. Department
of Justice to take legal action to protect patients' rights and
improve care at VSH.
"From an advocate's perspective, this has been a difficult, challenging
and flawed initiative over the past year" says Vermont Association
for Mental Health Executive Director Ken Libertoff. "The fundamental
issue is that we are unsuccessful in maintaining quality care in
our one small state institution. The lack of progress in developing
a plan with a consensus - not total agreement, just consensus -
has been disappointing."
In July, the Department of Justice issued a strongly critical
assessment of the hospital, based on a visit by specialists the
previous year. The DOJ report says the hospital failed to protect
patients from harm and undue restraint, failed to provide adequate
psychiatric and psychological services and did not ensure adequate
discharge planning.
Responding to the report, Jarris says the state would not challenge
the findings but "did not concede that it has violated the federal
statutory or constitutional rights of persons receiving care at
VSH."
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