Senate lawmakers this morning are frenetically preparing for a floor session this afternoon during which leaders aim to pass out, at long last, the mental-health bill that Gov. Peter Shumlin says will alleviate the “crisis” unfolding in hospitals across Vermont.
It’s been a long road for the legislation, which lays out a replacement plan for the 54-bed psychiatric hospital flooded out in Tropical Storm Irene. Seven weeks of legislative debate have done little to quell dissent over the administration’s plan. And a spate of amendments on the Senate calendar today spotlights the major areas of disagreement.
The size of the replacement hospital remains the biggest sticking point. Shumlin has demanded a bill that calls for a facility, to be located somewhere in central Vermont, with no greater than 16 beds. Exceeding that number, Shumlin says, will cost taxpayers nearly $10 million in foregone federal revenue annually. That’s because new rules in place at the Center for Medicaid and State Operations, he says, prohibit federal Medicaid matches for facilities with greater than 16 beds.
In a letter sent yesterday to Senate President John Campbell and House Speaker Shap Smith, Shumlin recalls a conversation he had this past Sunday with Human Services Secretary Kathleen Sibelius and Director of CMS and State Operations Cindy Mann.
“I asked them directly if there are any circumstances in which, if Vermont builds more than 16 beds, we could qualify for federal reimbursement,” Shumlin wrote. “The answer was no.”
The House passed a bill that calls for a 25-bed facility. The Senate Committee on Health and Welfare has since whittled the figure back down to 16. But amendments to be introduced on the floor today would increase the number to as many as 50 beds.
Those amendments come largely at the behest of the Vermont State Employees Association, which represents the 280 workers formerly staffing the Waterbury psychiatric hospital. Delivering proper care to acutely ill patients, hospital doctors have said, requires a facility of at least 25 beds, and preferably more.
Shumlin’s plan replaces the lost capacity in Waterbury with a combination of the 16-bed facility in central Vermont, and by ramping up in-patient capacity at the Brattleboro Retreat and Rutland Regional Medical Center.
Critics say those facilities won’t be capable of delivering the specialized, dedicated care of a facility designed specifically for mental health patients.
The VSEA also stands to lose scores of jobs under the administration plan. Last Friday, the administration sent pink slips to 80 state hospital workers, many of whom have been idle since the flood. Others have been performing their jobs in hospitals, which have been forced to absorb patients that would have otherwise gone toWaterbury.
The fate of those workers is the subject of at least two amendments today. Sen. Tim Ashe, a Progressive/Democrat from Chittenden County, has offered language that would force the hospitals handling new in-patient capacity to give former state workers preference in the hiring process.
Sen. Vince Illuzzi, and Essex County Republican, goes a step further, saying those workers should not only be given the new jobs created at hospitals, but shall retain their status as state workers, and retain the wages and benefits negotiated in the VSEA’s collective bargaining process.
Shumlin said he can’t abide either amendment. While he’ll cheerlead for the former state workers seeking new jobs in Brattelboro or Rutland, Shumlin says, the state can’t dictate hiring protocols to independent entities.
“We are encouraging all our private providers to hire our qualified workforce,” Shumlin said at a press conference Tuesday. “I’m saying there is a difference between encouraging, urging, begging, and requiring them (to hire former state workers). And I will not require them.”
Shumlin had until recently taken a diplomatic tone when discussing publicly the disagreements over the bill. Even after Feb. 17 – the date on which Shumlin had said he wanted a bill on his desk – administration officials were praising the Legislature for their diligence on the legislation.
With town meeting break just around the corner, however, Shumlin has taken a more aggressive tack.
As if to heighten the drama, he underscored the urgency by issuing a dire warning to lawmakers Tuesday:
“We got flooded out of our state hospital. We have people right now, health care providers, who are in danger because we don’t have a sate hospital anymore,” Shumlin said. “I am hoping there will be no loss of life because of this. But I can’t guarantee it.”
The Senate is schedule to head to floor at 3:30 this afternoon.