Report to the 2007 General Assembly

Legislative Report 1A

Title: Vermont State Hospital – Futures Project

 Status of work/construction planning connected to Act 122 of the Acts of 2003 “Futures Project”. CON process and negotiations

2006 Act 147, Sec. 4(a)(3):  The Department of Buildings and General Services and the Agency of Human Services shall report at each remaining meeting of the JMHOC and of the JFC during calendar year 2006 and to the house committee on human services, the senate committee on health and welfare, and the house and senate committees on appropriations and on institutions (collectively the “Committees of Jurisdiction”) in January 2007 regarding:
(A) The progress made on the planning, design, siting, and permitting of the new state hospital facility, including specific updates on steps being taken consistent with subchapter 5 of chapter 221 of 18 V.S.A regarding the certificate of need process.
(B) The status of negotiations, if any, with a nonstate partner regarding the resolution of outstanding issues, including building ownership, staffing, and administrative responsibilities.  “Staffing” shall include demonstrated due diligence in support of the statement in the Vermont futures strategic implementation plan of July 11, 2005 that the “expertise and experience of the current VSH staff is a valuable resource” by identifying potential avenues that would enable current qualified staff to maintain their status and contractual benefits as Vermont state employees.
In accordance with 2006 Act 147, Sec. 4(a)(3)(A)(B) the following report is submitted on the progress of work regarding planning, the CON process, and negotiations connected with the “Futures Project” required from the Secretary of Human Services by Sec. 141a of No. 122 of the Acts of the 2003 Adj. Sess. (2004).  

The planning process for the replacement of the inpatient facilities for the Vermont State Hospital has been slowed by the need to acquire a Conceptual Certificate of Need (CON).  BISHCA regulations restrict the expenditure of funds for planning and design until and authorized by the issuance of the Conceptual CON Permit.  To date, we have completed a preliminary statement of space needs.  We are also working collaboratively with Fletcher Allen Health Care (FAHC) to develop a concept of how these facilities will operate integrated with their current medical and mental health facilities.

The information developed during the space planning and the concept of operations efforts facilitated the submission of the Conceptual CON Application.  This application was submitted to BISHCA on August 16, 2006.  BISHCA’s review of the application generated a list of 160 numbered questions with many having sub-questions.  These questions were received on September 5, 2006.  The answers to the questions were submitted on October 16, 2006.  In response a second round of 14 questions was received by AHS on November 3, 2006.  The Agency of Human Services completed and submitted answers on November 13, 2006.  The application was ruled complete that afternoon and the public hearing before the Public Oversight Commission (POC) was scheduled for December 13, 2006.  A pre-hearing conference was also scheduled to determine issues in controversy and to identify documents and other evidence to be offered.  This pre-hearing conference was held on November 29, 2006.  We anticipate a ruling on the application to be received on or before March 13, 2007.  Assuming a favorable ruling, the Agency of Human Services and the Department of Buildings and General Services will then proceed with the planning and design for the new inpatient facilities and the submission of the full Certificate of Need application. 

Negotiations with potential non-state partners have also been slowed by the need for a CON Permit.  Several meetings have been held to begin discussions around the issues of ownership, administration and staffing, but no definitive agreement has been reached.  In an effort to evaluate the potential for staffing the new inpatient facilities with current State employees, a VSH Employees Work Group was established in April 2006, charged to identify the range of options for the future of VSH staff to accomplish the transition of the psychiatric care services currently provided at VSH to a new facility.  The results of this work group’s effort were reported to the Futures Advisory Committee in a report dated September 7, 2006.  The preferred options included in the report are:

Public – This model means that the inpatient care services will be owned, operated, and licensed by the State and all positions will be State jobs with related rights and benefits.

Public senior management and workforce working under private license – Under this model, the majority of staff would have State positions, but private sector positions would be embedded within the organization to oversee responsibilities related to licensure of the facility.

Public workforce / Private senior management (such as CEO, CFO, Administrators) – This model means that the State will own the inpatient care services, but members of the management team will work directly for an external entity.  Under this model, most positions would continue to be State jobs with related rights and benefits.

Because of the complexity of the issues involved, the Agency of Human Services is prepared to provide detailed testimony on this matter.