MONTPELIER - The state's psychiatric hospital in Waterbury should be replaced by a new rehabilitation treatment center with other services moved into community hospitals and facilities, according to a consultants' report released yesterday.
The report was commissioned by legislative leaders to evaluate existing plans for replacing the aging state hospital.
"We came away thinking that the Vermont State Hospital Futures Plan was really misnamed, that this plan really should not center around building a new asylum," said the lead consultant, Richard Surles, former state mental health commissioner.
Community hospitals, with support from the state, could replace some of the Vermont State Hospital's acute care, and a state-controlled rehabilitation treatment facility in Waterbury or elsewhere could be set up to serve long-term patients, the consultants said.
Surles said the group shifted the focus from acute care to what happens when people respond to treatment.
"We all know that if people are seen early and treated well . . . the vast majority of people respond extremely well to treatment and don't really require to be hospitalized," he said. "But if they do, they should be hospitalized as close to home as possible, with as much dignity as possible."
The report does not estimate the cost of replacing the 113-year-old hospital. But the consultants warned that relying totally on federal Medicaid funding could restrict flexibility and drive up expenses.
The consultants, including Surles, former human services commissioner Con Hogan, and Thomas Moore, a former deputy of the Department of Social and Rehabilitative Services, also recommended a review of the state's involuntary commitment law for mentally ill patients, to see how it applies to community hospitals.
The 12-page report, completed over six months, is intended to provide a blueprint for moving forward in replacing the state hospital. It recommended moving in phases, starting with replacing the nonacute, secure care services.
The study was commissioned by House Speaker Gaye Symington, Senate Pro Tem Peter Shumlin, and various committee chairs to give a fresh look to the existing plans, including opening a facility at Fletcher Allen Health Care in Burlington.
"We must in this legislative session leave this building with a plan for the state hospital," Shumlin said yesterday. "We must make progress."
Mental Health Commissioner Michael Hartman said he hopes the report will lead to more solid agreement between the administration and Legislature by the end of the session.
Ken Libertoff, executive director of the Vermont Association for Mental Health, said the report "points a sense of direction rather than pointing fingers."
"We've had three unsuccessful years of trying to have a conversation where we reach consensus. So I think the report will help us move in that direction," Libertoff said.
He agreed with Representative Anne Donahue, Republican of Northfield, who said the report "puts to bed the concept that an asylum is an appropriate place for acute mental health care."
She said it does not change the fundamentals of what is being planned to replace the hospital.
"It reaffirms where we need to be going," she said.