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Full-time focus

Posted February 23, 2007

Last year, the Vermont Guardian argued in favor of a full-time mental health commissioner to help bring some stability and focus to the task of replacing the Vermont State Hospital (VSH) and better integrating mental health care into the overall health care system.

However, we’re no longer sure that putting a figurehead on top of a department is going to help bring to bear any greater understanding in the public, or better care in the system, or a deinstitutionalization of mental health care.

No commissioner could improve what is quickly becoming a burgeoning project in terms of scope and size beyond anything needed by such a small state to provide “treatment” for some those individuals labeled mentally ill. What started at $10-20 million is now grown to more than $100 million with little explanation.

At the same time, the census at VSH is more than at capacity, which means that the beds available at regional hospitals are either also full, or the hospitals are refusing to take people.

Those high numbers are due, in part, to the state’s allowance of fewer psychiatric bed slots at Springfield Hospital, and the loss of beds at Rutland Regional Medical Center due to staffing shortages.

The recent suicide of a patient on the watch of Fletcher Allen Health Care, and its subsequent investigation, raises serious questions about the care that is being delivered to Vermonters. Investigators found at Fletcher Allen some of the same problems they found at VSH after two people there committed suicide — improper oversight and falsifying records to cover up the fact that care has not been delivered properly.

It’s important to note that Fletcher Allen is the state’s solution to the mental health system crisis — and wants it to host a new multi-bed psychiatric facility.

We are on the verge of a crisis in Vermont in terms of helping people who have been labeled mentally ill, and in many cases abandoned, or shunned, by society.

It’s time for less talk about titles, and glossy blueprints, and more about ways to provide the right care at the right time, and put the patient, not policy, first.

Make it sexy, Speaker

House Speaker Gaye Symington told the Guardian recently that despite the claims of some Republicans, and a general sense among Vermonters, the Democratic-led Legislature is working on ways to tackle the rising cost of education, and its impact on Vermonters’ wallets.

Though not grabbing headlines in the way that global warming, aid to farmers, or the withdrawal of troops from Iraq have, Symington said plenty of work is underway in the House Education and Ways and Means committees with an expectation that by Town Meeting Day an outline of how to move forward will be complete.

This template is part of the agreement between Symington, Sen. Peter Shumlin, the president pro tem of the senate, and Gov. Jim Douglas. The trio agreed to an outline of how education funding should be tackled this session and next.

“It isn’t as sexy or exciting, but the work is getting done,” said Symington.

While it’s true that tax policy, in general, isn’t “sexy,” there is a need to get at the root cause of why education funding is rising, and why some in Vermont — despite property taxes being a lower share of their income than before Act 60 — are feeling a financial pinch.

Perhaps the statewide property tax is a bogus bogeyman, and it’s a slide in personal income, or higher energy costs, or health care costs. Or, too many loopholes, as the Guardian reported last week, that allow companies with more than $1 billion in taxable income in Vermont to walk away with only paying $250, or some Vermonters to pocket an Act 60 rebate of $25,000.

Working Vermonters are looking for leadership on an issue that is confronting many families in this state — the ability to get by and house and feed their families.

To them, while their hearts and minds may understand the impact of global warming on their future livelihoods, there are pressing concerns to them right now that can, and should, be dealt with.

Speaker Symington, Sen. Shumlin, and Gov. Douglas have the responsibility to make this issue not only “sexy,” but downright lustful.