NMC Commentary

Is Brattleboro Retreat Crucial to Northwest Vermont?

Yes, it is and Vermont cannot allow it to close. I cannot emphasize strongly enough how crucial the Brattleboro Retreat is to the people of northwestern Vermont. For those not familiar, Brattleboro Retreat houses 100% of Vermont’s inpatient psychiatric beds for children and 44% of Vermont’s inpatient psychiatric beds for adults. NMC refers children and adults with significant psychiatric health needs to the Brattleboro Retreat on a regular basis. They are an essential partner and, in many circumstances, our patients would have no other inpatient options if the Brattleboro Retreat closed. Getting patients accepted into psychiatric beds is already a burdensome challenge without a reduction in options. In addition, they provide a comprehensive range of outpatient mental health and substance abuse services which are critical to their region. They are also the largest employer in Windham County with 850 employees (nearly NMC’s size). Plus, the Vermont Association of Hospitals and Health Systems (VAHHS) points out that the State of Vermont itself would lose millions in Medicaid funding for the Vermont Psychiatric Care Hospital (VPCH) with the closure of Brattleboro Retreat. Closure cannot be an option.

As you may have seen in the media, the Brattleboro Retreat is in a very challenging and critical financial situation. They are working hard to adapt their organization to be sustainable so they can continue to care for their patients who come from all across Vermont. Recently, other hospital CEOs (chief executive officers) and I participated in a meeting with Brattleboro Retreat CEO Louis Josephson; Kevin Mullin who chairs the Green Mountain Care Board; Mike Smith, the Secretary of the Agency of Human Services; and others to better understand the situation and discuss the identification of a sustainable path forward.

It is so important to all of Vermont that a positive resolution is reached. I have seen possible closure described as having impacts that would be “incredibly difficult, expensive, and disruptive to manage.” Backing up patients in need of specialized inpatient psychiatric care in the Emergency Departments of Vermont’s hospitals is not the answer. It is not the right care environment for these patients’ needs. It puts everyone at risk and drives high expense. I understand why the Brattleboro Retreat has included closure as an option to consider, however, the rest of us in Vermont including our elected officials and the leaders of our agencies must step up and prevent closure. I know the Brattleboro Retreat team and the engaged stakeholders are working hard on this and I am optimistic about their ability to make this work.

You have seen that Springfield Hospital has entered bankruptcy proceedings and are now watching the Brattleboro Retreat press to stay open. This illustrates the difficulties facing rural Vermont hospitals all across the state. I have shared with you NMC’s own efforts to have revenues meet expenses as we transform from fee-for-service to capitated population health. It is incredibly challenging and I am impressed by the effort our Board, our Medical Staff, our Leadership and Management, and our staff are all putting in to containing expenses while continuing to push for higher quality, better access, and an exceptional patient experience. Even though we are comparatively stronger from a financial standpoint, we still must be hyper-attentive to our own sustainability as the criticality of the situations for hospitals is real.

Please join me in being a voice for Vermont’s efforts to maintain the services of the Brattleboro Retreat. All our communities need proper access to inpatient psychiatric care and Brattleboro Retreat is a crucial and essential resource for all Vermonters.

— Jill Berry Bowen, RN, NMC’s Chief Executive Officer