By Erin Mansfield, VTDigger
Surrounded by government officials and the state’s top health care regulator, executives at Rutland Regional Medical Center cut the ribbon Thursday on a $6 million expansion of the hospital’s emergency department.
The expansion adds 1,880 square feet, with five rooms designed to help patients in psychiatric crisis who are being held there feel more comfortable. The project also renovated existing space in the emergency department.
At the time of the ribbon-cutting, two patients were waiting in the emergency department to be placed in other care settings, according to Tom Huebner, the CEO of Rutland Regional Medical Center. Earlier in the week there were nine waiting, Huebner said.
Since damage from Tropical Storm Irene forced the closing of the state’s psychiatric hospital in Waterbury in 2011, psychiatric patients throughout the state have waited for days in emergency rooms to be placed in a new facility.
Rutland Regional Medical Center applied in 2014 for a state-level permit, called a certificate of need, to add five mental health and substance abuse treatment rooms to the emergency department to accommodate those patients.
At the time, Huebner said there were only two dedicated rooms for that population, and they were in the middle of the emergency department — which is the second-busiest in the state.
“We often have four, five, seven, eight, sometimes nine patients,” Huebner said. “Two is just an insufficient quantity [of rooms], and they’re really not set up properly for patients with mental illness or substance abuse issues. It was not calm or comfortable for them.”
Three years later, Huebner said the number of psychiatric patients keeps flowing to his emergency department at the same rate as in 2014. And while the hospital is doing a better job of treating them, Huebner said, those patients still should not be waiting in the emergency department.
“It’s a stopgap,” Huebner said of the expansion. “It is far more appropriate than what we were doing, by a lot. We now do a good job for those patients while they’re here, but … we had a teenager here last week for 11 days. That’s not appropriate. We want them to be in community placement, or if it’s appropriate, in inpatient placement.”
Gov. Phil Scott held the scissors in the ribbon-cutting with Huebner. Scott toured the new mental health and substance abuse rooms with Tom Rounds, the manager of the emergency department.
The new rooms each have a single window facing out toward a mountain, so patients can enjoy the view from their rooms. The rooms have televisions and chalkboards for drawing. Patients will be able to watch Netflix on mobile devices and adjust the light switch dimmers if they want.
At the same time, the rooms are designed so patients who are behaving violently will not be able to hurt themselves. The rooms also have specially designed doors so patients cannot create a barricade that keeps out doctors and nurses.
All five rooms open into a hallway facing a nurses’ station. At the end of the hallway in the expansion is a room dedicated to staff at Rutland Mental Health Services, the publicly funded mental health agency that serves the region.
Rounds said the rooms were designed with help from the hospital’s inpatient psychiatric department, Vermont Psychiatric Survivors and Disability Rights Vermont, among others.
Scott said in an interview that his administration is working to solve the emergency room crisis. “It’s an ongoing struggle, obviously, and we’re attacking it from different angles,” he said. “One is giving some relief to projects like this.”
Additionally, Scott said his administration is working with quasi-public mental health agencies — organizations such as Rutland Mental Health Services that exist around the state — to build capacity for psychiatric patients in different ways.
“We’re still working with the UVM Medical Center as well and trying to establish as many beds as possible,” Scott said, “and to try and have more counselors out there as well, because a lot of it is not just mental health — it’s due to the opioid crisis, and that … is integrated as well.”
Huebner also welcomed Kevin Mullin, the chair of the Green Mountain Care Board, to the event. The board regulates hospital budgets, including that of Rutland Regional Medical Center, and went through a judicial process to approve the emergency department expansion in May 2016.
Huebner said the hospital is “very regulated” and called that a good thing. “We see it as a collaboration, not a contest, and it has worked well for us to do that,” he said. “We strive to be open and transparent and partners, not adversaries.”
Mullin, a longtime state legislator from Rutland Town, was appointed to the board in late May. Mullin said with a laugh that “everything would be on the merits” at the board. He also said it was hard to separate his pride for the hospital as a member of the community from his position as a regulator.
Mullin referenced information from the hospital’s permit application in 2014. At the time, he said, the emergency department was overcrowded 39 percent of the time, and 13 percent of emergency department patients were being seen in beds situated in the hallways. He said the renovation will make patients feel safer.
“This project really brings that safety home, not only for the patients but also for the staff,” Mullin said. “I’m very proud to say that I’m from Rutland, Tom, and proud of all the work your team has done and look forward to working with you in the future.”
Photo by Evan Johnson
Gov. Phil Scott (left) snips the ribbon with the help of Rutland Regional’s Tom Huebner (right) as Rutland mayor David Allaire, Kevin Mullin, Susan Elliot, and others look on.