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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Brattleboro Retreat Says It Doesn't Have Enough Funds To Complete Expansion

A sign that says Brattleboro Retreat: We'll help you find the strength. Snow on the ground and buildings in background.
Howard Weiss-Tisman
According to Brattleboro Retreat CEO Louis Josephson, after years of balancing its budget by using its surplus funds there's just not enough money left to cover the cost overruns for a project build to 12 new inpatient beds at the facility.

The Brattleboro Retreat says it doesn't have enough money to finish a 12-bed expansion that's underway. The recent announcement that the state won't add any more funding to the project is putting more pressure on the financially-strapped hospital.

The Brattleboro Retreat has a contract with the Vermont Agency of Human Services to provide 14 beds for the state’s most acute psychiatric patients.

About two year ago, the state asked the Retreat to build 12 new inpatient beds. Workers were busy this week moving ahead with construction in one of the hospital's buildings.

Brattleboro Retreat CEO Louis Josephson said the hospital agreed to tackle the project with $5.5 million in state money. But, with work underway, Josephson said they need another $1.5 million to open the unit.

"We need some cash to finish the project," Josephson said. "The $5 million they gave us was not quite enough. So I worry, again, if we don't have the cash, whether we’ll be able to do that on time. But we’re working hard towards it as we speak."

Josephson acknowledged that the Retreat underestimated the cost of the project after the Agency of Human Services asked the hospital to consider the expansion — and that in better times the hospital probably could have found the money to finish the work.

But, according to Josephson, after years of balancing its budget by using its surplus funds there's just not enough money left to cover the cost overruns.

"If we were able to bring those 12 beds on, they're part of that state contract. That's a good, fair, reimbursement for us, so that would help our financial picture," Josephson said. "But I can't get there unless I can fund it. So having such [a] tough financial position is such a big distraction, right? Because you're worrying about payroll, you're worrying about paying your bills, and it just takes a lot out of you."

A construction worker on a ladder
Credit Howard Weiss-Tisman / VPR
Construction workers are on site at the Brattleboro Retreat's 12-bed expansion but the psychiatric hospital says it does not have enough money to complete the job.

The state, however, doesn't seem swayed by the Brattleboro Retreat's plea to chip in more funds.

In November state officials agreed to increase the hospital's Medicaid reimbursement rate, but Josephson went back to the agency in December seeking more money to help the struggling hospital.

Human Services Secretary Mike Smith said the state already kicked in an extra $250,000 for the project, plus about $5 million over the next two years to operate the new 12-bed unit. And so, Smith said, the Retreat will have to dig itself out of the financial hole without additional state money.

"The Agency of Human Services has provided every reasonable financial option it can," Smith said. "But the Retreat is clearly at a point now where significant management and operational changes are necessary to save it, and save the jobs that are there."

More from VPR — Scott Administration Says Brattleboro Retreat Slated For Possible Closure [Jan. 5]

State Rep. Emilie Kornheiser said the Retreat deserves more support, because the hospital is only battling a deficit due to its agreement to care for the state’s highest need patients.

"Since Tropical Storm Irene, as everyone knows, the Retreat has served as essentially a contracted arm of the Agency of Human Services," said Kornheiser. "And over the last 10 years the number of patients who are on Medicaid being served by the Retreat, and the number of beds being requested by the state to be available for folks from throughout Vermont, has widened. And so, yes, I think a lot of the responsibility does sit with the state."

Kornheiser was one of 13 Windham County lawmakers who recently signed a letter of support for the Retreat. The legislators wrote they were "disappointed" with Secretary Smith's position and vowed to work with the Scott administration to help the hospital.

Disclosure: The Brattleboro Retreat is a VPR underwriter.

Howard Weiss-Tisman is Vermont Public’s southern Vermont reporter, but sometimes the story takes him to other parts of the state. 
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