Legislative panel studies specialized services dilemma
By Neal P. Goswami
VERMONT PRESS BUREAU | September 18,2013
Stefan Hard / Staff Photo
Margaret Joyal of Washington County Mental Health Services speaks Tuesday at the Statehouse before a panel of lawmakers studying community supports for people with severe functional impairments.
MONTPELIER — A panel of lawmakers is asking for recommendations from the Agency of Human Services on how a group of inmates requiring specialized services should be dealt with after the agency placed a moratorium on funding those services earlier this year.
The study committee, made up of both House and Senate members, heard testimony Tuesday on the criteria in place for providing either one-on-one or two-on-one supervision for about 22 people designated as having serious functional impairments because of cognitive disabilities or mental health issues.
As they complete sentences and transition back into the community, they require additional support systems that other inmates do not. Addressing their needs — both clinical and security — in some cases requires multiple round-the-clock employees for a single offender.
There is also a cost for the residential homes in which the offender and the supervisors are housed.
Those with the “serious functional impairment,” or SFI, designation are deemed to be at a higher risk of harming themselves or others or committing new crimes. The specialized treatment provided by the state for those 22 individuals costs more than $3 million this year alone, and as much as $500,000 per case.
Because of the cost, Human Services Secretary Doug Racine placed a moratorium on funding for placing SFI designees into community settings earlier this year. Funding will continue through June 2014, but the committee heard Tuesday that there is no plan for the next fiscal year when funding is no longer available.
“I think we are very hopeful that this committee and the agency can create a plan,” Monica Hutt, director of policy and planning for AHS, told the committee.
The agency is awaiting direction from the Legislature on how to proceed with and pay for the placements.
Several witnesses Tuesday, including Susan Wehry, commissioner of the Department of Disabilities, Aging and Independent Living, and Margaret Joyal, director of the Center for Counseling and Psychological Services for Washington County Mental Health Services, said the SFI designation follows screening by a local interagency team and the Department of Corrections to determine what services are needed.
Factors that trigger an SFI designation include a history of violent behavior to self or others, history of criminal convictions, legal conditions ordered by a court, and substance abuse.
Joyal said that without funding, many SFI designees will lose the supports that are intended to help them remain out of jail. While therapy, case management and psychiatric support will be available, housing and supervision will not, she said.
“I haven’t seen drastic changes yet because the budgets are still in place for the rest of this year,” she said in an interview after her testimony. “What I fear will occur is that these very people we’re talking about today, … the people who have higher levels of need, we’ll no longer be able to provide them with that level of support.”
With the moratorium in place, and no funding available next year, changes — and a plan to deal with offenders requiring specialized treatment — are needed.
Joyal told the committee it should consider excluding people with severe personality disorders from the SFI treatment program because it typically does not serve them well.
“What they tend to do is eat up these dollars, eat up these services, and they tend not to improve,” she said.
Sen. Dick Sears, D-Bennington, the chairman of the Senate Judiciary Committee, said people with severe personality disorders will still need to be dealt with, whether as part of the SFI program or otherwise. He said he believes the Shumlin administration and others may seek a civil confinement law that would allow for some inmates to remain incarcerated after completing their sentences.
“Obviously, there’s going to be a big push for civil confinement for some offenders come this January. I have some concerns about that,” he said.
After the hearing, Sears said the state will be spending money whether inmates receive services in the SFI program or remain locked up under civil confinement.
“You’re going to have to provide treatment for these folks. You’re going to have to spend the money,” he said. “You can’t just lock them up.”
Sears said lawmakers will have to address the issue in the upcoming legislative session. There are 110 people currently incarcerated and nearing release who are considered to have serious functional impairments, he said, although only some would be considered serious enough to require one-on-one or two-on-one supervision.
Still, the problem is not new or unique to Vermont, Sears said. A representative from the Council of State Governments is expected to provide the committee information about how other states are addressing the issue.
“We’ve had this problem for a long time, and really the committee is looking at what we should do for a long-term solution,” he said.
Committee co-chairwoman Sen. Jane Kitchel, D-Caledonia, asked that AHS prepare and deliver its own recommendations for the committee’s next meeting, which has yet to be scheduled.