§ 7251. Principles for mental health care reform
The General Assembly adopts the following principles as a framework for reforming
the mental health care system in Vermont:
(1) The State of Vermont shall meet the needs of individuals with a mental condition or
psychiatric disability, including the needs of individuals in the custody of the Commissioner
of Corrections, and the State’s mental health system shall reflect excellence, best
practices, and the highest standards of care.
(2) Long-term planning shall look beyond the foreseeable future and present needs of the
mental health community. Programs shall be designed to be responsive to changes over
time in levels and types of needs, service delivery practices, and sources of funding.
(3) Vermont’s mental health system shall provide a coordinated continuum of care by the
Departments of Mental Health and of Corrections, designated hospitals, designated
agencies, and community and peer partners to ensure that individuals with a mental
condition or psychiatric disability receive care in the most integrated and least
restrictive settings available. Individuals’ treatment choices shall be honored to
the extent possible.
(4) The mental health system shall be integrated into the overall health care system and
ensure equal access to appropriate mental health care in a manner equivalent to other
aspects of health care as part of an integrated, holistic system of care.
(5) Vermont’s mental health system shall be geographically and financially accessible.
Resources shall be distributed based on demographics and geography to increase the
likelihood of treatment as close to the patient’s home as possible. All ranges of
services shall be available to individuals who need them, regardless of individuals’
ability to pay.
(6) The State’s mental health system shall ensure that the legal rights of individuals
with a mental condition or psychiatric disability are protected.
(7) Oversight and accountability shall be built into all aspects of the mental health
system.
(8) Vermont’s mental health system shall be adequately funded and financially sustainable
to the same degree as other health services.
(9) Individuals with a psychiatric disability or mental condition who are in the custody
or temporary custody of the Commissioner of Mental Health and who receive treatment
in an acute inpatient hospital unit, an intensive residential recovery facility, or
a secure residential recovery facility shall be afforded rights and protections that
reflect evidence-based best practices aimed at reducing the use of emergency involuntary
procedures. (Added 2011, No. 79 (Adj. Sess.), § 1a, eff. April 4, 2012; amended 2013, No. 96 (Adj. Sess.), § 101; 2015, No. 21, § 2, eff. May 13, 2015; 2017, No. 200 (Adj. Sess.), § 13.)
§ 7252. Definitions
As used in this chapter:
(1) “Adult outpatient services” means flexible services responsive to individuals’ preferences,
needs, and values that are necessary to stabilize, restore, or improve the level of
social functioning and well-being of individuals with a mental condition, including
individual and group treatment, medication management, psychosocial rehabilitation,
and case management services.
(2) “Designated agency” means a designated community mental health and developmental disability
agency as described in subsection 8907(a) of this title.
(3) “Designated area” means the counties, cities, or towns identified by the Department
of Mental Health that are served by a designated agency.
(4) “Enhanced programming” means targeted, structured, and specific intensive mental health
treatment and psychosocial rehabilitation services for individuals in individualized
or group settings.
(5) “Intensive residential recovery facility” means a licensed program under contract
with the Department of Mental Health that provides a safe, therapeutic, recovery-oriented
residential environment to care for individuals with one or more mental conditions
or psychiatric disabilities who need intensive clinical interventions to facilitate
recovery in anticipation of returning to the community. This facility shall be for
individuals not in need of acute inpatient care and for whom the facility is the least
restrictive and most integrated setting.
(6) “Mobile support team” means professional and peer support providers who are able to
respond to an individual where he or she is located during a crisis situation.
(7) “Noncategorical case management” means service planning and support activities provided
for adults by a qualified mental health provider, regardless of program eligibility
criteria or insurance limitations.
(8) “No refusal system” means a system of hospitals and intensive residential recovery
facilities under contract with the Department of Mental Health that provides high-intensity
services, in which the facilities shall admit any individual for care if the individual
meets the eligibility criteria established by the Commissioner in contract.
(9) “Participating hospital” means a hospital under contract with the Department of Mental
Health to participate in the no refusal system.
(10), (11) [Repealed.]
(12) “Psychosocial rehabilitation” means a range of social, educational, occupational,
behavioral, and cognitive interventions for increasing the role performance and enhancing
the recovery of individuals with a serious mental condition or psychiatric disability,
including services that foster long-term recovery and self-sufficiency.
(13) “Recovery-oriented” means a system or services that emphasize the process of change
through which individuals improve their health and wellness, live a self-directed
life, and strive to reach their full potential.
(14) “Serious bodily injury” means the same as in section 1912 of this title.
(15) “Warm line” means a nonemergency telephone response line operated by trained peers
for the purpose of active listening and assistance with problem-solving for persons
in need of such support. (Added 2011, No. 79 (Adj. Sess.), § 1a, eff. April 4, 2012; amended 2013, No. 96 (Adj. Sess.), § 101; 2013, No. 192 (Adj. Sess.), § 1a.)
§ 7253. Clinical resource management and oversight
The Commissioner of Mental Health, in consultation with health care providers as defined
in section 9432 of this title, including designated hospitals, designated agencies, individuals with mental conditions
or psychiatric disabilities, and other stakeholders, shall design and implement a
clinical resource management system that ensures the highest quality of care and facilitates
long-term, sustained recovery for individuals in the custody of the Commissioner.
(1) For the purpose of coordinating the movement of individuals across the continuum of
care to the most appropriate services, the clinical resource management system shall:
(A) Ensure that all individuals in the care and custody of the Commissioner receive the
highest quality and least restrictive care necessary.
(B) Develop a process for receiving direct input from persons receiving services on treatment
opportunities and the location of services.
(C) Use State-employed clinical resource management coordinators to work collaboratively
with community partners, including designated agencies, hospitals, individuals with
mental conditions or psychiatric disabilities, and peer groups, to ensure access to
services for individuals in need. Clinical resource management coordinators or their
designees shall be available 24 hours a day, seven days a week to assist emergency
service clinicians in the field to access necessary services.
(D) Use an electronic, web-based bed board to track in real time the availability of bed
resources across the continuum of care.
(E) Use specific level-of-care descriptions, including admission, continuing stay, and
discharge criteria, and a mechanism for ongoing assessment of service needs at all
levels of care.
(F) Specify protocols for medical clearance, bed location, transportation, information
sharing, census management, and discharge or transition planning.
(G) Coordinate transportation resources so that individuals may access the least restrictive
mode of transport consistent with safety needs.
(H) Ensure that to the extent patients’ protected health information pertaining to any
identifiable person that is otherwise confidential by State or federal law is used
within the clinical resource management system, the health information exchange privacy
standards and protocols as described in subsection 9351(e) of this title shall be followed.
(I) Review the options for the use of ambulance transport, with security as needed, as
the least restrictive mode of transport consistent with safety needs required pursuant
to section 7511 of this title.
(J) Ensure that individuals under the custody of the Commissioner being served in a designated
hospital, an intensive residential recovery facility, a psychiatric residential treatment
facility for youth, and a secure residential recovery facility shall have access to
a mental health patient representative. The patient representative shall advocate
for persons receiving services and shall also foster communication between persons
receiving services and health care providers. The Department of Mental Health shall
contract with an independent, peer-run organization to staff the full-time equivalent
of a representative of persons receiving services.
(2) For the purpose of maintaining the integrity and effectiveness of the clinical resource
management system, the Department of Mental Health shall:
(A) require a designated team of clinical staff to review the treatment received and clinical
progress made by individuals within the Commissioner’s custody;
(B) coordinate care across the mental and physical health care systems as well as ensure
coordination within the Agency of Human Services, particularly the Department of Corrections,
the Department of Health’s Division of Substance Use Programs, and the Department
of Disabilities, Aging, and Independent Living;
(C) coordinate service delivery with Vermont’s Blueprint for Health and health care reform
initiatives, including the health information exchange as defined in section 9352 of this title and the Health Benefit Exchange as defined in 33 V.S.A. § 1803;
(D) use quality measures, manageable data requirements, and quality improvement processes
to monitor, evaluate, and continually improve the results for individuals and the
performance of the clinical resource management system;
(E) actively engage stakeholders and providers in oversight processes; and
(F) provide mechanisms for dispute resolution. (Added 2011, No. 79 (Adj. Sess.), § 1a, eff. April 4, 2012; amended 2013, No. 96 (Adj. Sess.), § 101; 2015, No. 11, § 18; 2021, No. 115 (Adj. Sess.), § 4, eff. July 1, 2022; 2023, No. 137 (Adj. Sess.), § 4, eff. July 1, 2024.)
§ 7254. Integration of the treatment for mental health, substance abuse, and physical health
(a) The Director of Health Care Reform and the Commissioners of Mental Health, of Health,
and of Vermont Health Access and the Green Mountain Care Board or designees shall
ensure that the redesign of the mental health delivery system established in this
chapter is an integral component of the health care reform efforts coordinated pursuant
to 3 V.S.A. § 3027. Specifically, the Director, Commissioners, and Board shall confer on planning efforts
necessary to ensure that the following initiatives are coordinated and advanced:
(1) any health information technology projects;
(2) the integration of health insurance benefits in the Vermont Health Benefit Exchange
to the extent feasible under federal law;
(3) the integration of coverage under Green Mountain Care;
(4) the Blueprint for Health;
(5) the reformation of payment systems for health services to the extent allowable under
federal law or under federal waivers; and
(6) other initiatives as necessary.
(b) The Department of Financial Regulation shall ensure that private payers are educated
about their obligation to reimburse providers for less restrictive and less expensive
alternatives to hospitalization. (Added 2011, No. 79 (Adj. Sess.), § 1a, eff. April 4, 2012; amended 2011, No. 78 (Adj. Sess.), § 2, eff. April 2, 2012; 2017, No. 85, § F.8, eff. June 28, 2017.)
§ 7255. System of care
The Commissioner of Mental Health shall coordinate a geographically diverse system
and continuum of mental health care throughout the State that shall include at least
the following:
(1) comprehensive and coordinated community services, including prevention, to serve children,
families, and adults at all stages of mental condition or psychiatric disability;
(2) peer services, which may include:
(A) a warm line;
(B) peer-provided transportation services;
(C) peer-supported crisis services; and
(D) peer-supported hospital diversion services;
(3) alternative treatment options for individuals seeking to avoid or reduce reliance
on medications;
(4) recovery-oriented housing programs;
(5) intensive residential recovery facilities;
(6) appropriate and adequate psychiatric inpatient capacity for voluntary patients;
(7) appropriate and adequate psychiatric inpatient capacity for involuntary inpatient
treatment services, including persons receiving treatment through court order from
a civil or criminal court;
(8) a secure residential recovery facility; and
(9) a psychiatric residential treatment facility for youth. (Added 2011, No. 79 (Adj. Sess.), § 1a, eff. April 4, 2012; amended 2013, No. 96 (Adj. Sess.), § 101; 2023, No. 137 (Adj. Sess.), § 5, eff. July 1, 2024.)
§ 7256. Reporting requirements
Notwithstanding 2 V.S.A. § 20(d), the Department of Mental Health shall report annually on or before January 15 to
the Senate Committee on Health and Welfare and the House Committee on Health Care
regarding the extent to which individuals with a mental health condition or psychiatric
disability receive care in the most integrated and least restrictive setting available.
The Department shall consider measures from a variety of sources, including the Joint
Commission, the National Quality Forum, the Centers for Medicare and Medicaid Services,
the National Institute of Mental Health, and the Substance Abuse and Mental Health
Services Administration. The report shall address:
(1) use of services across the continuum of mental health services;
(2) adequacy of the capacity at each level of care across the continuum of mental health
services;
(3) individual experience of care and satisfaction;
(4) individual recovery in terms of clinical, social, and legal results;
(5) performance of the State’s mental health system of care as compared to nationally
recognized standards of excellence;
(6) ways in which patient autonomy and self-determination are maximized within the context
of involuntary treatment and medication;
(7) the number of petitions for involuntary medication filed by the State pursuant to
section 7624 of this title and the outcome in each case;
(8) barriers to discharge from mental health inpatient and secure residential levels of
care, including recommendations on how to address those barriers;
(9) performance measures that demonstrate results and other data on individuals for whom
petitions for involuntary medication are filed; and
(10) progress on alternative treatment options across the system of care for individuals
seeking to avoid or reduce reliance on medications, including supported withdrawal
from medications. (Added 2011, No. 79 (Adj. Sess.), § 1a, eff. April 4, 2012; amended 2013, No. 96 (Adj. Sess.), § 101; 2013, No. 192 (Adj. Sess.), § 2; 2015, No. 11, § 19; 2023, No. 137 (Adj. Sess.), § 6, eff. July 1, 2024.)
§ 7257. Reportable adverse events
(a) An acute inpatient hospital, an intensive residential recovery facility, a designated
agency, a psychiatric residential treatment facility for youth, or a secure residential
recovery facility shall report to the Department of Mental Health instances of death
or serious bodily injury to individuals with a mental condition or psychiatric disability
in the custody or temporary custody of the Commissioner.
(b) An acute inpatient hospital shall report to the Department of Mental Health any staff
injuries caused by a person in the custody or temporary custody of the Commissioner
that are reported to both the Department of Labor and to the hospital’s workers’ compensation
carrier. (Added 2011, No. 79 (Adj. Sess.), § 1a, eff. April 4, 2012; amended 2013, No. 96 (Adj. Sess.), § 101; 2013, No. 192 (Adj. Sess.), § 3; 2023, No. 137 (Adj. Sess.), § 7, eff. July 1, 2024.)
§ 7257a. Mental Health Crisis Response Commission
(a) There is created the Mental Health Crisis Response Commission within the Office of
the Attorney General for the following purposes:
(1) to conduct reviews of law enforcement interactions with persons acting in a manner
that created reason to believe a mental health crisis was occurring and resulted in
a fatality or serious bodily injury to any party to the interaction;
(2) to identify where increased or alternative supports or strategic investments within
law enforcement, designated agencies, or other community service systems could improve
outcomes;
(3) to educate the public, service providers, and policymakers about strategies for intervention
in and prevention of mental health crises;
(4) to recommend policies, practices, and services that will encourage collaboration and
increase successful interventions between law enforcement and persons acting in a
manner that created reason to believe a mental health crisis was occurring;
(5) to recommend training strategies for public safety, emergency, or other crisis response
personnel that will increase successful interventions; and
(6) to make recommendations based on the review of cases before the Commission.
(b)(1) Each incident involving an interaction between law enforcement and a person acting
in a manner that created reason to believe a mental health crisis was occurring that
results in a death or serious bodily injury to any party shall be referred to the
Office of the Attorney General by the relevant law enforcement agency for review,
analysis, and recommendations within 60 days after the incident. Interactions not
resulting in death or serious bodily injury may be referred for optional review to
the Commission, including review of interactions with positive outcomes that could
serve to provide guidance on effective strategies. A law enforcement officer or mental
health crisis responder involved in such an interaction is encouraged to refer it
to the Commission.
(2) The review process shall not commence until any criminal prosecution arising out of
the incident is concluded or the Attorney General and State’s Attorney provide written
notice to the Commission that no criminal charges shall be filed.
(c)(1) The Commission shall comprise the following members:
(A) the Attorney General or designee from a division other than that investigating the
interaction;
(B) the Commissioner of Mental Health or designee;
(C) a member of the Vermont State Police, appointed by the Commissioner of Public Safety;
(D) a representative of frontline local law enforcement, appointed by the Vermont Association
of Chiefs of Police;
(E) the Executive Director of the Vermont Criminal Justice Council or designee;
(F) a representative of the designated agencies, appointed by Vermont Care Partners;
(G) the director of Disability Rights Vermont or designee;
(H) an individual who has a personal experience of living with a mental condition or psychiatric
disability, appointed by Vermont Psychiatric Survivors;
(I) a family member of an individual who experienced or is experiencing a mental condition
or psychiatric disability, appointed by the Vermont chapter of the National Alliance
on Mental Illness; and
(J) two regionally diverse at-large members, appointed by the Governor, who are not representative
of subdivisions (A)-(G) of this subdivision (c)(1), such as an emergency dispatcher,
specialist in interactions between law enforcement and individuals with a perceived
mental condition, or a representative of the Vermont Human Rights Commission or Vermont
Legal Aid.
(2) The members of the Commission specified in subdivision (1) of this subsection shall
serve two-year terms. Any vacancy on the Commission shall be filled in the same manner
as the original appointment. The replacement member shall serve for the remainder
of the unexpired term.
(3) Members who are part of an organization involved in an interaction under review shall
recuse themselves from that review and shall not access any information related to
it. The Commission may appoint an interim replacement member to fill the category
represented by the recused member for review of that interaction.
(d)(1) The Attorney General or designee shall call the first meeting of the Commission to
occur on or before September 30, 2017.
(2) The Commission shall select a chair and vice chair from among its members at the first
meeting and annually thereafter.
(3) The Commission shall meet at such times as may reasonably be necessary to carry out
its duties, but at least once in each calendar quarter.
(e) In any case under review by the Commission, upon written request of the Commission,
a person who possesses information or records that are necessary and relevant to review
an interaction shall, as soon as practicable, provide the Commission with the information
and records. The Commission may subpoena information or records necessary and relevant
to the review of an interaction from any person who does not provide information or
records in his or her possession to the Commission upon receiving an initial written
request. A person who provides information or records upon request of the Commission
is not criminally or civilly liable for providing information or records in compliance
with this section.
(f) The proceedings and records of the Commission are confidential and are not subject
to subpoena, discovery, or introduction into evidence in a civil or criminal action.
The Commission shall not use the information, records, or data for purposes other
than those designated by subsections (a) and (i) of this section.
(g) To the extent permitted under federal law, the Commission may enter into agreements
with nonprofit organizations and private agencies to obtain otherwise confidential
information.
(h) Commission meetings are confidential and shall be exempt from 1 V.S.A. chapter 5,
subchapter 2 (the Vermont Open Meeting Law). Commission records are exempt from public
inspection and copying under the Public Records Act and shall be kept confidential.
(i) Notwithstanding 2 V.S.A. § 20(d), the Commission shall report its conclusions and recommendations to the Governor,
General Assembly, and Chief Justice of the Vermont Supreme Court as the Commission
deems necessary, but no less frequently than once per calendar year. The report shall
disclose individually identifiable health information only to the extent necessary
to convey the Commission’s conclusions and recommendations, and any such disclosures
shall be limited to information already known to the public. The report shall be available
to the public through the Office of the Attorney General. (Added 2017, No. 45, § 1; amended 2017, No. 113 (Adj. Sess.), § 99; 2023, No. 6, § 196, eff. July 1, 2023.)
§ 7257b. Emergency Service Provider Wellness Commission
(a) As used in this section:
(1) “Chief executive of an emergency service provider organization” means a person in
charge of an organization that employs or supervises emergency service providers in
their official capacity.
(2) “Emergency service provider” means a person:
(A) currently or formerly recognized by a Vermont fire department as a firefighter;
(B) currently or formerly licensed by the Department of Health as an emergency medical
technician, emergency medical responder, advanced emergency medical technician, or
paramedic;
(C) currently or formerly certified as a law enforcement officer by the Vermont Criminal
Justice Council, including constables and sheriffs;
(D) currently or formerly employed by the Department of Corrections as a probation, parole,
or correctional facility officer;
(E) currently or formerly certified by the Vermont Enhanced 911 Board as a 911 call taker
or employed as an emergency communications dispatcher providing service for an emergency
service provider organization; or
(F) currently or formerly registered as a ski patroller at a Vermont ski resort with the
National Ski Patrol or Professional Ski Patrol Association.
(3) “Licensing entity” means a State entity that licenses or certifies an emergency service
provider.
(b) There is created the Emergency Service Provider Wellness Commission within the Agency
of Human Services that, in addition to the purposes listed in this subsection, shall
consider the diversity of emergency service providers on the basis of gender, race,
age, ethnicity, sexual orientation, gender identity, disability status, and the unique
needs that emergency service providers who have experienced trauma may have as a result
of their identity status:
(1) to identify where increased or alternative supports or strategic investments within
the emergency service provider community, designated or specialized service agencies,
or other community service systems could improve the physical and mental health outcomes
and overall wellness of emergency service providers;
(2) to identify how Vermont can increase capacity of qualified clinicians in the treatment
of emergency service providers to ensure that the services of qualified clinicians
are available throughout the State without undue delay;
(3) to create materials and information, in consultation with the Department of Health,
including a list of qualified clinicians, for the purpose of populating an electronic
emergency service provider wellness resource center on the Department of Health’s
website;
(4) to educate the public, emergency service providers, State and local governments, employee
assistance programs, and policymakers about best practices, tools, personnel, resources,
and strategies for the prevention and intervention of the effects of trauma experienced
by emergency service providers;
(5) to identify gaps and strengths in Vermont’s system of care for both emergency service
providers who have experienced trauma and their immediate family members to ensure
access to support and resources that address the impacts of primary and secondary
trauma;
(6) to recommend how peer support services and qualified clinician services can be delivered
regionally or statewide;
(7) to recommend how to support emergency service providers in communities that are resource
challenged, remote, small, or rural;
(8) to recommend policies, practices, training, legislation, rules, and services that
will increase successful interventions and support for emergency service providers
to improve health outcomes, job performance, and personal well-being and reduce health
risks, violations of employment, and violence associated with the impact of untreated
trauma, including whether to amend Vermont’s employment medical leave laws to assist
volunteer emergency service providers in recovering from the effects of trauma experienced
while on duty; and
(9) to consult with federal, State, and municipal agencies, organizations, entities, and
individuals in order to make any other recommendations the Commission deems appropriate.
(c)(1) The Commission shall comprise the following members and, to the extent feasible, include
representation among members that reflects the gender, gender identity, racial, age,
ethnic, sexual orientation, social, and disability status of emergency service providers
in the State:
(A) the Chief of Training of the Vermont Fire Academy or designee;
(B) a representative, appointed by the Vermont Criminal Justice Council;
(C) the Commissioner of Health or designee;
(D) the Commissioner of Public Safety or designee;
(E) the Commissioner of Corrections or designee;
(F) the Commissioner of Mental Health or designee;
(G) the Commissioner of Human Resources or designee;
(H) a law enforcement officer who is not a chief or sheriff, appointed by the President
of the Vermont Police Association;
(I) a representative, appointed by the Vermont Association of Chiefs of Police;
(J) a representative, appointed by the Vermont Sheriffs’ Association;
(K) a volunteer firefighter, appointed by the Vermont State Firefighters’ Association;
(L) a representative of the designated and specialized service agencies, appointed by
Vermont Care Partners;
(M) a representative, appointed by the Vermont State Employees Association;
(N) a representative, appointed by the Vermont Troopers’ Association;
(O) a professional firefighter, appointed by the Professional Firefighters of Vermont;
(P) a clinician associated with a peer support program who has experience in treating
workplace trauma, appointed by the Department of Mental Health;
(Q) a professional emergency medical technician or paramedic, appointed by the Vermont
State Ambulance Association;
(R) a volunteer emergency medical technician or paramedic, appointed by the Vermont State
Ambulance Association;
(S) a person who serves or served on a peer support team, appointed by the Department
of Mental Health;
(T) a representative, appointed by the Vermont League of Cities and Towns;
(U) a Chief, appointed by the Vermont Career Fire Chiefs Association;
(V) a Chief, appointed by the Vermont Fire Chiefs Association;
(W) a representative, appointed by the Vermont Association for Hospitals and Health Systems;
(X) the Executive Director of the Enhanced 911 Board or designee; and
(Y) a member of the National Ski Patrol appointed by consensus agreement of the National
Ski Patrol Northern Vermont and Southern Vermont Regional Directors.
(2) The term of office of each member shall be three years. Of the members first appointed,
10 shall be appointed for a term of one year, 10 shall be appointed for a term of
two years, and the remainder shall be appointed for a term of three years. Members
shall hold office for the term of their appointments and until their successors have
been appointed. All vacancies shall be filled for the balance of the unexpired term
in the same manner as the original appointment. Members are eligible for reappointment.
(3) Commission members shall recuse themselves from any discussion of an event or circumstance
that the member believes may involve an emergency service provider known by the member
and shall not access any information related to it. The Commission may appoint an
interim replacement member to fill the category represented by the recused member
for review of that interaction.
(d)(1) The Commissioner of Health or designee shall call the first meeting of the Commission
to occur on or before September 30, 2021.
(2) The Commission shall select a chair and vice chair from among its members at the first
meeting and annually thereafter.
(3) The Commission shall meet at such times as may reasonably be necessary to carry out
its duties but at least once in each calendar quarter.
(4) The Department of Health shall provide technical, legal, and administrative assistance
to the Commission.
(e) The Commission’s meetings shall be open to the public in accordance with 1 V.S.A.
chapter 5, subchapter 2. Notwithstanding 1 V.S.A. § 313, the Commission may go into executive session in the event a circumstance or an event
involving a specific emergency service provider is described, regardless of whether
the emergency service provider is identified by name.
(f) Commission records describing a circumstance or an event involving a specific emergency
service provider, regardless of whether the emergency service provider is identified
by name, are exempt from public inspection and copying under the Public Records Act
and shall be kept confidential.
(g) To the extent permitted under federal law, the Commission may enter into agreements
with agencies, organizations, and individuals to obtain otherwise confidential information.
(h) Notwithstanding 2 V.S.A. § 20(d), the Commission shall report its conclusions and recommendations to the Governor
and General Assembly as the Commission deems necessary but not less frequently than
once per calendar year. The report shall disclose individually identifiable health
information only to the extent necessary to convey the Commission’s conclusions and
recommendations, and any such disclosures shall be limited to information already
known to the public. The report shall be available to the public through the Department
of Health. (Added 2021, No. 37, § 1; amended 2021, No. 134 (Adj. Sess.), § 7a, eff. May 24, 2022; 2023, No. 6, § 197, eff. July 1, 2023.)
§ 7258. Review of adverse community events
The Department of Mental Health shall establish a system that ensures the comprehensive
review of a death or serious bodily injury occurring outside an acute inpatient hospital
when the individual causing or victimized by the death or serious bodily injury is
in the custody of the Commissioner or had been in the custody of the Commissioner
within six months of the event. The Department shall review each event for the purpose
of determining whether the death or serious bodily injury was the result of inappropriate
or inadequate services within the mental health system and, if so, how the failure
shall be remedied. (Added 2011, No. 79 (Adj. Sess.), § 1a, eff. April 4, 2012.)
§ 7259. Mental Health Care Ombudsman
(a) The Department of Mental Health shall establish the Office of the Mental Health Care
Ombudsman within the agency designated by the Governor as the protection and advocacy
system for the State pursuant to 42 U.S.C. § 10801 et seq. The agency may execute the duties of the Office of the Mental Health Care
Ombudsman, including authority to assist individuals with mental health conditions
and to advocate for policy issues on their behalf; provided, however, that nothing
in this section shall be construed to impose any additional duties on the agency in
excess of the requirements under federal law.
(b) The agency may provide a report annually to the General Assembly regarding the implementation
of this section.
(c) In the event the protection and advocacy system ceases to provide federal funding
to the agency for the purposes described in this section, the General Assembly may
allocate sufficient funds to maintain the Office of the Mental Health Care Ombudsman.
(d) The Department of Mental Health shall provide any reportable adverse events reported
pursuant to section 7257 of this title and a copy of the certificate of need for all emergency involuntary procedures performed
on a person in the custody or temporary custody of the Commissioner to the Office
of the Mental Health Care Ombudsman on a monthly basis. (Added 2011, No. 171 (Adj. Sess.), § 11f; amended 2013, No. 192 (Adj. Sess.), § 4; 2023, No. 137 (Adj. Sess.), § 7a, eff. July 1, 2024.)
§ 7260. Mental health response service guidelines
(a) The Department shall develop guidelines for use by municipalities, including use by
emergency medical technicians and public safety personnel, such as law enforcement
officers as defined by 20 V.S.A. § 2351a and firefighters as defined in 20 V.S.A. § 3151, who are employed, volunteer, or are under contract with a municipality. The guidelines
shall recommend best practices for de-escalation and for mental health response services,
including crisis response services. The Department shall make the guidelines available
to municipalities and publish the guidelines on the Department’s website.
(b) In developing the guidelines required pursuant to subsection (a) of this section,
the Department shall consult with the following entities:
(1) the Department of Health;
(2) the Department of Disabilities, Aging, and Independent Living;
(3) the Department of Public Safety;
(4) the Vermont Care Partners;
(5) the Vermont Psychiatric Survivors;
(6) the Vermont chapter of the National Alliance on Mental Illness;
(7) the Vermont Criminal Justice Council;
(8) the Vermont League of Cities and Towns;
(9) Disability Rights Vermont;
(10) the Department’s State Program Standing Committees; and
(11) any other stakeholders the Department deems appropriate. (Added 2023, No. 115 (Adj. Sess.), § 1, eff. July 1, 2024.)
§ 7261. Psychiatric residential treatment facility for youth
(a) A person or governmental entity shall not establish, maintain, or operate a psychiatric
residential treatment facility for youth without first obtaining a license from the
Department of Health in accordance with this section.
(b) Upon receipt of the application for a license, the Department of Health shall issue
a license if it determines that the applicant and the proposed psychiatric residential
treatment facility for youth meet the following minimum standards:
(1) The applicant shall be a nonprofit entity that demonstrates the capacity to operate
a psychiatric residential treatment facility for youth in accordance with rules adopted
by the Department of Health and in a manner that ensures person-centered care and
resident dignity.
(2) The applicant shall maintain certification from the Centers for Medicare and Medicaid
Services under 42 C.F.R. §§ 441.151–182.
(3) The applicant shall maintain accreditation by the Joint Commission or other accrediting
organization with comparable standards recognized by the Commissioner of Mental Health.
(4) The applicant shall fully comply with standards for health, safety, and sanitation
as required by State law, including standards set forth by the State Fire Marshal
and the Department of Health, and municipal ordinance.
(5) Residents admitted to a psychiatric residential treatment facility for youth shall
be under the care of physician licensed pursuant to 26 V.S.A. chapter 23 or 33.
(6) The psychiatric residential treatment facility for youth, including the buildings
and grounds, shall be subject to inspection by the Department of Disabilities, Aging,
and Independent Living, its designees, and other authorized entities at all times.
(7) The applicant shall have a clear process for responding to resident complaints, including:
(A) the designation of patient representative pursuant to section 7253 of this title;
(B) a method by which each patient shall be made aware of the compliant procedure;
(C) an appeals mechanism within a psychiatric residential treatment facility for youth;
(D) a published time frame for processing and resolving complaints and appeals within
a psychiatric residential treatment facility for youth; and
(E) periodic reporting to the Department of Health of the nature of complaints filed and
action taken.
(c) A license is not transferable or assignable and shall be issued only for the premises
named in the application.
(d) Once licensed, a psychiatric residential treatment facility for youth shall be among
the placement options for individuals committed to the custody of the Commissioner
under an order of nonhospitalization.
(e) The Department of Health shall adopt rules pursuant to 3 V.S.A. chapter 25 to carry out the purposes of this section. Rules pertaining to emergency involuntary
procedures shall:
(1) be identical to those rules adopted by the Department of Mental Health governing the
use of emergency involuntary procedures in psychiatric inpatient units;
(2) require that a certificate of need for all emergency involuntary procedures performed
at the psychiatric residential treatment facility for youth be submitted to the Department
and the Mental Health Care Ombudsman in the same manner and time frame as required
for hospitals; and
(3) require that data regarding the use of emergency involuntary procedures be submitted
in accordance with the requirements of the Department.
(f) The Department of Health, after notice and opportunity for a hearing to the applicant
or licensee, is authorized to deny, suspend, or revoke a license in any case in which
it finds that there has been a substantial failure to comply with the requirements
established under this section. The notice shall be served by registered mail or by
personal service setting forth the reasons for the proposed action and fixing a date
not less than 60 days from the date of the mailing or service, at which the applicant
or licensee shall be given an opportunity for a hearing. After the hearing, or upon
default of the applicant of licensee, the Department of Health shall file its findings
of fact and conclusions of law. A copy of the findings and decision shall be sent
by registered mail or served personally upon the applicant or licensee. The procedure
governing hearings authorized by the section shall be in accordance with the usual
and customary rules for hearing. (Added 2023, No. 137 (Adj. Sess.), § 8, eff. July 1, 2024.)