Vermont Legislature SmartTranscripts:

[Wendy Harrison (Chair)]: I have to do it, Chuck.

[John Benson (Member)]: Okay, great.

[Wendy Harrison (Chair)]: Today is 03/17/2026. This is the Senate Committee on Institutions. And today we are reviewing bill S193, which is a bill relating to establishing a forensic facility for certain criminal justice involved persons.

[John Benson (Member)]: Can we have something?

[Wendy Harrison (Chair)]: Sure, here's some. Some of them have colds or are getting over colds because that's the time of year it is. So, we have Ledge Council with us. We're going to hear from WellPath and we're going to hear from the Department of Mental Health and the Department of Corrections. So, do you know everybody? Let me, yes. Let's continue moving in this committee very much. So, Wendy Harrison, I represent Windham District.

[Robert Plunkett (Vice Chair)]: And I'm Robert Plunkett, Jameson. Joe Major Windsor, Russ Ingalls Essex District, John Benson

[Wendy Harrison (Chair)]: Orange. So if you would please take us through the amendment that was approved by Senate Health and Welfare today. I'd be happy to.

[Katie Manson (Office of Legislative Counsel)]: Katie Manson, Office of Legislative Counsel. Senator Benson's gonna have to put up with

[Karen Barber (General Counsel, Department of Mental Health)]: me twice to write the amendment So I will

[Katie Manson (Office of Legislative Counsel)]: say it hasn't been approved yet by Senate The Health and committee, I'll pull it up. The committee talked about the amendment. They made some suggested changes. I made those changes, but the committee didn't go back through the amendment after we made those changes. Senator Lyons said, go ahead and have senate institutions take a look at this version this afternoon. So that's kind of where things stand. This is multiple instances of amendment. The first instance of amendment is amend section four of Senate Judiciary's Bill. That is a section that pertains specifically to the forensic facility. It contains definitions about what a forensic facility is, what a qualifying condition to get into a forensic facility is, and there is a subsection B in that section. And the proposal here is to strike the whole subsection B and put a new subsection B in. So that's what you're looking at in that first instance of amendment. And you'll notice there's some yellow highlighting. That's to show what came from Senate Health and Welfare and what portions of the language came from Senate Judiciary. So Senate Judiciary is not highlighted. Yellow highlighting is from Senate health and welfare. You'll also see green highlighting. Those are the changes that Senate health and welfare asked for this morning but it hasn't looked at yet.

[Karen Barber (General Counsel, Department of Mental Health)]: Okay, so just to

[Robert Plunkett (Vice Chair)]: be clear, so everything highlighted in yellow or green

[Wendy Harrison (Chair)]: was in Senate health and welfare. Yes. Thank you.

[Katie Manson (Office of Legislative Counsel)]: Okay, so we have language that the Commissioner of Corrections shall establish and operate a locked secure forensic facility for the secure evaluation, treatment, and care of individuals who have been transferred pursuant to other sections of the bill into the forensic facility. The forensic facility shall be designed and operated in a manner that supports a therapeutic recovery oriented and trauma informed environment comparable to a community based residential treatment setting while maintaining appropriate levels of safety and security. It shall not refuse any persons it is ordered to admit and shall not require any clinical or diagnostic prerequisites for admission. The forensic facility shall provide for the safe housing and management of persons, including the ability to separate the population by sex and to otherwise address clinical, safety, or operational considerations as appropriate, including the possible operation of multiple facilities if required by the clinical needs of the transferred persons. The forensic facility shall employ a clinical services director to oversee all forensic clinical and competency restoration services provided to transferred persons. It shall implement staff qualifications, licensure training and supervision requirements that are sufficient to ensure that persons transferred to the forensic facility have access to clinically appropriate care, treatment, services, and supports consistent with individual needs and with applicable professional standards, and it shall ensure that persons receive clinically appropriate assessment and treatment planning, including the development of an initial person specific treatment plan within seventy two hours following transfer, which shall be reviewed periodically as clinically indicated. So that is the first instance of amendment. The second

[Robert Plunkett (Vice Chair)]: Oh,

[Karen Barber (General Counsel, Department of Mental Health)]: yeah, are you

[Wendy Harrison (Chair)]: okay if we do? Please. Yeah, it's better.

[Joseph "Joe" Major (Member)]: What was the issue with an initial?

[Katie Manson (Office of Legislative Counsel)]: The Department of Mental Health, who's with you today, asked for that change to make it specific that after, that the treatment plan within the seventy two hour window would happen after an initial transfer, but there might be other updates to a treatment plan over time as a person is held. So this is just governing when a person is first being transferred into a forensic facility, how quickly that forensic facility team of providers would have to put a treatment plan in place for that person.

[Joseph "Joe" Major (Member)]: But not the subsequent? I don't know.

[Katie Manson (Office of Legislative Counsel)]: It doesn't cover the subsequent.

[Joseph "Joe" Major (Member)]: Okay. I could provide just a little more of that. And

[John Benson (Member)]: that is we felt there ought to be a timeframe for an initial plan to be put together so that somebody's just not in there for weeks on end before a plan is put together, but that initial plan may not be the final plan as the patient is further evaluated and their needs are further assessed, so it simply says you got to deal with them within forty or seventy two hours with some initial plan for treatment.

[Wendy Harrison (Chair)]: And then I have a question on this section also, if there were going to be a twenty four hour care requirement, would that be in this section?

[Katie Manson (Office of Legislative Counsel)]: Meaning that the person would have access to clinical care providers on a 20 fourseven basis? Is that

[Wendy Harrison (Chair)]: what you're suggesting? Yes, or something similar. That I probably would add it here. Should

[Katie Manson (Office of Legislative Counsel)]: I take notes on this? Do want to know what I'm gonna do?

[Wendy Harrison (Chair)]: Is something I want to discuss

[Katie Manson (Office of Legislative Counsel)]: Okay. In this meeting. Let me make a note for myself.

[Wendy Harrison (Chair)]: And then another question. There's a draft 2.1 which has language that is very similar to the language that I requested. And I don't know if the other committee reviewed that. They did and they asked that it be removed. Okay, so that was the, so let me just let us know, this committee know. And do you have, I have a copy of this. Does the rest of the committee have a copy of this? It's 2.1.

[John Benson (Member)]: Okay.

[Wendy Harrison (Chair)]: So the first section where it says the commissioner shall operate the forensic facility in a building that is separate and apart from the correctional facility, including both a separate entryway and dedicated staff to serve persons transferred to the forensic facility. I am concerned that having folks be, currently there is, we're saying there's a facility but there's not really a facility. The individuals who are in the prisons are in the prisons and there's no separate place for them. And I I would like to discuss with this committee the importance of having that the place, whether it's a facility, we call it a facility, that it should be separate from the other people in the prison. It doesn't necessarily need to be a separate building in my opinion, but it should be a separate place because it's a different level of care and it's a different group of folks and this is something I want to talk to Wellpath about today. I just wanted to highlight that where

[John Benson (Member)]: you appreciate a little light on some of our discussion that was the way that it went to ineligible welfare, as this was calling for your a separate facility with a dedicated staff. The question there was, you know, where we are with the women's prisons, you could be looking at something five, ten years out in the future if we were looking for a completely separate facility to be developed, and the thought was to concentrate less on the physical plant, but more on the treatment and care for the individuals, and give some flexibility in the facility itself or how the facility was to be developed, and that's why the thought was to remove that piece.

[Wendy Harrison (Chair)]: Okay. That's very helpful. Thank you. And there are ways that we could provide a physical facility without building a whole building.

[Joseph "Joe" Major (Member)]: Just clarification for for what you you wanted. Were you asking in your separation, were you asking for a in another building or were you asking for a possibly another part of the the same facility?

[Wendy Harrison (Chair)]: Either part of the same facility or for example in Southern State, there's the big open area where they always point out the concrete pad for the educational facility that was never built. Are you all familiar with that? So there's a lot of space there and there is a pad that's available. So it could be a modular building, but I think it's important to at least consider that this facility, we've been talking about this facility for years and it's always been intended to be a separate facility. It could be, have the advantages of a separate facility and be on the grounds of one of the prisons. Is still my thought.

[John Benson (Member)]: As I recall, he then added something later on to give that flexibility

[Wendy Harrison (Chair)]: to You the

[Katie Manson (Office of Legislative Counsel)]: did. The Senate Health and Welfare didn't wanna the concept altogether. So in the rulemaking section, there's a place for any other rules that are necessary to implement the forensic facility, including the potential of having a separate unit for the forensic facility where populations are mixed. So it's broad, it is sort of optional whether the department wants the doctorals on the topic, but that is where that issue was preserved in the draft.

[Karen Barber (General Counsel, Department of Mental Health)]: Okay, that's

[Wendy Harrison (Chair)]: great. And it's a good segue to continuing with the presentation.

[Katie Manson (Office of Legislative Counsel)]: Sure, okay. Second instance of amendment, this is adding a new section of the bill. It's amending the previous section of the bill, but it's happening at a later date. That's why it's in a separate section. And this is an annual report from DOC on the forensic facility. It was thought that there would need to be some time after the forensic facility opened to have data to report on. That's why this provision takes effect at a later date. So we have annually on or before January 15, DOC in consultation with the Departments of Health Mental Health and Dale shall submit a written report, to the House Committees on Corrections and Institutions on Human Services on Judiciary and the Senate Committees on Institutions on Health and Welfare and on Judiciary, addressing the number of persons served at the forensic facility during the previous calendar year, and the types of clinical services and treatment provided during the previous calendar year. So that is the annual report and I believe that is a July 1 or January 1, I have to look, 2029 edition. Next is the third instance of amendment. This is a rule making provision. So in the underlying committee report from senate judiciary, there is a provision in section five about emergency rule making. And the date of, the effective date of Senate Judiciary's committee report is July. Since that has passed, there's been conversations that a forensic facility would not be operational for at least a year out. And the emergency rules in that draft were meant to have something in place for 07/01/2026 openings. But because it doesn't seem that there will be a 07/01/2026 opening, and that the departments have testified that they would need more time to put a forensic facility in place, the effective date of all the forensic facility language has been bumped out. And instead of having emergency rules, this just requires permanent rules to be put in place. This also is more specific about what would be the most permanent rules in terms of addressing clinical services. Let me ask you a question

[Wendy Harrison (Chair)]: about that. So, regarding the two types of rules. So emergency rules obviously would happen quicker than regular rules. Are regular rules more comprehensive in any other way?

[Katie Manson (Office of Legislative Counsel)]: There's much more opportunity for public comment on permanent rules. Emergency rules, the agency just puts them in place and then there's an LCAR process to make sure that the emergency rule making standard has been met and that they don't violate the legislative intent behind the request for the rules. But permanent rulemaking is a longer process. It takes, I always hear about nine months to a year for the permanent making process to be put in place, and there is much more robust requirements around having a comprehensive public comment period before LCAR sees the rules.

[Wendy Harrison (Chair)]: Great, thank

[Katie Manson (Office of Legislative Counsel)]: you. Yes. So this requires the Commissioner of Corrections in consultation with Departments of Health, Mental Health, and Dale to adopt rules implement, to implement the provisions of this act related to the forensic facility. Specifically, the rule shall establish clinically appropriate standards governing the provision of services at the forensic facility, including requirements related to staffing patterns and ratios, staff qualifications, licensure and training, clinical supervision, and the delivery of safe, effective evidence informed care. The rule shall establish standards for quality assurance and improvement, clinical oversight, documentation and reporting requirements, safety and risk management protocols, and mechanisms for monitoring

[Wendy Harrison (Chair)]: compliance. And,

[Katie Manson (Office of Legislative Counsel)]: the rule shall address any other provisions necessary to ensure a safe, effective, and clinically appropriate implementation of the sections pertaining to the forensic facilities, including potentially requiring the provision of forensic facility services in a unit that is separate from other correctional populations. So that's where that issue was sort of held onto. Okay. So that's rulemaking. Fourth instance of amendment. This strikes out the effective date section in Senate Judiciary's Committee report, and it puts in place two sections. So it puts in place an interim reporting section and a new effective date section. So first, it's our interim report. By October 1, DOC in consultation with the three other departments is to submit a written interim report to the same six committees we highlighted before with the annual report containing draft rules required pursuant to section five of this act. The interim report shall also address the status and anticipated timeline for the adoption of rules under this act, forensic facility planning, including the specific proposed location of the forensic facility, space considerations and design elements necessary to support the provision of therapeutic services, and security at the proposed location, and the timeline for any necessary fit up of the forensic facility. And then, interim report shall also address initial staffing considerations, including anticipated staffing levels, required qualifications and potential contracting needs. And it will address an anticipated timeline for the development of a forensic facility, including preliminary cost estimates and initial operations. So that's what's in the interim report and then we have a new effective date section. So this section, meaning the effective date section and section two, which is not specifically related to the forensic facility, those two pieces take effect July '26. The pieces about the forensic facility itself take effect 01/01/2028. So that's a eighteen month lead time. And then section four a, which is the addition of that annual report after the forensic facility is up and running, takes effect July. So those are the different moving pieces on the timeframe. And you know, while I'm sitting here talking to you, I'm thinking out loud that our rulemaking section, it might be beneficial for that to take effect sooner than when the rest of the forensic facility takes effect. So, I might add that in at an earlier timeframe.

[Robert Plunkett (Vice Chair)]: The report section is what? Section seven?

[Karen Barber (General Counsel, Department of Mental Health)]: I'm sorry, can

[John Benson (Member)]: you go

[Karen Barber (General Counsel, Department of Mental Health)]: ahead again?

[Robert Plunkett (Vice Chair)]: Section seven had a report due on

[Katie Manson (Office of Legislative Counsel)]: October 1. In charge part o. Thank you. Yeah.

[Karen Barber (General Counsel, Department of Mental Health)]: So rulemaking should be earlier.

[Robert Plunkett (Vice Chair)]: And if I may, the the eighteen month delay, where did that come from?

[Katie Manson (Office of Legislative Counsel)]: That came from a conversation with the Department of Mental Health, also with the chair of Health and Welfare, I don't know if it came up in the whole committee, but there is a conversation that since the Friendly facility wouldn't be operational, what date was realistic to have rules ready and to have a facility that was ready to start accepting transferred persons.

[Robert Plunkett (Vice Chair)]: Okay. And where did it come from that it wouldn't be operational?

[Katie Manson (Office of Legislative Counsel)]: On July. Yeah. The Department of Mental Health, when I asked that it wouldn't be operational this this July,

[Robert Plunkett (Vice Chair)]: which would be the department that would be different. So department of corrections didn't say that?

[Katie Manson (Office of Legislative Counsel)]: I didn't hear that from the department of corrections.

[Wendy Harrison (Chair)]: I heard that from the department of mental health.

[John Benson (Member)]: We didn't have the department of corrections sitting in committee. Okay.

[Wendy Harrison (Chair)]: So, you saying it's possible that it would be?

[Robert Plunkett (Vice Chair)]: I don't know. I know that the Department of Mental Health wouldn't be the department that would actually be implementing this. I don't

[Russ Ingalls (Member)]: know why they would say that.

[Robert Plunkett (Vice Chair)]: But we'd have to ask that.

[Joseph "Joe" Major (Member)]: All right, we can ask them and then we

[Wendy Harrison (Chair)]: can also ask the corrections. And, tell me again what exactly was delayed?

[Robert Plunkett (Vice Chair)]: Implementing a tire, most of it. Could guess a piece

[John Benson (Member)]: maybe to add, that is, since this gives some flexibility to develop what are the standards and what are the requirements are, We don't even know what the facility is going to consist of, so it gives some time to define what that is, what improvements or where it's even going to be located, and what improvements then need to occur at that facility, all to get in place, in a reasonable period of time. Right, but I don't know

[Robert Plunkett (Vice Chair)]: where the 07/01/2026 came from to begin with and I presume that that was

[Russ Ingalls (Member)]: done advisedly. I

[Wendy Harrison (Chair)]: didn't know what that plan was. Okay, so thank you. Any additional questions? Think I'm good. So, we're going to look at this again tomorrow. We're not going to vote today.

[Karen Barber (General Counsel, Department of Mental Health)]: Okay. Are you available?

[Robert Plunkett (Vice Chair)]: So, I guess I'm sorry, do have a The amendment says that it refers to, Committee on Health and Welfare, but it was, it was referred to appropriations, so it's not in the jurisdiction of health and welfare.

[Katie Manson (Office of Legislative Counsel)]: I did

[Wendy Harrison (Chair)]: not realize that. Yeah. Okay. Okay.

[Katie Manson (Office of Legislative Counsel)]: Do you know that?

[Robert Plunkett (Vice Chair)]: Yeah, I'm just, okay. I'm just making sure that, to know where the

[Russ Ingalls (Member)]: bill I think it, I

[Robert Plunkett (Vice Chair)]: believe it's in a corporation, sorry.

[Wendy Harrison (Chair)]: So then that means, so

[Katie Manson (Office of Legislative Counsel)]: this is work that Senate Health and Welfare has been doing. So that means Senate Health and Welfare, I would presume, is going to continue working on this tomorrow, and instead of them acting as a committee, it would be an amendment from the five individual members if they all decide to sign on to it is probably how we would proceed. But thank you for saying that because Well, I I did not know. I'm actually

[Robert Plunkett (Vice Chair)]: asking because I'm not sure exactly how the procedure is, but I know that I believe it was done today or yesterday, or Friday to the perforations, but I

[Wendy Harrison (Chair)]: I believe that's the case, yes. But that sort of

[Katie Manson (Office of Legislative Counsel)]: raises an interesting question, because I know this committee is looking at similar issues and trying to navigate, are we doing two separate amendments? Are both committees maybe working together on one amendment that would be under 10 names for the committee members, or nine names for the committee members. So, I'll let you sort of decide how you want to handle that piece, but for the time being, I'll make the changes to the Good, Jay.

[Wendy Harrison (Chair)]: It's good. I prefer to have one amendment from both committees.

[Robert Plunkett (Vice Chair)]: The members of both might wanna

[Russ Ingalls (Member)]: have a conversation with the other chair. There are way too many committees involved, whether there's three committees involved trying to do the same thing, and I think that it might save you some time, my suggestion only, of having a sit down with the chair of health and welfare and see if you can come through a compromise. Uh-huh. I'm just gonna go back and forth and back and forth and back and forth.

[Wendy Harrison (Chair)]: Alright, well, let's defer that conversation to the end of this meeting because we haven't, I haven't heard from all of you about how you feel about this amendment. Think it's consistent with what I was looking for. But obviously we haven't all talked about it. So we'll have to figure out the process.

[Karen Barber (General Counsel, Department of Mental Health)]: Yeah, I think so.

[Katie Manson (Office of Legislative Counsel)]: So I'll go ahead and make the changes to the rule making. I know you talked about access to 20 fourseven clinical care. I feel like maybe that should be part of the conversation about one amendment. So, I might just hold off on that. These minutes, very easy to add if everybody is in agreement.

[Wendy Harrison (Chair)]: Right, well and I'm gonna talk to, ask DOC because I suspect that if it is a unit that is separate that there would be folks in that unit. So, I will ask DOC about that. Okay. Okay? Alright. Good. So let us go to Wellback to Doctor. Hodges.

[Karen Barber (General Counsel, Department of Mental Health)]: Good afternoon.

[Wendy Harrison (Chair)]: Hope I'm pronouncing your name correctly.

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: You did, yes, thank you.

[Wendy Harrison (Chair)]: And did you hear us introduce ourselves?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: I did, yes. Would you like me to introduce myself and give you a little Yes,

[Wendy Harrison (Chair)]: definitely, thank you.

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Absolutely, I can give you a little background on WellPath as well as our history with Competency Restoration if that's helpful as well. Yes. Okay, excellent. So my name is Robin Hodges, and I am a psychologist by training. I'm the Senior Vice President of Mental Health for WellPath. And I've been with WellPath about twenty years now, working my way through DOCs, jails, and spent about half of my time in the main DOC as the Regional Mental Health Director. So right next door to Vermont, had a great time living up there. A little bit about WellPath for those who don't know, we're a correctional healthcare company. We have about forty two years of experience in correctional healthcare. We have contracts in 37 states currently, about 300 partner facilities across The United States, about 8,000 ish employees, and we have about 148,000 plus encounters per day across all of our systems. And I've taken that down to what is it that we do in Vermont. I always like to talk about Vermont being a very unique system because you have a unified system where you have both sentenced and unsentenced folks together, where you traditionally see those folks at a jail or a prison. But we provide your healthcare services across Vermont DOC. So all healthcare across the six facilities, medical, mental health, substance use, dental, etcetera, any of their mental health needs is also addressed. And we have been the vendor in Vermont since 2023. And then just a little bit about our history of competency restoration. So we were one of the first private partners to develop jail based competency programs with the California Department of State Hospitals. And part of the reason that happened was that there's a real issue around access to beds at the state hospitals and the increased wait times for folks to kind of address their charges while they were waiting to transfer. WellPath partner, we have a lot of JBCT programs, a lot of experience crafting competency programs around what the statutes are for particular states. And generally, once those statutes are settled, we develop the competency restoration programs in collaboration with district attorneys, public defenders, DMH, courts, etcetera. And we really sort of integrate psychiatric stabilization, psycholegal education, and competency assessment altogether, depending on how your statute looks at the end. And that's kind of what we do. We're capable of doing these competency restoration programs. We're likely treating some of these folks already who are already in our custody. We do have an acute mental health unit as well as a residential mental health unit in the Vermont DOC. And this is really what we do. We provide healthcare. So with that, I'm going to stop talking and let you guys ask some questions.

[Wendy Harrison (Chair)]: -With competency restoration, I'm sure there's many ways of doing it. Can you give the ideal way and then maybe a stripped down method?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Yes, so I think the best option is your milieu based capancy restoration. Restoration. So essentially, you're doing treatments other than competency restoration. So your competency restoration is like your psycholegal education piece, which is really like how to assist your attorney, do you understand the charges against you, etcetera. And then with the milieu based, you're really sort of implementing other mental health treatment in there. So understanding your illness, problem solving, etcetera. So that's kind of the preferred way to do competency restoration is milieu based. That's really what you're going get when someone to a state hospital. They're there for being generally mentally ill, but they have competency restoration happening at the same time. That's your ideal scenario. You can have programs for folks who are just, given what I've heard about what your program's going to look like and potentially having it in maybe a different building, I'd say that is really your best option. Otherwise, I don't know you'd be having folks hanging out. And so it's really best to keep folks engaged. Especially sort of mentally ill folks, they need time to practice skills and doing those skills in general. And so you want to keep activities going, recreational activity kind of therapy things in place as well. So milieu based is really what I think would be ideal. And what's ideal is and that's what we do on our main DOC one as well.

[Wendy Harrison (Chair)]: -I just want to make sure. Milieu, is that like the French word? Milieu, is that what you're using?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: -Yeah, just like general milieu of the unit, yeah.

[Wendy Harrison (Chair)]: -Okay. Yes, I know. I'm sorry. Know. I I'm sorry. Doctor.

[Joseph "Joe" Major (Member)]: You threw me off there for a while. What when you say separate and I guess I wanted to clarify what you meant as well, separate facility. Are you mean living facility that they're they're 20 fourseven or you just mean during their treatment?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: No, I was just talking about, depending on how you set it up in Vermont, we have it set up in various different ways. So like main DOC, we have them living in our mental health unit, the individuals who are there for competency restoration. So they're getting general mental health treatment as well as competency based treatment. Others are set up where it's a unit inside the jail, and that's just where you go for your competency restoration and your treatment, and you're away from the general population. Some mix, like activities, education, etcetera, with the rest of the population. It really just depends on how it's set up. And we can work with any way that it's set up. It just really depends on statue, physical plant structure, how it's set up in general.

[Joseph "Joe" Major (Member)]: And I guess this question is for Haley. Haley, in our present facilities, if we go across the board, do we have separate areas for, the mental health or are they in mixed populations or how are they set up currently? Or is it dependent upon the facility?

[Hailey Summer (Director of Communications, Vermont DOC)]: Sure. I'm happy to answer that question. And for the record, my name is Hailey Summer. I'm the director of communications for DOC. So at the Springfield facility, Southern State Correctional Facility, there is a living unit that is for acute mental health care. In other facilities, there are specific areas in which incarcerated people will go to meet with mental health providers. But Southern State is the only one right now that has a separate mental health unit.

[Russ Ingalls (Member)]: Okay.

[Joseph "Joe" Major (Member)]: Thank you.

[Wendy Harrison (Chair)]: Can I just I'm going to just clarify? So, which unit is the mental health unit?

[Hailey Summer (Director of Communications, Vermont DOC)]: Oh, I don't know the name off the top of my head, but I can ask the facility and get back

[Wendy Harrison (Chair)]: to you with that.

[Joseph "Joe" Major (Member)]: Yeah, that would be good. Because I think

[Wendy Harrison (Chair)]: it might be part of a unit, like Bravo or something. I think it's within one of the existing units.

[Hailey Summer (Director of Communications, Vermont DOC)]: Yeah, I just don't have the name of it. Okay. But I could ask and get that answer pretty quickly.

[Wendy Harrison (Chair)]: Okay, thank you.

[Joseph "Joe" Major (Member)]: And Doctor. Hodges, you're saying a separate unit or facility altogether. Is that accurate? Understanding Am that correctly?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Upsetting, it can be done any way that you desire. So in some states, they are separate units where they have no interaction with the other population. And then at other states, they are living in a mental health unit. And so it kind of just depends on what your statute requires.

[Joseph "Joe" Major (Member)]: Given that, obviously you've seen both, what are the best outcomes?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: I think the outcomes are similar. I would have to look to see if there is anything in particular around outcomes related to individuals who are participating in competency restoration and have interaction with the rest of the population versus separate. I don't have an answer for that.

[Joseph "Joe" Major (Member)]: Okay, thank you.

[Katie Manson (Office of Legislative Counsel)]: Oh, okay, I thought when

[Wendy Harrison (Chair)]: you said the ideal that that was a separate unit. All right, So, Doctor. Hodges, can you explain how you do the restoration with folks, now in Vermont?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: So we don't participate

[Katie Manson (Office of Legislative Counsel)]: Oh, in

[Wendy Harrison (Chair)]: because we don't have the registration.

[Hailey Summer (Director of Communications, Vermont DOC)]: Right, right.

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: We don't have it yet, yes.

[Wendy Harrison (Chair)]: So what services do you provide for the mental health?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: So in Vermont DOC, we provide all of the mental health care. So from your crisis intervention all the way through just stabilization, like I mentioned earlier with mental health units. So we have individuals who are engaged in pretty, not heavier amounts of, more frequent, let me say that, more frequent contact with mental health. And then obviously when they're out in the general population, some folks just don't have any mental health needs, and then they contact us via the sick call system. So we run the gamut from intensive crisis intervention to folks who just need a little extra support.

[Wendy Harrison (Chair)]: Okay, and then what's the

[Katie Manson (Office of Legislative Counsel)]: staff level

[Wendy Harrison (Chair)]: for mental health at Southern State and at the Chittenden facility, the women's facility?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: I was so prepared to answer across the state. I don't have the actual staffing level for Southern or Chittenden. I can get that for you and send it to you via Haley.

[Wendy Harrison (Chair)]: Okay, so what is the overall state level?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Overall state for mental health, we have about 17 individuals for mental health, and then we also have a regional mental health director who's overseeing all of the mental health across the state. And then we also have a travel MHP. It's very important to us that we ensure we have in person mental health services. So our staffing consists of at least one mental health staff at every facility. Obviously, some facilities like Marble Valley are very small. So when people go on vacations, we want make sure we're covering those. We do all of our services primarily in person.

[Wendy Harrison (Chair)]: Okay. So that 17 statewide full time, forty hours a week?

[Joseph "Joe" Major (Member)]: All right.

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: I think we might have like a thirty two hour mixed in there, but yeah, for the most part, full time.

[Wendy Harrison (Chair)]: Okay, thank you. Any other questions? So I guess I do have another question just about what we're proposing. Do you have any concerns about the various levels of service, the process? Sounds like you're ready to implement various scenarios.

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Yeah, I mean, have experience implementing with various scenarios depending on how the statutes are written. Nothing I heard today about any of the changes concerned me, if that's helpful.

[Joseph "Joe" Major (Member)]: Sorry. Yeah,

[Wendy Harrison (Chair)]: that is

[Russ Ingalls (Member)]: helpful. All

[Wendy Harrison (Chair)]: right. Okay, thank you.

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: No problem.

[Wendy Harrison (Chair)]: Okay, so next, Karen Barber, are you available? Sure.

[Karen Barber (General Counsel, Department of Mental Health)]: The record, Karen Barber, Department of Mental Health General Counsel. I mostly was here just to answer questions, but I can address a few things that have come up. When we were speaking about dates, were speaking on behalf of the Agency of Human Services, and when we submitted our comments with the dates, were it specifically said the Agency of Human services. So it was not DOC speaking on an island. Was us me being the person who was communicating to AHS.

[Robert Plunkett (Vice Chair)]: And just to be clear, AHS includes DOC

[Karen Barber (General Counsel, Department of Mental Health)]: Yes.

[Joseph "Joe" Major (Member)]: Health Department of Health.

[Karen Barber (General Counsel, Department of Mental Health)]: Yes. They're six departments.

[Wendy Harrison (Chair)]: Yeah. So Yeah.

[Robert Plunkett (Vice Chair)]: Every one of them. Yeah. So

[Karen Barber (General Counsel, Department of Mental Health)]: I don't know where the July 1 initial date came from. That was never feasible, but it was not something we were worried about addressing right now.

[Joseph "Joe" Major (Member)]: We could it was something we would

[Karen Barber (General Counsel, Department of Mental Health)]: have just addressed in the house, but when Katie and I were talking about it, made sense to change. So just to be clear on the dates.

[Robert Plunkett (Vice Chair)]: Thank you.

[Karen Barber (General Counsel, Department of Mental Health)]: I did just wanna highlight Vermont is, again, an outlier because we don't have any form of confidence or restoration services. Most states do. The other thing when you're talking about how many people are doing confidence or restoration or where are you doing it, other states do much broader confidence or restoration programs. So they have many, many more people doing confidence or restoration,

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: which is why you hear

[Karen Barber (General Counsel, Department of Mental Health)]: about wait list and beds and those sorts of things. Dismetors, felonies, all sorts of folks are being restored, and so in those cases, it may make sense for economy of scale scale to think about how you're doing that. In Vermont, we are not talking about doing confidence or restoration for everyone. We are talking about only towing it for individuals accused of the most serious crimes who are being held without bail. Again, we're only talking three to five people a year. As Doctor. Hodges talked about, care is provided value based, which means it's really important that you're around lots of other people and you're engaging in group therapy and you're doing things together. You don't want to separate people in other states where they have lots of people undergoing confidence restoration. It's a lot easier to do that because there are so many of them. But again, in Vermont, we're not talking about large populations. So I just want to highlight that that is traditionally how treatment is provided. If you you know, we oppose the plan to call this out. We think it's important that maybe that is the outcome, but to not prejudge it. And in fact, give DOC and the agency of human services time to assess the clinical needs of the folks who are going to serve and design a program without limiting the options that we have on the table, which is why we think it's really important that the language is in there about how we provide the care, but not what it's going to look like until we've had time to do that. I think those are the things I just wanted to say

[Wendy Harrison (Chair)]: and I'm happy to answer any questions. Okay. Yes.

[Joseph "Joe" Major (Member)]: You you talked about being able to to judge what do you think the length of time that you can evaluate whether it's the type of care that you want to give.

[Karen Barber (General Counsel, Department of Mental Health)]: I think the way the preliminary report is that we submit a preliminary report back, was it October 1? September 1? Oh, I'm sorry. You're talking about the treatment phase? Oh, my apologies. So it depends. So the reason we asked for initial was simply that, generally, like in the hospital type setting, people come in and they get an initial treatment plan right away, and then it takes, could take up to a month to develop a full blown treatment plan because you need time to get records, you have to know the person, you have to develop trust. And so the idea is that, you know, they're required to be there on an ongoing basis, but you have an initial one coming in, but understanding it's initial. It's gonna not be comprehensive within seventy two hours.

[Joseph "Joe" Major (Member)]: And Apologize. Every no. No. No. And and everybody's different. Right. So I so that would go into factors. Well, okay. Alright. Thank you. Yeah. Thank you very

[Wendy Harrison (Chair)]: Okay, so why would we not provide services to more than just one group? I expect there are other folks in the prisons who would benefit. So we are

[Karen Barber (General Counsel, Department of Mental Health)]: focused on a very small gap within the system. The idea is that we would start small. Could you contemplate doing competency restoration for much broader swaths of people? Absolutely. Those are much bigger programs. So right now, we're here front of you with a pretty narrow proposal. We have in the past proposed larger confidence restoration programs. Tended to not they're not implemented to the day. So we are trying to be really narrow. We, you know, we submitted reports. We talked about best practices. I think there's, you know, again, we're an outlier in that we don't have any form of competency restoration. But right now we're not asking for a full blown program. We're just asking for kind of a small narrow subset as we try to address the most critical gaps. And certainly we do hope that the legislature would continue to think about this issue and in the future potentially expand the population.

[Wendy Harrison (Chair)]: Okay. And then could you talk more about the gap? Because what I am understanding is that there are folks who are already in the frivans. You've identified six is what I've heard. But then there are folks outside of the prisons who would be your customers, actually, or folks who would need the competency restoration. So can you talk more about that? Because I think we need a better sense, I need a better sense of the numbers that we're talking about.

[Karen Barber (General Counsel, Department of Mental Health)]: So based on kind of traditional data that we've seen, there's about three to five individuals each year that we see that are accused of committing these high level crimes that are facing life offenses and that have been found incompetent. So we're talking about those individuals and it's, again, only those individuals that would not be eligible for hospitalization. So there is no secure setting for them. We frankly have very few people that are found not guilty by reason of insanity. That's because most folks don't actually get there because there's there's confidence that this human because we're not restoring competency. They tend to not actually get there. We do anticipate it's likely, and we can factor that in, that some of these folks would not necessarily be incompetent, but then instead they would be found not guilty by insanity. It's a pretty high bar. Most folks that you know, it's pretty rare, even if you do go to a child, they're actually found that guilty by reason reason of insanity, but certainly do have a few. There's a couple I can think of in the last few years that weren't inpatients, but also not accused of these serious crimes. So that's the gap we're talking about. So those are individuals that, again, there is no secure setting for them to be in, and we're also only talking about the subset of those that have been found by the court to be a danger to the public. So if the determination of the court decides they can be treated in a less restrictive setting in the community, then they would be discharged to the community. It's really only for folks that have both clinical needs and there are real public safety concerns.

[Wendy Harrison (Chair)]: But I thought some of them are being discharged to the community. I thought that was one of the reasons that we're doing this.

[Karen Barber (General Counsel, Department of Mental Health)]: They are. So how many are there? As we said, I don't know off the top. So we're talking about three to five individuals a year. How many at any one point are in the community? It varies.

[Katie Manson (Office of Legislative Counsel)]: Right.

[Karen Barber (General Counsel, Department of Mental Health)]: There's probably a couple right now. I think we've, you know, we've seen some bad outcomes, frankly, for folks. So we, I mean, I can't give you exact numbers right now, but those are the numbers we're talking about. We don't have a lot of folks that are charged with those serious crimes on a yearly basis.

[Wendy Harrison (Chair)]: So if we're going to have a facility, we need to have a plan for the number of people who can be in that facility.

[Karen Barber (General Counsel, Department of Mental Health)]: Correct, and so I think part of the planning process will be again helping to flush out those numbers and thinking about what space requirements would look like. Okay.

[Wendy Harrison (Chair)]: But we've been talking about this for years, and we don't have a number.

[Karen Barber (General Counsel, Department of Mental Health)]: Because every year we propose the facility, it's looked different in terms of what population. This is the narrowest we've ever proposed the facility. And so again, we have run the numbers in terms of, on average, we have three to five people a year. You know, it doesn't change sometimes, sure, but on average, that's what we're saying, is three to five people a year. Okay. So,

[Wendy Harrison (Chair)]: alright, the three to five would be the folks needing service. Yes. And they wouldn't be staying for, but some people are going stay for their whole lives, it sounded like.

[Karen Barber (General Counsel, Department of Mental Health)]: So, we can't say that, it depends. But it's a possibility. If they are never, if the court never finds that they can be treated in the less restrictive setting, then technically it's possible. Okay.

[Wendy Harrison (Chair)]: It's just challenging having, because so eight beds were what we looked at previously. That was one of the more recent ideas. So, just somewhere between eight and three?

[Karen Barber (General Counsel, Department of Mental Health)]: So, it's not 15. Right, it's not No.

[Wendy Harrison (Chair)]: So, it's probably not 30. No. Okay, so that's helping to get, so less than 10.

[Karen Barber (General Counsel, Department of Mental Health)]: Yeah, it's a very narrow subset of the population.

[Wendy Harrison (Chair)]: That's helpful. Okay, with the committee, does the committee have any other questions?

[Robert Plunkett (Vice Chair)]: No. Okay.

[Wendy Harrison (Chair)]: Thank you. And we have Haley here. Do we have questions for Haley? Anybody?

[Joseph "Joe" Major (Member)]: I gave her my question. She answered.

[Wendy Harrison (Chair)]: Yes. I appreciate that.

[Hailey Summer (Director of Communications, Vermont DOC)]: If there are no questions, I'm happy to just add two points of clarification. The first is that the mental health unit at Southern State is Bravo, very good memory chair. The unit capacity is 26 people, and there are 24 people in the unit at the moment. And the other thing I would just wanna expand on Karen's point around the potential harms of negating to mixed populations, specifically as it relates to different types of services. For example, we have a pretty robust pickleball program that's volunteer run at CRCF. And if we were to not mix that population with the general population, it would essentially exclude these individuals from having access to the same services that our general population does. So just wanted to make sure that the committee was aware of this in terms of your expectations for what it might look like.

[Wendy Harrison (Chair)]: I appreciate that. I think the pickleball went south when they had to use the, they needed the room for the excess people?

[Hailey Summer (Director of Communications, Vermont DOC)]: Yes, it is up and running again. And that was frankly just one example. We have volunteered at all of our facilities and wouldn't want to run into a situation where someone couldn't access those because they had to be segregated from the population.

[Wendy Harrison (Chair)]: Right. I'm sure we could figure that out. Okay, thank you. Anything else? Something that I would like to discuss is that when we looked at a forensic facility previously, there were other entities involved. And I think there's three entities now in this, but I think there are more. We had the representation from the corrections staff and I just remain very concerned that we have staffing shortages and inmate populations at a very high point. The facilities are overcrowded with minimal amount of staff. And so that's a concern that I have. I think we would have time to talk about that with the information or the changes that are in the amendment. But I think there needs to be another entity that would represent what's actually happening in the facilities, in the corrections facilities. All right, so Senator Ingalls, did you wanna bring up anything?

[Russ Ingalls (Member)]: No. I am very disappointed in the timeline of what it's taken to put a forensic facility in place. I think there's just, way too much haggling about, what needs to happen, and nothing I have to comment on this bill is going to change that. So I will stay silent and just say express my very sincere disappointment that real people are suffering my Rome burns, and that's how it did. Mhmm. This is an ongoing problem that can be solved tomorrow, and, yeah, it isn't us that's affected. It's other people, and and therefore, you know, it's just not the way to run a

[Wendy Harrison (Chair)]: program. Okay.

[Joseph "Joe" Major (Member)]: Yeah.

[Wendy Harrison (Chair)]: Alright. Anybody else? So, well, you had, you had suggestions about how we do the amendment. Do you want to discuss that or not? My comments were put into this amendment. So, I'm generally good at wanna have some, another chance to just talk about it and have you all be able to look at it. Does the committee wanna do something other than this amendment?

[Robert Plunkett (Vice Chair)]: Do we agree with the amendment right now?

[Wendy Harrison (Chair)]: Generally. I

[Joseph "Joe" Major (Member)]: can't I can't say. Basically, it's

[Robert Plunkett (Vice Chair)]: the way it was before is everything was gonna be in rulemaking through DOC. Now we're throwing stuff in and that would have been the whole thing.

[John Benson (Member)]: But I wanna look at

[Robert Plunkett (Vice Chair)]: it more closely because I heard that it doesn't really matter in terms of well path. It sounds like, in terms of how they will be implementing it, that it may just be guidepost rather than, somebody's maybe, something that we shouldn't be doing and that we should need to be experts. But I'm looking at it for the first time now.

[Wendy Harrison (Chair)]: Okay. So we should get this out tomorrow for sure. So do you have? It

[Robert Plunkett (Vice Chair)]: sounds like right now we don't have any. So it would be whether or not we need adding a floor amendment.

[Wendy Harrison (Chair)]: Right, or we would agree with this amendment.

[Robert Plunkett (Vice Chair)]: Right, but this amendment isn't in the committee that has Jurisdiction. The bill. Right,

[Wendy Harrison (Chair)]: Or the bill, right. Neither one of us do. But we had an arrangement with the judiciary committee that we would have an opportunity comment on the bill.

[Robert Plunkett (Vice Chair)]: Yeah, and I don't know exactly how that's what had been described as a drive thru. I'm not sure exactly how that works.

[Wendy Harrison (Chair)]: Well, this is how it works. I don't know if the Legion Council wants to say anything.

[Katie Manson (Office of Legislative Counsel)]: Sure. What I think a potential process would be, you have language that you looked at, you talked about small tweaks to it, I will make those small tweaks. Sounded to me like health and welfare was gonna be looking at it again tomorrow. So at this point, I'll just put it in Senator Lyons' name, and my guess is that Senator Lyons tomorrow would give her committee members a chance to sign on to the amendment. And then similarly, if the two committees are deciding to work together, then members of this committee could likewise probably decide to sign on to the same amendment, and

[Wendy Harrison (Chair)]: then you'd have a package moving from both committees. Okay. Thank you.

[Karen Barber (General Counsel, Department of Mental Health)]: Alright.

[Wendy Harrison (Chair)]: Is that clear?

[Robert Plunkett (Vice Chair)]: Sort of. Something tomorrow it'll be clear. Yeah. Okay.

[Joseph "Joe" Major (Member)]: So, tomorrow

[Wendy Harrison (Chair)]: That's why I'm glad we have tomorrow because initially we were trying to get this all done today. All right, so I think we are done with that topic. Yes? Anything else anyone wants to bring up? Okay, well we will be back here tomorrow. We are adjourned.