I read, with interest, the recent articles about the financial problems of the Brattleboro Retreat. Having been involved in health care for the past 40-plus years, let me assure you there’s no health care provider that hasn’t been in the exact same circumstance as the Retreat. Every health care agency is chronically strained to the breaking point as a result of the failure of the state and federal governments to take behavioral health disorders like mental illness and addiction seriously. “Seriously” means appropriating sufficient Medicaid and Medicare funds to achieve adequate reimbursement rates.

It amazes me that after decades of political soundbites and platitudes about how serious mental health issues are, we continue to fail to achieve meaningful funding from our state and federal elected officials. Sure, there are a multitude of so-called “one-time”grants, but at the state level there continues to be virtually no new or increased funding to increase reimbursement rates.

State government has literally been starving providers to death for nearly two decades so it is ironic that government officials in Vermont find it convenient to somehow blame the Retreat for their financial problems. Medicaid rates have not been increased or been adjusted for inflation for nearly 20 years.

The governor has lauded his efforts to increase Medicaid rates for some (but not all) Medicaid providers by 3.1 percent. While it can be rude to complain about receiving more funding, it’s critical to understand the impact of that meager overdue increase. A 3 percent increase today against a backdrop of virtually no increases in the past 20 years means the net benefit to reimbursement is about 15 cents. While increases like this make for good soundbites, they do little to actually address the crisis of mental illness and addiction.

Every year when funding mental health disorders is discussed, new studies are launched by the Legislature (mostly using one-time grants) to determine what should be done. I have reviewed each of these 23 studies and without exception, the conclusion is that more funding is needed to have any impact on what everyone says is a crisis. Yet the legislative response is pale and pathetic. For 20 years, the Legislature has failed to act on the recommendations of two dozen studies.

So here we are with the newest set of headlines about a struggling agency doing its best to address the mental health crisis with little but criticism from government leaders. It’s all about the money. It always has been.


6 Old Stage Road


(This writer is a Cheshire County commissioner and former county administrator.)