Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Public Inebriate Programs topic
No spam. Unsubscribe anytime.
Lawmakers probe decline in public inebriate beds as hospitals warn of ED strain
Summary
At a House Human Services hearing on S.36, Department of Health officials told lawmakers that public inebriate program bed numbers and screenings have fallen sharply in recent years while hospitals said PIP closures are pushing intoxicated, non-medical patients into emergency departments and correctional custody.
Lawmakers in the House Human Services Committee heard at-length testimony on S.36 and a potential repeal of language in Section 4 concerning the use of correctional facilities for people detained for incapacitating intoxication. Kelly Dougherty, deputy commissioner at the Vermont Department of Health, described public inebriate programs (PIPs) as statutory, voluntary programs that screen people detained by law enforcement for public intoxication and determine whether they can be safely monitored in a community PIP, require medical attention, or need protective custody with the Department of Corrections.
"So what the PIPs do is they provide an initial screening to determine whether somebody can be managed in a public inebriate program or whether they need to have medical attention or if they need to be placed in the custody of the Department of Corrections," Dougherty said. She added that PIP services are voluntary: people can refuse to be served.
Dougherty and other witnesses described a decade-long decline in PIP screening and bed utilization. The department said eight PIP beds currently exist in the state, with several programs closed in recent years because low utilization and unpredictable on-call demand made 24/7 staffing unsustainable. Committee members were shown historical data the department described as covering fiscal year 2013 to the present and were told the number of screenings and PIP bed-days has dropped substantially.
Committee members asked how that decline squares with other indicators of alcohol and substance use in Vermont. Dougherty said the decline predates COVID and likely reflects multiple causes, including community and law-enforcement practices, changes in where and how people consume substances, and program closures. She noted that one region historically performed 65–70% of statewide screenings and that closure or reduced capacity there accounts for a large share of the statewide drop.
The committee also reviewed where people end up when no PIP bed is available. Dougherty and staff presented data showing an increase in people taken to DOC protective custody for behavioral concerns and transport barriers; one slide cited that roughly 40% of people who went to corrections in FY24 did so because no PIP bed was available.
Dr. Allison Davis, medical director of the Rutland emergency department, told lawmakers that when police bring intoxicated but medically stable individuals to emergency departments, staff and patients face safety risks and hospitals incur costs. "Agitated and uncooperative intoxicated individuals without any medical needs are a danger to staff and they prevent us from caring for your loved ones," Davis said, and she urged lawmakers not to shift that population to emergency departments.
Liz Kudo, director with the Emergency Nurses Association (Vermont), said emergency departments already face high workplace-violence rates and that forcing additional non-medical intoxication cases into EDs could exacerbate overcrowding, staff burnout and patient-safety risks. "The healthcare and social service industries experience a high rate of injuries caused by workplace violence and are 5 times more likely to suffer violence, injury than workers in any other precinct," she said.
Committee members and department staff discussed data ambiguities: utilization measures in the slides were based on beds in existence rather than beds reliably available at any given time (some beds remained technically in the system but closed due to staffing). Members requested more granular data, including by day of week; clearer categorization of why individuals were sent to DOC (behavioral concerns, medical concerns, transport barriers); and whether people sent to DOC had received hospital medical screening and clearance prior to lodging there.
Dougherty said staffing models that co-locate PIP services with a 24/7 residential treatment provider appear more sustainable; Rutland’s co-located model was cited as an example. Several witnesses urged the state to consider options to stabilize PIP capacity (including co-location and sustained staffing funding) rather than letting the statutory PIP system erode. The committee did not take a final vote on S.36 during this session.
