Vermont DOC: incapacitated people taken after ER screening are held up to 24 hours as community beds vanish

The Vermont Department of Corrections receives people described as “incapacitated” after an emergency department screening and holds them for medical and safety monitoring, often for up to 24 hours, DOC Chief of Operations Al Cormier told the House Corrections and Institutions Committee on April 29.

Those encounters are not part of the department's offender-management system and, DOC staff said, are increasingly frequent as community treatment beds and designated agencies have cut services or closed.

Why it matters: The practice places security and medical responsibilities on corrections staff for people who are not adjudicated, the department says, and statutory rules limit the length of hold periods. Committee members questioned liability, costs and whether a legislative solution or more community funding is needed.

“The incapacitated population … we take that population in at the request of a law enforcement agency after they have been screened in an emergency room, and found to need further care and custody for their own safety,” Al Cormier said. He added that the department tracks health and welfare while those people are in DOC custody but does not enter them into the offender-management system because they are non‑adjudicated.

Cormier told the committee that an intern review of paper intake forms from 2019 identified almost 3,000 incapacitated intakes statewide in that year and that roughly 1,100 of those were taken into corrections custody. The department estimated about one-third of individuals in that year were repeat intakes. He said screening information from hospitals often comes in a simple form saying a person was “screened and cleared,” but does not consistently convey detailed diagnostic or toxicology results, and that HIPAA concerns sometimes limit the amount of medical information transmitted to DOC staff.

Committee members and DOC staff described operational challenges: people arrive without phones or clothes because law enforcement has removed personal effects during transport; long travel distances and limited local transport mean some released people must walk from a bus stop; winter conditions and late‑night releases raise safety concerns. Cormier said previous local pickup arrangements with mental‑health and substance‑use providers have diminished because of funding and staffing cuts at those agencies.

DOC staff described clinical and security burdens inside facilities: highly intoxicated or potentially self‑harmful people require close observation, sometimes a 24‑hour suicide watch or an ambulance transfer if medical care exceeds DOC capacity. Cormier said the department will call an ambulance if it judges it cannot provide appropriate medical care.

Committee members pressed the department on cost and tracking. Cormier said the department has estimated an incarceration cost roughly in the range of $299 per day for a held individual and noted that the department’s paper‑based historical records make manual review necessary to assemble multi‑year statistics. He pointed to a 2019 dataset the department can share as a starting point, but added it is dated.

Several committee members urged a statutory or policy fix to reduce DOC’s role as the default place for people who need medical or behavioral‑health beds but are not charged with crimes. Members also cited a 2009–2010 study prepared for the committee and a later legislative sunset that repeatedly was extended while funding and bed placement plans were not fully implemented. One member described a previous incident in which a person left a DOC facility after a hold and collapsed in the parking lot; committee members said that example illustrates liability and public‑safety risks when community capacity is limited.

The committee asked the department to provide available historical intake reports and to help identify data elements that the Legislature could require for better tracking. DOC staff said they and partner agencies will continue to provide temporary holding and medical screening, but repeatedly told legislators that sustainable solutions will require state and community investments in secure and semi‑secure treatment beds and clearer statutory direction.

Looking ahead: Committee members recommended locating and re‑circulating the 2009–2010 study and agreed to press other state agencies for data and options for funding designated‑agency beds or other alternatives to using corrections facilities as default holding locations.