Mental‑health capacity and staffing drive major adjustments in DMH testimony to appropriations panel
December 17, 2025 | Appropriations, HOUSE OF REPRESENTATIVES, Committees, Legislative , Vermont
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The Department of Mental Health (DMH) presented its portion of the Agency of Human Services Budget Adjustment Act request on Dec. 16, highlighting increased utilization in private nonmedical institutions (PNMIs), continuing reliance on travel nurses and plans to add in‑state capacity for youth.
Emily Hawes, speaking for DMH, described the statewide care continuum from community services to inpatient hospitalization, noting VPCH (Vermont Psychiatric Care Hospital) operates a 25‑bed adult unit, and DMH contracts with the Brattleboro Retreat and Rutland Regional Medical Center. Hawes said a youth Psychiatric Residential Treatment Facility (PRTF) at Brattleboro Retreat is expected online in coming months and will allow the state to reduce out‑of‑state placements for youth.
Shannon Thompson, DMH financial director, outlined several line items in DMH’s ‘ups and downs’: increased transportation costs (Youth Transit Authority and sheriff contracts) that have shifted some previously Medicaid‑reimbursable costs to general fund; rising forensic/competency evaluation costs that the department moved to general fund because many ordered evaluations are not Medicaid‑eligible; and a $3.2 million PNMI increase for youth residential utilization (in‑ and out‑of‑state placements).
Hawes and Thompson also described staffing pressures: DMH reported that VPCH reduced its travel‑nurse usage from the prior year but still relies on dozens of travelers (the department cited roughly 47 travelers covering vacancies), and VPCH’s vacancy rate was described as about 39 percent (down from roughly 43 percent the prior year). DMH said it is renegotiating contracts and working with HR and hiring partners to increase permanent staff and reduce travel‑nurse dependence.
Committee members asked for dollar estimates of the transportation and travel‑nurse increases; DMH said it would provide more detailed, dollar‑level answers later.
Next steps: DMH will provide requested magnitude estimates and line‑item detail to the committee before formal budget decisions.
Emily Hawes, speaking for DMH, described the statewide care continuum from community services to inpatient hospitalization, noting VPCH (Vermont Psychiatric Care Hospital) operates a 25‑bed adult unit, and DMH contracts with the Brattleboro Retreat and Rutland Regional Medical Center. Hawes said a youth Psychiatric Residential Treatment Facility (PRTF) at Brattleboro Retreat is expected online in coming months and will allow the state to reduce out‑of‑state placements for youth.
Shannon Thompson, DMH financial director, outlined several line items in DMH’s ‘ups and downs’: increased transportation costs (Youth Transit Authority and sheriff contracts) that have shifted some previously Medicaid‑reimbursable costs to general fund; rising forensic/competency evaluation costs that the department moved to general fund because many ordered evaluations are not Medicaid‑eligible; and a $3.2 million PNMI increase for youth residential utilization (in‑ and out‑of‑state placements).
Hawes and Thompson also described staffing pressures: DMH reported that VPCH reduced its travel‑nurse usage from the prior year but still relies on dozens of travelers (the department cited roughly 47 travelers covering vacancies), and VPCH’s vacancy rate was described as about 39 percent (down from roughly 43 percent the prior year). DMH said it is renegotiating contracts and working with HR and hiring partners to increase permanent staff and reduce travel‑nurse dependence.
Committee members asked for dollar estimates of the transportation and travel‑nurse increases; DMH said it would provide more detailed, dollar‑level answers later.
Next steps: DMH will provide requested magnitude estimates and line‑item detail to the committee before formal budget decisions.
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