Debate over S.193 centers on who should lead competency restoration and role of private contractor

Emily Hawes, commissioner of the Vermont Department of Mental Health, told the House committee that S.193 is aimed at a narrow group: people charged with serious offenses whose competency is in question but who are no longer in an acute phase of illness. "This bill with S.193 looks to support the folks who are coming into the competency conversation with a broader diagnostic challenge," Hawes said, adding that hospital-level care remains available for those who meet medical necessity.

The bill would authorize the state to provide competency-restoration services in a locked, secure forensic facility; Hawes and other agency staff described an existing memorandum of understanding between DMH and the Department of Corrections used to coordinate inpatient placements and consultations. Karen Barber, general counsel for DMH, told the committee the agencies "do have an MOU that is in place between the Department of Mental Health and the Department of Corrections" and said the MOU governs daily interaction, transfers to hospitals and training.

Why corrections, not a hospital? Committee members cited CMS separation requirements and practical constraints at the Vermont Psychiatric Care Hospital (VPCH). Hawes said running a separate forensic unit inside VPCH would require taking libraries, yards and other shared spaces "offline" and separating sight and sound in ways the hospital was not designed to support. She also emphasized that some people the bill targets are stable on treatment but nevertheless present a continuing public-safety risk: "They are still presenting with a significant public safety issue," she said.

Several members raised governance and conflict-of-interest concerns. "This bill, as written, places the Department of Corrections at the helm," one member said, arguing that the measure does not require clinical agencies to lead custody and treatment decisions. Another member warned about contracting clinical services to a for-profit vendor, citing national data on care problems and saying a private contractor could have a financial interest in keeping the population in place. Hawes and Barber responded that courts, attorneys and petition processes are part of the checks on decisions about competency and release, and that contractor roles (the committee heard Wellpath currently provides many contracted services in corrections) would be shaped further in rulemaking.

Operational details — staffing, unit design and monitoring — were deferred to rulemaking and implementation work. Commissioner John Murad of the Department of Corrections later told the committee DOC already houses many detained people who could fit the statutorily described group and supports adding a clinical restoration process. Matt Nault, acting DOC chief of operations, said Springfield’s Alpha and Bravo units provide existing infrastructure that could be used and that DOC would expect to add contracted clinicians to deliver restoration services.

Committee members asked how long someone could remain in a forensic facility if restoration attempts fail and what procedural safeguards (periodic review, restorability hearings) would govern long-term detention or supervised release. Staff said those provisions were being clarified in judiciary-drafted amendments; the committee scheduled follow-up sessions to work through statutory language, rulemaking responsibilities and coordination with DMH, the Department of Health and the Agency of Human Services.

The committee did not take a vote. Next steps: staff said they will return to the panel with clarifying amendment language, more detail on rulemaking timelines and operational plans, and coordinated input from DOC, DMH and the treasurer's and building-services offices where appropriate.