Uh-oh, we had a little oopsie yesterday in Montpelier…

Gov. Peter Shumlin announced on Tuesday that his administration plans to replace the Vermont State Hospital in Waterbury with a decentralized, “community-based” plan with 40 inpatient beds in four locations around the state. …

The unveiling of Shumlin’s proposal came on the same day a top mental health psychiatrist called for almost the exact opposite of what the governor proposed. Dr. Jay Batra, medical director of the state hospital since 2009 and a professor at UVM, told lawmakers at a hearing on Tuesday that the state should have one central mental health facility serving 48 to 50 patients in order to provide the best clinical treatment and best staffing model. 

The preceding account from Vermont Digger, which has a long and detailed report on Shumlin's new plan and the mixed reaction it has received. Now, Tonstant Weaders* already know where I come down on this issue. I believe there is a need for a central state hospital to treat the extremely tiny number of Vermonters who are truly severely mentally ill. Some of them violently so. And I'm aware that this issue splits the GMD community. I invite your comments, but in the meantime hear me out.

*Obscure Harlan Ellison reference. Now who's the biggest nerd on GMD?

It was certainly embarrassing to have VSH's medical director unknowingly contradict the Governor on the day of his big policy announcement. But, aside from the entertainment value, it points to a serious flaw in Shumlin's decision-making process. It seems obvious that Dr. Jay Batra was not a key player in the process. And that's just stupid and shameful.

If Batra had been fully involved, wouldn't Shumlin have wanted him on hand to share the spotlight and answer questions? Of course. The fact that he was absent suggests that his opinion was not valued.

A doctor friend of mine, who supported Shumlin in the 2010 Dem primary and in the general election and is now somewhat disillusioned, told me, “Shumlin doesn't think doctors and nurses have anything to contribute to this discussion.” A believable assertion, given how Jay Batra spent his Tuesday. And given the kinds of folks who did share the spotlight with the Gov:

The governor made the announcement at an unusually crowded press conference on the Fifth Floor, with several dozen advocates, lawmakers and hospital administrators in attendance 

Advocates, lawmakers, and administrators. I'm glad the advocates had a foot in the door. But no VSH doctors, nurses, or social workers?. Possibly an oversight by Vermont Digger, but I only know what I read.

Now, as for the merits of the Shumlin plan…

Community-based care is the preferred option for those who can benefit from it. But there is a tiny minority of people who need the best possible care. Replace mental illness with, say, asthma and see what you think: “Governor Shumlin calls for the replacement of Fletcher Allen's pulmonary department with community-based treatment facilities in different parts of the state.”

Or, let's say the good folks at Dartmouth decided that they don't really need the Norris Cotton Cancer Center anymore; they think they can deliver better care by splitting their resources among four widely-scattered clinics.

Stupid, no? If you're dealing with a severe, obscure, devastating illness, don't you seek out the greatest expertise? Go to the Mayo Clinic if you can? Well, the same applies to the most serious cases of mental illness. The Vermont State Hospital was sometimes depicted as a warehouse at best, and a Cuckoo's Nest house of horrors at worst. Maybe it was that way once upon a time, but not in recent years. And new and better facilities are clearly needed. But there's a tremendous amount of experience and expertise in the staff. Sending them here and there across the state will dilute the quality of care, not improve it.

In return for decentralizing hospital services, Shumlin dangles the carrot of an improved community-based system. As Floyd Nease of the Vermont Association for Mental Health and Addiction Recovery said, the plan has the potential to work if it is “executed well.” But look at Vermont's track record: has mental health ever gotten the resources it needs? This is a state that allowed its hospital to decay and decline to the point where the feds raised hell. Do you think the situation will improve now, given a struggling economy, the expenses of post-Irene recovery, and Shumlin's opposition to any tax increases? (And given another news story from Tuesday: the filing of a lawsuit over the state's huge backlog of uninvestigated cases of elder abuse?)

And above all, given Shumlin's emphasis that the new system will be “more affordable”? I think State Rep. Anne Donahue (corrected my mistake, sorry Morgan) hit the nail on the head:

“I think now we've shifted to expediency: What can we do with FEMA and insurance money instead of paying attention to what quality care means.”

Shumlin talked of a new system that would “deliver the best quality care of any state in the country.” Well, his system would certainly be different. Even before the closing of VSH, Vermont was near the bottom among the 50 states in mental health care hospital beds per capita. No state has developed an alternative to hospitalization for the most severely mentally ill. Somehow, I doubt that Shumlin and his “advocates, lawmakers and hospital administrators” have come up with a revolutionary new, better, cheaper system without consulting those with the most expertise and the greatest commitment to care: the mental health professionals.

Addendum to my previous post, entered as a separate post because (a) the original “Lismania” is plenty long enough already, and (b) I wanted to promote some good information out of the Comments, mainly from Doug Hoffer.

The more I look at the Campaign for Vermont website, the more it resembles a politician’s website. It’s billed as a public-spirited gathering of individuals from across the political spectrum, but Bruce Lisman’s name and face are ubiquitous. He’s on the home page in his hiker’s garb, and his smiling mug (w/oddly unfocused eyes) sits prominently in the right-hand side of every page, right next to the “Join The Campaign For Vermont” option.

The group’s “platform” is described as “a compilation of policy ideas from many Vermonters,” but it’s entitled “The Lisman Perspective.” (Which, btw, sounds like the most boring Robert Ludlum novel ever written.)

Then there’s the fact that Lisman is the only public face of the CFV. It’s supposed to be a broad-based gathering of selfless individuals — but Bruce Lisman is omnipresent in everything the group does, and his is the only voice you ever hear. I guess he’s sorta like the Borg Queen of Policy Ideas, subsuming everyone’s thoughts into his own. Either that, or he’s running for something.

This didn’t really strike me full-force until after I’d posted “Lismania.” Yeah, the Campaign for Vermont looks a whole lot like the precursor of a potential run for Governor in, say, 2014: a way of positioning a wealthy Wall Streeter* as a solid citizen with Vermont’s best interests at heart, rebranding conservative Republican ideas in a liberal state, and avoiding the fate of notorious political flameouts Rich Tarrant and Jack McMullen.

Finally, thanks to BP and Doug Hoffer for pointing out the solidly Republican nature of this “nonpartisan” initiative. Doug even did the spadework I didn’t bother to do:

A quick check found that together these individuals have contributed almost $250,000 to various political campaigns over the last 20 years (mostly the last ten). Of that, about 90% went to Republicans (state & federal). The largest recipients were the Vermont Republican Federal Elections Committee, Brian Dubie, and Jim Douglas.

If they contribute to the CFV as they have to Republican candidates and committees, then most of the money is coming from Messrs. Pizzagalli ($100k+ in political contributions), Lisman ($65k), and (Walt) Freed ($22k).

Bold prediction: the “Campaign for Vermont,” if it gains any traction, will morph into the “Campaign for Bruce” sometime in the near future.

*A wealthy Wall Streeter who has the cojones to assert, in The Lisman Perspective, “We also must diligently make sure that the principles of Main Street prevail over the excesses of Wall Street.” If he can say that with a straight face, my hat’s off to him.

Okay, so who is this Bruce Lisman who's suddenly unavoidable? He's all over the newspapers, and spending God knows how much money on advertising (though I do appreciate his support of my favorite local station, WDEV). He's touting the Campaign for Vermont, a new, nonpartisan Hands Across The Water nonprofit organization seeking A Better Future For Us All. 

I don't know Bruce Lisman from Adam. (Or Steve, for that matter.) But while I admire his dedication to pursuing a more prosperous and better-governed Vermont… and while there are certainly a lot worse things he could be doing with his bankroll (lookin' at you, Koch Bros)… I have to say that every time I read about him or hear him talk, I get the unmistakable whiff of farm-fresh fertilizer, if you know what I mean and I think you do. 

His goals are phrased in such a way as to be almost mom-and-apple-pie inarguable. “Campaign for Vermont” — who among us is against Vermont? His publicly visible supporters are hearteningly, Vermontingly, bipartisan. The Campaign homepage features a photo of Bruce on a mountain trail in full hiking gear, just like a real Vermonter. Other photos show a group of smiling multicultural children, a happy family, a construction worker, two people petting a horse, a child with a bushel of apples. Awwww. 

But the rhetoric, while artful, is full of dog whistles echoing conservative talking points. 

The language on health care is full of muted warnings about the possible impact of a single-payer system, the bete noire of conservatives. It posits the riskiness of single-payer in a series of hypothetical questions: What if it doesn't contain cost? What if it can't satisfy patients and providers? What if political pressure affects the quality or cost?

Boogeymen, one and all. “What if it's a disaster?” Well, what if it isn't? What if we cling to the current system, which is a proven disaster? CFV's vision of health care is all about the preservation of competition — because we can all see how well the free market has served us to date. You might as well tell us to stay in bed because there might be monsters in the closet, you never know. 

CFV's position on energy is heavy on conservative talking points with the overt conservatism stripped out. “Reliable, affordable, safe and clean” — words right out of the Vermont Yankee playbook, without actually mentioning nuclear power. CFV offers support for alternative energy, but also raises questions about reliability and cost, particularly when spending public funds on the effort. (Solyndra, anyone?) 

Its statement on education bristles with conservative attacks on the current system, couched in pleasantly neutral tones. It says the schools cost too much and aren't good enough. It appears to call, in polite language, for spending cuts, school choice, and disempowering the unions — more or less the John Kasich/Scott Walker agenda.  

The Campaign also wants to see a lot more transparency and accountability in government. Yes, that is a good thing. And Vermont institutions often fall short on these important goals. But when Lisman starts talking about measuring the outcomes of government programs, he is wrapping a nonpartisan cloak around the old conservative call for “running government like a business.” Well, Bruce, government isn't a business. And there are lots of government operations you can't evaluate on a spreadsheet or quarterly report. 

The CFV focuses its attention on the Agency for Human Services. It asks why we can't be told how many of “the most vulnerable” there are in Vermont, why they are “vulnerable,” (quotation marks are theirs) and whether AHS programs are achieving results. This isn't as bad as Newt Gingrich wanting to hire poor kids as part-time janitors, but it's the same tactic: go after the programs that help the poor. (They could have pointed to transportation spending, which is a merry-go-round of political influence and patronage. Road contractors are routinely among the most generous donors to local and state political campaigns.) 

And then there's Bruce Lisman himself. I don't doubt that he is firmly convinced of the purity of his purpose. And as I said earlier, there are a lot worse things he could be doing with his money. 

But is he the best messenger for this cause? I look at his resume, and I see a career spent on Wall Street, culminating with a top executive position at the late lamented Bear Stearns, victim of the 2008 Wall Street collapse. Profile pieces in the Vermont media paint him as a relatively good guy and basically absolve him of any of the nefarious dealings that almost brought down the global economy. But he was certainly in the power structure. And a top position at Bear Stearns doesn't exactly qualify him as a standard-bearer for transparency, social responsibility, good government, and a sound economy. 

And then there's his years of service on the UVM Board of Trustees, that paragon of openness, transparency, and quality. He's been off the Board for several years, so he can't be blamed for the Dan and Rachel Kahn-Fogel imbroglio or the liberal handouts of nondisclosure agreements, severance packages, and golden parachutes routinely used to sweep scandal under the Catamount-skin rug. But it is fair to say that he was part of UVM's power structure, and was in a position to change the culture. If he tried to change anything, he didn't exactly succeed. If he didn't try, then his credibility as the face of reform is severely impaired. 

But let's set aside the atmospherics of the message, and the questionable qualifications of the messenger. The sudden ubiquity of this Campaign makes me wonder: Who's really behind it? Where is all the money coming from? Why is CFV automatically given “centrist” credence and largely uncritical reportage? And, most importantly, where does it go from here? How will it seek to impact the political process? Is it a gathering of good and honest folk who simply want what's best for Vermont? Or is it a Trojan horse for a conservatism (and a Republican Party) that has fallen out of favor and out of power in our state? A new “rebranding” of policies that can't gain political traction in their present guise? And is Bruce Lisman selflessly promoting a better future, or is he the next Rich Tarrant, generously offering to share a rich man's wisdom and leadership with the unwashed?

I honestly don't know. And if anyone has a contrary view or a more informed opinion on Mr. Lisman, I'm happy to hear it. He and the CFV aim to be a significant political force in Vermont, and we should know who and what we're dealing with.

But I smell manure. 

First, let me make clear that I have absolutely no inside information on Shumlin Administration plans to rebuild or replace the state office complex in Waterbury. I only know what I read in the papers (or websites, ahem). But from what I’ve seen, there seems to be significant consideration of a partial move away from Waterbury. The leading candidate to receive some of the displaced appears to be Barre.

Well, it is if you believe Thom Lauzon, Barre’s Battlin’ Mayor. He’s all up in the pages of Seven Days, touting his plan for a new downtown office building and bragging of his “direct line to the governor and his deputies.”

That made me shiver a little bit, although it may simply be Lauzonian hyperbole. Just like his line about Barre being on a “bit of an upward trend.” I’ve been hearing lines like that for a decade or more, going back at least to the ill-fated opening of the Farmers Diner. And I’ve rooted for every tiny signal of a turnaround; I’d love to see a stronger, more vibrant Barre.

Plus, the move of a state agency to Barre would be a bit of payback for the routine (if unplanned) dumping of large numbers of parolees and former inmates on Barre. Lauzon’s been right to complain about that. But I have two big objections to Lauzon’s current dream: one is logistical, and one political. Please stay with me after the jump…  

Logistical: Barre is simply not that easy to get to. It’s “only a 15-minute drive” from Montpelier, but that’s a 15-minute drive along the slow and crowded Barre-Montpelier Road. And then a stately crawl into downtown Barre on its jampacked Main Street. (Which would be exacerbated by a few hundred more state commuters.) But sure, 15 minutes isn’t that bad — if you’re starting from Montpelier. But how many of Waterbury’s state workers live in the Burlington area? For them, a relatively painless commute to Waterbury would become an onerous 75-to-90-minute one-way trip.

(By the way, did Barre not get screwed in a tremendous way when I-89 was built? It glides practically to the front door of the Statehouse in Montpelier, but it bypasses Barre by several miles. Exits 6 and 7 are only somewhat helpful. Considering all the granite traffic there used to be when they were laying out the freeway, and the fact that Barre was a much larger and livelier town than Montpelier at the time, why didn’t I-89 go closer to Barre? It’s been a significant drag on the city’s economy ever since.)

And in terms of the daily business of governing, Barre is awfully distant. In politics, proximity equals power, and if I headed a state agency, I’d fight tooth-and-nails against a move to Barre. The Seven Days article posits the Agency of Natural Resources as a candidate for relocation; if so, what would that mean for its ability to influence the course of environmental policy?

Political: While I’d love to help Barre, the fact is that it has a Republican Mayor who’s openly salivating at the prospect of running for statewide office. Peter Shumlin has already given a big leg up to Phil Scott and Neale Lunderville by giving them significant responsibility and touting their leadership skills. He really doesn’t need to do the Vermont GOP any more favors by elevating another potential Republican candidate.

To the good people of Barre, that’s harsh. I would like to see Barre get a fairer shake. But this is a case where politics trumps policy. And I don’t want to lend any more credibility (or any more “bipartisan” cred) to another potential Republican candidate for higher office. Shumlin’s already done enough of that.  

I’m sure there’s a lot of opposition in these parts to the Lowell Mountain wind farm. Sorry to say, I’m not convinced. We need to develop new sources of energy. Wind power is one of the least environmentally harmful sources, and goodness knows we’ve got plenty of wind here. And the anti-wind farm arguments strike me as melodramatic and redolent of NIMBYism.

Let’s take the characterization of the project as “the rape of Lowell Mountain.” First of all, that phrase has to be a little offensive to sexual assault survivors and their advocates. Second, we’re not talking about untouched wilderness here; a century ago, most of Vermont had been clearcut for farming and timber harvest. What is now “pristine” forest was a barren wasteland. Somehow it recovered from that; I think it can withstand the installation of some wind turbines.

Now, compare the effects of a wind farm to other kinds of energy production: deep-water drilling, widespread hydrofracking, mountaintop removal in coal country, the hazards of supertanker transport, the Alberta tar sands.

We’ve used up most of the easily extracted energy sources. Whether or not you believe in the “peak oil” theory, the remaining sources will be more difficult, costly and dangerous. Wind energy is relatively benign, especially compared to the alternatives.

Opponents have argued that we don’t need to produce more energy, we need to consume less. I agree that we need a lot more conservation. But that alone is not the answer; we will continue to need quite a bit of power, and we will need to replace hydrocarbons whenever possible with renewable energy sources.

We Vermonters have a responsibility to produce at least as much energy as we consume. Preferably more, if we have energy sources that can be used with relatively low environmental impact.  If we fail to do that, then we are preserving our environment on the backs of others — the Midwesterners who can set their tap water on fire, the fishermen of the Gulf Coast, the poor and working-class people who live downwind from refineries and power plants.

Now, if there are specific reasons that Lowell Mountain is a bad idea, I’m willing to listen. But you should be ready to propose alternatives. Are you saying there are better places for wind turbines? Fine, then build ’em there and leave Lowell Mountain alone. Are you saying that Vermont shouldn’t develop wind power at all? I have a much harder time with that.  

Oh, here they go again with an oft-used argument against liberal policies they don’t like: said policies create “uncertainty” that stifles business growth and entrepreneurship. Now appearing on Vermont Digger, a tale of woe entitled “New federal, state rules for health care rattle business,” about a Wednesday briefing for business leaders about the impact of health care reform.

At the federal and state level, businesses have lobbied to ensure new health care laws don’t force them to bear more than their fair share of the burden for expanded insurance coverage to more Americans.

But as new federal rules are implemented for the Affordable Care Act, and the state embarks on plans for a single-payer health care system that would provide universal coverage for all Vermonters, businesses worry about restrictions that could drive up their costs for medical benefits for workers.

Businesses, don’t ya know, are precious little blossoms that must be protected from the vagaries of the real world. (Especially if they are forced to pay “more than their fair share,” which presumably means not a dime more than they’re paying now, and preferably less.)

Now, this isn’t as heinous as the use of “uncertainty” in last year’s battle over the Bush tax cuts: Republicans argued, with a straight face, that our most affluent citizens would be paralyzed by the “uncertainty” over whether their income above $250,000 would be taxed at 36% or 39%. This latest whine isn’t up to that standard, but it’s still damn annoying. Viz:

Several prominent business people who attended were apprehensive about the changes. George Malek, executive vice president of the Central Vermont Chamber of Commerce, said companies would like to be able to reasonably predict what their costs will be for the next five years. Uncertainty about health care expenditures make that impossible, he said.

I feel ya, George. I’d like that kind of certainty myself. I’d love to know what the price of gas will be next year, let alone five years from now. Hell, I’d love to know the price of propane next month so I know whether to fill my tanks now or wait. Yeah, I’d love to know how much the cost of my health insurance will be in five years, and how high the deductibles will be.

For that matter, I’d love to know if I or my wife will be downsized in the next five years. Or whether I can continue to count on Medicare and Social Security, or if I have to ponder emigration to Canada.

In other words, good businessfolk, suck it up. It’s a big, bad, uncertain world out there. You can’t predict anything with certainty. Health care reform is a relatively small item compared to, say, oil shocks or real estate bubbles or stock market collapses.

Embrace the uncertainty! Step out boldly into the void! Hey, you might just find that health care reform will actually enhance your certainty. You’ll be less vulnerable to the current health-care marketplace. You won’t have to worry about employee turnover when you have to cancel or reduce health insurance due to cost.

Addendum. One more question for George: Are you actually arguing that the potential “uncertainty” of health care reform is worse than the unfortunate certainties of the current system? Exponential rate hikes, canceled coverages, crappier and crappier policy offerings every year? If that’s the prize package in Monty Hall’s hand, I think I’d gladly go for Door Number Three.

It’s been a while since I heard the bellicose rantings of Tom Tancredo, but the Republican presidential candidates continue to bang the drum of illegal immigration. Alleged moderate Mitt Romney wants a nearly 2,000-mile-long fence along the entirety of the US-Mexico border. Michelle Bachmann wants a double fence. Herman Cain called for an electrified fence. They all want more resources, more personnel, and more technology to keep the legions of brown people from inundating our fair land.

Well, wait. Here’s The Economist, not noted as a fount of radical socialist leftist dogma, with a little article they call “Crying Wolf: The Republicans are Fretting About a Disappearing Problem.”  

At a “processing centre” in El Paso, …there is precious little processing going on. Of the 20-odd workstations, only two are manned. The Border Patrol agents sitting at them chat idly to themselves. Just two detainees, their paperwork complete, sit timidly in the corner of an enormous holding cell.  …Asked whether anything is going on, an agent replies, “it’s really quiet today.”

It’s quiet most days in the El Paso sector, as the Border Patrol dubs this 268-mile slice of the border. Back in 1993, agents arrested 285,781 people trying to enter America illegally. In 2010, however, agents picked up only 12,251 illegal immigrants in the area-a 96% decline. Much the same is true of the border as a whole: last year’s tally, of 447,731 arrests, is barely a quarter that of the peak year, 2000, when 1,643,679 people were intercepted. This year’s figure will be under 350,000; a fifth of the peak.

Aha, you may be saying, must be that damn Obama opening the border to his Mexican/Muslim/Kenyan brothers! Gotta get that guy out of the White House, and get us a leader, not a reader!

Sorry, no. “The drop in arrests reflects not laxer enforcement, but stronger,” says The Economist. There are five times as many Border Patrol agents on the Mexican border as there were in 1993. They are better equipped. Their numbers are augmented by reconnaissance drones and three different kinds of sensors. And there may not be a fence along the entire length of the border, but…

A third of the border is fenced, and most of the rest is in areas so remote or rugged as to make fences pointless or impractical. Some parts of the fence are 17 feet high, with metal plates extending ten feet below ground to prevent tunnelling.

All that effort, over two decades, by Administrations from both parties, has paid off. There is no border crisis. One Border Patrol agent told the magazine that they would never be able to catch every suspect — but they are not very far off.

How about that. An issue that makes Republicans foam at the mouth is really not an issue at all. (Kinda like Iraqi WMD’s, no?) The border is about as secure as it can possibly be. And, as The Economist notes, that notorious softy Obama continues to pump more resources into border protection, even as he accedes to spending cuts in many other areas.

Funny. Why do I have to read about this in a British publication? Why don’t the American media point out — at least once in a while — that the Republicans’ immigrant-bashing and fearmongering has no basis whatsoever in reality?  

Detroit Free Press, November 27, 2011:

After closing psychiatric hospitals, Michigan incarcerates mentally ill



Wayne County Sheriff Benny Napoleon spoke for most sheriffs when he said, during a community meeting earlier this year, that his jail had become his county’s largest mental health care institution.

Over the last two decades, changes in state policy and big cuts in funding for community mental health care have pushed hundreds of thousands of mentally ill people into county jails and state prisons.

Between 1987 and 2003, Michigan closed three-quarters of its 16 state psychiatric hospitals… The state now provides the sixth-lowest number of psychiatric beds per capita in the nation, reports the Treatment Advocacy Center.

The original intent was to replace the lost hospital capacity with improved, community-based mental health care systems. But the promised support for those systems never came. Instead, they’ve received dramatic cutbacks in state funding. The result?

A University of Michigan study last year found that more than 20% of the state’s prisoners had severe mental disabilities — and far more were mentally ill. The same study found that 65% of prisoners with severe mental disabilities had received no treatment in the previous 12 months.

The problem is even worse in county jails, where psychiatric treatment is virtually nonexistent. In 1999, a Department of Community Health study of jails in Wayne, Kent and Clinton Counties found that more than half their populations were mentally ill… If anything, the crisis has worsened since then.

Vermont may be headed down this same path. Governor Shumlin wants to abandon the flooded Vermont State Hospital and replace it (most likely) with a smaller inpatient facility, plus improved community-based mental health services.

Remember that Treatment Advocacy Center ranking? The one that put Michigan sixth-lowest in the nation in psychiatric beds per capita? Coming in just below Michigan, at number five, was Vermont. And that report was written before the closing of the Vermont State Hospital.

There are some in the mental health advocacy community — and in the GMD community — who don’t want a new state hospital. They’d prefer a stronger community-based system. I agree that we need more and better community options. But we still need a state hospital of some kind. Two points:

Promises of improved community-based services are easily made and rarely kept. The Free Press story highlights this concern. You might argue that Vermont won’t make the same mistakes as Michigan. But look at a bit of history: the state hospital closures began under a good Democratic Governor, James Blanchard. But he was followed by a Republican, John Engler, who was firmly dedicated to cutting taxes and spending. You may trust Shumlin to promote a strong community-based system, but would you feel the same way about a future Governor Dubie or Lunderville or Lauzon?

And on this particular issue, I don’t trust the current Administration. Shumlin may have good intentions, but even before Irene, state government was facing some very tough times. Now, state officials are frequently invoking the specter of Irene as a harbinger of even more belt-tightening. I doubt that spending on any program will be increasing much; and mental health is usually at the top of the list for cutbacks.

Community services, no matter how good, cannot completely take the place of psychiatric hospitalization. The vast majority of cases can be — and should be — handled in the community. But there are a small number of people for whom hospitalization is the best option. Or the least bad option, anyway.  

We’re talking about a tiny percentage of people here. Before Irene, VSH had 50 beds. That’s .0008% of Vermont’s population, or roughly 1 in every 11,000 Vermonters. The absence of VSH is already putting a huge strain on the entire mental health care system. Its capacity was barely adequate to begin with, and is inadequate now. The result is poorer care, not only for those who would have been hospitalized, but for those displaced from care by the post-VSH domino effect.  

There are many stories about the horrors of state hospitals. Some are true. Some are true, but are old news; state hospitals are much better places than they used to be. And some are not entirely accurate: hospitalization comes at the lowest point of someone’s life, and is one of the worst events of his or her life. Please don’t misunderstand me; I’m not saying that they’re making it up. I am saying that for all of us, our perceptions and memories are affected by our state of mind at the time.

And if the Michigan experience is at all predictive for Vermont, the most likely alternative to a state hospital isn’t a rugged, well-funded community mental health system. It’s warehousing of the mentally ill in jails and prisons. That would be worse than hospitalization.  

( – promoted by Sue Prent)

(Pardon the lack of direct Vermont content here. But this drove me up a wall, and the best way to climb down is to write about it. Otherwise, I’ll grind my teeth to a fine powder while I sleep tonight.)

David Brooks, putative moderate conservative and Junior Wise Man of the New York Times op-ed pages, comes in for a lot of scorn on the left. I don’t always share that view; I often enjoy his weekly appearances with E.J. Dionne on NPR. They frequently manage to transcend the usual he-said/he-said of “balanced” punditry, and actually present some original thought.

However, this weekend Brooks said something I just couldn’t let pass.

He was on “Meet the Press” with Dionne, commenting on the week’s news. And, of course, the Penn State scandal came up. One key point of the scandal is that, in 2002, a graduate assistant at Penn State witnessed former assistant coach Jerry Sandusky committing a sex act on a young boy in the football program’s showers. Somehow, this didn’t result in Sandusky’s arrest — or even banishment from the premises. He continued to be closely associated with Penn State football for nine years.

Okay, back to Brooks. In his appearance on “Meet the Press,” he invoked one of the tiredest tropes of modern conservatism — that America’s moral and ethical decay is a product of the Sixties, when those dirty hippies undermined traditional values.*

We have lost our clear sense of what evil is, what sin is. And so when people see things like that, they don’t have categories to put it into. They vaguely know it’s wrong, but they’ve been raised in a morality that says, “If it feels all right for you, it’s probably okay.”  …  If you’re alert to the sense of what evil is, what the evil is within yourself, and what evil is in society, you have a script to follow. It’s not a vague sense, you have a script to follow.

See, we used to know what sin was. We used to have “scripts” that told us right from wrong.  But then the Sixties happened, and all that was good about America was irrevocably tarnished. Ever since, we have been “raised in a morality that says ‘If it feels all right for you, it’s probably okay.'” Which is a really clumsy rephrasing of the Sixties’ “If it feels good, do it.” Damn hippies! If it wasn’t for them, that graduate assistant would have had an infallible moral compass that would have automatically informed him that, yes, child rape is wrong.  

Here’s the thing, Bobo. You’ve got it exactly backwards. It’s the guys with the scripts who have been diddling America’s children. It’s the Catholic priests and bishops, who lead the world in peddling prefab moral scripts. It’s the most tradition-bound of football programs, Penn State, led by the famously old-school Joe Paterno.

“Scripts” do not, in fact, ensure standards of morality. Rather, they breed inertia and self-satisfaction. If you have a script and rely on it, you’re likely to see the world through the prism of that script (pardon mixed metaphor). And you’re more likely to reject new, incongruent information — e.g. that one of your script’s authority figures is raping a child in the shower.

The hippies didn’t make Jerry Sandusky into a pedophile, and they didn’t make the good men of Penn State Football into enablers of pedophilia. But David Brooks would rather blame the Sixties than face up to an unnerving reality: that our society’s heroes and leaders are as fallible as any of us. And perhaps even more so.

*Actually, our moral and ethical decay is the product, not of the Sixties, but of American capitalism co-opting and corrupting the values of the Sixties: “Do your own thing” transmuted into a consumerist call to unabashed self-interest. But that’s another story.

( – promoted by odum)

I don’t want to jump to conclusions… but I have to say that Peter Shumlin’s 11/8 speech at UVM gave me a case of the willies. It may have been well-intentioned; it may lead to new initiatives in higher education and better uses of public resources. But I found it disturbing in a couple of significant ways.  

He sounded like a Republican. State funding must be “focused in ways that have the maximum return on investment” and “advance Vermonters’ job opportunities.” There needs to be a greater focus on “the sciences, engineering, technology and mathematics,” and UVM must “support and expand partnerships in the state’s business sector and economy.”

That’s straight out of the Republican approach: Educators must get their heads out of the clouds and serve the needs of business. And, as I recently opined in this space, when Democrats adopt Republican talking points, they validate the conservative worldview.  

I could easily hear Shumlin’s speech being given by Jim Douglas. And if it had been given by Douglas, then Dems, Progs, faculty, students, and unions would be screaming bloody murder.

Watch out when politicians elbow their way into academia. Shumlin may have the best of intentions. He may have some good ideas. But do we really want “to maximize the relationship between the University and the state”?  

Let’s assume, for the sake of argument, that Shumlin could have a beneficial impact on UVM. Do you really want to set a precedent for heavy state involvement at the University? Do you want UVM making decisions based on the economic priorities of the state? Of its business community? Will you feel comfortable if the same influence were wielded by a future Governor Dubie or Governor Lunderville?

That said, I must acknowledge that UVM left itself wide open for this. Shumlin’s speech included an oblique but obvious reference to the Dan Fogel kerfuffle: “my concerns about some of the spending priorities,” “recent controversies.”

UVM often exhibits an unwarranted quantity of self-satisfaction. They think they’re better than they really are. This results in inertia-based decision-making and a tendency to ignore problems. (Or sign those involved to generous nondisclosure agreements.)

For example, the Fogel/Kahn-Fogel situation. To me, the real issue wasn’t Dan Fogel’s golden parachute; it was the fact that the situation was allowed to fester for years. And it wasn’t Rachel Kahn-Fogel running loose; it was, as UVM’s review found, “that staffing decisions in the development office were made based on the Fogels’ preferences… with certain individuals rather than their qualifications.” The Fogels.

UVM shot itself in the foot, big time. Thanks to its diminished reputation and the relative disempowerment of its interim President, it left the door open for a power grab from the corner office. And now it has one.