by Dave Soulia, for FYIVT.com

Vermont lawmakers have advanced S.193, a bill that would establish a secure forensic facility for individuals caught at the intersection of the criminal justice and mental health systems—a population that has increasingly strained courts, hospitals, and correctional facilities.

The legislation marks a significant structural shift in how the state handles people who are not competent to stand trial but do not meet the criteria for hospitalization and are not appropriate for jail. Under S.193, the Department of Corrections (DOC) would be responsible for operating a locked forensic facility, while the Department of Mental Health (DMH) would oversee clinical care within that setting.

A System Gap Comes to a Head

The issue has been building for years. Vermont’s long-term move away from large state-run psychiatric institutions toward community-based care left a gap for individuals involved in the criminal justice system who fall outside traditional treatment or custody categories.

By 2023, lawmakers began addressing the problem incrementally. Act 27 authorized a small forensic unit concept—roughly nine beds—at the Vermont Psychiatric Care Hospital (VPCH) in Berlin. Act 28 created a multi-agency working group to study competency restoration and system design, but the group did not reach full consensus on a statewide approach.

In 2024, Act 137 refined legal processes such as civil commitment but stopped short of creating a dedicated forensic facility.

Meanwhile, system pressure intensified. Emergency departments reported ongoing “boarding” of psychiatric patients—often 15 to 25 individuals statewide at any given time—while courts faced delays and the Department of Corrections continued housing individuals who, by policy standards, did not belong in jail but had nowhere else to go.

What began as a policy discussion evolved into what lawmakers increasingly described as a system failure.

What S.193 Does

S.193 attempts to resolve that gap by mandating the creation of a secure forensic facility and defining who must be placed there.

Under the bill, individuals charged with serious offenses and found not competent to stand trial would be transferred to the facility if they do not qualify for hospitalization. The facility would provide competency restoration services—such as medication, education, and behavioral supports—under a plan approved by a clinical services director.

Patients would remain in the facility until they are restored to competency or their criminal case is resolved. The bill also allows courts to authorize involuntary medication under specific conditions, including a finding that it is clinically appropriate and likely to restore competency.

The legislation also addresses case backlogs by requiring dismissal of certain misdemeanor charges if a defendant remains incompetent and the case is inactive for a period equal to the maximum possible sentence, unless the court determines dismissal would be contrary to the interests of justice.

In addition, individuals found not guilty by reason of insanity for serious offenses would be committed to the forensic facility for an indeterminate period, with periodic court review and conditional release options based on risk assessments.

A Shift in Control

Perhaps the most consequential aspect of S.193 is where it places operational authority.

Earlier proposals centered on a treatment-driven model, with DMH leading efforts through hospital-based or therapeutic settings. S.193 instead places primary control with the Department of Corrections, with mental health services layered into a secure custody environment.

The bill explicitly defines the facility as a “locked” setting operated by DOC for the “custody, control, correctional treatment, and rehabilitation” of individuals transferred under the statute. At the same time, it requires a clinical services director and mandates that care be trauma-informed and consistent with professional standards.

That hybrid structure reflects an unresolved tension that has run through years of policy debate: whether this population should be treated primarily as patients or as individuals requiring secure custody.

S.193 effectively resolves that question—at least operationally—in favor of a security-first model with clinical oversight.

Capacity and Cost Questions

The bill does not specify final facility capacity, leaving open questions about whether the system will scale to meet statewide demand. The original nine-bed concept tied to VPCH was driven largely by available space and federal regulatory considerations, not a comprehensive needs assessment.

Fiscal impacts are also uncertain. While the facility could reduce pressure on hospitals and emergency departments, it shifts costs onto the state for construction, staffing, and ongoing operations. Public data demonstrating net savings has not been clearly established.

Multi-Agency Complexity

Even with a defined facility, Vermont’s forensic system will remain spread across multiple agencies. DOC will operate the facility, DMH will oversee clinical care, the Judiciary will retain legal authority over commitments and releases, and the Department of Disabilities, Aging, and Independent Living (DAIL) will continue to manage related populations.

That structure raises ongoing questions about coordination, accountability, and oversight—particularly as cases move between custody, treatment, and community settings.

Implementation Will Determine Outcome

S.193 represents the culmination of several years of incremental legislative steps. Acts 27, 28, and 137 laid the groundwork; S.193 attempts to build a functioning system on top of it.

Whether it succeeds will depend less on statutory language than on execution—facility design, staffing, interagency coordination, and the ability to manage costs while maintaining both public safety and clinical standards.

The bill’s effective dates are staggered, with key provisions taking effect beginning in 2026 and full implementation extending into later years, reflecting the scale of the undertaking.

In practical terms, Vermont is moving from a fragmented, ad hoc approach to a defined—if still evolving—model. The question now is whether that model can hold under real-world pressure.