More than a year has passed since the federal government decertified Maine’s biggest state hospital for people with mental illness, and the Riverview Psychiatric Center is still failing to meet minimum quality standards for the approximately 70 residents in its care.
This is more than just an embarrassment for state officials – it’s also a failure to deliver a core government service. Federal certification comes with $20 million in Medicaid and Medicare money that is not going into state coffers.
But even worse, this mismanagement represents a broken promise to some of the state’s most vulnerable residents and their families, who were told that Maine would never go back to the ugly history of the Augusta Mental Health Institute, which was closed in 2004 after decades of patient abuse and neglect.
This is a time when the state needs leaders to stand up, take responsibility for the mess and make sure it gets resolved. Instead, the people ultimately responsible for Riverview – Gov. Le- Page and Health and Human Services Commissioner Mary Mayhew – are choosing to deflect blame and minimize the problem.
The governor argues that failure to meet minimum licensing standards at Riverview is the U.S. government’s fault. He recently told Maine Public Broadcasting that restrictive federal standards were not suited to conditions in Maine and caused more harm than good. “You know, frankly, I think we ought to just go at it alone and not take the federal money,” he said.
If this is the direction the governor thinks that Maine should be heading, he should also explain how the state will manage to run a $30 million-a-year hospital without $20 million in federal funds. Either taxpayers would have to pay the whole cost, or the state would have to cut by two-thirds the services for the Maine people most severely affected by mental illness. The governor makes it sound as if these are some esoteric standards that the federal government set too high for Mainers to reach, but they are basic, minimum standards that every other hospital in the state routinely fulfills.
Riverview was penalized for failing to document what kind of treatment patients were actually receiving. Superintendent Jay Harper described the treatment plan as “a contract between us and the federal government that we’re going to deliver X-Y-Z to patient 42.”
If the hospital cannot supply that documentation, that means that the federal government doesn’t know whether that treatment was ever delivered or if it was effective. Harper acknowledged to the Maine Sunday Telegram that this was not nitpicking by the federal inspectors.
“Their objection was reasonable,” he said. “Basically, we didn’t do a good job of that.”
Harper’s candor was refreshing, but the same cannot be said for the reaction from his boss, Commissioner Mayhew.
She defended the hospital’s performance on the inspection, saying that it failed in only one area, after being out of compliance in eight areas last year.
“I am extremely pleased that we were in compliance with many areas of focus related to patient safety, quality and patient rights,” she said.
She’s right that it’s good that the hospital is not failing in those key areas, but it is still failing – and that’s nothing to brag about.
If the hospital staff can make the necessary changes and pass this basic test, it would still be struggling with serious problems within in the state’s mental health system, including its interface with the criminal justice system and the treatment of adults who are not eligible for Medicaid. How can the state tackle those difficult problems when it is struggling with easy ones like this?
The state has an obligation to treat people with mental illness. It’s time for someone in charge to take responsibility for this management failure and get this facility working.