Staffing and overtime problems at the Riverview Psychiatric Center took center stage Tuesday during a legislative hearing that painted a dire picture of working conditions at the state hospital.

Riverview Superintendent Jay Harper told members of the Legislature’s Health and Human Services Committee that overtime has at least tripled so far this year compared with 2014 just to cover minimum staffing needs.

The LePage administration is asking for an increase of $3.3 million to the hospital’s $33 million budget, primarily to pay for additional hires.

“I wish I had a better story for you,” Harper said.

But a union president said even more must be done to improve front-line workers’ working conditions, including hiring temporary workers to ease immediate staffing shortages.

Laura Fisher, president of AFSCME Local 1814, which represents mental health workers, agreed that working conditions are difficult.. She told a Press Herald reporter Tuesday that many workers are going on extended medical leave after routinely working 16-hour days.

“People are getting so exhausted that they’re getting doctor’s notes, and they can’t take it anymore,” Fisher said. She said overtime has ballooned to 800 hours per week in recent weeks, with many employees forced to work 25-30 hours or more of overtime per week.

Harper acknowledged that mandatory overtime has increased to nearly 600 hours per week in 2015, compared with 100-200 hours per week through most of 2014.

“The mandatory overtime is out of control,” Harper told lawmakers “We’re hurting the heart of Riverview right now.”

STEPS TAKEN, BUT ISSUES PERSIST

Harper said Riverview is temporarily not accepting new patients and is fast-tracking some patient discharges. But the 92-bed hospital is still operating with 88 patients, a heavy load, he said. The hospital cares for people who are found not responsible for their crimes because of mental illness, and people with severe mental illness who are civilly committed.

Harper said he’s working on reforms that will help alleviate staffing shortages, including hiring 18 “acuity specialists” – a new job classification for specialists who help defuse situations between patients and staff members.

The hospital lost its federal accreditation in September 2013 after an inspection revealed officers had used stun guns and handcuffs on patients, among other problems. A Portland Press Herald article in 2014 highlighted a case of abuse against a patient that Riverview tried to cover up. Harper was hired in 2014 to institute reforms.

Harper said it will be about 90 days before workers start noticing substantial improvements. Stopgap plans, such as hiring temporary workers, would be counterproductive because those workers would likely leave because of the difficult conditions, he said.

But Fisher disputed Harper’s time frame. Fisher said that even though mental health workers – front-line workers who care for the mentally ill – are paid about $12 per hour for difficult jobs, many could be hired quickly if Harper would post the jobs.

“We can’t get him to post the positions,” Fisher said. “We have a stack of applications.”

Fisher said mandatory overtime has been a problem for years, along with workers going on medical leave because working conditions are making them ill. Also, some employees who have been assaulted by mental health patients end up on disability.

conflict over scheduling

Nearly 40 mental health workers, about a third of the staff, are now on disability, on leave or have doctors’ notes excusing them from work, she said. About 115 of the hospital’s 375 employees are mental health workers.

Fisher said hiring staff will help, but the hospital needs more mental health workers than the 2016-17 budget will cover. Fisher said an additional 15 workers would help ease the temporary staffing shortages.

Harper blamed a rigid scheduling system and union rules as barriers to hiring and keeping new employees from quitting. But Fisher disputed Harper’s characterization of work rules, and said the union wants new workers to stay on the job. She said she is willing to work with Harper on scheduling issues so existing staff can be used more efficiently, which could help cut down on mandatory overtime.

The loss of federal certification as a mental hospital in September 2013 means Riverview no longer qualifies for about $20 million in federal funding per year, according to high-ranking federal officials with the U.S. Centers for Medicare and Medicaid Services.

Maine officials have said the state has continued to receive the funding since then, but federal Medicare officials have said repeatedly that the state will have to repay that money unless it can convince a court that Riverview should never have lost its certification in the first place.

All the state’s appeals of the hospital’s decertification have been denied so far, and there is no timetable for Riverview to be re-certified. More appeals are pending.

Committee members asked numerous questions and thanked Harper for being frank about the center’s problems.

“Every time I walk out of here I get more worried than ever before,” said Rep. Drew Gattine, D-Westbrook, the committee’s House chair.

Harper said the problems facing the hospital are complex. “I wish I had an easy solution.”

Joe Lawlor can be contacted at 791-6376 or at:

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