A new, separate treatment facility for mentally ill patients who have committed crimes might be the best way to care for those patients, and the only way to restore federal funding for the troubled Riverview Psychiatric Center.

Privatizing the facility may even be the best way to run it.

But far more details on the plan are needed from the LePage administration, which has yet to show that a privately operated facility will be held to the clear standards of care and high level of accountability that are necessary.

In fact, so far, the administration has yet to say much of anything.

The proposal first surfaced in early May, when Gov. LePage included in a revised budget proposal $6 million for “secure residential treatment facilities,” run by a private contractor, to house 14 forensic patients, specifically those who have been found not criminally responsible because of mental illness.

Later that month, the governor submitted a bill calling for the creation of a 50-bed unit to house and provide treatment for those patients as well as those found incompetent to stand trial. The facility also would provide court-ordered mental health evaluations.

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Both proposals were short on specifics, a concern when considering the problems with cost- and corner-cutting that often occur during privatization.

The bill, which came in the busy final days of the legislative session, included not much more than the measure’s cost – over $1.5 million for one month, or $18.5 million a year – and a rehash of the problems facing Riverview. It was killed by lawmakers.

Last week, Mary Mayhew, commissioner of the Department of Health and Human Services, which oversees Riverview, said that the plan for a separate facility remains on the table.

According to Mayhew, the proposal may be the only solution to the problems at Riverview, which two years ago lost its federal accreditation – and the $20 million in annual funding that comes with it – largely because of its improper and dangerous handling of forensic patients.

She is likely right. The state has thus far been unable to satisfy the federal agency that hands out the accreditation, and probably cannot without removing the forensic patients from Riverview.

That would not only make life more safe and productive for the other patients and the staff at Riverview, it also would free up beds at the hospital, which has been operating at below capacity because of efforts to keep forensic patients segregated within the facility.

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The bed shortage has created a backlog of patients needing care. Without access to inpatient mental health services, the patients end up in emergency rooms and even jail, at a much greater cost, and with little chance of improvement.

A separate facility for forensic patients could remedy that situation and more effectively care for the hard-to-treat forensic patients.

And it doesn’t necessarily matter who runs it.

What does matter is that it be clear what state and federal agencies are providing licensing, certification and oversight, and how patients are to be managed and treated.

Until those details emerge, to be vetted by legislators and the media, it’s impossible to tell whether the LePage administration is on the right track.


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