August 17, 2013

Maine psychiatric facility could lose $20 million

A federal agency says Riverview Psychiatric Center is not complying with guidelines.

By Steve Mistler smistler@pressherald.com
State House Bureau

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click image to enlarge

This aerial photo taken on Tuesday April 30, 2013 shows The Riverview Psychiatric Center on banks of Kennbec River in Augusta. The Riverview Psychiatric Center in Augusta is in danger of losing about $20 million in federal funding because the facility is out of compliance with federal guidelines.

Joe Phelan / Staff Photographer

click image to enlarge

The Riverview Psychiatric Center is located on the east side of Augusta.

Joe Phelan / Staff Photographer

Related Documents

PDF: Termination notice from the Centers for Medicare & Medicaid Services
The Aug. 14 notice from the Centers for Medicare & Medicaid Services notifying the Riverview Psychiatric Center that the facility remains out of compliance with federal mandates and that federal funding could be terminated by Sept. 2.
Read the memo requesting the carry-over of legislation
This is the June 25 email from Nick Adolphsen, legislative liaison for DHHS Commissioner Mary Mayhew, asking the Legislature’s budget-writing committee to hold over L.D. 1515 until next session. The bill would have created additional beds at the Maine State Prison in Warren to accommodate a backlog of forensic patients at Riverview Psychiatric Center in Augusta.

Despite the federal notice and the blame exchange between LePage and lawmakers, Mary Louise McEwen, the superintendent at Riverview, told the Press Herald on Friday that she's confident that a correction plan negotiated with federal authorities will pre-empt the loss of federal dollars. That plan, McEwen said, has been in the works since the first audit, although the federal government has twice rejected the facility's mitigation strategy.

According to McEwen, the audit was prompted by a March 16 assault at Riverview in which 47-year-old Mark Murphy, a patient, allegedly attacked a 26-year-old mental health worker, punching her, striking her with his hands and stabbing her with a pen before another patient intervened.

The attack highlighted growing concerns by law enforcement and mental health advocates that Riverview is struggling to handle a sharp uptick in mental health patients channeled through the corrections system.

In May, a review of data by the Kennebec Journal showed there were 37 injuries at Riverview in 2012, the most since 2009, when there were 53. According to the report, the data didn't tell the whole story. Employees at the hospital and the unions representing them cited increasingly brutal attacks.

Many of the patients at Riverview first arrive at county jails, which have been reporting an increase in forensic patients for several years, according to Col. Mark Westrum, administrator of the Two Bridges Regional Jail in Wiscasset.

Westrum attributed the increase to changes in policies dealing with the mentally ill and the loss of funding for support services.

"A lot of these people have ended up out on the street," he said. "Whether it's from a lack of housing or treatment, they've ended up in the county jails."

The inmates posing risks to themselves or others are then pushed to Riverview for evaluations. That's where the bottleneck is, Westrum said.

The psychiatric center is the state's only hospital for forensic patients -- people committed to state custody after being found not criminally responsible for criminal offenses.

According to state officials, the number of forensic patients at Riverview has increased dramatically. McEwen said Friday that there are 44 beds dedicated to forensic patients. She said there is an average daily waiting list of five to seven people coming from county jails and nearly a dozen from court-appointed evaluations, which are the hospital's top priority.

The hospital has about 300 employees to manage and treat an average population of 83 patients, McEwen said.

McEwen said Friday that the passage of L.D. 1515 may not have prevented the federal notice of violation, but it may have helped negotiations with authorities of a mitigation plan. Asked if she informed lawmakers that the proposal may have assisted in those efforts, McEwen said that advocacy for the bill was handled by DHHS officials.

"Commissioner Mayhew has been very supportive of the bill," McEwen said.

However, it's unclear why officials at DHHS asked lawmakers to hold the bill until next session. According to a June 25 email from Nick Adolphsen, Mayhew's legislative liaison, to the budget-writing committee, the department believed L.D. 1515 was "an essential reform for both Riverview" and the Corrections Department. However, Adolphsen continued, "we understand the limited availability of funding."

Adolphsen's email was sent well after lawmakers had negotiated a deal on the state budget. The Legislature overrode LePage's veto of the budget on June 26. The bill was carried over July 10.

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