October 4, 2013

Feds terminate funding for Maine's psychiatric hospital

The state will appeal the decision, which comes after ongoing staffing and governance problems, which first arose in March.

By Steve Mistler smistler@pressherald.com
State House Bureau

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The state’s Riverview Psychiatric Center faces the loss of an estimated $20 million in federal funding because the federal government has decided that the hospital in Augusta has not solved staffing and governance problems.

Staff photo by Joe Phelan

Related Documents

CMS letter regarding RPC termination

Safety issues in the Lower Saco Unit were not cited in the termination report, but staffing issues caused by the decertification of the unit were. The report cited several instances in which members of the nursing staff who were assigned to the unit were also responding to emergencies elsewhere in the hospital.

Auditors also made it clear that there had to be distinct delineation between staff hours billed to the portion of the hospital that still qualifies for federal reimbursement and the Lower Saco Unit.


Patient advocacy groups have often complained that staffing at Riverview is inadequate, particularly for forensic patients. In August, J. Harper, with the Augusta-based Disability Rights Center, told lawmakers that the psychology staff at Riverview had been cut in half since 2009, from 14 to seven positions. Harper noted that the majority of the documented assaults at Riverview – cited as a concern in the first audit – occurred after the first shift of the psychology staff left for the day.

Other infractions cited in the audit included inaccurate record-keeping and documentation of the receipt and distribution of scheduled drugs.

State Rep. Mike Carey, D-Lewiston, said Thursday that the termination report raises questions about the DHHS’s handling of the now imminent funding crisis. “It goes to the broader question about management of (DHHS) and Riverview.”

In her statement, Mayhew said, “I regret that the state must spend additional financial and staff resources to appeal a decision that is not supported by the facts and I am confident that this decision will be overturned.”

DHHS officials could not immediately say how the federal funding mechanism works or what the deadline is to appeal.

Tim Feeley, a spokesman for Attorney General Janet Mills, said in an email that she was reviewing the termination letter and the appeals process.


Riverview has been dogged by noncompliance issues since the first federal audit, in March. Lawmakers were troubled that they were not notified of the potential loss of federal funding until mid-August. At the time, the LePage administration blasted the Legislature for not approving a bill to allow the state to send forensic patients to the state prison, to ease crowding at Riverview.

Gov. Paul LePage urged the Legislature to pass the bill during a special session in late August, citing the potential loss of federal funding.

Democratic lawmakers said it was the first time that they knew about the audit. On Thursday, some were frustrated that Mayhew and McEwen assured them that the remediation plan would be approved by the federal government.

“The state was able to run this facility for almost 20 years and provide a solid therapeutic environment but now we are struggling to maintain federal compliance and we need to have corrections officers on-site to maintain safety,” said Rep. Drew Gattine, D-Westbrook, a member of the Health and Human Services Committee. “We need to figure (out) what it is going to take to turn this around and make sure people who are very ill are getting the treatment they are entitled to.”

Carey said Thursday that he was frustrated that the administration focused on the bill to move forensic patients to the prison. “The administration wasn’t fixing the real problem,” he said.

Steve Mistler can be contacted at 791-6345 or at:


Twitter: @stevemistler

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