August 23, 2013

Maine bill may expand to address Riverview funding

The state psychiatric hospital could lose $20 million in federal money if problems aren't fixed.

By Michael Shepherd
State House Bureau

AUGUSTA — A legislative committee may consider a bill next week to address the tenuous status of Riverview Psychiatric Center, which could lose $20 million in federal funding next month.

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

Joe Phelan / Kennebec Journal

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The Legislature's Appropriations and Financial Affairs Committee agreed Thursday to have a panel of mental health interests, legislators and state officials take a look at, and possibly broaden, a bill that would establish a new mental health unit at the state prison.

But that bill is likely to be a long-term fix, not a solution to Riverview's current troubles with the federal government.

Last week, the federal Centers for Medicare and Medicaid Services told the Maine Department of Health and Human Services that because the hospital is out of compliance with federal law, $20 million in federal dollars -- more than half the 92-bed center's budget -- could stop going to Riverview as of Sept. 2.

Two previous plans to fix the problems have been rejected, and if a corrective plan proposed by the state and sent to the federal government Aug. 16 isn't approved by Sept. 2, the embattled state-run hospital will lose its federal certification.

Department of Health & Human Services Commissioner Mary Mayhew told members of the Appropriations Committee on Thursday that she believes a "vast majority of identified deficiencies have been addressed" by the lastest correction plan.

The Kennebec Journal reported Wednesday that a principle reason the federal government has threatened to withdraw funding is the use of stun guns and handcuffs by Kennebec County corrections officers to subdue aggressive patients.

Crowding, inadequate staffing and mingling of civilian and forensic patients -- those referred by Maine's judicial system -- were also cited as reasons.

After questioning Mayhew, Riverview Superintendent Mary Louise McEwen and corrections officials on Thursday, the committee agreed to assemble the various interests to examine possible additions to the bill that would establish a new mental health unit at the Maine State Prison in Warren at a cost of more than $3 million.

Committee members said that when they convene next Thursday they may consider broadening that bill, L.D. 1515 -- which was proposed by Gov. Paul LePage's admininstration -- with the group's recommendations.

Central to the state's short-term correction plan for Riverview, Mayhew said, is federal decertification of 20 beds in Riverview's Lower Saco Unit, where corrections officers used stun guns and handcuffs to control patients.

The unit segregated judicial system patients from the rest of the Riverview population. Decertifying the beds would mean the state could keep it open, but wouldn't get federal reimbursement for them under Medicaid, the federal health care system for the poor, and Medicare, the system for the elderly.

Many of these patients are sent to Riverview to receive mental evaluations before trial, or because they have been found not criminally responsible.

Joseph Fitzpatrick, clinical director of the prison system, said the Maine State Prison in Warren has a 32-bed mental health unit. If L.D. 1515 passed, it would retain some beds there to serve the prison population.

In the long term, the state wants to establish a more permanent mental health unit at the state prison that would be overseen by Riverview staff and staff from the Maine Department of Corrections.

In the past few years, some violent Riverview patients have been shuffled between the hospital and the prison, which many believe is the only place they can be safely kept.

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