Friday, April 18, 2014
By Steve Mistler email@example.com
State House Bureau
AUGUSTA — The Legislature approved a bill Thursday that will partially fund a multimillion-dollar staff expansion at the Maine State Prison's psychiatric ward but will do little to alleviate problems at the Riverview Psychiatric Center.
The 2007 file photo shows a section of the Maine State Prison. The Legislature approved a bill Thursday, Aug. 29, 2013 that will allow some patients from the Riverview Psychiatric Center in Augusta to be shipped to a newly staffed mental health unit at the state prison.
2007 Staff File Photo
Rep. Kathleen Chase, R-Wells, Sen. Patrick Flood, R-Winthrop, and Sen. Emily Cain, D-Orono, confer over a draft version of L.D. 1515 before a work session of the Appropriations and Financial Affairs committee Thursday at the State House in Augusta.
Joe Phelan / Kennebec Journal
The issues at Riverview, outlined in a recent report by the Centers for Medicare and Medicaid Services, had threatened about $20 million in federal reimbursement, more than half of the hospital's operating budget.
The potential funding loss was the impetus for L.D. 1515, a bill that was tabled in June at the request of the LePage administration but reintroduced during Thursday's special legislative session at the urging of the governor.
The administration, in a news release issued at 7 p.m. Thursday – after the Legislature had approved L.D. 1515 – said the federal government had accepted Riverview's correction plan.
Riverview's noncompliance with federal mandates ran the gamut from reporting issues and governance to safety and overcrowding. L.D. 1515 is aimed at reducing some of the backlog at Riverview by allowing the state to transfer some forensic patients from the 92-bed hospital to the state prison in Warren.
However, lawmakers, the attorney general and the superintendent of Riverview acknowledged that the bill addresses very few of the problems at the hospital.
Forensic patients are those committed to state custody after being found not responsible for criminal offenses, those who are being examined to determine their competency to stand trial, and those whom a judge has declared incompetent to stand trial and are being treated to restore their competency.
The original version of L.D. 1515 would have allowed patients found incompetent to stand trial and those awaiting evaluations to be housed in the prison. Civil libertarians and mental health advocates fought to amend the bill, arguing that a prison is neither appropriate for those who haven't been convicted of crimes nor conducive to stabilizing mental health patients.
The amended version enacted Thursday would allow only those who are being evaluated for competency to be moved to the prison. Defendants found incompetent would remain at Riverview.
Riverview treats people with violent mental illness in addition to forensic patients and those committed by courts for being a danger to themselves or others.
The LePage administration argued that the bill would create a safer environment at Riverview. But some were skeptical, saying the amended version did little to address the systemic problems.
The amended version of L.D. 1515 could mean that fewer patients will be housed at the prison.
The annual cost for the expanded ward in Warren is $3 million per year for additional staffing. The bill passed Thursday allocates $1.3 million for about six months of 2014, when the expanded ward is expected to become operational.
Meanwhile, the loss of federal dollars at Riverview loomed. The deadline to comply with federal mandates was Sept. 2.
On Thursday afternoon, Health and Human Services Commissioner Mary Mayhew told lawmakers that she was confident that the federal government would approve the facility remediation plan.
It's not yet clear when the federal government notified the administration that the plan had been accepted.
Nonetheless, the proposed fix at Riverview is likely to cost the state federal dollars, at least in the short term.
A key component of the plan is the federal decertification of 20 beds in Riverview's Lower Saco Unit, where corrections officers have used stun guns and handcuffs to control patients. Decertification means the loss of Medicare and Medicaid reimbursement money while Riverview would continue serving patients in the Lower Saco Unit.
Asked this week how much decertification would cost the state, Riverview Superintendent Mary Louise McEwen said the department was still developing an estimate. However, she said, the long-term plan is to recertify the beds and the federal reimbursement.
Mental health advocates told lawmakers earlier this week that the state should be investing its resources in Riverview.
J. Harper, with the Augusta-based Disability Rights Center, said the problems identified in the federal report stem from the loss of staff trained to deal with forensic patients, who may be a risk to other patients or Riverview's staff.
He said the state cut staffing levels in half from 2009 to 2012 to help balance the state budget.
Harper said trained staff members are on the first work shift at Riverview but qualified staffing drops off during the night and early-morning shifts. Harper said the majority of the documented assaults occur after the first shift.
Harper said it would cost the state more than $700,000 to restore the staffing at Riverview.
Steve Mistler can be contacted at 791-6345 or at:
click image to enlarge
Rep. Dennis Keschl, R-Belgrade, left, and Rep. Kathleen Chase, R-Wells, confer over a draft version of L.D. 1515 before a work session of the Appropriations and Financial Affairs committee on Thursday at the State House in Augusta.
Joe Phelan / Kennebec Journal