Lawmakers on the Legislature’s budget committee and the state human services commissioner exchanged heated comments Monday over whether Maine should try to regain federal certification and funding for Riverview Psychiatric Center.
The nearly two-hour meeting gave vent to frustrations over who is responsible for chronic problems at the Augusta center, which could cost Maine taxpayers over $30 million in the short term and potentially more in the future.
There was no immediate resolution, and the next session of the Legislature will have to take up the matter again when it convenes in January.
The administration of Gov. Paul LePage is considering a proposal to remove mentally ill patients who have committed or been accused of crimes from Riverview and locate them in a separate facility. The administration believes that move would help the state regain federal certification for Riverview and qualify for about $16 million in annual funding for which the center is no longer eligible.
However, lawmakers have criticized the proposal as lacking in detail, and advocates for the mentally ill fear that a new facility for the so-called forensic population at Riverview would operate more like a prison and less like a treatment center.
The federal Centers for Medicare and Medicaid Services suspended Riverview’s certification in 2013, after auditors found numerous problems at the center, including the use of stun guns, pepper spray and handcuffs on patients, improper record-keeping, medication errors and failure to report progress made by patients. Since then, the Department of Health and Human Services and the Legislature have traded accusations about who is responsible for creating and solving problems at the 92-bed hospital, one of two state-run psychiatric centers. The second facility is the Dorothea Dix Psychiatric Center in Bangor, which retains its federal certification.
‘CREDIBILITY ISSUE’
The tension over Riverview was on full display Monday before the Appropriations and Financial Affairs Committee, as DHHS Commissioner Mary Mayhew read eight pages of testimony that appeared to criticize the Legislature for the challenges at the center. Several lawmakers bridled at Mayhew’s prepared remarks, which concluded with her request for the committee to decide whether Maine should try to get Riverview recertified.
If not, she said, then the Legislature should find $24.5 million to fund the hospital for the remainder of the current two-year state budget.
Democratic lawmakers were incredulous. Several saw Mayhew’s remarks as an attempt to shift blame for Riverview’s struggles. Rep. Peggy Rotundo, D-Lewiston, co-chairwoman of the committee, accused Mayhew of ignoring lawmakers’ efforts to help DHHS restore accreditation, including five separate emergency funding requests since 2013.
Rotundo said the administration’s proposal to create a larger facility was introduced late in the legislative session and lacked detail. Sen. Linda Valentino, D-Saco, then criticized Mayhew for not providing an update on the hospital’s progress and a proposed solution.
“Do you think there’s a confidence or credibility issue here? Are we at the juncture that we need to get an independent agency to tell us what to do?” Valentino asked.
Mayhew responded, “You continue to ask, ‘What is the plan? What is the plan? What is the plan?’ I have answered, I have proposed, we have presented. I cannot appropriate funds.”
Rep. Gay Grant, D-Gardiner, said the Legislature cannot dole out funds without knowing what it’s paying for.
“The responsibility for administering and operating the state’s hospital for the mentally ill lies with the (DHHS) and the administration, not the Legislature,” she said. “If you, as the administration, are asking us to make a severe departure from the way we treat and care for our mentally ill patients, to go to a privatized type of system, we need adequate details on why and how and under what standards that hospital, or that facility, will be operating.”
Mayhew, irked by Grant’s suggestion that the administration was not forthcoming or hadn’t accepted responsibility for the problems at Riverview, responded, “I came here to provide information. I am not going to sit here and listen to an attack or be questioned about the executive branch’s role. I will not sit here and listen to attacks.”
LOOKING FOR SOLUTIONS
While Democrats were critical of Mayhew’s characterization of the Riverview crisis, Republicans seemed perplexed about what the administration wants. Mayhew had detailed two separate proposals: One would create a 16-bed facility to remove the forensic patients from Riverview. The second would create a 55-bed unit that Mayhew said would help alleviate pressure at county jails that are holding people who may need a psychiatric evaluation to determine if they’re competent to stand trial.
Both proposals were rejected by the Legislature in the spring – a source of contention Monday. The proposal for a 55-bed facility also drew concerns that DHHS was moving to privatize mental health services, following a trend in other states that have turned over the services to for-profit corporations, in some cases with disastrous results.
Mayhew’s preference – for the smaller facility or the larger one – eluded some lawmakers.
“I want you to tell me what the solution is to this problem,” said Rep. Jeffrey Timberlake, R-Turner. “We need to move from here. I need to know what it is we have to do, whether we bite the bullet and do something different. I’ve listened to this for an hour now and I still don’t know what I’m supposed to do.”
Mayhew later said that she wasn’t advocating for the larger facility. However, after the meeting she told reporters that the smaller one was a “no brainer” and would likely help restore certification and funding for Riverview. Mayhew said the smaller residential treatment unit would cost about $3.8 million annually and that a contract with a provider could be drafted quickly.
Mayhew told the committee that she will provide more information about the new facility. It’s unclear if lawmakers will accept the proposal when the Legislature reconvenes in January. Meanwhile, Mayhew said the administration hadn’t decided if it will continue to fight an Aug. 13 ruling by a federal judge who rejected the state’s appeal of the federal decertification of Riverview.
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