AUGUSTA — The court master assigned to ensure that patients held at the state’s Riverview Psychiatric Center receive proper treatment says that inadequate staffing, training, and seclusion and restraint techniques continue to plague the 92-bed facility.

The eight-page report was submitted to the state on Oct. 26 and is now being reviewed by the Legislature’s Health and Human Services Committee. Oversight by the court master, former Maine Chief Justice Daniel Wathen, stems from a 1990 consent decree designed to ensure that people treated for mental illness receive appropriate care. Still, the latest report details overlaps in deficiencies that have prevented Riverview from regaining its federal certification, thus jeopardizing $20 million in annual funding.

The Department of Health and Human Services has fought since 2013 to regain federal certification, but has been unsuccessful.

In August DHHS Commissioner Mary Mayhew asserted that the only way to achieve certification is to build a separate facility that will hold violent patients who have been found not criminally responsible and those who are incompetent to stand trial. The separation of so-called forensic patients and civil patients, and the sharing of staff, was cited in the federal audits that led the Centers for Medicare and Medicaid services to yank Riverview’s certification.

The separation issue is not cited in the court master report, but personnel problems, including insufficient staffing levels and the use of temporary and part-time practitioners to fill vacant psychiatry positions, led the on-sight reviewer to conclude that treatment is lagging because patients cannot form trusting relationships with physicians.

The report also found that mental health workers were working long hours to compensate to help the hospital meet minimum staffing levels. Mental health workers logged over 1,083 hours overtime in August, including 312 hours of mandated overtime.

On Nov. 5, DHHS responded to the court master review, stating that the agency doesn’t “fully concur with the findings.” The agency also noted that deficiencies at the hospital required additional funding by the Legislature. While that funding has been approved, the on-site visit took place less than three months after the money became available. Finally, the agency reiterates its belief that separating the so-called forensic patients from civil patients is necessary.

“The hospital welcomes reviews of our progress toward becoming a Center of Excellence in Psychiatric Care,” the agency wrote. “However, Riverview’s problems will never truly be solved, and the hospital will always generate negative media attention, until a second facility is established that may house violent, not criminally responsible and incompetent to stand trial patients.”

The LePage administration floated the idea of another psychiatric facility toward the end of the legislative session.

Gov. Paul LePage submitted a bill in May that would have allocated money to create a 50-bed Behavioral Assessment Safety Evaluation unit. It was introduced in the last days of the legislative session and died when lawmakers balked at the lack of detail about who would manage the facility and a funding request of more than $1.5 million for one month, or $18.5 million a year.

The LePage administration is expected push the proposal when the Legislature reconvenes in January.

Meanwhile, Rep. Drew Gattine, D-Westbrook, is hoping his bill to implement a correction plan at Riverview will also be considered. Gattine’s bill is also geared toward regaining federal certification. It first has to clear the Legislative Council to be considered next year. The council initially rejected the bill last month, but Gattine is appealing the decision and will make his case before the committee on Thursday.

“It’s appalling that Riverview is failing to meet the minimum federal standards that every single other hospital in Maine is able to satisfy,” Gattine said in a statement. “We need to take a hard look at what’s going on here and move forward purposefully. We must protect the well-being and constitutional rights of patients and the safety of the staff. The Department needs to stop pointing fingers and bring forward a comprehensive plan that will get Riverview back on track and in compliance with the law.”