AUGUSTA — State lawmakers remain divided over a LePage administration proposal to transfer some violent or disruptive mental health patients to a special unit at the Maine State Prison from the Riverview Psychiatric Center.

The Legislature’s Health and Human Services Committee voted 5-4 Friday to change the proposal to ensure that the patients continue to receive care recommended by the Joint Commission on Accreditation of Healthcare Organizations, an amendment that precludes sending the patients to the state prison in Warren. The change, supported by the Democrats on the committee, followed unexpected testimony by Gov. Paul LePage, who told the panel that his proposal is part of a comprehensive strategy to regain federal certification of the beleagured Riverview Psychiatric Center in Augusta.

LePage tried to make a financial and moral case for a plan that has been sharply criticized by advocates for the mentally ill. In doing so, he appeared misinformed about the type of care patients currently receive at the prison’s Intensive Mental Health Unit, or IMHU. That standard of care, confirmed in a memo from the Department of Corrections and distributed to the Health and Human Services Committee, is at the center of the debate over whether patients deemed by a judge to be incompetent to stand trial or not criminally responsible should be housed and treated alongside convicted criminals.

Opponents of the governor’s plan argue that those patients should not be treated the same as someone who has demonstrated criminal intent. Proponents, including the governor, argue that housing the patients at the prison unit will keep them in Maine and closer to their families.

“My issue is purely not taking these people away from their families,” LePage told lawmakers on the Health and Human Services Committee during an unexpected appearance Friday. “I think it’s cruel and unusual punishment. These people are ill.”

Republicans on the Health and Human Services Committee supported the governor’s bill and added a provision that would end the transfer of patients to the IMHU when another state facility can house them.

“I don’t think sending people out of state is ideal and I don’t think the IMHU is ideal,” said Sen. Eric Brakey, R-Auburn. “We are left in an unideal situation.”

LePage urged lawmakers to support a plan that he described as a temporary approach that will keep the patients in Maine.

During LePage’s testimony, Rep. Patricia Hymanson, D-York, a physician, said she too would prefer to keep the patients in the state, but not at the expense of no longer providing them with hospital-level care.

“The IMHU is a prison system and that facility deals with people … in every shape and form as criminals,” she said. “I would rather send those patients out of state to a hosptial setting than put them in a prison setting.”

LePage responded: “Unless I’ve been totally misled, you can have a hospital in any setting. The unit we’re talking about – the IMHU – is in a hospital setting and level of care.”

Hymanson noted that lawmakers had been told differently.

On March 8, a memo from the Department of Corrections stated that patients in the prison unit are not treated any differently from convicted criminals receiving mental health treatment. The memo also stated that the prison unit adheres to standards set by the American Correctional Association, which includes six mental health protocols, three of which are mandatory. The memo said the standards are “significantly less comprehensive” than those set by the Joint Commission on Accreditation of Healthcare Organizations.

The governor appeared unaware that the prison unit operated under different standards when Hymanson noted the different care standard.

“Maybe we should make sure it’s hospital care,” he responded. “I would urge you all to make sure that it happens.”

The governor’s testimony came as lawmakers continue to grapple with his proposed solutions for Riverview, which faces staffing shortages and the loss of federal certification that jeopardizes an estimated $20 million annually in federal reimbursements. The hospital was stripped of its federal certification in 2013, but the state continues to receive funding. On Friday, LePage told the committee that the proposal to house patients at the prison was part of a larger plan to address Riverview’s problems. He described the proposal as a stopgap effort to buy time while awaiting approval of a separate proposal to expand and rehabilitate the Maine Correctional Center in Windham. Lawmakers are considering a bill that would increase the borrowing authorization to expand and rehabilitate the Windham facility from $85 million to $165 million.

LePage told the committee that the Riverview issue had to be resolved before lawmakers adjourn for the session.

“If it’s not resolved it, (Riverview) will be shut down,” he said. “I can no longer continue to draw down federal monies (for Riverview) knowing that I may have to pay it back.”

The unit in Warren was created in 2013 after the administration told lawmakers that it would help Riverview secure its federal certification. The administration had proposed putting some forensic patients there, but the proposal was rejected after patient advocates raised concerns. The bill debated Friday is the administration’s second attempt to use the Warren unit to house certain forensic patients.

The problems at Riverview have become entangled in State House politics. The LePage administration and Democrats continue to exchange blame over the state’s failure to regain federal certification for the center.

The governor’s bill will undergo language review before being considered by the Senate and House of Representatives.

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