Federal officials are demanding that Maine repay $51 million in federal money that the LePage administration was forbidden to spend on the operation of Riverview Psychiatric Center in Augusta. Maine has been improperly using the federal money since 2013, according to a federal health official.
The 92-bed Riverview facility was decertified by the U.S. Centers for Medicare and Medicaid Services in 2013 for a number of deficiencies, such as the use of stun guns and pepper spray, the improper use of restraints and seclusion of patients, poor record-keeping and medication errors.
Read the letter
In 2014, a federal official told the Portland Press Herald that the LePage administration was not allowed to draw down Medicaid money for Riverview because the facility had been decertified. But the state did so anyway for more than three years, at the rate of about $3.5 million to $4.6 million per quarter, according to a June 7 letter to the state from Richard McGreal, associate regional administrator in the CMS Boston office.
Gov. Paul LePage said the Legislature was to blame for putting the state on the hook, but several Democratic lawmakers sharply disputed that assertion, saying the Republican administration failed to develop a consistent, credible plan to correct the facility’s deficiencies.
Daniel Wathen, court master for a consent decree that governs how the state treats the severely mentally ill, said it has been common knowledge among state officials and lawmakers for years that Maine would have to repay the money, even if Riverview is eventually recertified.
“This is not surprising. It’s been lurking in the background for a good number of years now,” said Wathen, a former chief justice of the Maine Supreme Judicial Court.
McGreal told the Press Herald in 2014 that he had warned LePage administration officials that the money was being drawn down inappropriately during decertification and would have to be repaid, even if Riverview is recertified. “We will be seeking the return of that money,” McGreal said at the time.
DECISION FINAL, CAN BE APPEALED
A spokeswoman at the CMS Boston office declined to comment Thursday, saying there was no further information available beyond what was in McGreal’s June 7 letter.
In the letter, McGreal wrote that the decision is final, but that an appeal could be filed within 60 days and would go before the agency’s Department Appeal Board. If the appeal fails, CMS will take back the $51 million, McGreal wrote.
Jenna Mehnert, executive director of the National Alliance on Mental Illness Maine, said she’s worried about the financial impact on the mental health system, and that state lawmakers won’t make up the shortfall from the $51 million. LePage said in a written statement that he expects the Legislature will make up for the lost federal money in the budget.
“The mental health system needs more resources, not less,” Mehnert said. “We are already at a crisis level. Where is this $51 million going to come from?”
LEGISLATORS WARNED, LEPAGE SAYS
Previous attempts by the LePage administration to fight the decertification in court have failed, as the courts have sided with the federal government’s determination.
In his statement, LePage indicated he would appeal the CMS demand for repayment, and he blamed lawmakers.
“Since Riverview Psychiatric Center was decertified in 2013, our administration has clearly communicated on numerous occasions that continuing to use (federal) funding posed a significant risk of disallowance. Our administration warned the Legislature over and over that action needed to be taken and those warnings were ignored. Now, we are faced with a financial tsunami,” LePage said. “I expect the Legislature to allocate $51 million in the biennial budget and take responsibility for its missteps and jeopardizing the financial well-being of our state.”
LePage also recently claimed that the Obama administration decertified Riverview because it was retaliating against Maine for failing to expand Medicaid. The governor never produced any evidence to support that claim.
Rep. Deborah Sanderson, R-Chelsea, also blamed Democrats in the Legislature for Riverview’s problems, claiming their “obstruction” and “antics” have cost the state $51 million.
“For years, Democrats have been using Riverview as a political weapon against Gov. LePage and his administration with no regard for the patients who depend on the facility for the care they need,” Sanderson said in a written statement.
DEMOCRATS REFUSE TO TAKE BLAME
But Rep. Patricia Hymanson, D-York, co-chair of the Legislature’s Health and Human Services Committee, said LePage has failed to present lawmakers with a concrete plan for upgrading Riverview.
“We’ve been waiting for four years and gave the governor ample opportunity to come up with a plan and show it to us so that we can vet it, and he has never done that,” Hymanson said. “We have given the governor permission to build a new facility … but he has been playing cat and mouse with us and blaming us for the problem.”
Meanwhile, Wathen believes that when federal officials do the next recertification inspection, Riverview will pass and regain good standing with the federal government.
“The next time they’re here for a site visit, they will see we’ve put in place a number of improvements,” Wathen said. Staffing levels have improved, employee pay is better and the staff has been trained to more adeptly handle difficult patients, he said.
Also, the state is moving forward with a plan for a 21-patient “step-down” facility in Bangor that would house forensic patients who cannot be released but who no longer require hospital-level care. Forensic patients are those who are sent to mental health facilities through the criminal justice system. In May, the Maine Department of Health and Human Services posted a request for proposals to operate the step-down center.
Joe Lawlor can be contacted at 791-6376 or at:
jlawlor@pressherald.com
Twitter: joelawlorph
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