Bangor, Augusta sites already share personnel

AUGUSTA, Maine — The Department of Health and Human Services is moving to merge the state’s two psychiatric hospitals, Dorothea Dix in Bangor and Riverview in Augusta, under one management.
“We have wanted to consolidate the administration of these two hospitals,” DHHS Commissioner Brenda Harvey said in an interview. “This would be more efficient, to maximize the use of each other’s strengths and to minimize the challenges.”
Her comments about the proposal were revealed at a meeting of the Appropriations Committee last week and surprised lawmakers.
“I don’t think anybody on the committee knew anything about this,” said Rep. Emily Cain, D-Orono, House co-chairwoman of the committee. “This really was a surprise.”
She said the proposal is likely to generate some controversy, given the long history of the Bangor facility, once named the Bangor Mental Health Institute. There have been several proposals over the last 30 years to close the one in Bangor and have one, state-operated psychiatric hospital.
“We have to be careful with terms like consolidation, coordination, merging,” she said. “Those mean very different things to different people based on your past experience.”
Harvey said legislation is being prepared for the next governor and Legislature to consider that would formally put the two hospitals under one management and one license. She said there are opportunities to save by merging management functions.
“We have already moved forward in some areas,” she said. “For example, there is a new COO [chief operating officer] for both, and we have merged the quality assurance people, and the training person is for both.”
Harvey said the department would like to put both facilities under one license, but she is not sure the national accreditation agency will allow a single license for the two separate campuses. She said that would be a logical extension of the effort to manage the two facilities as one and will save money.
“We know we need to do everything we can to reduce costs without affecting the quality of care,” she said. “We think this is one way to do that.”
Harvey said some savings could be identified easily, such as salary costs of eliminating one of two chief operating officers. She said others are more difficult and will depend on the level of administrative merging that national regulators will allow at the two hospitals.
“I don’t want staff to get the message that a decision has already been made,” she said. “That will really be up to the new governor and the new Legislature to decide. I expect there will be a bill, and there will be hearings and a full discussion of the proposals.”
Harvey said she recognizes the history of the facilities will cause some to be concerned, but she said the size of both facilities is a fraction of what they used to be, and they already are cooperating in many areas. She said her office and Gov. Baldacci have made it clear they have no plans to close either facility.
Cain said that while there may not have been any formal proposals to close Dorothea Dix in recent years, there have been discussions by lawmakers as they have searched to find savings as state revenues have plummeted in the recession.
“I think we probably would have had some sort of proposal this next session from some legislator, given the budget hole we are looking at,” she said.
Sen. Richard Rosen, R-Bucksport, the only GOP senator on the Appropriations Committee, agreed the DHHS proposal caught committee members by surprise. He said there undoubtedly would be some who see the move as an attempt to close the Bangor facility, but he is not one of them.
“I think we have to carefully and thoughtfully review this proposal,” he said. “As I understand it, she is talking about merging the administration to achieve some savings, and that is something we should look at.”
Rosen said whatever is proposed will likely prove controversial, given the long history of Dorothea Dix and its predecessor facility, BMHI. He said there likely would be a lot of controversial proposals in the next session with a projected billion-dollar budget shortfall for the next two-year budget.
“I am going to start with the question how does this impact the services that are being offered, where they are being offered and who is doing the work to provide the services,” Cain said.
She said it might be that the proposal would result in the ability to offer higher-quality services than now are offered by shifting dollars from administration to care. She agreed with Rosen that there likely would be more controversial proposals offered in the months ahead.