AUGUSTA, Maine — Lawmakers on the Legislature’s budget-writing Appropriations Committee reviewed Tuesday a list of written answers from the state’s Department of Health and Human Services regarding a host of issues at the state-owned Riverview Psychiatric Center.
The 92-bed center treats and houses the state’s most violent mentally ill patients. It is the only state-owned facility to house patients who are deemed either incompetent to stand trial or not criminally responsible for their actions.
The hospital has been the focus of intense scrutiny after federal decertification placed Riverview at risk of losing $20 million in federal funding — or about half the hospital’s operating budget — after it failed a series of unannounced inspections by the federal Center for Medicare and Medicaid Services in 2013. That funding lost, tied to the hospital’s federal certification, is the result of employee and patient safety issues that were identified in the 2013 surveys.
A subsequent corrective action plan for the hospital was implemented but another inspection found additional problems and so far the hospital remains without federal certification.
In a more than year-long controversy, allegations also have escalated concerns among some lawmakers that DHHS has failed to enact adequate reforms to protect the safety of staff and patients at Riverview.
The federal decertification was due to a range of problems, the most serious of which involved the use of Tasers and restraints on patients. Since the decertification — and with the threat of losing $20 million in federal aid — DHHS made changes at Riverview, including the replacement of the hospital’s superintendent. Last week the Legislature’s Government Oversight Committee also voted to launch its own investigation into the problems at the hospital.
On Tuesday, lawmakers reviewed answers from DHHS Commissioner Mary Mayhew to questions the budget-writing panel had posed. Mayhew did not attend Tuesday’s committee meeting.
Former Maine Supreme Judicial Court Chief Justice Daniel Wathen, who is responsible for overseeing the AMHI consent decree, also is investigating the hospital and its treatment of patients. The 1990 consent decree resulted from a class-action lawsuit brought on behalf of former patients at Riverview’s predecessor, the Augusta Mental Health Institute, after poor conditions and overcrowding resulted in several deaths. The consent decree required the state to establish and maintain a comprehensive mental health system.
Wathen told the Bangor Daily News in August that he would conduct his next audit of Riverview in early October. As courtmaster for the consent decree, Wathen has the authority to recommend fixes that DHHS must adopt or go to court over.
According to Mayhew’s written answers, the state has reapplied for federal certification based on changes it has made including the addition of new “acuity specialists” as well as changes in leadership and other specific treatment plans and procedures for patients.
In response to a question about the hospital’s recertification, Mayhew wrote she expects a new federal audit soon and that likely will determine whether the hospital again will become eligible for federal support.
The hospital, according to Mayhew, was also “confident significant improvements” would be noted by Wathen and his consultants when they review the facility in October.
But some lawmakers the Appropriations Committee leveled criticism at Mayhew and DHHS on Tuesday.
State Rep. Mike Carey, D-Lewiston, said the information from DHHS about what was being done to correct problems at the facility was far from detailed. Likening Mayhew’s response to the panel’s questions to a “couple of tweets” — referencing the social media platform that limits communication to 140 characters — Carey said the answers from Mayhew were not “a response to a massive problem.”
“We need to have more information and accountability of where we are going and how this gets fixed,” Carey said.
State Rep. Peggy Rotundo, D-Lewiston, House chairwoman of the Appropriation Committee, issued a similar concern, saying the committee was interested and concerned and wanted to work with the Legislature to solve the problems at Riverview.
Rotundo said the committee had suggested it would find more funding and other solutions as necessary but wasn’t getting the response it needed from DHHS and Riverview staff.
“We are very, very eager to work with the administration to fix this problem,” Rotundo said. “But we need to have the administration engage.”
She also said the loss of federal financial support had “enormous implications for Maine taxpayers” and the committee needed to figure out “how we deal with that huge hole if we are not certified.”
Meanwhile, state Sen. Margaret Craven, D-Lewiston, said she continued to hear from Riverview staff that they felt unsafe in the facility.
“Staff that work there feel like they are not safe and there is not adequate staffing on the ground even though it may look that way on paper,” Craven said.
Nick Adolphsen, DHHS legislative liaison, said that Riverview superintendent Jay Harper, who was unable to attend the committee meeting Tuesday, was willing to provide tours of the facility to committee members so they could see what was happening in terms of improvements at the facility.
“(By) going to Riverview and walking through with the superintendent and seeing in real terms what is going on there, it would provide an excellent perspective to you,” Adolphsen said.
Rotundo said she appreciated the invitation, but problems the committee is trying to solve “extend beyond a tour of the facility.”
Adolphsen said he would convey the committee’s messages to Harper and Mayhew. Conditions at the facility will be on the agenda of the Legislature’s Health and Human Services Committee when it meets next on Oct. 15.