August 28, 2013

Panel told LePage's Riverview bill just a small fix

The bill would establish a mental health unit at the state prison where some of Maine's psychiatric patients would be sent.

By Steve Mistler
State House Bureau

AUGUSTA — A special committee charged with assessing a bill to alleviate overcrowding and backlogs at the Riverview Psychiatric Center heard Tuesday that the proposal is only a small fix to a larger problem at the 92-bed facility.

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This aerial photo taken on Tuesday April 30, 2013 shows The Riverview Psychiatric Center on banks of Kennebec River in Augusta.

Staff photo by Joe Phelan

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The legislative panel also was told that the bill, which would establish a mental health unit at the state prison in Warren where some Riverview patients would be sent, would do little to address a litany of issues at Riverview that threaten to cut off an estimated $20 million in federal funding.

Meanwhile, the Sept. 2 deadline for the funding loss looms. Riverview Superintendent Mary Louise McEwen told the panel that the facility was still working with the federal Centers for Medicare and Medicaid Services to craft a mitigation strategy. However, she also said that a reassessment of conditions at the facility may not occur before Sept. 2.

The federal funding represents more than half of the hospital's operating budget.

McEwen told the Press Herald Aug. 17 that she was confident the federal government would accept the state's remediation plan. A key component of that plan is the federal decertification of 20 beds in Riverview's Lower Saco Unit, where corrections officers have used stun guns and handcuffs to control patients.

The unit segregates forensic patients from the rest of the Riverview population.

Forensic patients are those committed to state custody after being found not responsible for criminal offenses, those who are being examined to determine their competency to stand trial, and those whom a judge has declared incompetent to stand trial and who are being treated to restore their competency.

Decertification would mean the loss of federal reimbursement for patients through Medicaid and Medicare.

Mental health advocates said the bill, L.D. 1515, didn't address the use of stun guns and handcuffs by Kennebec County corrections officers to subdue aggressive patients -- issues highlighted by a federal report that put the facility out of compliance.

Crowding, inadequate staffing and mixing civilian patients with those awaiting competency assessments through the courts were also highlighted in the report.

The audit was prompted by a March 16 assault at Riverview in which 47-year-old Mark Murphy, a patient, allegedly attacked a 26-year-old mental health worker, punching her, striking her with his hands and stabbing her with a pen before another patient intervened.

The attack highlighted growing concerns by law enforcement and mental health advocates that Riverview is struggling to handle a sharp uptick in mental health patients channeled through the corrections system.

In May, a review of data by the Kennebec Journal showed there were 37 injuries at Riverview in 2012, the most since 2009, when there were 53.

J. Harper, with the Augusta-based Disability Rights Center, told the committee that the problems identified in the report stemmed from the loss of staff trained to deal with forensic patients, who may be a risk to other patients or Riverview staff. He said the state had cut staffing levels in half between 2009 and 2012, a move designed to help balance the state budget.

Harper said trained staff members were present during the first work shift at Riverview, but qualified staffing dropped off during the night and early-morning shifts.

Harper said the majority of the documented assaults occurred after the first shift.

Attorney General Janet Mills echoed some of Harper's concerns. She said the bill had been cast as a "silver bullet" when it wasn't. Mills also said she was disappointed that lawmakers weren't made aware of the federal audit earlier.

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