Gov. Paul LePage said Thursday his administration had abandoned its effort to put a new 21-bed secure psychiatric facility next to the state’s Riverview Psychiatric Center in Augusta.
Speaking on WGAN radio, LePage blamed Democrats in the Legislature for obstructing his efforts to expand the state’s capacity to care for mental health patients in state custody who have been found criminally not responsible by the courts.
Democratic lawmakers on the Legislature’s Legislative Council, which must approve new construction in the Capital Area of Augusta, including the Riverview grounds, have twice blocked LePage’s attempt to move ahead with the new $3.5 million facility.
“We will have a site picked by the first of the week,” LePage said. When asked if that meant the Riverview site was no longer an option, LePage said, “Yeah, that’s gone. We are moving on.”
LePage said the state needed to move quickly because it was under pressure from federal regulators who are threatening to reclaim millions in federal funds the state uses to run Riverview. If the state doesn’t bring the facility up to federal standards, Maine taxpayers could be on the hook for that spending.
The federal government says Riverview isn’t meeting standards because it is housing both forensic patients – those who have committed violent crimes but have been found not responsible for those crimes because of mental illness – and other patients who are being held under civil court orders for treatment.
The Department of Health and Human Services, which operates Riverview, wants the new facility for patients who cannot be released to society but who no longer need hospital-level treatment for their illnesses.
“We take down $14 million a year from DSH funding and the federal government has told us we are doing that illegally and we are expecting them to ask for the money back and we’ve been doing that for three years now,” LePage said. DSH is an acronym the federal Department of Health and Human Services uses that stands for “Disproportionate Share Hospital” funds paid to qualifying hospitals that serve a large number of Medicaid and uninsured patients. LePage said the state risks owing the federal government that money at a rate $3.5 million each fiscal quarter.
“The Legislature has known it now for three years and I don’t know why they are just playing games. It’s politics as usual and I just can’t afford to risk the general fund money we so badly need for other programs simply to play games,” LePage said.
The federal agency that oversees Riverview’s funding revoked the hospital’s certification in 2013 after regulators found many problems during an audit, including the use of stun guns, pepper spray and handcuffs on patients, improper record-keeping, medication errors and failure to report progress made by patients.
The federal agency, the Centers for Medicare & Medicaid Services, also determined that the 92-bed facility was improperly commingling patients who needed intense hospital treatment with those who no longer required hospitalization. In 2015, the state lost an effort to appeal the decertification of Riverview when a federal judge found the state missed a filing deadline.
Since then, the Legislature and the administration have been unable to reach an agreement on how to best resolve the problems at Riverview, while the demand for beds in secure mental health facilities in Maine has increased.
House Speaker Sara Gideon, D-Freeport, met with LePage this month to try to find a way forward on the new facility. Democrats agree it is needed, but have requested more public vetting of the administration’s proposal, including hearings before the legislative committees with jurisdiction. After meeting with LePage, Gideon said they had agreed to move forward with the Augusta location. But LePage said his administration was still pursuing alternative locations that would not require the consent of the Legislature to move forward.
In a statement Thursday, Gideon said she and Senate President Michael Thibodeau, R-Winterport, had agreed to hold a joint hearing of the Legislature’s committees of oversight on LePage’s proposal for the Riverview location the first week in January.
“As I have been saying for weeks, we need to ensure the safety of patients, the workers who care for them, and of the public, and also that we are spending taxpayer dollars appropriately,” Gideon said.
On Dec. 13, Daniel Wathen, the former chief justice of the Maine Supreme Judicial Court who was appointed to oversee a consent decree the state entered into in 1990 over its treatment of mental health patients in its custody, wrote in a quarterly report to the courts that a fix for Riverview that included a solution for the shortage of bed space was “evident and urgent.” The hospital also has struggled with staff turnover, and in an effort to improve recruitment and morale, lawmakers approved pay increases for direct care workers at the facility, over a LePage veto.
The consent decree covers “all persons who on or after Jan. 1, 1988, were patients at the Augusta Mental Health Institute and all persons who will be admitted to the Augusta Mental Health Institute in the future.” Riverview, which opened in 2004, replaced the Augusta Mental Health Institute.
During the three-month period from September to November, Wathen wrote, the waiting list for admission to Riverview averaged nine patients, but at one point recently the list reached a high of 16 patients.
LePage said on Thursday that he notified Gideon on Wednesday that his administration was moving to a new site, “She’s insisting on reopening the whole thing and we simply are not going to do that. The Maine people deserve better,” LePage said.
But Senate Minority Leader Troy Jackson, D-Allagash, said the creation of a new psychiatric facility that would house a certain population in state custody was a significant policy shift that warranted more transparency.
“Creating a new psychiatric care facility is a big deal,” Jackson said. “The governor should not expect to take such drastic steps without any accountability or transparency.” Jackson reiterated that Democrats agree that a new facility is needed.
“But taxpayers deserve to know that its construction and operation have been vetted,” Jackson said. “There are still many questions: It’s no secret that rumors are swirling about privatization, but we still don’t know one way or the other whether that’s part of the governor’s plan.”
Jackson said Democrats want to know what privatization would mean for patients, and he outlined other questions they have in a release issued Thursday.
“Who would be entrusted with (patient) care? What factors will be considered before a contract is handed out? Would the state realize any savings, or would it simply outsource state funds to a private corporation without any benefit to taxpayers?” he asked.
“The decision of whether to privatize one of Maine’s mental health facilities is a major policy decision that legislators need to be involved in making,” he said. “So far the administration has not answered key questions about what this facility would be like, who would run it, how much it would cost, and what the standards of care and staffing would be.”
Maine AFL-CIO President Cynthia Phinney said holding hearings on the proposal was the correct path forward and the one the union workers at Riverview supported. Phinney also raised concerns about privatizing the new facility.
“There has been a disturbing national trend of private prison corporations seeking to privatize mental health institutions and undermining transparency and accountability,” she said in a prepared statement. “Workers at Riverview look forward to a full discussion and an open and transparent process for moving forward and ensuring the best care for their patients.”
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