AUGUSTA — The Riverview Psychiatric Center could see more than half of its operating budget stripped away by the federal government for failing to meet guidelines.

The Centers for Medicare & Medicaid Services cited overcrowding and inadequate staffing for its threat to withhold $20 million by Sept. 2.

Gov. Paul LePage blamed lawmakers for failing to act on his bill to create a mental health ward at the Maine State Prison to cut down on overcrowding at the 92-bed hospital in Augusta.

On Thursday, LePage issued a statement accusing Democratic leadership of misplaced priorities. But Democratic lawmakers said the LePage administration recommended holding his $3 million proposal for the state prison over for the next session in January.

“We have now learned the CMS is going to take action that would put federal funding for Riverview in jeopardy,” LePage said. “Democratic leadership and certain members of the Appropriations Committee made the decision to fund other things, such as revenue sharing, while ignoring the needs of our mentally ill.”

The number of forensic patients — those being held at the facility because they were either found psychologically unfit to stand trial in a criminal case or were deemed not guilty by reason of insanity — reached an all-time high of 62 in April, according to LePage.

The bill he offered would have added a forensic wing to the Maine State Prison in Warren, along with 15 new staff members.

“Our administration worked diligently to provide information to the Legislature, knowing that certification and critical funding for Riverview was in jeopardy, yet there was a failure to act,” LePage said. “These patients, their families and hospital employees can be assured that the administration is working toward a resolution, and we are requesting swift action from the Legislature.”

As a federally-certified hospital, Riverview must operate under federal guidelines to maintain federal certification and associated federal funding, LePage said.

But Jodi Quintero, a spokeswoman for House Speaker Mark Eves, D-North Berwick, said the administration asked them to hold the bill for consideration in the next lawmaking session set to start in January 2014.

“Action was delayed on the measure until next year at the request of the Department of Health and Human Services,” Quintero said. “The measure had unanimous support from the Criminal Justice Committee. The bill was not rejected.”

Quintero also sent a copy of the June 25 memo to the Appropriations Committee from Nick Adolphsen, the DHHS liaison to the Legislature.

“I am writing to request that LD 1515, An Act to Increase the Availability of Mental Health Services, be carried over for further consideration during the second session of the 126th Legislature,” Adolphsen wrote. “While we consider this bill an essential reform for both Riverview and corrections, we understand the limited availability of funding and know that its passage this session is unlikely.”

It also remains unclear whether the state legislation would satisfy the concerns of the federal government. 

Quintero said Democratic leadership and key officials within the administration were working to find a resolution to the issue.

“We have a serious problem that will require cooperation and swift action to resolve,” Eves said.

Senate President Justin Alfond, D-Portland, vowed to cooperate with the administration to fix the problem.

“Now is not the time for partisan politics; we should move quickly to make sure we take care of our mentally ill and ensure public safety,” Alfond said.

According to LePage, the hospital has about 300 employees, and there is an average daily population of 83 patients, including forensic patients.

“This year, a staff member was severely injured after an attack by a forensic patient,” according to LePage’s news release. “CMS regulations for a certified hospital are not well suited for managing the increased forensic population. For instance, CMS does not allow hospital staff to utilize typical law enforcement tools to manage aggressive patients.”

LePage said the state’s Department of Corrections and DHHS have been working with the federal government on a corrective action plan.

Still, he said, Legislative action was needed to ensure federal certification of the facility and the federal funding.

“First and foremost, we are concerned about the safety of our staff and our patients,” Mary Mayhew, the state’s DHHS Commissioner said. “We have focused a great deal of attention on addressing these challenges and ensuring we have appropriate care for our civil and forensic patients, while maintaining staff and patient safety.”

Mayhew said DHHS believed creating a mental health unit within the DOC would not only make Riverview safer, it would also allow for another option for individuals in county jails, “who are in desperate need of mental health treatment.”


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