DHHS chief says safety issues at Riverview addressed after attack

Health and Human Services Commissioner Mary Mayhew discusses the state's request to the federal government to reduce Medicaid coverage in August.
Health and Human Services Commissioner Mary Mayhew discusses the state's request to the federal government to reduce Medicaid coverage in August.
Posted Oct. 29, 2013, at 2:07 p.m.
Last modified Oct. 30, 2013, at 6:40 a.m.

AUGUSTA, Maine — Lawmakers on the Legislature’s Health and Human Services Committee were updated on the status of the state’s embattled Riverview Psychiatric Center on Tuesday.

The state’s only forensic hospital that houses those with violent mental illness has been under the scrutiny of the federal Centers for Medicare and Medicaid Services for months.

The hospital is required by state law to accept patients from the criminal justice system that are too dangerous to themselves or others to be safely housed in a jail or prison setting.

The hospital also has beds for patients who are committed to the system through a civil court process. But Maine’s Department of Health and Human Services Commissioner Mary Mayhew told lawmakers Tuesday the hospital was deferring requests for civil bed space to the state’s other private facilities.

Meanwhile the hospital continues to house 52 forensic patients that have been sent to the facility from the courts or prison system. Another 22 patients at the hospital are in there from the civil side, Mayhew said.

Most recently the hospital learned changes it made in an effort to save about $20 million in federal funding did not go far enough.

A move that created a 20-bed segregated unit, which is ineligible for federal funding because of the presence of Department of Corrections officers, is a concern for CMS because the hospital “co-mingles” other staff between the certified and decertified units, Mayhew said.

The issues with underlying safety concerns at the hospital that emerged in March after a patient attacked and seriously injured a health care worker mostly have been addressed, Mayhew said.

She also told the committee the state was appealing the CMS decision to make the entire hospital ineligible for federal funds while it was making changes and reapplying for federal certification.

Lawmakers and Gov. Paul LePage attempted to address some of the federal government’s underlying concerns with legislation passed in September that expanded capacity and treatment staff for a mental health ward at the Maine State Prison in Warren. The expansion of the prison mental health ward to 30 beds is expected to relieve some of the demand for beds at Riverview.

Still, under the new law, individuals found either not criminally responsible for their actions by the courts or those determined to be incompetent to stand trial would remain at Riverview.

The committee also learned more details from Mayhew and Riverview’s Superintendent Mary Louise McEwen about efforts to re-establish federal certification for the entire hospital.

Efforts to improve staff training and pay continue as an eventual means toward eliminating the need for correction officers at Riverview.

McEwen said they focus first on the decertified unit.

“We are focusing on that unit first knowing that’s the most pressing need,” she said.

Changes at the hospital may also include the full-time staffing of a Capitol Police resource officer at the hospital, McEwen noted.

Capitol Police are a division of the Maine Department of Public Safety and are tasked with providing security and law enforcement for state-owned facility in Augusta. They are fully certified police officers.

The Riverview resource officers would not be stationed in a treatment unit but would be able to quickly respond to emergency scenarios anywhere in the hospital, Mayhew said.

Those officers would also help provide security checks and screening of visitors while also working to proactively correct any safety risk identified. The officer would also conduct any of the criminal investigation stemming from incidents at the hospital.

McEwen told the committee Tuesday that about 95 percent of the Capitol Police’s criminal investigations originate at Riverview.

Sen. Margaret Craven, D-Lewiston, asked about efforts to increase pay for registered nurses and psychologists at the facility in an effort to improve staff retention and recruitment.

Mayhew and McEwen said efforts were under between employee unions and the state’s Department of Administration and Financial Affairs to ensure pay scales were being adjusted upward.

They also are looking at ways of bringing additional staff on board through other agencies that can provide trained staffing, McEwen said.

 

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