AUGUSTA, Maine — Lawmakers on the Legislature’s finance committee grilled a Riverview Psychiatric Center official Wednesday about why the facility hasn’t moved faster to correct problems that could lead to a loss of $20 million in Medicaid funding.
The federal Centers for Medicaid and Medicare Services notified the state in early October that it was terminating Riverview’s Medicare Provider Agreement because of overcrowding, inadequate staff and the use of methods such as handcuffs and Tasers to subdue violent patients.
The 92-bed hospital in Augusta is run by the Department of Health and Human Services and houses some of the state’s most troubled mental health patients, including some who committed violent crimes and were found by the judicial system to be not responsible because of mental incapacity. After a series of violent outbursts by patients, the Center for Medicaid and Medicare Services conducted an unannounced inspection of the facility in March. The results of that audit led to the revocation of the funding, a decision which the state is appealing.
Mary Louise McEwen, Riverview’s superintendent, told the Appropriations Committee on Wednesday that efforts are underway to train staff and officers from the Capitol Police to better handle crises, establish a mental health unit at Maine State Prison and contract with a traveling nurse service to make up for nine nursing positions Riverview has been unable to fill. McEwen said those initiatives require coordination between state agencies and departments that are bound by statutory timelines to create new positions and develop contracts, as well as waiting for training opportunities.
All of those projects could be weeks or months from completion, said McEwen, which drew criticism from lawmakers who said there should have been more progress by now, considering that CMS nullified Riverview’s certification six weeks ago.
Rep. Michael Carey, D-Lewiston, questioned why four positions that are needed to comply with the federal guidelines for Riverview’s so-called “Lower Saco Unit” were just posted on Nov. 8.
“What’s the delay?” said Carey. “We’re talking about $20 million. That’s $55,000 a day. It’s a massive amount of money. I’m just concerned that the urgency isn’t there.”
Rep. Peggy Rotundo, D-Lewiston, agreed.
“I want to see your timeline, when the requests were made and where things have progressed along the way,” said Rotundo, House chairwoman of the Appropriations Committee. “I know there are processes in place but we’re talking about an emergency. We’re talking about patient and staff safety as well as $20 million that we could lose as a state. … Clearly, we have to be able to do better than six weeks and counting in an emergency situation. … This is not acceptable.”
McEwen said everyone involved recognizes the urgency of the situation.
“Almost everything we’ve talked about that we needed to do, we have no control over once that idea leaves us and goes somewhere else,” said McEwen. “We’ve stressed to the other state agencies involved that this is a priority and they are rushing things through much faster than I’ve seen in the past.”
Riverview officials, along with representatives from the attorney general’s office and others, agreed with CMS on a timeline for the state’s appeal. According to McEwen, CMS will file paperwork associated with the appeal by Dec. 3 and Riverview will respond by no later than Jan. 3, 2014. CMS will then have 10 days to make a decision.