December 11, 2017
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Court watchdog offers hope that Maine can fix $50 million psych care problem

By Christopher Cousins, BDN Staff
Seth Koenig | BDN | BDN
Seth Koenig | BDN | BDN
Daniel Wathen

The state’s progress in correcting serious problems with the taxpayer-funded mental health system has been strong but problems remain when it comes to medication management for patients, according to a new report from Maine’s mental health overseer.

Former Maine Supreme Court Chief Justice Daniel Wathen, who is the courtmaster for Maine’s Mental Health Consent Decree, wrote in a progress report filed Wednesday in Kennebec County Superior Court that “progress is being made, although haltingly at times.”

Wathen’s written assessment, which covers from Dec. 1, 2016, to July 31, 2017, is part of his ongoing oversight of the mental health system, which is trying to recover from dismal days on several fronts.

Perhaps the most serious problem is that Riverview Psychiatric Center in Augusta was decertified in 2013 by the federal Centers for Medicare and Medicaid Services because of, among other things, the use of stun guns and corrections officers in the hospital.

In June of this year, CMS notified the state that it is recalling more than $51 million in payments that have been made to Maine since then, but the state is appealing that decision. If Maine loses that appeal, it will have to repay the money, plus interest. The repayment would be made out of the state’s rainy day fund, according to provisions in the recently passed biennial state budget.

Wathen told the Bangor Daily News on Friday that CMS inspects facilities on a surprise basis and that many of the organization’s concerns from the past have been corrected.

“My expectation would be that Riverview will make a much more favorable presentation to CMS than it has in the past,” he said.

Wathen reported that the state has made impressive progress on reducing waitlists for various services — the waitlist for mental health caseworkers, who Wathen said are crucial in helping people access services, went from 656 in 2014 to 38 in June of this year, for example — and for adequately supporting programs such as the Bridging Rental Assistance Program, which helps people with mental illness reintegrate into communities.

One area that still remains a problem is medication management, which Wathen wrote “chronically remains in short supply.” He said that’s mostly due to a shortage of psychiatrists and psychologists in the state but praised the Legislature for blocking a Maine Department of Health and Human Services plan to reduce the reimbursement rate for psychiatric service providers.

“In my own opinion, which I expressed to the department and the Legislature, the proposed reduction was based on a wage assumption that was at odds with the market,” he wrote.

In an interview, Wathen called his report “positive, but with reservations.” In the past, Wathen’s recommendations have at times landed the state in court over disagreements about how to implement them.

“At this point, there’s really no specific recommendation that I’m making,” he said. “I’m just recommending that they continue to pursue the course that they’re on. I have to say that attorneys on both sides are doing that in good faith and doing a good job of it. They’re serious about their effort to improve.”

 


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