Now that the melodrama about whether and when Department of Health and Human Services officials will appear before a legislative committee to answer questions about the Riverview Psychiatric Center looks settled, the facility’s managers and lawmakers must turn their attention to solutions.
The hospital in Augusta has been without federal accreditation for more than two years. The most recent report from a court-appointed overseer of the facility chronicled numerous problems, especially with regard to staffing. Frustrated by confusing and vague responses to its inquiries, the Government Oversight Committee finally got serious last week and threatened to subpoena the superintendent of Riverview and the DHHS commissioner to compel them to answer questions from the panel.
DHHS Commissioner Mary Mayhew said Thursday, in a press release, that it was “ludicrous” that any commissioner be expected to be at the “beck and call” of the legislative oversight committee. On Friday, she said she would meet with the committee next month, as will Superintendent Jay Harper.
What may have been a scheduling conflict exposed a dangerous misunderstanding of the role of commissioners. In October, Gov. Paul LePage wrote to legislative leaders to say that all requests to question executive branch employees must go through him. All requests must be in letter form — no email. Written questions must be submitted to the governor and, if asked to appear before legislative committees, “the executive branch employees will only be permitted to clarify their written responses,” the Oct. 2 letter said.
“I fully expect that department staff will be treated with respect when they take time away from conducting the people’s work to appear before legislative committees,” LePage added.
LePage and Mayhew treat legislative oversight as an annoyance. It is not. It is essential to well functioning government.
Riverview is not functioning well.
The Centers for Medicare and Medicaid Services pulled Riverview’s federal accreditation in 2013 for reasons that included overcrowding, inadequate staffing and using handcuffs and Tasers to subdue violent patients. The state lost $20 million in annual federal funding as a result.
In late 2014, Daniel Wathen, the former Maine supreme court chief justice who oversees the state’s compliance with a mental health care consent decree, had a consultant visit Riverview several times. Elizabeth Jones, who briefly ran the facility when it was called the Augusta Mental Health Institute, reported that staff still relied on seclusion and restraints too often and that the facility needed more staff. She warned that “there is sufficient reason to question whether the state is in compliance with the consent decree provisions regarding individualized treatment and adequate staffing.”
As a result, Wathen successfully advocated for more funding for Riverview, as well as changes in patient treatment.
Jones returned to Riverview in October to see if the officials had addressed the deficiencies. She reported that staff shortages remained, causing staff to work more than 1,000 hours of overtime in July and August, and that staff hired for specific roles were instead filling in elsewhere to alleviate staff shortages.
She also found continuing treatment problems.
Frustrated by the lack of improvement, Wathen plans to soon visit Riverview for his own “fact-finding mission.”
Between Wathen, the Government Oversight Committee and DHHS, problems must be pinpointed and solutions must be found — and quickly implemented — to ensure patients and staff at Riverview are safe, now and in the future.
The only real, long-term solution, the department has long said, is to create a separate facility for violent patients who have been found criminally not responsible by the court system or incompetent to stand trial. Such a facility may be appropriate, but it won’t address immediate concerns. Fixing treatment and staff problems now is where lawmakers and the department should focus their attention.