Legislative Action Needed to Ensure Safety of Patients, Funding at Riverview Psychiatric Center 

Increase in forensic patients, lack of funding for Governor’s bill, puts hospital’s federal certification at risk

AUGUSTA – Governor Paul R. LePage today called on the Legislature once again to fund the creation of a mental health unit within the Department of Corrections in direct response to a notice from the federal government that the state-run Riverview Psychiatric Center in Augusta may lose its federal certification and federal funding. The notice is largely attributable to the growing number of forensic patients and conflicts with federal hospital standards.

This spring, Governor LePage sounded the alarm to address the need for additional safety measures, capacity to handle the increase in forensic patients and compliance regulation with the Centers for Medicare and Medicaid Services (CMS), which certifies the hospital. As a result, the Governor proposed LD 1515, “An Act To Increase the Availability of Mental Health Services”, to establish an inpatient-level treatment facility within a correctional institution.

The Criminal Justice and Public Safety Committee recognized the urgency of this matter and unanimously endorsed the bill. However the Appropriations and Financial Affairs Committee failed to appropriate $3 million for a facility, effectively rejecting the plan.

“We have now learned the CMS is going to take action that would put federal funding for Riverview in jeopardy,” said Governor LePage. “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.”

“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. 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,” the Governor continued.

As a federally certified hospital, Riverview must operate under federal guidelines to maintain a federal certification and associated federal funding. This week, the Centers for Medicare and Medicaid Services expressed concern about compliance with certification at Riverview. A major factor prompting this concern is the significant issues related to the increased number of forensic patients at Riverview. In the past 18 months the level of forensic patients has increased dramatically. In January 2011, there were 44 forensic patients at Riverview. That number reached an all-time high of 62 in April 2012 and has been consistently over 50 ever since.

Forensic patients are individuals who arrive at Riverview through the corrections system and pose a risk for serious physical harm to themselves or others because of mental illness. The hospital has about 300 employees, and there is an average daily population of 83 patients, including forensic patients.

In addition, there is not sufficient security at Riverview to address the threat of serious physical harm by forensic patients. This year, a staff member was severely injured after an attack by a forensic patient. 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.

The Department of Corrections and Department of Health and Human Services (DHHS) have worked diligently with federal partners to address challenges at Riverview through corrective action plans, but action is needed to ensure federal certification of the facility.

“First and foremost, we are concerned about the safety of our staff and our patients. 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.” said Mary Mayhew, Commissioner of DHHS.

“We believe that creating a mental health unit within the Department of Corrections will allow for another option for those in our jails who are in desperate need of mental health treatment, create a safer environment at Riverview, and allow us to serve the civil and forensic clients that the hospital was designed to help. We also believe this will assist us in restoring full compliance with CMS regulations and ensuring the maintenance of federal funding for Riverview,” Commissioner Mayhew said.