AUGUSTA — State legislators told Riverview Psychiatric Center officials today they’re not moving fast enough to fill staff positions and improve patient and staff safety to get the hospital re-certified — and funded — by the federal government.
Last month, the federal Centers for Medicare and Medicaid Services terminated funding for the state psychiatric hospital after determining, through visits and surveys, the hospital was not meeting federal standards. The hospital now faces the loss of $20 million in federal funding, which represents more than half of its $36 million annual budget.
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“We’re talking about patient and staff safety, as well as $20 million we could lose as a state,” said Rep. Peggy Rotundo, D-Lewiston, house chairwoman of the Joint Standing Committee on Appropriations and Financial Affairs, noting that the state has had six weeks to add to Riverview’s staff. “We’re talking about an emergency here. We have to find a way to get the system to move faster, because clearly we have to do better than six weeks and counting in an emergency situation. This is not acceptable.”
Riverview Superintendent Mary Louise McEwen said state officials are working to finalize, probably next week, a contract with an agency to provide travel nurses to work at Riverview until permanent nurses can be found to fill nine vacant positions there.
McEwen said once the contract is signed, it still could take a few weeks to find temporary nurses to fill the positions, adding that part of that challenge could be finding nurses “who are willing to come to Maine in the winter.”
She said shifts aren’t going unfilled, but the staff is required to work overtime. She said the staff has been willing to do so, but warned extensive overtime can create stress.
She said officials are rushing, but it takes time to go through the state’s human resources process to establish and fill new positions in state government. She said things are being pushed through much faster than she has seen previously, both by Riverview and human resources officials. That didn’t seem to reassure legislators.
Rep. Michael Carey, D-Lewiston, said he didn’t consider six weeks to be “rushing things through faster.”
“We are where we are because the federal government said we were abusing patients’ human rights and putting staff in unsafe positions,” he said.
Other steps that have been taken to address federal concerns at Riverview include having Capitol Police and Riverview staff members travel to the New Hampshire state hospital for training, and holding staff training at Riverview on how to respond to patient misbehavior, McEwen said.
She said Maine is considering methods that are used in New Hampshire to limit patient violence.
Also, McEwen said the state has identified but not yet filled additional staff positions needed for the Lower Saco Unit, where the most violent forensic patients are housed. In addition, it is furthering talks with the state Department of Corrections with a goal of establishing a mental health unit at the Maine State Prison by mid-February.
McEwen said a mental health unit at the prison could reduce the number of forensic patients at Riverview.
The state has appealed the federal termination of its funding and requested an expedited hearing, and is expected to file briefs in the appeal by Jan. 3.
McEwen said if federal officials come back to Riverview to conduct what she called a survey it would not be announced in advance.
Other steps meant to address federal concerns include having Capitol Police take over security positions within Riverview previously filled by deputies from the Kennebec County Sheriff’s Office.
One of the deficiencies cited by regulators who inspected the state forensic hospital in unannounced visits May 8-10 was the presence of sheriff’s deputies providing security within Riverview, which McEwen said federal authorities viewed as making the unit less a treatment unit and more a punishment unit.
Security at the hospital was stepped up after an attack on a mental health worker March 16 by patient Mark P. Murphy. He’s been charged with aggravated assault and assault following an incident in which he allegedly stabbed the worker in the hand with a pen and punched her repeatedly.
Federal authorities said deputies used stun guns to subdue unruly patients, and that action, as well as their presence within center units, agitated patients.
The contract for sheriff’s deputies to provide security has since been terminated. McEwen said Capitol Police were being trained to take their place, and the staff is being trained to deal with patient outbursts better.
Rep. Dennis Keschl, R-Belgrade, said his understanding was that it has been hard to get new state positions approved in the current political climate. He asked McEwen whether the current “situation at the national level, with Obamacare and the computer system,” was taking Centers for Medicare and Medicaid Services resources away and potentially delaying consideration of Maine’s appeal seeking the reinstatement of the $20 million in federal funding for Riverview.
McEwen said she thinks a separate entity within the agency deals with hospital certification.
At a Nov. 6 public forum on mental health in Augusta, a Riverview employee said the Legislature should enact a law to protect health care workers from violence.
Keith Edwards – 621-5647 kedwards@centralmaine.com
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