A judge overseeing Riverview Psychiatric Center’s compliance with a 25-year-old consent decree said Friday he’s encouraged by progress being made at the mental hospital in Augusta that has been criticized for its handling of patients and failed to comply with federal standards during the past two years.
Superior Court Justice Andrew Horton, who oversees the consent decree resulting from a 1990 lawsuit settlement against the former Augusta Mental Health Institute, said he was pleased with “significant changes” and the “forward-thinking” leadership at the hospital. Riverview opened in 2004, replacing AMHI, but the consent decree still applies.
Daniel Wathen, the special master in charge of monitoring Riverview who reports on hospital issues to Horton, said a proposal by the administration of Gov. Paul LePage to boost funding by $2.7 million will help, as will overhauling policies, such as reducing the use of seclusion and restraint.
“I’ve seen a lot of plans over the last 10 years, and this is a very highly thought-out and funded plan,” Wathen said at Friday’s hearing in Portland. Horton did not issue any rulings on Friday, but he and Wathen are expected to tour Riverview within the next year to monitor progress.
Riverview Superintendent Jay Harper has led a number of reforms at the hospital, including additional training, eliminating on-site corrections officers, hiring more psychiatrists and creating the “acuity specialists” position. The acuity specialists are trained to de-escalate conflicts with patients.
Harper also integrated the Lower Saco forensic wing with the rest of the hospital on Oct. 24, nine days after Wathen criticized the segregation of the unit at a hearing of the Legislature’s Health and Human Services Committee.
The Lower Saco unit is where the most challenging forensic patients at the 92-bed hospital are housed. The hospital is split about evenly between forensic patients – those sent to the hospital through the criminal court system – and patients who have been committed through a civil process.
The U.S. Centers for Medicare and Medicaid Services notified Riverview in 2013 that it no longer met federal standards after deficiencies were discovered, including use of Tasers on patients, improper record-keeping and poor treatment plans. A Portland Press Herald investigation revealed that Riverview attempted to cover up an incident of abuse against a patient. In December 2013, a naked patient was pepper-sprayed in her room by a corrections officer and held in seclusion and restraints for hours afterward despite not posing a threat to staff.
After Riverview was decertified by the federal government in September 2013, causing the state to lose its eligibility for $20 million in federal funding, the Lower Saco unit was segregated from the rest of the hospital in an attempt to regain federal certification.
But Wathen said segregating the hospital did not persuade federal officials to restore the certification, and it violated the state’s consent decree because the Lower Saco patients did not have access to the same services and amenities as the rest of the patients – such as the gymnasium and cafeteria.
“It was not conducive to operations at the hospital,” Wathen said. “For instance, if someone was going from Lower Saco to Upper Saco, they had to be discharged and readmitted. It was not something the administration wanted to perpetuate.”
Harper, meanwhile, said at the hearing that Riverview is not the proper setting for some of the more combative patients. The hospital is designed to give patients freedom to make choices and walk about the hospital, he said, and some patients need more structure. Harper said there should be another facility that takes such challenging patients.
A proposed bill before the Legislature would relocate such patients to the Cumberland or Somerset County jails for treatment, but Wathen said he does not believe that bill is supported by the administration.
Harper declined to answer questions after the meeting and a question sent to a Maine Department of Health and Human Services spokesman went unanswered Friday afternoon.
Jenna Mehnert, executive director of the Maine chapter of the National Alliance on Mental Illness, said she’s concerned the administration will send patients found “not criminally responsible” for their actions because of mental illness to a correctional institution. She said she doesn’t oppose creating an additional facility for patients who are not criminals, but it shouldn’t be at Riverview, and the new treatment center should be operated by DHHS, not the correctional system.
“We need an in-between place, but it has to be in a therapeutic hospital setting and not a correctional setting,” Mehnert said.
Joe Lawlor can be contacted at 791-6376 or at: