The LePage administration wants to create “secure residential treatment facilities” for some mentally ill individuals caught up in the criminal justice system, offering it as an alternative to sending them to the troubled Riverview Psychiatric Center in Augusta.

Riverview, Maine’s only facility for so-called forensic patients, lost its federal certification in 2013 after a review found numerous deficiencies. The Department of Health and Human Services manages the hospital and has tried to address the issues, but the federal government recently notified the state that Riverview might not regain certification – and its eligibility for $20 million in federal funding – until more of its forensic clients are moved out of the hospital.

Forensic patients are generally defined as either accused criminals who have been found not competent to stand trial or individuals who have been found not criminally responsible because of a mental illness.

An extra appropriation of $6 million to fund the secure facilities was included in a package of revisions Gov. Paul LePage submitted Thursday to his biennial budget bill, which is slowly making its way through the Legislature.

Riverview Superintendent Jay Harper said the additional funding would provide for 14 beds at secure off-site locations, essentially group homes, that would be operated by private contractors.

Only those designated as not criminally responsible would be eligible for placement in one of the group homes and the state would decide whether to house a forensic patient at a group home or Riverview.

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Harper said the extra beds would ease capacity problems at Riverview, and provide another option for housing some forensic patients other than an acute care hospital, which is expensive, or integrating them into a community setting, where they may not get all the services they need.

“This is a piece of the pie that we haven’t had before,” Harper said Friday.

Riverview has 92 beds and an increasing number are being filled with forensic patients, in some cases because the facility is the only option.

But Harper said not all of these individuals need the level of care offered at the hospital and having another choice would certainly help with recertification.

“It also helps us better meet the terms of the consent decree, which says patients should be in the least restrictive environment,” he said, referring to the court order that governs how the state should manage mentally ill individuals.

Jenna Mehnert, executive director of the Maine chapter of the National Alliance on Mental Illness, said her organization supports the proposal.

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“We strongly support having a complete continuum of care,” she said. “If someone is taking up a hospital bed they don’t need, we should be looking at other options.”

Mehnert also said a secure group home setting is more appropriate for an individual found not criminally responsible than, say, a prison – an alternative that has been used in the past.

“We want to see Riverview get its certification back, but not if it just means moving people,” she said.

“If they are getting quality, appropriate treatment, I think it makes sense.”

However, she did say that the location of these proposed group homes could create concerns.

DETAILS STILL LACKING

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Democrat Rep. Drew Gattine of Westbrook, the co-chair of the Health and Human Services Committee, supports the concept but wants more details.

“It still doesn’t seem like a well-defined plan,” he said. “Every time we talk about Riverview, the problems haven’t changed for two years, but the department seems to be very slow in coming up with a global solution.”

Gattine said the Legislature already has approved four requests for additional funding for Riverview and two more are pending.

Harper acknowledged that the details need to be worked out. He said if the funding is approved, the state would go out to bid for the beds.

Asked why this option had not been considered before, Harper said capacity has only been a crisis for the last 16 months or so.

Maine officials have said the state has continued to receive the $20 million in federal funding since Riverview lost its certification, but federal Medicare officials have said repeatedly that the state will have to repay that money unless it can convince a court that the hospital shouldn’t have lost its certification in the first place.

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All the state’s appeals of the decertification have been denied so far, and there is no timetable for Riverview to be recertified.

Eric Russell can be contacted at 791-6344 or at:

erussell@pressherald.com

Twitter: @PPHEricRussell


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