How long should it take to get Riverview Psychiatric Center on track? A year and a half after the hospital’s shortcomings drew a warning from the Centers for Medicare and Medicaid Services? Or a year after the federal agency pulled Riverview’s certification, along with $20 million per year in federal funding? Or perhaps six months after the superintendent was fired, and a replacement brought in?

Whatever the correct timeframe for expecting change at Riverview, the state has most certainly exceeded it. In a case that called for an honest and thorough response, the state has come up short, and officials are now depending on a long-shot argument in federal court to bail them out, when the focus should be on meeting the federal guidelines.

The Riverview affair has been handled poorly from the start. The first warning from the federal government was issued to the Department of Health and Human Services on April 17, 2013. Lawmakers, however, were not told that the facility’s certification — and $20 million in annual federal funding — were in danger for three months, even as they debated a bill aimed at alleviating overcrowding at Riverview.

In fact, DHHS Commissioner Mary Mayhew testified at a public hearing in favor of that bill, L.D. 1515, in May of 2013, and on June 25, after a second federal warning had been issued, she sent lawmakers an email asking that the Legislature carry over the bill until the next session. At neither point did the commissioner mention that Riverview was facing the loss of more than half of its $36 million annual budget.

At the time, it appears, the state was counting on the success of the mitigation plans developed in response to the federal concerns. But those plans were not approved, and Riverview’s certification was pulled on Sept. 2, 2013.

Now, a year later, state officials are banking on winning an appeal against the federal government.

In January, an administrative law judge with the Centers for Medicare and Medicaid Services rejected the state’s request for a hearing on the decertification. Last month, a three-member department appeals board upheld the ruling.

That leaves federal court as the last hope for the state. The state hopes the court will rule that Riverview was decertified in error, so that the state does not have to pay back the federal money it has spent since decertification, an estimated $11 million-$17 million as of the end of July.

While both the LePage administration and the Office of the Attorney General remain convinced in their argument, the chances the state will win appear slim.

And as the state makes its argument in court, the problems at Riverview continue.

Mayhew and Jay Harper, Riverview’s acting superintendent, say the safety issues that first drew the attention of federal authorities have been fixed.

But a number of other issues — poor record-keeping, medication errors, and lack of one-on-one treatment — have since surfaced, causing Riverview to fail its latest federal evaluation.

Current and former workers at the facility also have told the Kennebec Journal that the environment at Riverview is stressful and sometimes hostile, and that supervisors have not responded to complaints by the staff.

All of that provides a somewhat full picture of the systemic problems facing Riverview. Unfortunately, after all this time, it remains unclear whether the state has a solution.

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