A report issued late last month by former Maine Chief Justice Daniel Wathen, the court master who oversees Riverview Psychiatric Center, found insufficient staffing and substandard care at the state hospital. If that sounds familiar, it should. The findings are similar to the conclusions reached in a report issued a year ago.

It’s troubling that Wathen’s report, based on work by a consultant, found so little progress at Riverview, which has been unable to regain the federal certification it lost in 2013. And it’s perplexing that the Department of Health and Human Services, which issued a lengthy rebuttal to Wathen’s findings, sees the situation so differently.

Wathen will now follow up on the report with visits of his own to Riverview. That’s a important step for determining what’s really going on, and what can be done to correct it.

DHHS Commissioner Mary Mayhew, meanwhile, continues to push an ill-defined and costly plan for a new psychiatric unit as the only solution to the problems at Riverview.

She may be right, but it is impossible to know without learning more about the operation and oversight of the facility. After two years of fumbling operations at Riverview, Mayhew cannot expect the Legislature to take her word for it.

PERSISTENT PROBLEMS

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Wathen’s latest report does not help that credibility gap.

According to the court master report, staffing shortages at Riverview have people working excessive overtime to cover shifts, and performing duties for which they were neither hired nor trained.

As a result, patient care has suffered, and some of the programs designed to help patients, such as vocational employment, have been cut back or eliminated.

Riverview, the report also found, has been slow to fill open slots for forensic patients, or those found not criminally responsible by reason of mental illness, leaving these patients languishing in jail and missing the opportunity for beneficial early intervention.

RIVERVIEW RESPONDS

In its response, DHHS argued that Riverview had made strides in some areas, while others were being addressed with money from the state budget passed in July and had not yet had time to make an impact.

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In part, that is valid. Riverview has progressed since the use of stun guns to subdue patients first brought the ire of federal inspectors. Significant changes were made, and the progress in many areas has been noted. In other areas, there have been difficulties filling positions that are out of the hands of hospital administrators.

But the department has used the defense of bad timing before, when federal authorities visited, and other areas remain uncorrected.

Mayhew says they will never be fixed unless the Legislature creates a second facility for violent forensic patients.

SHORT ON SPECIFICS

That may or may not be the case. Riverview operated as a certified hospital while housing both forensic and civil patients before, and other hospitals continue to do so without issue.

It is, though, a tack worth considering if it can improve care, free up beds for civil patients, and regain federal certification.

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But without more information, there’s no way to tell if it will.

Gov. Paul LePage first proposed a new 14-bed facility, run by a private contractor, in early May.

Later that month, as the end of the legislative session neared, LePage submitted a bill calling for a 50-bed unit. The bill included only the cost — $18.5 million a year — and an explanation of the problems at Riverview.

No more information has been presented since then, and there’s been no indication of how the private operator would be selected, what standard they would be held to, and who would hold them to it. That’s unacceptable for such a significant change, with so much at stake for patients.

From Mayhew and LePage, the stance seems to be that legislators should just trust them.

But with their poor record at Riverview, that’s impossible.


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