Maine DHHS Commissioner Mary Mayhew addresses members of the Legislature's Appropriations Committee.
After quickly passing a series of unanimous votes on a $150 million bond package for the fall ballot, members of the Legislature's Appropriations Committee moved on to a problem that will require a considerably longer timetable to work out.
And state Department of Health and Human Services Commissioner Mary Mayhew says time is not on the state's side as it struggles comply with federal requirements at the 92-bed Riverview Psychiatric Center. "If our corrective action plan is not approved by Sept. 2, the hospital certification will be terminated," Mayhew told lawmakers.
That loss of certification from the federal Centers for Medicare and Medicaid Services would cost $20 million. as a result of the state's failure to provide a safe environment for non-forensic patients - or those who are there for reasons unrelated to criminal activity.
Forty-four of the facility's beds are reserved for forensic patients, but those numbers have risen to up to 62 patients over the last 18 months. Mayhew says the patients are prone to violent behavior, necessitating the presence of corrections officers or police in the co-mingled forensic and non-forensic setting.
Mayhew told members of the Appropriations Committee that federal officials had rejected earlier proposals for bringing the facility into compliance. Now, she says her best hope is a volunteer reduction of the facility's certified beds that will also come with a cost.
"We have proposed to decertify 20 beds on the lower Saco Unit, which includes the creation of a separate and distinct unit for court-ordered patients," Mayhew said.
By removing the violent forensic patients from the non-forensic area, Mayhew says she can mitigate the multi-million dollar problem posed by the loss of federal funds on a short-term basis. The long-term solution, she says, rests with the Legislature, which could have acted this year on LD 1515, a bill that has been carried forward until next year.
"We continue to believe that the long-term solution to address additional capacity for court-ordered patients lies with LD 1515, an Act to Increase the Availability of Mental Health Services," Mayhew said. "Passage of this legislation would create a unit at the Maine State Prison for those who are currently court-ordered to Riverview and allow, ultimately, Riverview to bring those beds back into certification."
"Sooner or later, regardless, we're going to have to address this, and it seems to be coming sooner than later now," said Rep. Kathleen Chase, of Wells.
Chase, the lead Republican on the legislative panel, is one of several lawmakers who favor prompt reconsideration of the bill that was carried over to the next session, after the Appropropriations Committee could not find the $3 million needed to fund the new unit at the Maine State Prison.
State Sen. Emily Cain, an Orono Democrat, says next week's special session on bonds would provide the Legislature with a chance to act on the bill, and possibly amend it to address the concerns of federal regulators.
"The Legislature can't pass it today, so we do have the benefit of a little bit of legislative time to talk about what's is in here maybe that's not needed, and I'm also concerned about the question of costs, and I want to make sure we're being cognizant of that as we look what options are before us in the next seven days," Cain said.
Mayhew says she is awaiting a response from the Centers for Medicare and Medicaid Services on the state's proposed decertification of beds at Riverview. The Legislature will convene for a special session on bonds on Aug. 29.
Photo: Mal Leary