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Maine Officials Vow to Appeal Decision to Defund Psychiatric Hospital
10/03/2013   Reported By: A.J. Higgins

The federal govenment has decided to eliminate $20 million in annual funding to the state's Riverview psychiatric hospital in Augusta, due to unresolved problems with staffing and governance. State officials say they will appeal the decision, and are confident the ruling can be overturned. But in the meantime, operations at the hospital will be a challenge. A.J. Higgins has more.

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Federal inspectors from the Centers for Medicare and Medicaid Services are terminating the state's $20 million in annual federal funding until the facility is brought up to standards. Mary Mayhew, the state commissioner for the Department of Health and Human Services, says her department responded effectively to a number of safety issues cited at the hospital by CMS earlier this year.

Mayhew said the decision to terminate funding is connected to the hospital's creation of two distinct areas in the facility: one for forensic patients referred through the criminal justice system and one for civil patients. Mayhew says many of the perceived shortcomings listed by the feds allege that the hospital failed to distinguish staff and equipment allocations between the two units.

"I am extremely disappointed with the federal decision that I believe ignores the consequence upon the people who most depend upon critical access to inpatient psychiatric services," Mayhew says.

Mayhew says the federal funds received by Riverview accounted for more than 50 percent of its operating budget, and that the state faces a significant challenge going forward until the issue can be resolved. Until then, hospital administrators are evaluating the situation in an attempt to determine what support arrangements may be reached with the state's other psychiatric hospital in Bangor, as well as private hospitals throughout the state.

Mayhew says her department is doing its best to respond to the loss of revenue, and remains hopeful that an appeal to CMS will result in the restoration of federal funds.

"The bottom line is we simply do not have the state dollars to replace this lost federal funding," Mayhew says. 'We are closing admissions to civil patients. That is going to have a significant consequence for the entire mental health system. We need to move quickly to address these challenges, but the federal government needs to absolutely revisit this decision."

For the mental health community, the decision to close civil admissions at Riverview feels like another step backward for a state mental health system that has struggled for decades. Jenna Mehnert, executive director for the Maine chapter of the National Alliance on Mental Illness, says this latest development only underscores the need for Maine to take a long hard look at its system for delivering mental health services in the state.

"And now we've taken away what's a key component of our mental health system by not having the ability to admit anymore civil patients," Mehnert says. "That's just going to create ripple effects throughout our emergency rooms across the state, throughout our jails across the state. It's a serious concern."

Gov. Paul LePage offered no public statement on the CMS defunding decision at air time. LePage has said that he will not submit a supplemental spending plan to close what is now estimated to be a shortfall of $40 million.

Maine Senate President Justin Alfond says the governor hasn't notified Democratic leadership at the State House of the Riverview decision. But he says Democrats will ensure that the state's finances are balanced, and will open a line of communications with federal officials and work with the state's congressional delegation to resolve issues at Riverview.

"Because if we can't get information from this administration or from Commissioner Mayhew, then we have to go to other routes to try to figure out what the best next step is, and to ensure that the patients, the families and those who are needing services at Riverview get them, and get them in a way that doesn't return us to our past," Alfond says. "We've closed down Pineland, we've closed down AMHI, and we know that we must do better for those patients who need mental health services in the state of Maine."

Alfond says the Appropriations and Health and Human Services Committees are considering the option to convene a joint emergency debriefing of Mayhew if the governor's office continues to keep lawmakers out of the loop on events at Riverview.

Photo:  Mal Leary

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