Riverview Psychiatric Hospital Superintendent Mary Louise McEwen, right, listens as Maine Associate Corrections Commissioner Judy Breton testifies before a legislative committee.
What was supposed to be a two-hour meeting went four hours, as the members of three separate legislative committees met informally to ask officials at the Department of Corrections and the Department of Health and Human Services about how the state is addressing concerns raised by the federal government.
Officials at the Centers for Medicare and Medicaid have cited deficiencies at Riverview Hospital that will cost the state about $20 million a year in lost federal funds if not addressed.
While the administration is pushing LD 1515, a bill to expand the mental health unit at the Maine State Prison, as part of the solution, Riverview Superintendent Mary Louise McEwen told the group that one does not solve the other.
"It's two separate issues, LD 1515 and CMS," McEwen said, "so there is a small portion where they intertwine, and that is related to the decertification of the 20 beds on Lower Saco, which we felt we needed to do in order to comply with CMS standards."
Lower Saco is a one of the units at Riverview. One of the federal concerns is the close proximity of dangerous and violent patients with other mental health patients at the hospital.
Rep. Mike Carey of Lewiston serves on the Appropriations Committee and chaired the meeting. He says it's clear to him that while the legislation expanding the prison mental health unit may be needed, it will not solve the immediate problems federal officials have with Riverview.
"So much of it is dealing with things that CMS has absolutely no - that the report from the federal government - has absolutely no bearing on," Carey says. "This seems like trying to exploit a crisis to get something done they wanted to do all along."
Several groups also raised questions about how the proposed legislation addresses the problems at Riverview. Zachary Heiden, staff attorney for the ACLU of Maine, says there are issues that have to be addressed at Riverview, and not at the prison.
"People that are held, determined to be incompetent to stand trial, or people who are determined to be not criminally responsible are not criminals," Heiden said. "And they do not belong in jail or prison. They do not go to prison, and there is no way to simply transfer them over to a prison, simply because somebody decides they are too difficult to manage in a hospital."
Under questioning by lawmakers, Riverview Superintendent McEwen acknowledged that the state will lose some federal funds if 20 hospital beds are decertified as Medicare eligible, but she could not provide an estimate of costs. She also told the group that changes made so far to meet federal concerns have been carried out within existing resources. But, she added, additional funding requests will be made.
"There is some additional requests for additional staff that we saw that we needed," she said. "I guess I could say it was related to CMS, but we probably would have asked for it regardless of CMS."
Rep. Mike Carey says it's clear that additional state resources will be needed over and above the money for the expansion of the prison mental health unit.
"To say that what appear to me to be fairly profound management and governance problems can be fixed within existing resources seems to misunderstand the scope of the problem we are facing, and what it is going to mean if we lose $20 million as a state because we didn't fix these problems," Carey says.
Carey assured McEwen that the members of the Appropriations Committee will want some solId estimates on costs when they discuss the bill Thursday.
There was broad agreement among the lawmakers that the problems facing Riverview are long term and will require a detailed plan. Some are recommending that the Legislature set up a special committee to work on the problem.
Photo: Mal Leary