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Maine Lawmakers Press LePage Administration for Answers on Riverview Funding Cut
10/09/2013   Reported By: A.J. Higgins

The LePage administration says it's confident that the state will be able to convince the federal government to reinstate $20 million in funding for the Riverview Psychiatric Center in Augusta. Maine's Health and Human Services chief went before lawmakers today at the State House. But Democratic leaders say Commissioner Mary Mayhew's presentation was short on details, and that they still don't understand how the administration plans to cover the funding loss, or resolve the staffing issues that brought it about. A.J. Higgins has more.

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Maine Lawmakers Press LePage Administration for An
Originally Aired: 10/8/2013 5:30 PM
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The Legislature's Appropriations and Health and Human Services committees have been looking for answers from the LePage administration about why it claimed to have resolved federal concerns about staffing and operations at Riverview, only to have the Centers for Medicare and Medicaid Services withdraw $20 million in funding.

For Ken Albert, DHHS director of Licensing and Regulatory Services, told lawmakers he had been through earlier hospital inspections with CMS representatives in the past. On those occasions, he says he always made sure that Riverview and all hospitals in Maine were clear on what CMS expected. "In this case, I'm not so sure that occurred," Albert said.

Albert says DHHS staff thought they fully understood in August what changes federal regulators wanted at Riverview. But by mid-September, when CMS surveyed the facility, it became clearer that they were unhappy with the staffing structure.

"It was only during that survey that it became apparent to us - to the state survey team - that there was a shift in policy by CMS, or a shift in interpretation by CMS, about how a distinct-part hospital could be in compliance," Albert said.

Maine Health and Human Services Commissioner Mary Mayhew says she believes that the state will prevail in an administrative appeal of the CMS decision. When pressed by the committee about how the department plans to keep the unit funded in the absence of restored federal funding, Mayhew cited a review of salary changes and other costs.

She says the ongoing federal shutdown has made it difficult to work toward a resolution with CMS, as have tensions at Riverview, which has found itself under a federal microscope.

"We are evaluating the importance of creating a blameless culture, like many organizations strive to do," Mayhew said, "because outside of a blameless culture, it is difficult to get the type of reporting around concerns, errors, mistakes that allow for a continuous process improvement and quality improvement environment," Mayhew said.

Democrats expressed frustration with some of Mayhew's answers. "We're eager to work with the commissioner to solve the problem, but we need information," says Rep. Peggy Rotundo, a Lewiston Democrat and Appropriations Committee co-chair.

Rotundo says she's appreciates Mayhew's efforts to keep lawmakers informed. But she said there are still many key questions that remain unanswered.

But some Republicans believe Mayhew is doing the best she can under difficult circumstances. "She's giving us the answers that she has at this time," says state Rep. Deb Sanderson, a Chelsea Republican and member of the Legislature's Health and Human Services Committee.

"It's very clear that - it was made very clear, by both director Albert from DLRS and the commissioner, that though they're working from the same policy book, there is a severely different interpretation of what some of this stuff is meaning,' Sanderson says.

Commissioner Mayhew says she hopes to get an expedited process from CMS for the state's administrative appeal that could provide some answers within a month. But she also says that the ongoing federal shutdown only continues to frustrate that process.



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