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Lawmakers Question Hiring Delay at Maine Psychiatric Hospital
11/13/2013   Reported By: A.J. Higgins

Maine lawmakers say they're becoming increasingly frustrated by the state's delayed response to staffing problems at Riverview Psychiatric Center, which persist six weeks after federal officials terminated Medicaid funding for the 92-bed hospital. The state has appealed that decision, and $20 million dollars could be lost if the facility fails to address safety considerations, including adequate staffing. As A.J. Higgins reports, hospital administrators say the state's hiring process is complicated and does not lend itself to an accelerated timetable.

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Not all of the news delivered to the Legislature's Appropriations Committee was disappointing. Mary Louise McEwen, superintendent at the Riverview hospital in Augusta, says after the Centers for Medicaid and Medicare Services announced it would end federal funding at the facility because of safety concerns, the state responded by decertifying more than 20 beds.

And McEwen told lawmakers the facility is making some headway.

"We're continuing to address safety issues, and our long-term goal is to recertify the whole hospital - not just the three units, but the additional lower Saco unit," she said. "And so, to that end, we have identified several key things that we need to be working on."

Among those works in progress, McEwen says, are ongoing efforts to recruit new nurses and beef up the security formerly provided by county and state corrections officers, with personnel from the Capitol Police staff. That's the law enforcement agency that provides security inside the capitol and the state office building.

Security was a big topic when CMS made an unannounced inspection of Riverview, revealing non-compliance issues -many of which have since been corrected.

Still, state Rep. Erik Jorgensen, a Portland Democrat, had this question. "What would happen if CMS were to reappear today?" he asked.

McEwen said she believes Riverview has taken steps to bring the hospital into compliance with CMS policies. That includes additional staff training on controlling potentially assaultive patients. She says a forensic mental health unit at the Maine State Prison is expected to provide the hospital with some relief in the months ahead, and staffing concerns are being addressed.

"Regarding the staffing, I don't want to leave you with the impression that we're running short staffed - we're not," McEwen said. "We're making sure that people step in and fill in the holes to make up for the nine vacancies. So it does require people to work overtime. Fortunately staff is able to do that and willing to do that."

When McEwen informed the committee that job vacancies at Riverview identified as necessary a month ago were only posted last week, state Rep. Mike Carey, a Lewiston Democrat said the delay was unacceptable.

"My basic concern is just that I'm surprised we're not moving a little faster," Carey said. "What has kept us from having these positions posted last week? Those were positions that the commissioner talked about last month when she was here. What's the delay? It doesn't seem like the urgency is there. If there's $20 million dollars at this point that the state is footing the bill for that was not expected, that's $55,000 a day. That's a massive amount of money."

McEwen told lawmakers that the hiring process for posting jobs is a lengthy process, dictated by statue and involving other state agencies, and that it was beyond her control to expedite the timetable. Democratic state Rep. Peggy Rotundo, of Lewiston, said a six-week delay in posting jobs does not seem to rise to reflect the emergency situation that Riverview is confronting.

"If ever there were an emergency, this would be it," Rotundo said. "And we have to figure out a way to move this system faster. And I'm not doubting that you have done everything you can. But I'm interested in efforts on behalf of the commissioner, the governor, to speed this along, because clearly we have to be able to do better than six weeks and counting."

McEwen told lawmakers she expects a decision on the state's appeal of the Riverview decertification by CMS sometime in January.


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