AUGUSTA, Maine - One year after Riverview Psychiatric Center in Augusta lost its federal certification, the interim superintendent today told a legislative oversight committee that both safety and care have improved. But the "court master" who keeps tabs on Riverview says some problems persist.
Jay Harper says in the seven months he's been interim superintendent at Riverview, the hospital has made progress in two important areas: "We're reducing drastically psych emergencies, restraints and seclusions. And the effect of the reduction of that is more time in treatment," he said.
Riverview is safer, Harper says, and patient treatment has improved, because of a new focus on recovery. But a third area - which has to do with workplace culture - has been more challenging. Harper says the change involves a move from what he calls a "just good enough mentality" to a center of excellence.
"And make real investment in the hard-working staff that are there every day," he said. "So, they've been relatively cut loose and left adrift for several years now - probably at least half a dozen."
Harper told the Legislature's Health and Human Services Committee that Riverview is working with experts at Dartmouth and Harvard to implement training for every single staff member to achieve that goal.
But Court Master Daniel Wathen, who oversees a state consent decree that requires certain rights for Riverview patients, says he still has concerns. "I am most concerned about the safety of the hospital, from the point of view of both clients and the staff," he said.
Wathen says some Riverview staff float to different areas outside their expertise to meet required statf-to-patient ratios, compromising safety for both. Wathen says Riverview needs more experienced staff, and more tools to treat a growing forensic population brought in through the criminal justice system.
"In dealing with today's forensic population, the hospital must be authorized to resort to involuntary medication, to the full extent permitted by the United States Constitution," Wathen said.
The Maine State Employees Union submitted the results of a Riverview employee survey to the committee. Of 43 respondents, 37 reported being physically threatened, attacked, or injured at work. MSEA Political Director Mary Anne Turowski says staff have a number of suggestions to increase safety.
"There's some camera blind spots they've identified," Turowski said. "There are some workplace configurations so that there's clear line of sight from a nursing station to the rest of the unit."
Members of the Health and Human Services Committee asked Superintendent Harper for more data on staffing, and on the use of seclusion and restraints, to better gauge how Riverview is improving. Senate Committee Chair Margaret Craven, a Democrat, told Harper she's glad to hear that Riverview is taking staff complaints seriously.
"For several times that I've been hearing, it's blaming the population, instead of taking a hard look at the facility and the treatment," Craven said.
Harper says he firmly believes that Riverview will pass federal certification when it receives its next evaluation, which could occur at any time, without prior notification.
