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Report: Staffing Concerns Still Remain at Riverview

AUGUSTA, Maine — A second report about Riverview Psychiatric Center's progress in correcting deficiencies finds that the Augusta hospital still has work to do.

Riverview lost federal certification in 2013 for safety violations. While the hospital has improved in its reporting of incidents of seclusion, restraint and psychiatric emergencies, staffing issues remain a primary concern.

The staffing problems at Riverview aren't new. They were identified as an issue in the previous report, which came out a year ago. The fact that they haven't been resolved, says Kevin Voyvodich, an attorney for Disability Rights Maine, is troubling.

"The things that are pointed out are the core functions that you want Riverview to begin with, and that's treatment of the patients," he says.

The reports by outside consultant Elizabeth Jones were commissioned by Dan Wathen, the court master of a consent decree that oversees certain rights for Riverview patients.

Wathen says Riverview has about 30 vacant positions, and that shortage leads to problems. Acuity specialists, who were hired to improve care at Riverview because they can diffuse or prevent potentially violent situations, must now sometimes fill in other roles that they're not trained to do.

"They were to be a supplement to mental health workers and an additional resource, not a replacement for mental health workers," Wathen says.

The report also finds that the strain on staffing prevents patients from pursuing vocational training, which is considered an important strategy for treatment.

"I think that we always have room to do improvements and stuff like that," says Jay Harper, superintendent of Riverview "It's always good to have a set of outside eyes to tell us how we're doing."

He took the helm a few months after the hospital lost its federal certification in 2013 for issues such as corrections officers' use of stun guns and handcuffs to subdue patients. Harper has been moving Riverview toward a recovery-based model, where patients are actively involved in shaping their care.

While he acknowledges Riverview has more work to do, he says the report fails to grasp the full picture, such as the hospital's high number of forensic patients and those incompetent to stand trial.

"Which wasn't touched on by the consultant at all, but that puts a lot of pressure on us here at the hospital," Harper says.

In recent months, the LePage administration has proposed building a separate rehabilitation facility for forensic patients. The idea has, so far, failed to gain broad support from lawmakers.

"I'm not convinced, and there's nothing in this report that that indicates — or nothing from the court master that indicates building a new facility is better," says Drew Gattine, Democratic co-chair of the Health and Human Services Committee.

Gattine submitted a bill that would require the Department of Health and Human Services to create a comprehensive plan for Riverview. It was rejected for consideration in the next legislative session, but Gattine says he's appealing.

He calls the recent report a wake-up call to DHHS, the Legislature, and Riverview management to successfully address chronic issues at Riverview.

Meanwhile, Dan Wathen says he's submitted the report to the court, which will likely meet in December to consider what, if any, action to take.