AUGUSTA, Maine — Maine Health and Human Services Commissioner Mary Mayhew clashed with lawmakers Monday in a two-hour meeting about the future of forensic patients at Riverview Psychiatric Center.
Mayhew is once again pressing for funding for a separate facility to house and treat them. She says that could help the hospital win certification from the federal government.
Unless the issue is resolved, Maine may have to return $30 million in Medicaid payments.
During her two-hour appearance before the Legislature's Appropriations Committee, Mayhew told lawmakers that the only way to preserve millions of dollars in federal funding for the beleaguered Riverview Psychiatric Center is to create a new residential treatment facility to care for mentally ill patients who have committed crimes.
The decision would end the state's current practice of housing forensic and nonforensic patients in the same building, she says, at an annual cost of about $4 million. It would also safeguard about $20 million annually in Medicaid funding.
Mayhew says it shouldn't that tough of a choice for lawmakers.
"It does seem like a no-brainer," she says. "The ball has been in their court from a funding perspective. We have worked diligently over the last two years. We have addressed every quality and safety concern originally identified by the federal government."
Despite a nearly 100 percent Joint Commission accreditation rating, Mayhew says the federal government will not be satisfied until all of the forensic patients are in a separate facility. Minus that commitment Mayhew says lawmakers must consider the costs of maintaining the status quo at Riverview.
"I am requesting the Appropriations Committee as the appropriators of state general funds to provide the department with a decision on how you wish us to proceed regarding the ongoing use of federal funds," Mayhew says. "Should you determine that the future liability and risk is too great to continue draw down these federal funds, we would request an appropriation of $10.5 million for the remainder of this fiscal year and $14 million for state fiscal year '17."
For Democrats on the Appropriations Committee — and even one or two Republicans — Mayhew seemed to be trying to shift the responsibility for Riverview from her department to the Legislature. But Democratic Sen. Linda Valentino of Saco told Mayhew that the problems at Riverview were clear in 2011 when Republicans controlled the Legislature and that it was unfair for the commissioner to hold the Legislature responsible.
"I guess I take a little exception to everybody blaming the Legislature and rehashing old history," she say. "Why is it then that you have been unsuccessful in getting any plans through? Do you think there's a confidence or a credibility crisis, or what can we do?"
Democratic Rep. Gay Grant of Gardiner reacted angrily to Mayhew's eight-page report that she said attempted to assign blame for all of the problems at Riverview to nearly anyone except the responsible party.
"The responsibility for operating and administering the state's hospital for the mentally ill lies with the Department of Health and Human Services and the administration — not the Legislature," Grant says.
For Mayhew, the tone of the lawmakers' questioning and the repeated demands for details on the operational plan for a forensic residential treatment facility were, at times, difficult to endure.
"I came here to provide information, I am not going to sit here and listen to an attack or be questioned about the executive branch's role," Mayhew says. "I provided information to the extent that there are more questions that you need asked, we will provide those in writing, but I will not sit here and listen to attacks."
Mayhew said lawmakers had the opportunity to fund the new forensic facility in the governor's budget revision last spring, but chose to do other things with the money.