Following Riverview’s Recertification, Mills Abandons Plans For Step Down Psychiatric Facility

Feb 27, 2019

Gov. Janet Mills is abandoning the proposal initiated by her predecessor to create a so-called “step down” unit in Bangor to handle psychiatric patients who don’t need hospital care, but are still considered a risk to the public.

In April of 2013, federal inspectors found a long list of problems at the state’s Riverview psychiatric hospital in Augusta, including the use of excessive force by security personnel, concerns over medication use, and poor record keeping. This resulted in the hospital being decertified and the loss of about $20 million per year in Medicare funds.

The Administration of then-Gov. Paul LePage responded with a number of changes in staffing and oversight, with a proposal to create what it called a “step-down unit" to house about twenty patients that did not meet the criteria for hospitalization, but still were a risk to the general public.

Mills told reporters at the statehouse Wednesday that because Riveriew was re-certified last month, the unit is no longer needed. And she says that her administration will take a different approach.

“If somebody has a psychiatric need, wherever they come from, wherever they are, lets address them, lets provide them. I think that’s the bottom line,” Mills says.

Mills says that the building under construction next to the Dorothea Dix Psychiatric Center in Bangor will be utilized as part of that hospital and will add twenty beds to the state’s mental health care system.

She is submitting a budget change to lawmakers to fund the nearly $7 million operating cost of the facility, which will be state-run, rather than privately run, as LePage had intended.

Health and Human Services Commissioner Jeanne Lambrew says the administration will undertake a study to figure out how best to utilize all of its psychiatric facilities.

“We are going to do a comprehensive look at the range of care that is needed in communities, communities and residential,” says Lambrew.

Maine’s care for people with mental illness has been overseen by the courts as a result of a 1990 agreement. Former Chief Justice Dan Wathen, the court master who oversees the agreement, welcomes the additional capacity in the Mills' plan. He says the federal review of Riverview over the last several months has shown that past problems related to tracking which patients require hospital level care have been resolved.

“They have found the documentation to be lacking,” says Wathen. “So in the process of the next number of years, the hospital has done a better job of documenting.”

Wathen says the public should know that there are safeguards in place to make sure patients who do need hospital-level of care are getting it.

Mills says her administration believes that more services are needed, and it is seeking a waiver from federal officials to allow more flexibility in the use of Medicaid funds to pay for them. She says the legislature will have the opportunity to weigh in on the issue as it takes up the state budget.