February 1st, 2017

Maine Gov. LePage intends to move stepdown unit to Bangor

Maine Gov. Paul LePage (R) has moved on after abandoning plans to build a proposed 21-bed stepdown unit next to the Riverview Psychiatric Recovery Center in Augusta.

As in nearly 80 miles to the north.

Two days before last Christmas, the LePage administration revealed it had picked a site in Bangor to build the psychiatric facility for forensic patients in state custody who no longer need hospital-level care.

The new facility is part of the effort to free up space and resolve safety issues that led to the loss of Riverview’s hospital certification in 2013 along with $20 million in annual federal funding.

The new location is reported to be a 6.3-acre parcel near the state’s 51-bed Dorothea Dix Psychiatric Center in Bangor.

LePage’s original plan to put the new facility next to Riverview in Augusta – at an estimated cost of between $3 million and $5 million – was blocked by a 3-3 party line vote by lawmakers on the Legislative Council last November.

Peter Steele, director of communications for Gov. LePage, said the governor preferred to build the facility in Augusta but opted for Bangor after the Legislature’s Democratic leadership refused to decide on the project before Christmas despite earlier indications they would do so.

“Democrats have played politics for years with this facility, and they had plenty of time before Christmas to approve it. Democrats are not interested in doing what is best for the patients. They are solely focused on protecting union jobs in Augusta.” Steele wrote in an email.

Under state law, the Legislative Council has authority to approve new construction on state grounds in Augusta. Legislators said they wanted more information about the proposed facility, which the LePage administration planned to have staffed and managed by a private contractor.

Daniel Wathen, a former Maine Supreme Judicial Court chief justice who was appointed court master to oversee Riverview as part of a 1990 consent decree, said the location of the stepdown unit is a strict legal matter and that it is not his role to voice an objection to it.

“As a practical matter, I think it makes more sense next to Riverview. That’s where most of the clients will come from,” Wathen said.

“I don’t see any benefit to going to Bangor,” added Simonne M. Maline, executive director of the Consumer Council System of Maine, which advocates for consumers on mental health public policy, services and funding decisions.

Lawmakers at a Jan. 5 joint hearing of the Appropriations Committee and the Health and Human Service Committee observed that no governor has ever built such a facility for a public purpose with taxpayer dollars without the Legislature’s approval.

“People say it isn’t possible. It’s never happened without legislative oversight and approval. I think we’re in uncharted territory at this point,” Maline said.

Riverview forensic patients have been deemed by the courts to be either incompetent to stand trial or not criminally responsible for their actions. They are clinically stable but lack court authorization to return to the community so continue to occupy hospital beds at the Augusta facility while there are patients in need of inpatient psychiatric beds stuck in emergency departments around the state. Wathen said progress has been made in reducing the wait list for a state psychiatric hospital bed from nine patients last November to two in January.

A week after the Jan. 5 joint hearing at the Statehouse, no application for a stepdown unit site plan had been filed with the Bangor Planning Board. Samantha Edwards, spokesperson for the Maine Department of Health and Human Services, said plans for the Bangor site were “still in the early stages.”

Maine DHHS had obtained approval from the Augusta Planning Board for the site when it was planned to be next to Riverview, a process that made details of the design for the facility available to the public.

An initial plan showed razor wire and cuffports – holes in a door to allow for handcuffing someone before they are allowed through – but both features were eliminated in subsequent documents.

At the Augusta Planning Board hearing last October, DHHS Commissioner Mary Mayhew stated publicly that a competitive bid process for a private contractor to provide treatment services in the stepdown unit would occur. But DHHS has revealed no details about when a Request for Proposals would be issued.

Wathen said he reviewed a preliminary draft for the privatization RFP but said he could not discuss details in it. “I had some concerns which I expressed to the folks and I expect that I will hear back from them,” he said.

The U.S. Centers for Medicaid & Medicare Services revoked the hospital certification of the 92-bed Riverview Psychiatric Recovery Center in Augusta in 2013 after citing the facility for a series of violations including correctional officers using stun guns on patients and other problems with patient care and a lack of staff training.

But despite progress in improving conditions, the uncertainty about what the stepdown unit will be like, where it will be, when it will be built and who will work there concerns many patients.

“Moving is a highly stressful event,” Maline said.

“They’re asking, ‘Can we keep our TVs? Can we keep our gaming stations. What are we going to be allowed to do? What about our jobs?’ Because many of them have jobs in the hospital,” Maline said. “This is somebody’s home and we need to be mindful of that.”

“It is not a good time to be a patient in there because there’s all this political stuff swirling around you. They have no voice in the process,” Maline added.

By Janine Weisman

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