Psychiatric center license threatened over deficiencies

AUGUSTA – Maine’s new Riverview Psychiatric Center, the replacement facility for the Augusta Mental Health Institute, has several deficiencies that must be corrected within weeks to remain licensed to operate.

Among the concerns cited by the state’s Division of Licensing and Certification are that treatment plans at the state psychiatric hospital are not individualized, relevant or reflective of actual patient needs and that therapeutic programs selected for patients are neither related to treatment plans nor based on patient conditions.

“It seems like deja vu all over again,” said Carol Carrothers, executive director of NAMI-Maine, a group that advocates for those with mental health problems. “When a licensing review questions patient health and safety, it certainly leads one to question how far they are in complying with the consent decree.”

As the successor facility to AMHI, Riverview must follow the terms of the 1990 consent decree in which the state agreed to provide certain minimum levels of care for Mainers with mental illnesses.

The decree settled a class-action lawsuit filed by AMHI patients in 1989 after the deaths of several patients from heat exposure and suicide.

Failure to comply with some terms of the decree led to courts finding the state in contempt three times since 1990.

The facility remains under court oversight until a judge determines all of the terms have been met. The court appointed receiver, Elizabeth Jones, was traveling and could not be reached on Wednesday.

But an August review of the facility by the state’s Division of Licensing and Certification has raised more concerns about the progress being made to meet those terms.

The division issued a conditional license to Riverview provided the conditions outlined “be met within the specified time frames.”

Some of those conditions, which were “deemed necessary for the protection of the health and safety of the patients of the facility,” must be met within either 30 days or 60 days.

Beyond the problems with treatment plans and therapeutic programs, the report also indicated that nurse staffing plans were not meeting regulations and it criticized the way data are used to develop care plans for patients.

Failure to be licensed as a psychiatric hospital also would jeopardize federal funds needed to operate the facility, which cost $33 million to build and has a maximum capacity of 92 patients. It replaced the 140-year-old AMHI facility that housed, at its peak, more than 1,500 patients.

“These are the same problems from years and years ago,” said Carrothers. “The inability to have individualized treatment and to have decent treatment planning goes back to before the consent decree. It looks as though there appears to be a fair amount of work still to be done.”

Sen. Michael Brennan, D-Portland, co-chairman of the Legislature’s Health and Human Services Committee, shares the concerns raised by Carrothers. He met with Department of Health and Human Services officials about the licensing report on Wednesday.

“Clearly, there are issues in there that are of concern, particularly with the time frames of 30 and 60 days to correct problems,” he said. “There is troubling language about treatment plans and what has not been done.”

Brennan said the committee, which has oversight of the agency, was not notified until Tuesday about the licensing report, which was filed on Aug. 12.

He said it is not the first time the committee has found out about such problems from outside the department, and that communication would be among the many issues his panel would want to discuss with department officials at the committee’s next meeting in September.

But Brenda Harvey, deputy commissioner of the Department of Health and Human Services, said she too had not been given a copy of the licensing report, even though she is responsible for Riverview.

She said that was a mistake due to the merger on July 1 of the Department of Behavioral and Developmental Services and the Department of Human Services and will not happen again.

Harvey also was responsible at the former Department of Behavioral and Developmental Services for making sure the state was meeting terms of the decree.

She said Wednesday she was aware of specifics in the report from discussions with staff and Brennan.

“There are serious issues raised in the licensing report,” Harvey said, “but I think we are working to make the changes that need to be made in treatment plans and have been working on them.”

Harvey believes Riverview can meet the requirement to have new processes in place to create individualized treatment plans that meet the licensing requirements within the time limits in the report.

She said it will take longer to get the actual treatment plans in place for each patient.

“I am optimistic we can have everything in place that is needed by the licensing division and the consent decree,” Harvey said.