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EDITORIAL: After warning from judge, contract for Bangor psychiatric facility should be put on hold
Bangor Daily News - 12/15/2018
Dec. 15--December 15, 2018
After more than a year of refusing to implement Medicaid expansion because he didn't like the funding source, Gov. Paul LePage plans to push forward with a contract for a new psychiatric facility in Bangor even though the retired judge who monitors the state's mental health services has said that its funding source violates a court order.
Daniel Wathen, the former chief justice of the Maine Supreme Judicial Court, recommended that the state not sign a contract for administration of the yet-to-be built facility.
The Department of Health and Human Services "plan to utilize Consent Decree Funds to support the operation of the Secure Residential Treatment Facility in Bangor is at odds with and contravenes the appropriations made by the Maine Legislature," Wathen wrote in his recommendation, which was filed in court Tuesday. "In addition it violates the provisions of Consent Decree and the Consent Decree Plan adopted in 2006 with respect to the provision of core community health services."
With this recommendation, the LePage administration should not sign a contract for this project, which has been rushed and has lacked transparency from its inception.
Instead, the LePage administration says it still plans to sign a contract with Correct Care Recovery Solutions before leaving office. It will leave the funding problems to the next administration and Legislature.
"If the funds are not an appropriate source then the department has until April at the earliest to identify an alternative funding source for the unit," LePage spokesman Julie Rabinowitz wrote in an email to the Bangor Daily News.
This "don't worry about the funding" approach to the Bangor facility is the exact opposite of the governor's objections to Medicaid expansion, which was approved by Maine voters last year. LePage has refused to implement the law -- even after a court said the state must -- because he said the funding sources identified by lawmakers were inappropriate.
Now a court master is telling the administration its funding source for the Bangor psychiatric facility is wrong. Yet, it still plans to commit the state to a project that may not be appropriate or even in the right location.
This project has been veiled in secrecy from the beginning. This is bad for taxpayers who will foot the bill and for the patients who will be housed there.
The Bangor facility could be just what the state needs to comply with federal requirements that will allow the state-run Riverview Psychiatric Center to regain federal certification. Or, it could be a facility where patients are treated more like inmates with little emphasis on treatment and rehabilitation, which could run afoul of requirements for how these patients are cared for.
We don't know because DHHS and the governor have shared little about their plans.
This saga began five years ago when Riverview lost its certification from the federal government after reviews by the Center for Medicare and Medicaid Services revealed shortcomings in patient treatment and staffing at Riverview. The 92-bed center in Augusta treats and houses the state's most acute mentally ill patients. It is the only state-owned facility to house patients who are deemed either incompetent to stand trial or not criminally responsible for their actions and who have been ordered by a court to be housed in a state mental health facility.
Some of the patients at Riverview do not need a hospital-level of care and would be better served at a less restrictive facility. Moving these patients out of Riverview would also free up beds for people who need its high-level of treatment, but who are often held in emergency rooms when the state hospital is full.
Initially, the LePage administration proposed to build a new step-down facility in Augusta since keeping it in close proximity to Riverview makes sense from a treatment perspective. Building such a facility in Augusta requires approval from the Legislature.
Rather than work with lawmakers to get this approval, LePage said he would build it in Bangor. Since then, DHHS officials have skipped meetings with lawmakers and refused to answer questions, preventing lawmakers from exercising their oversight responsibility.
LePage also said he did not need the Legislature to approve funding for the facility because it would be funded with money already in the DHHS budget.
Now, Wathen has raised red flags about the funding and the rush to sign a contract for the facility's operation.
Earlier in the week, Gov.-elect Janet Mills sent a letter to the LePage administration asking it to hold off on signing any new contracts until she took office. LePage was right to rebuff that blanket request because he, of course, will remain governor until Mills is sworn in Jan. 2, and he can continue to sign contracts.
However, with Wathen's concerns added to the list of unanswered questions about the Bangor facility, this contract should be put on hold pending a more thorough and transparent review of the project and its funding.
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