AUGUSTA — A new psychiatric facility under construction in Bangor will be state-run and serve a broader range of mental health patients than the private “step-down” facility envisioned by former Gov. Paul LePage.
In a shift from her predecessor, Gov. Janet Mills announced Wednesday that the facility nearing completion on the campus of the Dorothea Dix Psychiatric Center will be run as a new unit of the state-owned hospital, not by a private contractor. Mills also said that progress made at Riverview Psychiatric Facility in Augusta – including regaining federal certification – means the state can use the new Bangor facility to relieve pressure elsewhere on Maine’s mental health system.
Rather than serving only patients transitioning out of Riverview because they no longer need-hospital level care, as LePage had proposed, the Dorothea Dix unit will serve a broader array of patients who Mills said are not adequately served in communities, jails or emergency rooms. Those include two growing populations: individuals deemed incompetent to stand trial or jail inmates suffering from mental health crises that require residential psychiatric care.
“This new unit at Dorothea Dix represents the best path forward for the facility under construction and the best path forward for the Maine people,” Mills said at a State House news conference. “It’s a more efficient use of the building and it will allow us to strengthen the full range of mental health services.”
The debate over Riverview as well as the need and location of a “step-down” facility has been swirling in Augusta for years.
In 2013, the U.S. Centers for Medicare and Medicaid Services revoked Riverview’s federal certification after investigations revealed a host of deficiencies including poor record-keeping, the use of pepper spray or stun guns on patients, and improper use of restraints. The facility finally regained certification last week, but the state lost up to $20 million a year in federal reimbursements while the certification was revoked.
While seeking recertification, the LePage administration also sought to open a new “step-down” facility that would help Riverview patients transition to community-based care, such as group homes. However, the administration clashed with lawmakers, then-Attorney General Mills and others about where to locate and how to operate the facility.
LePage moved forward with plans for the Bangor facility, selling a portion of the Dorothea Dix campus and negotiating a proposed $60.3 million state contract with a Tennessee-based company to build and operate the 16-bed facility. The company, Correct Care Solutions, never finalized the contract because then Governor-elect Mills asked for an opportunity to review the plans.
Construction of the Bangor facility is expected to wrap up in May, and the state appears to be locked into a 30-year, $11.3 million lease for the building.
Mills said the new unit will function as part of the Dorothea Dix hospital, using shared staff, services and administrators. She estimated the annual price tag at $6.9 million but said $4.3 million would likely come from the federal Medicaid program.
The LePage administration had sought to use $5.4 million earmarked for community-based services. But former Chief Justice of the Maine Supreme Judicial Court Daniel Wathen had challenged in court the use of that money as inconsistent with a 1990 court decree on treating people with mental illness.
Wathen said Wednesday that Mills’ plan would relieve pressure on both Riverview and Dorothea Dix by serving the needs of individuals deemed incompetent to stand trial or referred from jails.
“I think it’s an effective use of the unit which is in existence,” said Wathen, who oversees the court decree governing how the state treats people with mental illness. “They are focused on the right population of patients for that facility. My position all along over these last few years is that there is a need for capacity. And I’ve always said the real issue is what is the population that you are going to put in there?”
Wathen said he was never convinced of the LePage administration’s position that Maine needed a step-down facility to regain federal certification at Riverview.
“The real reason was the treatment of patients that had occurred,” he said.
Jeanne Lambrew, commissioner of the Maine Department of Health and Human Services, said the administration will conduct a comprehensive look at future needs within the state’s mental health infrastructure. That would include whether a step-down facility is needed in the future, but Lambrew noted it was clearly not necessary to regain Riverview’s certification.
Rep. Drew Gattine, a Westbrook Democrat who has been heavily involved in the debate over Riverview and the step-down facility, said adding the new facility to state-run Dorothea Dix hospital solution makes sense from a financial and capacity standpoint.
“The reality is that building is built, mostly,” said Gattine, who is one of the Legislature’s chief budget writers as co-chair of the Appropriations and Financial Affairs Committee. “What I’m hearing the department saying – and I think this is right – is the best use of that building is to encompass it within the license of Dorothea Dix and to focus on some of the unmet needs.”
Gattine and other committee members will have to approve of the Mills administration’s request for roughly $2.6 million in state funding for the new facility.
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