AUGUSTA — Problems at Riverview Psychiatric Center, including the pepper-spraying of an inmate in December, will be evaluated by a Superior Court judge for possible penalties, according to the court master in charge of reviewing operations at the facility.
Daniel Wathen, a former judge charged with enforcing the court order to protect patients at 92-bed Riverview, said he believes the pepper-spray incident should not be brushed aside.
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“We can’t just say, ‘Well, this happened and let’s forget about it,’ ” said Wathen, who toured Riverview last week and has been meeting with current and former employees. “It’s a violation of the court order. It has to be reported to the court, and then the court can determine what the consequences are.”
Wathen and acting hospital Superintendent Jay Harper appeared Wednesday before the Legislature’s Health and Human Services Committee for a wide-ranging discussion about Riverview.
On Dec. 2, a corrections officer working at the hospital coated a nude, defenseless woman with pepper spray. Riverview staff then strapped her to a bed and held her in seclusion for four hours, even though the woman was compliant and not threatening staff.
Several Riverview employees knew about the abuse but failed to report it, as required by law, for nearly three months. A state investigatory report concluded the incident constituted abuse and that hospital employees altered records in an attempt to downplay the event. The incident was not publicly disclosed until a Maine Sunday Telegram story revealed it in September.
Wathen told lawmakers that in the coming months he will report the pepper-spray incident and other problems at Riverview to Maine Superior Court Justice Andrew Horton, who oversees the consent decree.
Wathen said Horton has wide latitude on what to do with the information. The judge could write a report or hold a hearing, and he could impose penalties on Riverview for failing to live up to the consent decree. The decree was imposed as a result of patient abuse at Riverview’s predecessor, the former Augusta Mental Health Institute, which closed in 2003. Riverview opened in 2004, and the decree applies to its patients as well.
About half the people housed at Riverview are forensic patients sent there through the criminal court system after they were found not responsible for their actions. The other half are civil patients.
Another issue that could be brought before Horton, Wathen said, is Riverview’s decision in 2013 to segregate its most troublesome forensic patients from those in the rest of the hospital. Segregating those patients in the Lower Saco unit limits their access to mental health treatment, Wathen said.
“The clients are deprived of treatment opportunities and recreational opportunities such as the gym,” Wathen said. “We have a difficult population, bored, with nothing to do and limited access to active treatment.”
The consent decree requires that all Riverview patients have the same access to care, he said.
The LePage administration decertified the Lower Saco unit after the U.S. Centers for Medicare and Medicaid Services yanked $20 million in federal funding from Riverview in September 2013. The federal agency cited numerous deficiencies, including reports of officers using stun guns and handcuffs on patients, and many of the hospital’s more troublesome confrontations between patients and staff have occurred in Lower Saco.
The hospital also removed corrections officers in March and replaced them with Capitol Police and security guards. Harper has said the overall security presence has been de-emphasized, and that guards will have as little interaction with patients as possible.
But Wathen said the administration’s decision to decertify Lower Saco – an attempt to please federal regulators and regain funding for 75 percent of the hospital – appears to have backfired.
“It was an attempt to be recertified quickly. (Administration officials) guessed that this would satisfy CMS, and they guessed wrong,” Wathen told the Press Herald after Wednesday’s meeting.
Wathen said the hospital should move to reintegrate Lower Saco patients as soon as possible.
Harper said he agrees that Lower Saco patients should rejoin the rest of Riverview, but not until federal inspectors evaluate the hospital and determine whether the other three units will regain good standing and the funding that goes with it. He expects a new inspection by the federal government at any time. Federal inspectors visited Riverview this spring, released a scathing report and denied the hospital’s request for recertification.
Wathen said Riverview’s lack of a policy that would require Lower Saco patients to take their prescribed medications should also be changed.
A Riverview psychiatrist told the Press Herald in September that patients in Lower Saco are left in a dangerous, psychotic state for up to a year because the hospital has no legal means of forcing patients to take anti-psychotic and other medications. About half of the patients refuse to take their prescribed medications, said Dr. Jean-Joseph Dansereau, a temporary psychiatrist at Riverview who recently left.
Dansereau said many of the conflicts between patients and staff could be avoided if patients were taking their prescribed anti-psychotic medications.
Wathen said he will recommend legislation for consideration in the January session that would allow Riverview to force patients to take their medications after their cases are reviewed by a hospital panel. Although Harper said last month that he wasn’t sure those steps should be taken, he said Wednesday that he now agrees such a policy is needed.
Wathen said he was also disturbed by Riverview’s policy of allowing “floating” employees from other units of the hospital to work in Lower Saco, calling it dangerous for patients and staff members. Employees need to be properly trained to work with the difficult Lower Saco population, he said.
Meanwhile, Harper outlined a number of changes under way at Riverview and said the hospital’s work culture is moving from a “just good enough” mentality to becoming a “center of excellence.”
“We are making big reforms here,” Harper said. These include better training on how to reduce conflicts with patients, hiring more psychologists and moving patients who could be better served at other psychiatric facilities. Harper said, for instance, that patients suffering from dementia or Alzheimer’s would be better served in a nursing home.
Lawmakers mostly listened to the testimony and asked for explanations from Wathen and Harper. Sen. Margaret Craven, D-Lewiston, said she was pleased about the depth of Wathen’s examination of Riverview.
Judith Dorsey, a former Riverview licensed social worker who revealed shortcomings at the hospital, said in a phone interview that Wathen’s commitment is a positive development.
“I’m really glad that someone from outside the hospital is looking at things and taking the next step,” Dorsey said.
Joe Lawlor can be contacted at 791-6376 or at:
jlawlor@pressherald.com
Twitter: @joelawlorph
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