An Act To Improve Care Provided to Forensic Patients
Maine Legislature, Session 129, LD 0284
Committee: Health and Human Services
Sponsors: GATTINE, BREEN, DOORE, HUBBELL, HYMANSON, MADIGAN, PERRY, SANBORN
Amends: 22 MRSA §1813-A, 22-A MRSA §208-A, 34-B MRSA §1001, 34-B MRSA §1207

Legislative Document
No. 284
H.P. 208
House of Representatives, January 22, 2019
An Act To Improve Care Provided to Forensic Patients
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative GATTINE of Westbrook.
Cosponsored by Senator BREEN of Cumberland and
Representatives: DOORE of Augusta, HUBBELL of Bar Harbor, HYMANSON of York, 
MADIGAN of Waterville, PERRY of Calais, Senator: SANBORN, L. of Cumberland.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §1813-A is enacted to read:
§1813-A.  License for forensic step-down facility
The state-operated residential forensic step-down facility established in Title 22-A, 
section 208-A is subject to licensure by the department under this chapter.  The 
department shall adopt rules that apply specifically to the licensure of a residential 
forensic step-down facility.  The rules must include, at a minimum, admission and 
discharge standards of the facility; the staffing model for the facility, with specific 
descriptions of staffing levels, roles and responsibilities; facility security; availability of 
and patients' access to treatment; and patient rights protections.  Rules adopted pursuant 
to this section are major substantive rules as defined in Title 5, chapter 375, subchapter 
2-A.
Transfer of a forensic patient into the forensic step-down facility established in Title 
22-A, section 208-A must be approved by a court of appropriate jurisdiction.
By January 1, 2021 and on or before January 1st of each year thereafter, the 
department shall submit to the joint standing committee of the Legislature having 
jurisdiction over health and human services matters a detailed report about the forensic 
step-down facility established in Title 22-A, section 208-A that includes information 
about construction of the facility, capacity of the facility and staffing levels of the facility.
Sec. 2.  22-A MRSA §208-A is enacted to read:
§208-A.  Forensic step-down facility
The commissioner shall operate and maintain a 21-bed residential forensic step-down 
facility in Augusta in the Capitol Area called the Riverview Forensic Treatment and 
Rehabilitation Center to provide treatment and rehabilitation that continues the treatment 
of patients from a state mental health institute who no longer require hospital-level 
service as provided under Title 34-B, chapter 3, subchapter 4, but who are unable to be 
safely treated and cared for in a community setting under Title 34-B, chapter 3, 
subchapter 3.  For purposes of this section, "Capitol Area" has the same meaning as in 
Title 1, section 814, subsection 2.  As used in this section and Title 22, "forensic 
step-down facility" means the Riverview Forensic Treatment and Rehabilitation Center.
Sec. 3.  34-B MRSA §1001, sub-§8, ¶A-1 is enacted to read:
A-1.  The Riverview Forensic Treatment and Rehabilitation Center;
Sec. 4.  34-B MRSA §1207, sub-§1, ¶H, as amended by PL 2015, c. 189, §1, is 
further amended to read:
H.  The names and dates of death of individuals who died while patients at the 
Augusta Mental Health Institute, the Bangor Mental Health Institute, the Dorothea 
Dix Psychiatric Center, the Riverview Psychiatric Center, the Riverview Forensic 
Treatment and Rehabilitation Center or the Pineland Hospital and Training Center 
may be made available to the public in accordance with rules adopted by the 
department.  The rules must require the department to notify the public regarding the 
release of the information and to maintain the confidentiality of information 
concerning any deceased individual whose surviving relatives notify the department 
that they object to public disclosure.  Rules adopted pursuant to this paragraph are 
routine technical rules as defined in Title 5, chapter 375, subchapter 2-A; and
Sec. 5.  Rulemaking.  The Department of Health and Human Services shall 
provisionally adopt rules to implement the Maine Revised Statutes, Title 22, section 
1813-A no later than January 11, 2020.
Sec. 6.  Report.  The Department of Health and Human Services shall report in 
writing to the Joint Standing Committee on Health and Human Services by October 15, 
2019, December 15, 2019 and March 1, 2020 on the progress of the department in 
developing rules and creating the forensic step-down facility as required by the Maine 
Revised Statutes, Title 22, section 1813-A.
Sec. 7.  Advisory committee.  The Commissioner of Health and Human Services 
shall convene an advisory committee on the forensic step-down facility established in the 
Maine Revised Statutes, Title 22-A, section 208-A.  The advisory committee shall meet 
as necessary to guide the design of the forensic step-down facility and the implementation 
of the rules related to the facility; educate and inform the planning process to create a 
facility that best supports the treatment and safety needs of the patients and staff of the 
facility; make recommendations to the department; and report to the Joint Standing 
Committee on Health and Human Services any recommended legislation relating to the 
facility no later than January 15, 2020.  The joint standing committee may report out a 
bill to the Second Regular Session of the 129th Legislature based on the report.  The 
advisory committee consists of the Commissioner of Health and Human Services, or the 
commissioner's designee, and 9 other members as follows:
1.  Two patients of a state mental health institute as defined in Title 34-B, section 
3801, subsection 9, appointed by the commissioner;
2.  A representative from the Consumer Council System of Maine under Title 34-B, 
section 3611, appointed by the commissioner;
3.  Two staff members of a state mental health institute as defined in Title 34-B, 
section 3801, subsection 9, appointed by the commissioner;
4.  The Court Master appointed in Bates v. Commissioner, Department of Health and 
Human Services, Kennebec County Superior Court, Civil Action Docket No. CV 89-088;
5.  Class counsel appointed in Bates v. Commissioner, Department of Health and 
Human Services, Kennebec County Superior Court, Civil Action Docket No. CV 89-088; 
and
6.  Two representatives from separate community behavioral health organizations in 
the State, appointed by the commissioner.
SUMMARY
This bill establishes a residential forensic step-down facility, which provides 
treatment of forensic patients who no longer require hospital level care but cannot be 
safely treated in a community setting, in Augusta in the Capitol Area.  It authorizes the 
Commissioner of Health and Human Services to maintain and operate the 21-bed forensic 
step-down facility.  It provides that the facility must be licensed and that the Department 
of Health and Human Services must adopt rules that apply specifically to the licensure of 
a forensic step-down facility and that include the admission and discharge standards of 
the facility, the staffing model, security, patients' access to treatment and patient rights 
protections.  It requires that the department provisionally adopt rules to implement the 
licensure of the forensic step-down facility no later than January 11, 2020.  It creates an 
advisory committee to participate in and guide the planning process for the facility and to 
report to the Joint Standing Committee on Health and Human Services.  It authorizes the 
committee to report out a bill based on the advisory committee's report.  It requires the 
department to report to the committee on the progress of creating the facility and 
developing rules.  It provides that the transfer of a forensic patient into the forensic 
step-down facility must be approved by a court of appropriate jurisdiction.  It includes the 
forensic step-down facility in the Maine Revised Statutes, Title 34-B, chapter 1 as a "state 
institution."