Monday, April 22, 2013

Admit It, Nevada. We Have a Problem.

Over the course of the month, we've been looking at the tragic case of James Flavy Coy Brown, the Rawson-Neal Psychiatric Hospital patient who was "released" from the hospital, only to be thrown onto a Greyhound bus and dumped into Sacramento, California. Growing outrage over this heinous case of patient dumping resulted in state and federal investigations into Nevada's patient dumping habit. And we now Nevada has bused over 1,500 patients out of state since 2009, sending at least one patient to each and every one of the 48 continental states.

Recently, Governor Brian Sandoval (R-Denial) has been boasting about increasing the state government's budget, and especially education and health care funding, "without raising taxes" (and the accuracy of this statement actually depends on how one categorizes extending "The Sunset Taxes" of 2009 & 2011). Yesterday, The Las Vegas Sun's Andrew Doughman explained how Governor Sandoval has been able to do this. Surprise, surprise, there's a method behind his "magic"!

This month, he found $25 million for education programs and even released a handy slogan: “Increasing funds for education without raising taxes: Check.”

The next day, he said he found yet another $25 million for health programs for the state’s most vulnerable populations. Then, he announced $12 million more for eliminating furloughs for state workers by mid-2015.

How, exactly, did those presents end up under Nevada’s Christmas tree?

The majority of the money comes from regular state accounting adjustments, and it’s not necessarily good news. Nevada gets a portion of this new money because the federal government now projects the average American’s income will grow faster than the average Nevadan’s income. [...]

But in this case, economic growth isn’t fueling increases to the budget.

Besides getting more federal money because it’s getting poorer than other states, Nevada also is benefiting from revisions to the number of state residents enrolled in government health programs and a nationwide trend in lower-than-projected health care costs.

“Those are both pretty standard adjustments we’d make,” said Jeff Mohlenkamp, the state’s budget director. “They just happen to be working in our favor right now.”

So Sandoval has been able to increase the state's budget by claiming poverty and showing the number of Nevadans in need of some sort of federal/state aid. And there's technically nothing wrong with that in and of itself. It just becomes a problem when he and fellow Republicans demand austerity out of one side of their mouths... While simultaneously using the other side to milk the feds for more money!

It's also a problem that Sandoval wants to use these additional federal funds to claim he's "increasing funding without raising taxes"... And silence criticism of the shortcomings of Nevada's social safety net. Even with the additional federal funds, the state's mental health care budget still allocates much less per patient now than in 2007. And even the 2007 budget was not keeping up with 20 years worth of tremendous population growth.

And that leads us back to the patient dumping scandal. Yesterday, The Sacramento Bee published a stinging editorial on Nevada's patient dumping. And they cut right to the heart of this matter.

If they truly had the interests of the patients at heart, Nevada health officials would have contacted mental health authorities in locales that were receiving the patients. No mental health official in any city, county or state contacted by The Bee had heard of Nevada's practice of busing mentally ill patients – unescorted, no less.

Sandoval, thought to be one of the Republican Party's rising stars, has not acquitted himself well. When the Las Vegas television reporter caught up with Sandoval and asked about the "policy" of busing patients, he pushed back by saying, "I disagree with the premise of the question."

Exactly what Sandoval disagrees with is not clear. Nevada long has had a written policy to bus patients to their home states. The policy stated that one of its goals was to relieve the "burden" on Nevada taxpayers of the patients' care, though the state dropped the word "burden" from a revised policy after The Bee quoted from it.

"If there is a problem, we're going to correct it," Sandoval told the reporter.

Mr. Sandoval, you've got a problem. You need to correct it. [US Health & Human Services] Secretary [Kathleen] Sebelius, you need to make sure he does.

Especially since Sandoval is using additional federal funds to plug holes in the state's budget, he needs to come clean on this. After all, if he doesn't, the state may ultimately lose at least some of those federal funds. Accreditation of Rawson-Neal is now at risk. And on top of this, Los Angeles and San Francisco are considering suing Nevada over patient dumping.

So we can't just (mis)use additional federal funds to sweep our problems under the rug and deny their existence. After all, these federal funds are supposed to be used to help people in need! And Nevada will likely pay a heftier price if the state continues to neglect people in need of treatment.

So why live in denial any longer? Let's admit we have a problem. And then, we can truly fix it.

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