Wednesday, April 24, 2013

Problem Solved?

Earlier today, we examined the growing outrage in California over Nevada's patient dumping scandal. Los Angeles and San Francisco have launched their own respective probes into the matter, and a federal investigation is now underway. However today, a state investigation is wrapping up and there will be some sort of action taken as a result.

Mike Willden, director of the state Department of Health and Human Services, said today a decision will be made soon whether to continue sending discharged patients by bus out of state, to scrap the policy or require a chaperone to accompany the patient.

The majority of patients involved were not considered a “threat to themselves or to others” and expressed a desire to return to their families, friends or to an out-of-state treatment facility, the internal review found.

Two staff members at the Rawson-Neal Psychiatric Hospital were disciplined, but Willden refused to say if they were higher-echelon officials or what penalty they faced.

The review of the 1,500 cases — prompted by a series of stories in the Sacramento Bee — was completed at midnight Tuesday. The Bee first broke the story of Nevada patients being put on a buses and sent to other states, prompting officials in California to call for an investigation.

Nevada officials are still asserting that there were only 5 or 6 cases at Rawson-Neal Psychiatric Hospital in Las Vegas where the hospital's standard discharge policy was not followed. And they're insisting this little hiccup is being fixed. However, doubts remain in California over whether this was truly a little hiccup that only involved 5 or 6 cases. KQED recently posted more of its interview with The Sacramento Bee's Phillip Reese. He's been closely tracking this story, and he isn't so quick to confirm Mike Willden's assertion today.

"San Francisco told us that they've had at least two patients in the last year alone come from this particular facility, Rawson-Neal, without a plan or family members," Reese said. "[They] just showed up, in the way that Mr. Brown did."

According to the Bee's review of bus records, 36 patients took buses to San Francisco. Without talking to those people, it's hard to know what happened once they got to the city. They might have sought help. They might not have. They might be in San Francisco now. They might be elsewhere.

Reese said he and his colleagues are trying to track down patients, as well as Rawson-Neal employees and former employees. […]

One-third of patients bused out of Nevada were shipped to California.

Reese points to "severe" budget cuts in Nevada. The bus trips began to spike in 2009, around the same time a recent round of budget cuts took place.

Plus, he said, "They never had an elaborate safety net for mentally ill patients to begin with."

And even with today's latest development from Carson City, not everyone in Sacramento is satisfied. Oh, and San Francisco's own probe is still definitely happening. And that may not be all, as SF Weekly just learned.

Earlier this week, San Francisco City Attorney Dennis Herrera launched an investigation into Nevada's nefarious patient dumping, asking the state for for public records relating to Sacramento Bee reports which revealed the patient dumping problem. In one case, a patient reported that the Nevada hospital gave him a one-way ticket to California, with some snacks an only a few days worth of medication; his doctor told him to call 911 when he landed and he would received better health care than he would in Nevada.

Herrera told Reuters that he's pleased Nevada's governor has taken measures to stop the patient dumping, but that won't stop him from plunging ahead with his probe.

"Nothing changes my intention to pursue all legal options against the state of Nevada," Herrera said.

And there, we have it. The State of Nevada may be ready to close its books on this matter, but San Francisco certainly is not. Neither is Los Angeles. And we may still see more municipalities across California explore legal action against Nevada for patient dumping.

Governor Sandoval and Rawson-Neal administrators continue to insist the discharge of James Flavy Coy Brown was a mostly isolated incident. However, several throughout California continue to suggest otherwise. I have a feeling we're not finished with this story yet, far from it.

I can understand why Sandoval and Rawson-Neal administrators want this story gone. It doesn't look good. It's threatening federal funding for Southern Nevada's only state run mental health treatment hospital. And now, we may soon see law suits filed over this.

However, this story isn't going away. And at this point, the best thing the state can do is come clean with the truth and make a real effort to fix this problem. We'll see if that ultimately happens. And we'll be waiting to see if this means Nevada will finally fully fund mental health services.

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