Consequences

Over the past month, we've been digging deep into Nevada's burgeoning mental health patient dumping scandal. Initially, Governor Brian Sandoval (R-Denial) and Nevada mental health officials denied any widespread wrongdoing. But as cases continued piling up, they eventually began to promise solutions. Yet even with Sandoval and the Nevada Department of Health & Human Services claiming responsibility for 10 cases of patient dumping and promising that it will never happen again, several elected leaders in California are still calling for further investigation.



Oh, yes. That's right. 21 of California's Members of Congress are sending a letter to US Health & Human Services Secretary Kathleen Sebelius and US Attorney General Eric Holder demanding federal action.

The letter, initiated by Rep. Ami Bera, an Elk Grove Democrat, states that "if this practice of shipping patients with a history of mental illness to other states, known colloquially as 'Greyhound Therapy,' is occurring, it would not only be unethical and disgraceful, but would also be an illegal attempt by Nevada to evict members of the state's most vulnerable population to benefit its bottom line."

The letter cites a Bee investigation that found that Rawson-Neal Psychiatric Hospital in Las Vegas, Nevada's primary hospital for the mentally ill, has bused about 1,500 patients out of southern Nevada since 2008, sending people to every state in the continental United States. [...]

The congressional letter says busing patients to other states may violate several laws, including federal requirements that hospitals must stabilize patients before discharging them and requirements that hospitals meet certain conditions before receiving Medicare and Medicaid funding.

The letter also states that involuntary placement of a psychiatric patient on a bus to another state "may constitute interstate kidnapping."

The letter asks Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder to report any investigative findings to Congress within 30 days.

"Federal investigation is warranted here, particularly in light of admissions from Nevada officials that their own investigation found 'no pattern of misconduct,' " the letter says.

And that's not all. Late last month, we noted San Francisco's launch of a probe into Nevada patient dumping. A day later, Los Angeles followed suit in launching its own probe. Now, San Francisco City Attorney Dennis Herrera is poring through documents he just received from Nevada Attorney General Catherine Cortez Masto (D).

Late last week, Nevada's Attorney General Catherine Cortex Masto responded to Herrera's public records requests with a trove of documents, including nearly 400 pages of Greyhound Bus invoices and scores more detailing potentially improper discharges dating back to July 2008.

The documents cover five general areas:

The records provided to the Sacramento Bee,which first broke the story about Nevada's practice of "patient dumping." The documents related to "challenged" discharges, "specifically any discharges challenged on the basis of inadequate discharge planning." Copies of licenses for Nevada's mental health facilities. Copies of citations levied against the Nevada's mental health facilities. Documents showing the sources of funding for Nevada's mental health services. Hererra's investigation seeks to discover the extent of Nevada's patient dumping. The Bee's investigation found that Rawson-Neal bought bus tickets for more than 1,500 mentally ill patients over the past five years. Around one-third of those buses went to California, including 36 to San Francisco. But Nevada officials have maintained that nearly all of those discharges were appropriate --Sandoval admits to only one confirmed improper discharge, [then 5, then 10?] for which two hospital employees were fired. [...]

And, as Reuters reported last week, "San Francisco health director Barbara Garcia said outreach workers in the past year identified two psychiatric patients who arrived in the city on buses after being discharged from Rawson-Neal with neither relatives nor treatment plans awaiting them in San Francisco."

Herrera's public records query also included requests for documents showing that California approved to accept any of Nevada's mental health patients or agreed to exchange any patients with Nevada. Masto's response noted that none of those documents existed.

Ouch. Remember, shortly after the harrowing true tale of James Flavy Coy Brown began making headlines in California and Nevada, Governor Sandoval denied any widespread patient dumping. It wasn't until roughly the time when Orange County Supervisors began asking their mental health officials about Monica, just as even more cases were emerging here in Southern Nevada, when Sandoval began backtracking on his earlier blanket denials.

Already, this scandal is proving to be costly. The state is scrambling to head off threats of federal funding cutoffs. The state is also scrambling in a desperate attempt to avoid California law suits. And now, on top of all that, Clark County hospitals are now feeling the strain of Rawson-Neal bursting at the seams in the wake of #DumpGate.

Reports of improper discharges at the Rawson-Neal psychiatric hospital is affecting other local medical facilities.

The “Review-Journal” reports University Medical Center closed its emergency room to adults for 12 hours on Monday, after mentally ill patients filled nearly half of the hospital’s ER beds.

The Southern Nevada Health District says nearly 200 psychiatric patients are currently being held at local hospitals.

Jeez. And UMC was already swirling in controversy before Rawson-Neal fell deep into scandal!

Again, no one can't say we weren't sounding the alarms. We were. The state's social safety net has been woefully inadequate for some time. And in case that wasn't enough, we slashed and burned even more in recent years. And mental health care has especially been hit hard by recent state budget cuts.

And now, it's all coming back to bite us. This is what happens when Nevada won't take care of its own. Think about it.