Friday, May 3, 2013

Costly Denial

What else can be said? We told them so. Nevada has been rocked by the mental health patient dumping scandal for the past month. And so far, it only looks to be worsening.

Just moments ago, San Francisco City Attorney Dennis Herrera tweeted this.

Owly Images

Yikes. Is anyone here not thinking San Francisco is not gearing up to sue Nevada? Oh, and by the way, Los Angeles is considering suing as well.

Rawson-Neal Psychiatric Hospital has been under fire since last month, after a Sacramento Bee investigative series reported that hospital staff gave as many as 1,500 patients one-way Greyhound bus tickets from Las Vegas to California and 46 other states over the past five years.

"If the conduct is true as alleged, it's no less than human trafficking," Los Angeles City Attorney Carmen Trutanich told Reuters, adding he was working with San Francisco City Attorney Dennis Herrera, who last month opened an investigation into the practice.

"We have to find the individuals who were dumped. We're working on it. It's like finding a needle in a haystack," Trutanich said.

Oh, yes. That's right. They're going there. And Nevada is facing even more legal trouble over Rawson-Neal's now infamous patient dumping habit.

But wait, there's more. For the first time since The Sacramento Bee originally uncovered his harrowing true tale of "Greyhound Therapy", James Flavy Coy Brown just began telling his own side of the story. Brown explained to ABC News today how he landed at a Sacramento homeless shelter confused and suicidal. Brown also recently spoke with KSNV/News 3 (Las Vegas).

"I said, 'I don't want to leave Nevada,'" Brown told ABC News. "[His doctor at Rawson-Neal] said, 'California sounds like a really nice state. I think you'll be happy there.'"

Although Brown had never been to Sacramento, he says he was told he would get better mental health care there. Brown was driven to a Greyhound bus station with a $306 one-way bus ticket, six Ensure nutrition shake bottles and just a three-day supply of psychiatric medications. [...]

After a 16-hour overnight Greyhound bus trip, James arrived in Sacramento, but he didn't call 911. So instead, a confused Brown walked to a nearby police station- the police took him to a homeless shelter. By then, he was feeling the symptoms of medication withdrawal: a headache, profuse sweating and confusion.

He had no Social Security card, no food stamp card and no Medicaid card.

The Sacramento Bee first broke Brown's story last month, finding Nevada has purchased nearly 1,500 bus tickets since 2008, sending patients by bus to every state in the continental United States, mostly California.

With Brown's permission, ABC News obtained and reviewed his entire Rawson-Neal medical record. Documentation in the medical record shows his most clear wish regarding his discharge from Rawson-Neal was to go to a local group home.

At that Sacramento homeless shelter, Brown nearly killed himself. He soon had to be taken to the emergency room at UC Davis Medical Center. After three days in the ER, he was found temporary housing. And eventually, authorities there were able to reach Brown's daughter in North Carolina. And he's now staying with her there.

This is the kind of help Rawson-Neal should have provided. Instead, he, Orange County Monica, and possibly many more were unceremoniously tossed onto Greyhound buses and dumped into other states. Most were dumped into California, and local health agencies there were then forced to figure out what to do with these patients.

And now, those local governments want payback. While the separate federal investigation of Rawson-Neal continues, the Sacramento City Attorney is also considering legal action against Nevada. And on top of that, Alameda & Santa Clara Counties (in the SF Bay Area) are in the mix as well.

Meanwhile, Sacramento City Attorney James Sanchez has joined legal authorities in Los Angeles and the Bay Area in pressing for details about the cases of hundreds of mentally ill patients from Rawson-Neal who were given one-way Greyhound tickets to cities in California over the past five years.

"From our standpoint, this apparently was not a single instance of someone being bused somewhere without services," said Sanchez. "We feel it could be a significant number of cases, but we won't know for sure until we get into the files." [...]

The cities of San Francisco and Los Angeles have launched criminal probes to determine whether Nevada was systematically dumping indigent patients across state lines. The hospital's practices are also under scrutiny by the Center for Medicare and Medicaid Services, which oversees federal funding for health facilities, and the Joint Commission.

Elizabeth Eaken Zhani, spokeswoman for the Joint Commission, confirmed that the agency sent surveyors to the hospital Thursday. Their inspection was a response to possible violations of standards that cover "provision of care" as well as "rights and responsibilities" of patients, Zhani said. [...]

The survey played out as the Sacramento city attorney, along with city attorneys from San Francisco and Los Angeles, and county counsels representing Alameda and Santa Clara, waited for a response to their request for a joint meeting with Nevada Attorney General Catherine Cortez Masto to discuss Rawson-Neal's discharge practices.

In a letter dated Monday, the attorneys said they also want to find out "how Nevada may best assist us" in identifying patients who were dispatched to their jurisdictions "so we may ensure that they receive necessary medical care or medications."

Ouch. Even more California municipalities are expressing outrage over #DumpGate. And while Governor Brian Sandoval (R-Denial) has been doing some damage control lately, he still seems to be in denial of the larger problem.

But at this point, Nevada can no longer afford denial. While Governor Sandoval and his political consultants continue to present to us their "sunny" spin, reality is crashing down on us. Because of the EPIC FAIL of our mental health system (that is, what little we have to offer and slap with this label), this happened. Because we've chronically underfunded our social safety net and public infrastructure for so many decades, we're now just starting to feel the consequences.

We truly can't afford any more denial. Something must change. And legislators must recognize reality, even if a certain someone else in Carson City continues to deny it.

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