Monday, May 20, 2013

Sounding the Alarms

For some time, we've been sounding the alarms on Nevada's patient dumping scandal. We've been warning everyone that trouble was brewing. And we sensed that trouble was about to spill all over our fine state.

Today may be the first day of reckoning. And we can't say we didn't see it coming. Los Angeles and San Francisco launched their own respective criminal probes last month into the numerous discharges from Rawson-Neal Psychiatric Hospital who ended up in their cities, in other parts of California, and even in other parts of the country without any support system and/or treatment plans waiting for them. And now, the City of Los Angeles looks ready to sue Nevada.

Los Angeles is able to take a hard line because it has an ordinance that defines patient-dumping explicitly and lays out criminal penalties for violations. Other agencies are making use of state and federal laws that apply more broadly to hospital discharge practices – often targeting emergency rooms – or that don't list specific penalties.

"Doesn't this represent to you a crime?" asked Los Angeles City Attorney Carmen Trutanich, soon after the investigation was launched.

Rawson-Neal bused about 150 patients to the Greyhound bus station near Los Angeles' Skid Row in the past five years, far more than were sent to any other city.

To build their case, Trutanich's investigators are searching for former Rawson-Neal patients to learn if the circumstances of their discharges violated the city's ordinance against patient-dumping. That ordinance says patients cannot be transported from hospitals to anywhere but their homes, or the location they give as their home, without written consent.

Uh oh. But wait, there's more. Again, Nevada may soon face some very serious consequences for neglecting many of our state's most vulnerable.

If the investigation ends like several others, the hospital could settle with the city, be forced to adopt stringent discharge protocols and pay a fine.

Alternatively, the case could go to court, potentially leading to a misdemeanor criminal conviction for the hospital or some of its employees, Trutanich said.

"This is 150 people allegedly on the streets of L.A.," Trutanich said. "We're already stretched as it is."

And that's not all. The City & County of San Francisco is looking at the federal Emergency Medical Treatment and Active Labor Act and investigating whether Rawson-Neal violated this federal law. If so, San Francisco will sue in federal court. In addition, the federal Centers for Medicare & Medicaid Services are conducting their own investigation to determine whether Nevada's mental health patient dumps violated federal law.

Again, we've been sounding the alarms. And after decades of letting our social safety net fall apart, we're now beginning to feel the consequences. The supposedly wise sages in Carson City thought they were being so penny wise in shortchanging investment in our community's health care, but they're now just being revealed to be incredibly pound foolish. And we may all soon pay the price for their pound foolishness.

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