Wednesday, September 11, 2013

The Consequences of Foolishness

Remember, it was all supposed to be over by now. Governor Brian Sandoval (R-Denial) was supposed to have fixed all the problems at Rawson-Neal Psychiatric Hospital. And there's supposed to be no more patient dumping.

Last month, news broke of incredibly long wait lists at Lake's Crossing Psychiatric Hospital in Sparks. And after all the revelations of mental health patient dumping (into other states) from Rawson-Neal Psychiatric Hospital in Las Vegas, someone is now stepping forward to demand justice. Yep, San Francisco is taking the state to court.

San Francisco City Attorney Dennis Herrera filed the class-action lawsuit against Nevada, Rawson-Neal Psychiatric Hospital in Las Vegas and state mental health administrators, seeking reimbursement for the care of indigent patients he said the system “dumped” onto California in an effort to save money.

“What the defendants have been doing for years is horribly wrong on two levels,” Herrera said in a written statement announcing the lawsuit. “It cruelly victimizes a defenseless population, and punishes jurisdictions for providing health and human services that others won’t provide.”

In addition to unspecified financial damages, the suit asks for a permanent injunction preventing Nevada from dispatching psychiatric patients to California unless they are residents of the destination city or county, are being sent to family members who have agreed to care for them, or are being sent to a medical facility where arrangements have been made for their treatment.

Ever since The Sacramento Bee first uncovered the horrific story of James Flavy Coy Brown's bus ride to Northern California, media from across California began investigating the matter. Pretty soon, other states began reporting patient dumping incidents. Then, federal health officials began investigating Nevada's broken mental health care system.

And now, federal investigators are confirming what many had suspected all along.

The U.S. Centers for Medicare and Medicaid Servicesassessed a sample group of 41 charts for patients at Rawson-Neal Psychiatric Hospital in Las Vegas and found that in 16 cases, patients were discharged without evidence the hospital had made even basic arrangements for their shelter, support or follow-up care.

The majority of those patients were discharged directly to Greyhound buses bound for other states, without documentation of specific instructions about how to find housing or mental health treatment.

Most had been living in Las Vegas shelters or on the streets before being transported to other cities. A few were sent by bus to homeless shelters in the area.

CMS officials said the hospital's handling of the cases violated the Emergency Medical Treatment and Labor Act or EMTALA, sometimes known as the "anti-dumping" law, requiring hospitals to either stabilize emergency patients or, at the patient's request, to transfer them somewhere else. Rawson-Neal, which already has lost its accreditation following investigations into its discharge practices, could face further sanctions for violating the act.

So is anyone still wondering why San Francisco is suing the state? And why are we left to wonder when our state will finally invest in fixing our languishing public infrastructure?

These are the consequences we are now paying. Southern Nevada's only public hospital dedicated to mental health care is losing federal accreditation, at risk of losing federal funding, and now faces a law suit in federal court. And why? Oh, it's just because our state government has had a knack for penny wise and pound foolish bullshit.

These are the consequences of failure to invest in our own people. Can we afford to continue making this same mistake? Can we afford to continue being so foolish?

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