Nevada Being Sued Over Practice Of ‘Dumping’ Mentally Ill Patients In Cities Where They Know No One

Nevada has apparently come up with a new way of controlling the cost of caring for the institutionalized mentally ill: put them on buses and send them to other states.

That is the basis for a lawsuit that has been filed by the city of San Francisco against the state of Nevada, which claims that it has cost the city over $500,000 to house and care for homeless mental patients who had previously been living at Nevada’s state-run Rawson-Neal Psychiatric Hospital in Las Vegas. San Francisco City Attorney Dennis Herrera said in a statement:

Homeless, psychiatric patients are especially vulnerable to the kind of practices Nevada engaged in, and the lawsuit I’ve filed today is about more than just compensation. It’s about accountability.

Reuters reports that the suit has been filed as a class action, but has not yet been certified by the court.

The lawsuit stems from a Sacramento Bee report published last April, which found that starting in 2008 Rawson-Neal had sent more than 1,500 patients to cities around the country, sending at least one to every state. The paper discovered this information after reviewing bus receipts provided by the Nevada mental health division.

According to The Bee:

In recent years, as Nevada has slashed funding for mental health services, the number of mentally ill patients being bused out of southern Nevada has steadily risen, growing 66 percent from 2009 to 2012. During that same period, the hospital has dispersed those patients to an ever-increasing number of states.
By last year, Rawson-Neal bused out patients at a pace of well over one per day, shipping nearly 400 patients to a total of 176 cities and 45 states across the nation.

 The paper highlighted the story of 48-year-old James Flavy Coy Brown, who suffers from mood disorders including schizophrenia, and who showed up at a Sacramento homeless services office. Brown was discharged from Rawson-Neal in February, and given a Greyhound bus ticket to Sacramento, where he had no friends or family.

The hospital sent him on the 15-hour bus ride without making arrangements for his treatment or housing in California; he arrived in Sacramento out of medication and without identification or access to his Social Security payments. He wound up in the UC Davis Medical Center’s emergency room, where he lingered for three days until social workers were able to find him temporary housing.

For their part, Nevada mental health officials admit to making mistakes in Brown’s case, but have overall defended the practice of busing patients out-of-state. Nevada’s state health officer, Dr. Tracey Green, said that Las Vegas is an “international destination” and that patients who become ill while visiting have a right to return home. Nevada’s Health and Human Services Director Michael Willden told state legislators that there was “no pattern of misconduct.”

Jo Robinson, director of San Francisco’s Behavioral Health Services department told The Bee that at least two patients from Nevada arrived in the city during the past year without a plan for their care or any relative to care for them. Robinson said:

We’re fine with taking people if they call and we make arrangements and make sure that everything is OK for the individual. But a bus ticket with no contact, no clinic receptor, anything, it’s really not appropriate.

The National Alliance On Mental Illness reports that Nevada, under Republican governors Jim Gibbons and Brian Sandoval, has cut funding for mental health services by over 28 percent between 2009 and 2012, which was the fifth largest cut by any state. According to the Kaiser Family Foundation, Nevada, which has one of the highest suicide rates in the country, ranks 41st in per capita spending on mental health services out of 54 states and territories. At $68.32 per person, Nevada’s spending in this area is just over half the national average of $120.56 per person.

Thanks to the publicity generated by this story, Governor Sandoval in May proposed increasing funding for mental health services by $8 million. In August the Nevada State Board Of Examiners approved an additional $3 million in funding for Rawson-Neal.

ThinkProgress.org reports that Nevada officials have indicated that they will cooperate with the San Francisco investigation, but they are saying that they will not reimburse the city for any expenses, claiming that it lacks standing to represent the patients.