Nevada officials: Evidence 'insufficient' in San Francisco's patient-dumping claims

Faced with threatened legal action from San Francisco City Attorney Dennis Herrera who accuses Nevada of dumping mental patients on his jurisdiction, state officials on Monday said evidence to support his claims is insufficient.

In August, Herrera gave Silver State officials had until Monday to negotiate an agreement to avoid being sued.

The letter dated Monday and sent to Herrera by Linda C. Anderson, chief deputy attorney general at the Nevada attorney general’s office, says that documents requested by Herrera’s office and provided by the Nevada Department of Health and Human Services, “demonstrate that the policies are appropriate and that proper discharges were made.”

“You made a demand for approximately $500,000 but you fail to provide details to support your claim including how you identified the 20 patients,” the letter says. “Moreover, you do not provide sufficient explanation of your legal theory or standing for the initiation of a lawsuit by you on behalf of the ‘affected California cities and counties.’”

Late last month, Herrera warned Nevada officials that he planned to file a class-action lawsuit on behalf of California local governments to recover costs incurred for treating indigent patients he claimed Nevada improperly discharged from Rawson-Neal Psychiatric Hospital in Las Vegas. His investigation identified 500 patients who had been bused to California since 2008. He claimed that 24 patients had been bused to San Francisco and 20 of them had received emergency treatment upon their arrival.

In seeking a settlement agreement, Herrera asked for a reimbursement to his jurisdiction of $500,000 and called for Nevada to establish better protocols for the out-of-state transfer of mentally ill patients.

Herrera’s action came months after Rawson-Neal came under scrutiny for discharging James F. Brown, 48, to Sacramento, Calif. in February with no support. The hospital since then has been hit with a federal lawsuit and has lots its accreditation.

Nevada officials didn’t take questions Monday regarding their response to California officials.

“The letter speaks for itself,” Jennifer Lopez, spokeswoman for the Nevada attorney general’s office, said in an email.

Gabriel Zitrin, spokesman with Herrera’s office, said that if California officials didn’t receive a response from Nevada officials by Monday, that a lawsuit could be filed soon. An official response was planned for today.

In the letter, Anderson also cites reports from the press that a woman with mental health problems was sent to a Nevada hospital from California and that Nevada’s Department of Health and Human Services reports that many of their clients claim California residency.

Nevada and California are both financially impacted by the movement of people with mental illness across state lines, the letter says.

“We believe that government officials would benefit from better communication and collaboration on protocols to address the needs of these patients rather than trying to allocate financial responsibility through litigation,” Anderson wrote in the letter.

A state analysis determined that Rawson-Neal admitted more than 31,000 patients from July 1, 2008, through March 31, 2013. About 8 percent or 2,402 of the total admissions or discharges, were patients whose primary residency was not Nevada, the letter reads.

About 771 of those admissions or discharges appeared to be California residents, according to the letter. About 326 of the 771 were patients who received short-term care with an average stay of two days.

The other 445 admissions or discharges were to or from the inpatient unit with an average stay of 18 days, the letter says.

“Therefore, it could be argued that using the average cost of services in the Rawson-Neal Hospital of $653 per day, the taxpayers of the State of Nevada have subsidized the state of California over $6.2 million during this same period,” the letter reads.

Allen Lichtenstein, general counsel for the American Civil Liberties Union of Nevada, said the state of Nevada needs to accept responsibility for its own actions.

“They seem to either not understand or not care,” he said Monday. “If California behaved improperly, that doesn’t excuse Nevada. They should follow the law, which requires them to take care of people who can’t take care of themselves.”

Reporter Yesenia Amaro can be reached at (702) 383-0440, or yamaro@reviewjournal.com.