Facing scrutiny, Sandoval creates state mental health council

Nevada officials on Monday said they will delve more deeply into allegations of patient dumping at Rawson-Neal Psychiatric Hospital in Las Vegas, a commitment that follows a California newspaper report that hundreds of patients were given one-way bus tickets to out-of-state destinations in the past three years.

Gov. Brian Sandoval on Monday also announced an executive order that establishes the Governor’s Behavioral Health and Wellness Council, which will look at improving mental health services in Nevada. It was signed Friday.

These actions come at a time when the hospital is expecting an inspection by the Joint Commission, an independent organization that accredits hospitals across the nation.

“An internal investigation is already underway to ensure staff acted appropriately and followed all discharge policies correctly,” Mary Woods, spokeswoman for the Nevada Department of Health and Human Services said in a statement.

On Sunday, the Sacramento Bee reported that dozens of patients discharged from Rawson-Neal in recent years were transported out-of-state and later committed crimes. At least 50 other patient names matched names in a criminal database for offenses in Las Vegas, although the Sacramento Bee was not able to confirm that all the matches were the same people.

All individuals identified in the Sacramento Bee report are among discharges that have already been reviewed, according to Woods. Those discharges occurred before Sandoval ordered the state’s Department of Health and Human Services to improve its discharge practices earlier this year.

Earlier investigations resulted in stronger discharge policies and termination of staff. Two doctors were terminated and three other employees received lesser discipline.

The hospital also now requires a chaperon for every discharged patient.

Woods in her statement said it’s important for law enforcement agencies and mental health programs to coordinate.

“In fact, many admissions to the Rawson-Neal Psychiatric Hospital are initiated by local law enforcement officers,” she said. “They initiate the process to have someone held, evaluated and or treated.”

A policy that has been in effect since 1997 at the Nevada Division of Public and Behavioral Health directs employees to cooperate with law enforcement agencies, according to Woods.

“If a law enforcement agency requests notification of a client’s pending inpatient discharge, they will be notified and documented in the medical record,” she said. “Law enforcement records are not checked at discharge.”

The new established council will examine ways of improving the systems that deliver services to those living with behavioral health conditions in the Silver State, according to the governor’s office.

An analysis of Nevada’s mental health system, which began in May, will also be reviewed by the council when it’s completed.

“The creation of the council follows a recently completed DHHS analysis which provided recommendations to improve the delivery and availability of high-quality behavioral health services to individuals, their families, providers, communities and the state of Nevada as a whole,” according to Mary-Sarah Kinner, spokeswoman with the governor’s office. “This has been a months-long process which started in May.”

The council will submit a report to the governor on or before May 31 and Dec. 31 of each year. It will also be divided into regional subcommittees and be subject to open meeting law requirements, according to the governor’s office.

About $30 million more for improvements is included in the 2014-15 budget for the Nevada Mental Health System over the 2012-13 biennium, according to Woods.

The state hired two national experts to take a thorough look at Rawson-Neal and recently began to implement some of their recommendations for improvement.

A new drop-in center was opened and funding was approved to renovate a facility in Southern Nevada that will provide more beds for offenders with mental disorders and will also increase the number of beds for patients at Rawson-Neal. The facility will have 58 beds.

Forty-two of the beds will be for offenders with mental disorders. The remainder will serve as an overflow for Rawson-Neal.

Rawson-Neal lost its accreditation in July. State officials chose not to appeal the decision by the Joint Commission, but chose to reapply for accreditation instead. The hospital was notified it may receive an unannounced inspection anytime after Dec. 9. Woods on Monday said she wasn’t aware that any inspections had occurred.

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