San Francisco to investigate releases of Nevada mentally ill patients

The city attorney for San Francisco announced Monday that his office will investigate allegations of mental health patient dumping by Nevada, which already is under federal review for its discharge practices.

City Attorney Dennis Herrera sent a letter to Mike Willden, the director of the Nevada Department of Health and Human Services, requesting detailed records on the state’s bus transport of more than 1,500 mentally ill patients out of Nevada in the past three years. About 500 went to California, including 36 to San Francisco, Herrera said.

Herrera said he decided to investigate after reading articles in The Sacramento Bee, which discovered that a homeless, mentally ill man, James F. Brown, had been bused from Las Vegas to Sacramento with no support, family or friends waiting for him in California, a state where he said he had never been before.

“Assuming the reports are true, Nevada’s practice of psychiatric ‘patient dumping’ is shockingly inhumane and illegal,” Herrera said in a news release posted on his website with the letter to Willden.

“We intend to investigate these reports thoroughly, and I am inviting input from providers of services to San Francisco’s homeless, who may be willing to volunteer evidence and testimony to assist the city in a potential civil action.”

After Brown’s situation came to light, Nevada officials admitted proper state discharge policies were not followed in his case and disciplined those involved.

The state, however, denies dumping patients on other states as a practice. Nevada health authorities also instituted new policies aimed at preventing future discharge lapses, including requiring the administrator of the state psychiatric hospital, Rawson-Neal, to approve all out-of-state transport requests.

Brown was released from Rawson-Neal in February. Nevada’s investigation found two more cases of unsafe discharges out of 30 cases that month.

Gov. Brian Sandoval toured Rawson-Neal last Friday and “spoke extensively” with the administrator, his spokeswoman, Mary-Sarah Kinner, said Monday.

Kinner defended the state’s response to the patient dumping allegations, mentioning the disciplinary and corrective actions and policy changes the state has taken as part of its own investigations.

Sandoval has received regular updates, added Kinner, who noted Rawson-Neal was an accredited facility with a five-star rating.

“The governor supports the new strengthened discharge procedures and is committed to continuing to treat patients with a high level of care in a safe, modern, accredited facility,” Kinner said in a statement.

Kinner said Las Vegas is a “world-renowned tourist destination” that attracts millions of visitors each year, and Rawson-Neal regularly treats patients from outside Nevada.

“Once a patient is stable, Rawson-Neal provides patients assistance in returning to the home of the patient’s choice, as is the patient’s right and which most patients choose to do,” Kinner said.

Last Friday, Willden said the state is examining every case of busing psychiatric patients out of state since July 1, 2008, as part of its own continuing review.

He said a preliminary look indicates “the bulk” of 1,508 patients sent out of state by Greyhound as part of their discharge plans were sent home and had asked for help getting there.

A parallel federal probe of Nevada’s practices is pending. The U.S. Centers for Medicare & Medicaid Services is conducting the investigation at Nevada’s request.

In launching the probe, the San Francisco city attorney accused Nevada of dumping hundreds of indigent people with mental illnesses in California, leaving them “with inadequate provisions of food and medication, and without prior arrangements for their care, housing or medical treatment upon arrival.”

Herrera’s office said he opened the investigation in hopes it would help bring to the surface more specific cases from the Bay Area.

“We’re prepared to litigate aggressively on behalf of San Francisco and its taxpayers to recover whatever costs or damages we’re able to identify,” Herrera said in his release. “I also intend to pursue injunctive relief, including monitoring of the offending medical facilities, to send a strong message to any other state or locality that would consider similarly irresponsible public health practices.”

Herrera copied his letter to Willden to Nevada Attorney General Catherine Cortez Masto and to Sandoval, demanding release of public records on patient discharges.

Sandoval, a Republican running for re-election in 2014, has been criticized by the Nevada Democratic Party in a series of news releases based on Sacramento Bee articles and editorials.

“Nevada’s practice of busing patients with mental illness to all corners of the country is reprehensible,” the Bee said in an editorial published Sunday. “The response is not much better.”

After meeting with Sandoval for about 45 minutes Monday, Assembly Speaker Marilyn Kirkpatrick, D-North Las Vegas, said she doesn’t see a need for the Legislature to act yet.

“We’re working to handle everything internally, and you always have to have the facts first before you make a determination,’’ she said.

Kirkpatrick said she does not believe the issue stems from spending cuts in recent years.

“I believe that as all the facts come out that you will probably see that we have being doing our jobs and making sure that folks get where they need to and get the treatment that they need,” she said.

Review-Journal writer Sean Whaley contributed to this report. Contact Laura Myers at lmyers@reviewjournal.com or 702-387-2919. Follow @lmyerslvrj on Twitter.