Competency evaluations for Nevada detainees log-jammed

The hits just keep on coming for Nevada’s cash-strapped mental hospitals — two state facilities now face federal civil rights lawsuits.

Rawson-Neal Psychiatric Hospital in Las Vegas, which has been in the national spotlight for allegations of patient dumping and recently lost its accreditation, isn’t the only state facility under pressure. At a Tuesday meeting, a group of state lawmakers learned that Lake’s Crossing Center is being sued by the Clark County public defender’s office over the significant increase in delays for getting court-ordered patients admitted.

The Northern Nevada maximum security facility is the state’s only center for evaluating the competency of offenders referred by the court system.

“Incompetent detainees have routinely spent weeks and, in most cases, months, at detention facilities where the conditions are punitive and no prompt restorative treatment is available,” alleges the lawsuit, which was filed against the Sparks hospital in June in U.S. District Court in Las Vegas.

This is the second time Lake’s Crossing has faced a lawsuit over wait times for admission. Those who filed the latest lawsuit and a former state employee say legal issues could have been avoided if such services were available in Clark County.

Rawson-Neal, which was also hit with a federal lawsuit in June, came under scrutiny after discharging James F. Brown, 48, to Sacramento, Calif., in February with no support or family waiting for him.

Lake’s Crossing is supposed to admit court-ordered patients within seven days of the court order, said Clark County Deputy Public Defender Christy Craig, lead attorney in the lawsuit. That was part of a settlement agreement reached in 2008 for the first lawsuit, filed by the Nevada Disability Advocacy and Law Center in 2005.

On Tuesday, state officials said the problem arose because the number of Clark County prisoners waiting to be transported to Lake’s Crossing had increased since November, from six to 36 in July.

But Craig said it’s not about the number of people on the wait list. It’s about the number of days they have to wait to get into the hospital. The lawsuit names three plaintiffs and claims that “detainees declared incompetent by the Eight Judicial District Court are currently waiting approximately 80 days — or almost three months — in detention facilities for transport to Lake’s Crossing.”

That creates many issues, Craig said. Detainees awaiting evaluation are unable to participate in their legal case.

“Everything that happens in the case stops until they are found to be competent,” she said. “You can’t have a prelim, you can’t have a trial.”

When so much time goes by, public defenders are “not able to prepare an accurate defense,” Craig said. “It’s a delay in lots of ways.”

Lake’s Crossing is understaffed and the number of beds is just not enough to meet the demand, Craig said. A significant number of defendants referred to the hospital by the court system are from Clark County.

Dr. Tracey Green, the state’s chief medical officer, said more than one factor has contributed to the delay in getting defendants into Lake’s Crossing, such as an increase in referrals from the court system and a reduction of the number of flights for prisoners from Clark County. “We have not refused any clients,” she said.

The average length of stay at Lake’s Crossing is 71 days, Green said. The hospital has a provisional license from the state and is not certified by the Centers for Medicare and Medicaid Services. Slated improvements for patient safety would allow the hospital to become certified by the federal agency, she added. Those would include building upgrades and improving hospital security systems.

Las Vegas police spokesman Bill Cassell said any reduction in the number of flights to the Sparks facility was due to the center’s inability to take patients. “There is a backlog right now,” he said of Lake’s Crossing.

The Metropolitan Police Department contracts with Vision Holidays out of the North Las Vegas Airport to transport defendants to Lake’s Crossing “every couple of weeks.” It pays $5,250 per round-trip flight, or about $120,000 a year. Normally, five to six prisoners are transported to the hospital, where another six are picked up for transport back to Clark County, Cassell said.

“Clearly, flying patients it’s not the most efficient way,” said Green of detainee evaluations.

Especially when the majority of prisoners are from Clark County, said Carlos Brandenburg, who retired as administrator of the Nevada Division of Mental Health and Developmental Services in 2007. “It just doesn’t make a lot of sense,” he said.

Before Brandenburg retired, he began planning for a maximum-security mental facility in Southern Nevada to provide the same services as Lake’s Crossing. State officials on Tuesday said the Legislature had approved the project, but it stalled because of the recession.

However, Brandenburg said the action to stop that project from moving forward was for political reasons and it happened before the recession hit.

The project was approved between 2005 and 2007, Green said.

On Tuesday, the Legislature’s Interim Finance Committee tabled a proposal to renovate an old psychiatric hospital in Las Vegas and provide up to 42 beds for detainees in need of evaluation and or treatment. Legislators worried that approving the proposed renovation would divert $3 million in funds now earmarked for Lake’s Crossing projects deemed critical for patient safety.

But that facility has been needed in Southern Nevada for more than a decade, Craig said.

“I don’t think there’s any question that they are going to have to build a forensic facility down south,” she said. “I’m actually really hopeful. I believe that’s what they (state officials) are working” toward.

Officials at the state’s Department of Health and Human Services were asked to bring back a different proposal at the committee’s Aug. 29 meeting for the renovation of the old psychiatric hospital.

“What is it going to take? More clients committing suicide in jails?” Brandenburg asked. “What is it going to take for them to realize that they need to fund the services?”

Contact Yesenia Amaro at yamaro@reviewjournal.com or 702-383-0440.