Policy under review

A state mental health administrator said Tuesday that authorities are developing a plan to segregate the violent from the passive patients at Rawson Neal Psychiatric Hospital, where two rapes involving patients are alleged to have occurred in November.

A day after he acknowledged that federal, state and local authorities are investigating the sexual assault allegations, Harold Cook, administrator of the state Division of Mental Health and Developmental Services, said such a plan "has been in the works for some time."

Nurses and mental health technicians at the hospital have told the Review-Journal that both patient and employee safety are jeopardized by the inclusion of violent individuals and sexual predators within the general patient population. They say it is common for both staff and patients to be punched, kicked and knocked to the floor.

"From what I have seen, if any of my family members were in that hospital, I would do whatever I could to get them out," said one mental health technician who requested anonymity. "The powerful prey on the weak and that's just not right."

Cook said although the hospital must accept patients with a known violent past, the facility can take steps to keep them from hurting others.

"We haven't quite finished the (segregation) plan," he said, adding it's a "reasonable way" to ensure that patients aren't victimized.

Cook would not say what the catalyst was for the segregation plan or when it was proposed, nor did he know when it would be formalized.

"I hope soon," he said. "It's not rocket science."

Space and staffing issues must be dealt with before the plan is finalized, he said.

Though Cook did not detail what the staffing concerns might be, Gina Greisen, an organizer for the American Federation of State, County and Municipal Employees Local 4041, said employees have a simple question that needs answering if one section of the hospital is cordoned off only for those who exhibit violent or sexually aggressive behavior: "What would be the personal incentive to work with patients who are so aggressive that you are continually put in harm's way?"

That might take some kind of hazardous duty pay, Greisen suggested, which she acknowledged could be difficult with the state in a budget crisis.

Cook met with employees Tuesday at the hospital that sits near the College of Southern Nevada campus on Charleston Avenue. At the staff-only meeting, there was dialogue about how the state's economic problems could affect staffing, employees said.

Some employees have told the Review-Journal that both patients and staff are at risk at the institution because budget constraints are leaving positions unfilled, creating less supervision than necessary.

The Joint Commission, the accrediting agency for hospitals, does not stipulate a staffing ratio, only that there must be enough to get the job done safely.

Cook said staffing is not a problem, but rather how it is used. He said the elimination of 100 more positions at the hospital by July because of the economic crisis need not jeopardize safety at the institution.

He said the ratio of 2.4 clinical staff to each occupied bed at the hospital is better than at many hospitals, which he said often drops as low as 1.4 staff members per bed.

Cook said there have been a number of private companies that have expressed interest in running Nevada's psychiatric institutions.

"One of the reasons is that we have a rich staffing ratio," he said. "They say, 'We can save the state a ton of money if you let us run your facilities.' "

Las Vegas police have refused repeated requests to see the incident reports involving the rape allegations at Rawson Neal. One assault is alleged to have involved two male patients and the other involved a man and a woman, according to hospital staffers.

Police have not disclosed whether arrests have been made in connection with the investigations.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.