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Review-Journal investigation spurs call for mental health reform

Updated March 19, 2018 - 6:39 pm

Nevada health officials are examining how the state could license consultants who transfer mentally ill people to unregulated group homes, a step prompted by a Las Vegas Review-Journal investigation that highlighted the death of a suicidal woman after she was placed in an unsupervised residence.

“This story has been really motivating for people,” said Julie Kotchevar, deputy director at the Nevada Department of Health and Human Services. “It’s certainly been motivating for me to make sure it doesn’t happen again.”

At a legislative meeting Monday, Kotchevar presented lawmakers with an idea: Broaden the state statute that governs “referral agencies” to require anyone doing that type of work to obtain a license. Currently, state law requires a license only for businesses that refer patients to “residential facilities for groups.”

That definition — “residential facilities for groups” — excludes hundreds of other group homes, including community-based homes for severely mentally ill people and unregulated “independent living” homes for other vulnerable residents.

The issue came to light after Henderson-based consultant Eileen Lee — who has no license and no medical training or experience — transferred numerous mentally ill patients from local hospitals to unregulated and unlicensed group homes. Last month, she placed 33-year-old Rayshuana Roy, a bipolar, suicidal woman, into an unregulated group home. Roy was found dead a day later.

But Lee did nothing illegal. Kotchevar said broadening the definition of “referral agency” in the statute would require people such as Lee to obtain a license to transfer patients to all facilities.

“It’s to protect everyone,” she said. “The hospitals would then know they need to contract with someone who had that license. And then, just like any other licensed or regulated profession, if that person does something that does harm to another or malpractice, they can be held responsible for it.”

Robin Reedy, executive director of Nevada’s National Alliance on Mental Illness, said people with no mental health training should not make housing decisions.

“A consultant decided the severity of this person’s issue and had no medical training,” Reedy said. “Shouldn’t a psychologist or psychiatrist make the decision on whether someone goes to a support home?”

The Legislative Committee on Healthcare can choose to draft a bill during the 2019 legislative session to make that change.

Another change discussed by Kotchevar on Monday would require hospitals to check in with vulnerable patients like Roy after discharge, or to connect them with other services for follow-up. North Vista Hospital, which released Roy to Eileen Lee, declined to comment on the situation.

State health officials also discussed efforts to crack down on illegal group homes. A recent state audit revealed 37 homes were in deplorable condition, and many of them were uncertified. Since then, 13 homes have been shut down in Southern Nevada and five have been closed in Northern Nevada.

The homes are now regulated by the Bureau of Health Care Quality and Compliance — instead of the health department — using new checklists.

Kotchevar said unlicensed group home owners are “good at hiding.” Some obtain business licenses to appear legitimate, she said, but state officials will now check those listings. Others skirt the rules by claiming they don’t administer medicine or provide supportive services that require licensure.

Kotchevar wants the state to consolidate the homes into one category so they’re licensed and regulated consistently.

Also Monday, lawmakers heard about a plan to provide mobile outreach services in Las Vegas for people with mental disorders. The partnership with Las Vegas-area police and fire departments stems from a $1.8 million grant through June 2019. It would allow licensed clinicians to accompany law enforcement on calls related to mental health crises.

“We can’t afford not to have these services,” said Assemblyman James Oscarson, who sits on the health care committee.

Contact Ramona Giwargis at rgiwargis@reviewjournal.com or 702-380-4538. Follow @RamonaGiwargis on Twitter.

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