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San Francisco Says Nevada Dumping Mental Patients

(Photo: Gerardo Diego Ontiveros)

(Photo: Gerardo Diego Ontiveros)

Jonny Bonner, Courthouse News Service

Nevada dumped 1,500 mental patients on other states, including 500 in California, by putting them on Greyhound buses and sending them to cities where they don’t live, San Francisco claims in a class action.

“Virtually all” of the patients dumped on California need continuing medical care, but Nevada didn’t arrange for them to be received by family members or a medical facility, San Francisco says in its complaint in Superior Court. It claims the abusive practice has cost it at least $500,000.

The City and County of San Francisco sued Nevada, its Department of Health and Human Services, its Division of Mental Health and Developmental Services, Southern Nevada Adult Mental Health Services, and Rawson-Neal Psychiatric Hospital, from which the patients allegedly were discharged and dumped.

“Over the past five years, the state of Nevada has transferred to other states approximately 1,500 patients discharged from its state-run Rawson-Neal Psychiatric Hospital, including almost 500 patients that Nevada sent by Greyhound bus to cities and counties in California,” the complaint states. “Nevada knew many of these patients were not California residents at the time it discharged them to buses bound for California. A substantial number of the patients bused to California are mentally ill and indigent, and at the time of their discharge and transportation, were not residents of the California cities and counties to which they were bused.

“Further, despite the fact that virtually all of the patients transported to California required continuing medical care, Nevada did not make arrangements for the patients to be received by family members or a medical facility in the destination city or county prior to putting the patients on a Greyhound bus for California. Nevada jeopardized the bused patients’ physical and mental health by failing to provide them with adequate food, water and medication during their trip to California, and by failing to assure that shelter or medical care had been arranged for the patients at their destinations. While some of the patients were given the names of shelters or told to dial ‘911’ upon arrival in California, a substantial number were not provided any instructions or assistance in finding shelter, continued medical care, or basic necessities in the cities and counties to which they were sent.”

The defendants have sent 24 patients to San Francisco by bus since 2008, 20 of whom required medical care “shortly after their arrival in San Francisco, some within mere hours of getting of the bus,” San Francisco say s in the complaint.
The city says it provided medical care to the patients at San Francisco General Hospital or at health clinics run by the San Francisco Department of Public Health.

“San Francisco has to date expended approximately $500,000 to provide necessary medical care, shelter and housing, and other basic necessities to the patients that San Francisco has to date identified as having been bused to it by Nevada,” the complaint states.

Rawson-Neal Hospital and its administrators and staff – including doctors, social workers and nurses – were aware their patients were indigent, living in shelters or on the streets of Las Vegas or other Nevada cities, and suffered from mental illnesses requiring ongoing medical care and medication, San Francisco claims.

“Rawson-Neal understood and expected that the bused patients would rely on San Francisco’s public health resources for continuing medical care, and specifically directed some of the patients to seek care at San Francisco public health clinics and shelter at San Francisco-supported shelter and care programs,” according to the complaint.

“If defendants had not transported them to San Francisco, these 24 indigent patients would instead have been reliant upon Rawson-Neal or other publicly-supported hospitals and medical clinics in Nevada for their continued medical care, and upon shelter and support programs publicly funded by Nevada.”

Nevada thus jeopardized patients’ physical and mental health, the welfare of other bus passengers, and the safety of San Francisco residents, the city claims.

“By transporting to California cities and counties indigent and mentally ill patients who were not residents of those cities and counties, Nevada intentionally and wrongfully appropriated the resources that the destination California cities and counties had established to provide medical care and basic necessities to the indigent, and avoided expending its own public resources to care for these patients. Nevada, through its political subdivisions, is required by state law to provide ‘care, support and relief to the poor, indigent, incompetent, and those incapacitated by age, disease or accident’ to county residents,” the complaint states.

City Attorney Dennis Herrera wrote a letter of protest to Nevada Attorney General Catherine Cortez Masto in August and warned he would sue for this.

“Homeless psychiatric patients are especially vulnerable to the kind of practices Nevada engaged in, and the lawsuit I’ve filed today is about more than just compensation – it’s about accountability,” Herrera said in a statement Wednesday. “What the defendants have been doing for years is horribly wrong on two levels: it cruelly victimizes a defenseless population, and punishes jurisdictions for providing health and human services that others won’t provide. It’s my hope that the class action we’re pursuing against Nevada will be a wake-up call to facilities nationwide that they, too, risk being held to account if they engage in similarly unlawful conduct.”

Nevada’s Chief Deputy Attorney General Linda Anderson sent Herrera a letter on Monday claiming the transfers were “appropriate,” and saying that hundreds of California residents had been treated at Rawson-Neal since 2008, according to the Los Angeles Times. In August, in Herrera’s public threat to sue Nevada, the city attorney cited a Sacramento Bee story about a schizophrenic patient named Brown whom Rawson-Neal “sent on a 15-hour bus ride to Sacramento – despite having never before visited, having no friends or family members in the area, and with no prior arrangements for his care, housing or medical treatment.”

The Aug. 20 statement from the City Attorney’s Office continued: “The Nevada-run hospital had discharged Brown in a taxicab to the Greyhound bus station with a one-way ticket to Sacramento, snacks, and a three-day supply of medication to treat his schizophrenia, depression and anxiety. Brown was instructed to call 911 when he arrived. A Rawson- Neal physician reportedly recommended ‘sunny California’ to Brown as a destination, according to the Sacramento Bee, because they ‘have excellent health care and more benefits than you could ever get in Nevada.'”

The defendants were not available for comment Wednesday night.

San Francisco seeks class status and an injunction prohibiting the patient-dumping – plus damages, restitution and costs.

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