San Francisco Sues Nevada over ‘Patient Dumping’

Hemera/Thinkstock(SAN FRANCISCO) — The City of San Francisco has filed a lawsuit against Nevada for discharging psychiatric hospital patients too early and busing them out of state in a practice that’s become known as “patient dumping.”

The San Francisco City Attorney’s Office launched an investigation in April after news broke that Rawson-Neal Psychiatric Hospital in Las Vegas had bused nearly 1,500 patients out of state since 2008. Since then, the office has found that 500 of those patients were bused to California, at least 24 of which were bused to San Francisco even though neither they nor their families were San Francisco residents, according to the lawsuit.

Hospital officials did not reach out to anyone in San Francisco to make arrangements for patient care prior to putting them on buses bound for the city, according to the lawsuit, which also alleges that the patients were given a small amount of food and medication and told to dial 911 or find a shelter upon their arrival in their new city.

“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,” City Attorney Dennis Herrera said in a statement on Sept. 10.

The lawsuit claims these patients needed further care at the time they were relocated, and went on to cost San Francisco taxpayers $500,000.

James Brown, who has been diagnosed with psychosis, was the early face of the patient dumping scandal. Brown told ABC News that Rawson-Neal Psychiatric Hospital officials put him on a bus with six Ensure nutrition shake bottles and three days’ worth of medication. They told him to dial 911 when he arrived in San Francisco, he said.

The lawsuit also mentions a 36-year-old patient who had been living on the streets of Las Vegas prior to being hospitalized at Rawson-Neal and diagnosed with psychosis, schizophrenia and having suicidal and homicidal thoughts.  He was bused to San Francisco three times and he made his way back to Nevada on his own. The final time he was bused to San Francisco, he tried to buy a gun and intended to kill himself or others, according to the lawsuit, but was hospitalized after expressing his thoughts to police.

Investigators in San Francisco also learned of another patient who was from Florida but lived in Nevada since 2009 prior to being bused to San Francisco.

The hospital officials were just following a Nevada policy called Nevada’s Client Transportation Back to Home Communities, said Nevada Department of Health and Human Services spokeswoman Mary Woods, noting that San Francisco has a similar program.

Upon hearing about Brown, the Nevada department conducted an investigation and found that only 10 patients that were bused out of state had insufficient documentation to show whether they had shelter at their destinations, Woods said.

In addition, a response letter from the Nevada Attorney General sent on Sept. 9 further states that if the state of Nevada owes San Francisco $500,000, the state of California owes Nevada $6.2 million over the same period for 445 discharged patients who were California residents but received care in Nevada.

“Therefore, since both California and Nevada are financially impacted by the travel of individuals with mental illness between our states, we believe that government officials would benefit from better communication and collaboration on protocols to address the needs of these patients rather than trying to allocate financial responsibility through litigation,” the Nevada response letter concludes.

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