S.F. sues to recoup costs for patients ‘dumped’ by Nevada hospital

San Francisco City Atty. Dennis Herrera
San Francisco City Atty. Dennis Herrera has filed a class-action lawsuit against the state of Nevada over alleged patient dumping by a Las Vegas psychiatric hospital.
(Robert Durell / Los Angeles Times)

SAN FRANCISCO -- The San Francisco city attorney on Tuesday filed a class action lawsuit against the state of Nevada on behalf of all California local governments where patients have allegedly been bused from a Las Vegas psychiatric hospital in recent years.

The allegations of so-called patient dumping by Rawson-Neal Psychiatric Hospital were first brought to light in a March Sacramento Bee article about 48-year-old James Flavy Coy Brown, who was sent by the hospital on a 15-hour bus ride to Sacramento despite having never before visited there and having no friends or family members in the area.

No prior arrangements were made for his care, housing or medical treatment and he was told to dial 911 on arrival.

San Francisco City Atty. Dennis Herrera began his own investigation after the Bee followed up with reports that Rawson-Neal had bused about 1,500 psychiatric patients to cities and towns across the country over the last five years, including about 500 to California.


An investigation by the Los Angeles city attorney’s office is ongoing.

Herrera’s lawsuit, filed in San Francisco County Superior Court, seeks an injunction barring Nevada from similar patient discharge practices in the future, and reimbursement for San Francisco’s costs to provide care to the bused patients.

His investigation determined that two dozen Rawson-Neal patients have been “unsafely transported” to San Francisco by Greyhound bus since 2008 “without adequate food, water or medication, and without instructions or arrangements for their continued care when they reached their destination.”

Herrera said 20 of them required medical care shortly after their arrival in San Francisco -- some within hours of getting off the bus -- at a cost of approximately $500,000 to San Francisco taxpayers for medical care, shelter and basic necessities.


“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, saying the practice “punishes jurisdictions for providing health and human services that others won’t provide.”

If San Francisco wins reimbursement, he said, it would establish a precedent for other jurisdictions who can demonstrate similar claims.

“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,” Herrera wrote.

The lawsuit, however, could trigger tit-for-tat litigation.

Nevada authorities are currently probing the case of a mentally ill woman who was released from Napa State Hospital last month, picked up by a Plumas County, Calif., mental health caseworker and delivered to a Las Vegas emergency room.

Plumas County officials have declined to comment on the case of the woman, citing confidentiality laws.

A copy of the woman’s Aug. 16 discharge plan, drafted by Plumas County Mental Health Services and viewed by the Los Angeles Times, indicated that case manager Irasema Tavares was to pick up the patient and her medication at Napa State Hospital and “drive with client to her home in Las Vegas, Nevada.”

“Irasema will ensure linkage with care providers at Southern Nevada Adult Mental Health Services,” the plan reads.


However, the woman no longer has family or friends in Las Vegas, her mother, who lives in Quincy, Calif., told Sacramento Bee columnist Dan Morain. The mother was not notified that her daughter had been discharged.

In a Monday letter to Herrera, Nevada Chief Deputy Atty. Gen. Linda C. Anderson referenced the case and noted that hundreds of California residents were treated at Rawson-Neal between 2008 and 2013.

It could be argued, Anderson wrote, that at $653 per day “the taxpayers of the State of Nevada have subsidized the State of California over $6.2 million during this same period.”

“Since both California and Nevada are financially impacted by the travel of individuals with mental illness between our states,” the letter said, “we believe that government officials would benefit from better communication and collaboration ... rather than trying to allocate financial responsibility through litigation.”

Rawson-Neal earlier this summer lost its accreditation by the Joint Commission as a result of the busing issue but will undergo a review to regain it in the fall. Meanwhile, it failed one inspection by the U.S. Centers for Medicare and Medicaid Services and will lose federal funds if it fails another ongoing inspection.

Nevada’s Department of Health and Human Services earlier this year conducted an internal review and made changes to its transportation policy for patients discharged from Rawson-Neal Psychiatric Hospital, known as “Client Transfer Back to Home Communities.”

The review of 1,473 bus tickets purchased during a five-year period found 10 “where there was not enough documentation to know for certain if staff confirmed there was housing/shelter and supportive services at the destination,” department spokeswoman Mary Woods previously said.

The hospital terminated some medical staff. Out-of-state transit now requires “multiple medical staff and hospital administrator review and approval,” and clients who receive it are chaperoned.


Reached Tuesday, Woods said: “We are aware that a lawsuit has been filed. When we are served with the lawsuit, we will review it and make an appropriate response to the court.”


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