Community Currents

San Francisco Files Class Action Lawsuit Against Nevada for Patient Dumping

On September 10, 2013, San Francisco City Attorney Dennis Herrera filed a class action lawsuit against the State of Nevada, claiming that Rawson-Neal Psychiatric Hospital, a state-run mental facility in Las Vegas, improperly bused poor patients with acute mental illnesses.[1] The lawsuit arose out of information brought to light by The Sacramento Bee earlier this year, that Rawson-Neal reportedly bought one-way Greyhound bus tickets to California for approximately 500 patients[2] with mental illnesses and sent them with inadequate provisions for food and medication, and without prior arrangements for their care, housing or medical treatment upon arrival. For example, The Bee reported that 48-year-old James Flavy Coy Brown, a former Rawson-Neal patient, was "sent on a 15-hour bus ride to Sacramento - despite having never before visited there, having no friends or family members in the area, and with no prior arrangements" for housing or medical care. He was given snacks, a three day supply of medication, and told to call 911 when he arrived. Herrera alleges that from 2008 to the present, Nevada has bused 24 indigent patients with mental illnesses to San Francisco and calculates San Francisco has provided approximately $500,000 in medical care and basic necessities that should have been provided by the state of Nevada.[3]

Plaintiff San Francisco's complaint states that from March to May of 2013, the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services investigated Rawson-Neal's patient discharge practices and found evidence of improper medical screening examinations, patient transfers, and unsafe patient discharges in violation of the Emergency Medical Treatment and Labor Act and implementing regulations. The complaint alleges that the CMS report quotes directly from patient records and establishes that the Rawson-Neal "administrators and staff were aware that the patients they bused to San Francisco were indigent[, with] mental illnesses that require continuing medical care and medications, that the patients did not have homes in San Francisco, and that a substantial number" were Nevada residents and "either had no family in San Francisco or no effort had been made to contact the patient's family to determine whether the family was willing and able to provide a home and continued care for the patient."[4]

Herrera said, "Homeless psychiatric patients are especially vulnerable to the kind the practices Nevada engaged in, and the lawsuit I've filed today is about more than just compensation -- it's about accountability." Herrera added, "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."[5]

As of October 25, 2013, the State of Nevada had not filed a response to the complaint that launched the lawsuit.[6]

Shortly after Mr. Herrera filed the lawsuit, U.S. Representative Doris Matsui, from Sacramento, introduced federal legislation that would impose fines of up to $10,000 on facilities that engage in what The Bee has described as "Greyhound Therapy."[7]