Report explores alleged patient dumping

LAS VEGAS — A newly finished internal probe takes a closer look at 10 cases of patients who may have been improperly discharged from a Las Vegas psychiatric hospital, although Nevada officials maintain none of them rise to the level of “patient dumping.”

The review covered 1,292 Rawson-Neal hospital patients sent out of state between 2008 and March 2013, and singled out 10 cases where there wasn’t enough documentation to ensure proper discharge procedures were followed. Four of those patients were sent to their home states, including three who went back to California and one who went to Utah.

The other six patients were sent to states they weren’t from, including five to California and one to Florida. But Nevada Health and Human Services chief Mike Willden said patients had worked with a medical team on their discharge plans and were sent to destinations they requested.

“They were aware of their transportation and where they were going,” Willden told the Las Vegas Review-Journal.

Nevada has come under fire since the Sacramento Bee published the story of James Flavy Coy Brown this spring. Brown was discharged from the psychiatric hospital Feb. 13 and sent on a 15-hour bus ride to Sacramento, where he arrived homeless and disoriented.

Brown, 48, has since been reunited with his daughter and lives with her family in North Carolina.

City attorneys from Los Angeles and San Francisco and have vowed to investigate whether patients were dropped off in their cities, and the ACLU of Nevada has filed a lawsuit on Brown’s behalf alleging negligence and breach of fiduciary duty.

While Nevada health officials said they made mistakes in discharging patients, they’ve denied that the state has a systematic policy of dumping patients in other states.

Dr. Tracey Green, Nevada’s chief medical officer, told The Associated Press that discharge plans are discussed throughout the treatment process and include the patient’s input. Staff members are required to confirm that there is housing, shelter and a support system at the patient’s destination.

A new policy announced since Brown’s case came to light requires that patients have a chaperone on bus trips, Green said.

She also noted that doctors won’t release a patient until they’re stable — meaning doctors determine whether the patient is no longer a danger to themself or others, can take care of themselves and understands any medication regimen they may be on.

Whether the patient follows through with the plan is a different story. Some will choose not to take their medications, and “you have the right to make that decision,” Green said.

Willden added that state hospitals can’t keep patients against their will unless a court gives permission.

“These are people that upon discharge are well enough to travel. You can’t hold people against their will, especially if they are well and beyond their need for our service,” Willden said. “They have the right to their own self-determination.”

Meanwhile, Nevada ACLU lawyer Allen Lichtenstein argues Brown wasn’t well enough to travel, and the state didn’t do enough to ensure he made a safe transition from Rawson-Neal.

“If it was necessary to get court approval and give him the treatment that he needed, that’s what needed to be done,” Lichtenstein told the Review-Journal. “He was clearly incapable of taking care of himself. I don’t see how anybody can make the argument that that’s proper treatment.”