Nevada Changes Discharge Policy for Patients With Mental Illnesses
On Wednesday, Nevada health officials announced that they are changing a patient discharge policy following allegations that a hospital put patients with mental illnesses on buses and sent them to cities in California and other states, the Sacramento Bee reports (Hubert, Sacramento Bee, 4/24).
Details of Nevada's Alleged Practices
In recent years, Nevada has reduced spending on mental health services.
According to the Bee's review of bus receipts kept by the Nevada Division of Mental Health and Developmental Services, the number of patients with mental illnesses sent by Rawson-Neal Psychiatric Hospital in Las Vegas to other cities via Greyhound bus increased by 66% from 2009 to 2012.
The review found that since July 2008, the hospital has sent more than 1,500 patients to other cities.
According to the review, about one-third of such individuals traveled to California, including:
- 200 who arrived in Los Angeles County;
- 70 who arrived in San Diego County; and
- 19 who arrived in Sacramento.
This week, city attorneys for Los Angeles and San Francisco announced formal investigations into Nevada's practices.
In response to the investigations, Nevada health officials said that the majority of patients sent to other cities by bus were returning home and had family or treatment programs waiting for them.
In addition, Nevada Gov. Brian Sandoval (R) said there are no systemic problems related to patient dumping at Rawson-Neal.
According to Sandoval, disciplinary action was taken for isolated cases at the hospital and new policies were implemented weeks ago to improve oversight (California Healthline, 4/24).
Details of Policy Change
Mary Woods -- spokesperson for the Nevada Department of Health and Human Services -- said that, effective immediately, a chaperone must accompany any patient with a mental illness discharged from state facilities "for whom the state is paying transportation costs" to locations outside of Nevada.
She added that family members, legal guardians or state employers could serve as chaperones.
Woods said that the policy change was prompted by an internal review of the files of patients transported out the state by buses since 2008. According to Woods, the review found multiple cases in which Rawson-Neal's discharge policies were not followed.
She said that the review is ongoing and that it is "too early to tell" how many violations occurred.
However, Woods said that the problem "does not appear to be systemic" (Sacramento Bee, 4/24). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.