Nevada Legislative Panel Approves $2.1M in Mental Health Funding

On Tuesday, a Nevada legislative panel approved $2.1 million in emergency funding for mental health services that largely will be used to improve services at a psychiatric hospital that bused patients with mental illnesses to California and other states, the Sacramento Bee reports (Reese, Sacramento Bee, 8/7).

Background on Busing Practices

According to a Bee 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 Bee found that Rawson-Neal has sent more than 1,500 patients to other cities since July 2008.

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.

In April, the Joint Commission launched an investigation of the hospital. CMS also has launched multiple investigations of Rawson-Neal's patient discharge practices. In addition, San Francisco has launched a formal inquiry into the matter, while Los Angeles is pursuing a criminal investigation of the hospital.

In response to the investigations, Nevada Gov. Brian Sandoval (D) said that state officials have implemented a new policy that requires two physicians instead of one and a hospital administrator to approve a discharge order for a patient. In addition, a chaperone must accompany any patient with a mental illness discharged from state facilities and sent to locations outside of Nevada, hospital officials said.

Nevada officials also said that two employees at Rawson-Neal have been fired and another three were disciplined following an internal investigation that found 10 cases in which patients might have been placed on buses without family or treatment contacts at their destination.

Joint Commission Denies Accreditation

Last month, the Joint Commission issued a preliminary denial of accreditation for Rawson-Neal (California Healthline, 7/25).

Following the commission's decision, officials at the hospital said the facility would waive its right to appeal the denial, meaning that the facility and its affiliated programs are no longer accredited (California Healthline, 7/30).

Details of Approved Funding

Nevada's Interim Finance Committee approved the $2.1 million while the state legislature is in recess, according to the Bee.

The money will go toward:

• Hiring 11 new staff members at Rawson-Neal, including caseworkers, mental health technicians and nurses;
• Hiring 12 contractors, including occupational therapists, psychologists and social workers; and
• Expanding the facility to allow an additional 22 patient beds.

The building improvements are scheduled to be completed within 120 days, according to state officials.

Mike Willden -- director of the Nevada Department of Health and Human Services -- said the state plans to seek a new inspection by the Joint Commission in December, once the changes are implemented (Sacramento Bee, 8/7).