New plan could shorten ER waits

By Cy Ryan

Thursday, July 31, 2008 | 2 a.m.

State health officials think they’ve found a way to help alleviate the crowding of emergency rooms by mentally ill but physically healthy patients.

It’s a chronic problem: Because there are not enough mental health beds for patients who need to be monitored on 72-hour suicide holds, they are frequently taken to emergency rooms. There they occupy a bed for days that another patient might be in and out of in a matter of hours, said Dr. Edwin “Flip” Homansky, an emergency room physician and member of the State Health Board.

Dr. Harold Cook, who heads the state’s Mental Health and Developmental Services Division, says the 234 beds at Las Vegas’ Rawson-Neal Psychiatric Hospital are “pretty much” filled and as of Tuesday morning, there were 60 patients in hospital emergency rooms waiting to be transferred there.

The result is longer waits for other ER patients.

The solution calls in part for reopening a 50-bed community triage center at WestCare, a nonprofit mental health and drug rehabilitation clinic in Las Vegas. Richard Steinberg, president and chief executive of WestCare, said the building has been vacant and was scheduled to be demolished. Steinberg said it would be used for another four to five years.

Ambulance attendants and police would be trained to take those with mental health problems to the 50-bed triage center rather than placing them in emergency rooms until they are judged safe to be released or are sent to Rawson-Neal.

Cook, Steinberg, Shannon E. West, coordinator of the Southern Nevada Regional Planning Coalition, and Dr. Richard Failla, deputy administrator of the state mental health division, presented the proposal Tuesday to the Legislative Committee on Health Care.

West said this was “a vision rather than a quick fix.”

Failla said the aim is to divert patients from emergency rooms. “It’s a real challenge to the mental health patient who ends up in the emergency room.”

Failla said he wants to get the patient into the hospital and out as quickly as possible to receive care in the community.

Before Rawson-Neal was completed, hospital emergency rooms were even more crowded. The state had had a contract with WestCare to take some patients to relieve the emergency rooms and provide an interim solution.

In view of the financial difficulties of the state and Clark County, Steinberg said existing public money would be used to pay for the cost of establishing the triage center.

Homansky, the ER doctor, called the proposal a “terrific” multiplier of resources that would “immediately take care of 75 to 85 percent of the problem.”

Sun staff writer Marshall Allen contributed to this story.