Las Vegas Sun

March 28, 2024

Legal costs mount as Nevada fights patient busing lawsuit

Greyhound bus

Associated Press

Hundreds of patients over several years were discharged from Rawson-Neal Psychiatric Hospital in Las Vegas and placed on Greyhound buses bound for cities across the country.

Click to enlarge photo

This is the front sign for the Rawson-Neal Psychiatric Hospital Tuesday, May 7, 2013.

Nevada is shelling out big money to defend itself in a class action lawsuit alleging the Department of Health and Human Services misused public money and jeopardized the lives of nearly 500 mental health patients in what’s known as the Greyhound busing scandal.

The state’s board of examiners will vote today to approve a $400,000 contract extension between Nevada and a California-based law firm Bingham McCutchen to fight claims that mental health patients were discharged from hospitals, ushered onto buses and transported to various cities in California to pass off the cost of treating mental health patients.

The contract highlights the cost the state must endure in and out of the courtroom.

If approved, the contract extension will mean the state has allocated more than $1.9 million to defend itself in the suit, which was filed by the City and County of San Francisco on behalf of more than 50 California towns that were harbors for Nevada mental health patients between 2008 and 2013.

Nevada needs a California-licensed attorney to fight the case in that state, said Jennifer Lopez, a spokeswoman for the Nevada Attorney General’s Office. State officials made their case for the expense to the Legislature’s Interim Finance Committee on Monday. The committee approved the appropriations, signaling that the board will follow suit.

Court filings show that Nevada has aggressively tried to quash the case since it was first filed in September 2013.

“It was the individuals, and not the Nevada State Defendants, who took the (intervening) steps to reach California and, allegedly, seek additional medical care,” Nevada’s legal counsel wrote about the discharged mental health patients in legal filings.

Court filings also show that Nevada said that the mental health patients made “unilateral” decisions about where to go.

But a trial court and a state court of appeals said San Francisco does have the authority to charge Nevada. Nevada’s legal counsel then appealed to the California Supreme Court, which hasn’t stated whether it will hear the case.

In court filings, a San Francisco County judge painted Nevada as a state trying to save money by shifting costs to California. It said some patients were medicated when they were given bus vouchers and instructions to call emergency rooms, shelters and other treatment facilities when they arrived in California.

Between July 2007 and March 2013, Southern Nevada health officials had a policy to “assist patients” back to their home communities as a way to “remove the burden of treatment from the State of Nevada,” according to legal filings from John Munter, a San Francisco County judge.

The state was having budget problems. The Southern Nevada psychiatric hospital, Rawson-Neal, was consistently filled to capacity and understaffed. There was tremendous pressure to discharge patients, according to Munter’s filings.

Munter also wrote that Nevada “expressly targeted” California to achieve a result that would “impose financial burdens on California communities.”

“At least to some discharged patients, [Nevada] did not give [patients] any meaningful choice other than to go to California or any meaningful options to remain in Nevada,” Munter wrote. “In some instances, defendants gave referrals to medical care and housing facilities in California but not in Nevada, and advice that follow-up care was available in California but not in Nevada.”

The lawsuit alleges that Nevada’s busing practice forced California to misappropriate resources.

It cost the City of San Francisco $4 million to treat 21 Nevada patients who were bused into the state.

Of those 21 patients, more than half had no prior relationship with the state of California, according to court records.

And San Francisco wasn’t alone. Patients popped up in Sacramento and 50 other California cities.

The total cost for the whole state is still unknown.

At home, Nevada has done its best to repair the state’s mental health system.

From 2007 to 2011, the Legislature cut $80 million from the mental health budget.

Gov. Brian Sandoval has made efforts to make up for the losses and the nefarious spotlight that flung to the state when the busing scandal first made headlines. He’s done so alongside Mike Willden, Sandoval’s current chief of staff and former health department director listed as a defendant on the lawsuit.

They have boosted mental health funding by at least $30 million, and Sandoval signed an executive order to create the Behavioral Health and Wellness Council to oversee state programs and make recommendations. Since June, it has advocated for and Sandoval has awarded at least $3.5 million in state funding. More than 100 beds for mental health patients have been added to hospitals statewide.

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