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News Release: 2013-08-20

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Herrera vows class action lawsuit over Nevada 'patient dumping' scandal

Silver State can avoid litigation, according to demand letter, with commitment to reimburse California localities for costs, adopt strict mental health protocols

SAN FRANCISCO (Aug. 20, 2013) -- City Attorney Dennis Herrera today vowed to file a class action lawsuit against the State of Nevada on behalf of California local governments to recover costs they incurred to care for indigent patients Nevada improperly bused from its state-run psychiatric hospital, and to secure a court-ordered injunction to bar Silver State officials from continuing to transfer patients into California without prior arrangements for their care, housing or medical treatment.

Herrera informed Nevada State Attorney General Catherine Cortez Masto of his intent to pursue the litigation in a demand letter today, outlining conclusions from his ongoing investigation that found Nevada's patient discharge and busing practices to constitute a misappropriation of California taxpayers' funds in destination cities and counties. The improper transfers unlawfully burdened California local government resources, Herrera contends, in order to provide care and services "which Nevada was legally obligated to provide to its own indigent residents." Herrera's letter left open the door to avoid litigation, providing Nevada officials respond by Sept. 9 to negotiate a reimbursement agreement with California local governments, and adopt binding protocols to ensure that the improper patient busing practices end for good.

"While our prospective litigation asserts the rights of California taxpayers, it's equally necessary to protect society's most vulnerable from continued institutional abuse," said Herrera. "Homeless psychiatric patients are particularly defenseless from the kind of lawless 'patient dumping' practices Nevada officials engaged in. It's my hope that our investigation and possible class action will send a strong message to public health facilities nationwide that there is a price to pay for such inhumane treatment in the future -- especially when California jurisdictions are being victimized, too. I'm grateful to the public agencies and officials, non-profit service providers, patients and family members who continue to work with us on our investigation. I'm also thankful to the journalists whose reporting helped expose Nevada's improper patient discharge and busing practices, which may otherwise have gone unnoticed."

In April, in response to news reports that Nevada's Rawson-Neal Psychiatric Hospital in Las Vegas had questionably bused more than 1,500 psychiatric patients to locations throughout the nation, the San Francisco City Attorney's office launched an investigation to determine whether any of the 31 Greyhound bus tickets Rawson-Neal purchased for trips to San Francisco conveyed improperly discharged patients. The preliminary conclusion of Herrera's investigation is that among 24 patients bused to San Francisco (including some who made multiple trips), 20 sought and were provided emergency medical care shortly after their arrival. Though the City Attorney's investigation remains ongoing, Herrera's letter to Nevada officials notes that San Francisco expended nearly half a million dollars for medical care for the patients who were not city residents at the time that they were improperly bused here from Rawson-Neal.

Herrera's investigative team spent months reaching out to local homeless shelters, non-profit service organizations, and medical facilities, interviewing patients, family members and health care providers to determine the facts and then build an actionable record in support of possible litigation. Despite obstacles from Nevada public health officials, Herrera's office successfully identified the nearly 500 patients bused from Rawson-Neal to locations throughout California, and is continuing to cooperate with multiple jurisdictions as well as federal officials.

Accompanying his demand letter today, Herrera sent Nevada a set of proposed mental health care protocols "developed with reference to the regulations and guidance of the federal Centers for Medicare and Medicaid Services, which states best practices concerning out-of-state transfer of mentally ill patients." The protocols, to which Nevada would need to voluntarily stipulate to avoid litigation, would apply to all counties and cities in California.

In March, the Sacramento Bee first reported the story of 48-year-old James Flavy Coy Brown, a former Rawson-Neal patient who was sent on a 15-hour bus ride to Sacramento -- despite having never before visited, having no friends or family members in the area, and with no prior arrangements for his care, housing or medical treatment. The Nevada-run hospital had discharged Brown in a taxicab to the Greyhound bus station with a one-way ticket to Sacramento, snacks, and a three-day supply of medication to treat his schizophrenia, depression and anxiety. Brown was instructed to call 911 when he arrived. A Rawson-Neal physician reportedly recommended "sunny California" to Brown as a destination, according to the Sacramento Bee, because they "have excellent health care and more benefits than you could ever get in Nevada."

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Last updated: 8/20/2013 9:52:00 AM