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October 1, 2014

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health care:

Official says patient improperly discharged from mental hospital, bused to California

Nevada mental health personnel improperly discharged a patient from a Las Vegas hospital, putting him on a Greyhound bus to Sacramento, Nevada health officials told state legislators at a hearing Thursday.

“Policies were not followed,” said Mike Willden, director of Nevada’s Health and Human Services department. “We own it in this case. We blew it. We’re taking corrective action.”

They said the issue was not systemic, but the case was not well managed. Further details could turn up in a federal investigation that Nevada health officials called for.

“This is not a widespread issue,” Willden said in an interview with the Las Vegas Sun. “This is an isolated, rare incident where staff did not follow our policies, and that’s what our initial information shows. The state investigative efforts can and will be made public.”

The patient, 48-year-old James Flavy Coy Brown, arrived at a shelter in Sacramento in a confused state, prompting employees there to ask questions about his mental health.

The Sacramento Bee elevated the case by reporting Brown’s story, noting that it appeared as though Nevada had improperly discharged Brown to California.

“Discharge to Greyhound bus station by taxi with 3 day supply of medication,” read Brown’s discharge papers from Southern Nevada Adult Mental Health Services, which The Bee obtained. “Follow up with medical doctor in California.”

The incident was troubling to Assemblywoman Maggie Carlton, D-Las Vegas, who said this past week that legislators need to find out more about the incident.

Nevada staff should have confirmed Brown had housing and a support network available wherever he was discharged, according to Southern Nevada Adult Mental Health Services policies and procedures.

A physician reviewed Brown’s discharge plan after he’d been discharged, and fiscal staff had cleared his purchase of the Greyhound ticket, said Richard Whitley, administrator for Nevada’s health department.

Whitley said the department has updated its policies so that patients aren’t discharged before a physician review, and now hospital administrators must approve transportation out of state.

The news story prompted California state Senate President Pro Tempore Darrell Steinberg, D-Sacramento, to accuse Nevada of practicing interstate “Greyhound therapy” and essentially dumping a patient in California.

The senator’s formal letter asks U.S. Secretary of Health and Human Services Kathleen Sebelius to investigate and impose financial penalties to the federally licensed center in Southern Nevada if federal authorities find wrongdoing.

“Interstate dumping of society’s most vulnerable population is unconscionable and irresponsible,” Steinberg’s letter states. “Instructing an individual with schizophrenia to take a 15-hour bus journey to an unfamiliar city with insufficient medication and resources is a clear violation of the patient’s civil rights, tantamount to abuse.”

Following the news reports, the Nevada Department of Health and Human Services also requested a federal investigation of the incident.

“Right after we saw the news article, we asked for the investigation,” said Mary Wood, spokesperson for the state health department.

Patients do cross state lines after discharge, but they’re supposed to either return home, go to family or friends, or go to wherever they have requested treatment, according to the presentation delivered to legislators.

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  1. I hope he had the chance to go on Craigslist and purchase a gun before he got on the bus. Now I gotta wait for my background check to pass so I can start my new job at McDonald's.......