San Francisco files class action against Nevada over 'patient dumping' practices, expenses

SAN FRANCISCO, Sept. 10, 2013 /PRNewswire/ -- San Francisco City Attorney Dennis Herrera today filed a class action against the State of Nevada on behalf of California local governments to which indigent patients were improperly bused from the state-run Rawson-Neal Hospital in Las Vegas.  The lawsuit filed in San Francisco Superior Court this morning seeks a court-ordered injunction barring Nevada from similar patient discharge practices in the future, and reimbursement for San Francisco's costs to provide care to the patients bused there.

The litigation makes good on Herrera's legal threat in a formal demand letter to Nevada Attorney General Catherine Cortez Masto last month, alleging that Rawson-Neal improperly discharged and unsafely transported at least two-dozen patients by Greyhound bus to San Francisco between 2008 and 2013.  Herrera's investigation established that patients were transported without adequate food, water or medication, and without instructions or arrangements for their continued care when they reached their destination.  Twenty of the patients required medical care shortly after their arrival in San Francisco—some within hours of getting off the bus—at a cost of approximately $500,000 to City taxpayers for medical care, shelter, and basic necessities.  Herrera said he hoped the suit would be a "wake-up call" to similarly errant medical institutions nationwide that they risk being held accountable for mistreating indigent and mentally ill patients. 

"Homeless psychiatric patients are especially vulnerable to the kind of practices Nevada engaged in, and the lawsuit I've filed today is about more than just compensation—it's about accountability," said Herrera.  "What the defendants have been doing for years is horribly wrong on two levels: it cruelly victimizes a defenseless population, and punishes jurisdictions for providing health and human services that others won't provide.  It's my hope that the class action we're pursuing against Nevada will be a wake-up call to facilities nationwide that they, too, risk being held to account if they engage in similarly unlawful conduct."

If successful, San Francisco's claim for reimbursement of the amounts it expended to care for indigent patients Nevada bused here would benefit all California jurisdictions by establishing a precedent for award of restitution to all jurisdictions able to demonstrate claims for damages and restitution substantially similar to San Francisco's.  Herrera's suit additionally seeks injunctive relief that would apply statewide to prohibit Nevada from continuing to transfer non-residents into California without prior arrangements for patients' care, or in a manner that violates state or federal standards governing patient discharges. 

Case Background

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 there, 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."

The following month, 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 initial 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, some shortly after their arrival. 

Those findings led Herrera to issue the formal demand letter on August 20, giving Silver State officials until yesterday to respond, and threatening legal action if they did not do so satisfactorily.  The Nevada Attorney General's reply letter, dated yesterday, recounted its efforts to cooperate with Herrera's investigation, but proposed better collaboration between officials in both states "rather than trying to allocate financial responsibility through litigation."

The case is: City and County of San Francisco v. State of Nevada et al., San Francisco Superior Court case no. CGC-13-534108, filed Sept. 10, 2013.  A copy of the complete filing is available on the S.F. City Attorney's website at: http://www.sfcityattorney.org/. 

SOURCE City Attorney Dennis Herrera