San Francisco threatens to sue Nevada for releasing hundreds of psychiatric patients to California

The city of San Francisco is threatening Nevada with a class-action lawsuit for allegedly giving 500 poor and homeless psychiatric patients one-way bus tickets to California.

In a letter addressed to Nevada Attorney General Catherine Masto, San Francisco City Attorney Dennis Herrera threatened to file a lawsuit unless a settlement is made within 20 days. The city is asking Nevada to reimburse the $500,000 that San Francisco spent on medical care, housing, and other assistance for those patients.

If Nevada fails to pay and adopt interstate transfer rules that would prevent ‘patient dumping,’ San Francisco will take legal action.

Herrera’s office subpoenaed bus company records, obtaining a list of nearly 500 patients who were discharged from the state-run Rawson-Neal Psychiatric Hospital in Las Vegas and sent to California on a Greyhound bus. An earlier report found that 1,500 patients have been thrown on buses and sent out of state since 2008. Many of them became homeless, and one-third of them wound up in California.

Some of the patients were bused to cities where they had no family, friends, or housing – a practice that Herrera wants the state of Nevada to prohibit.

“The manner in which these patients were transported was inhumane and unacceptable,” Herrerra wrote in the letter, which was obtained by the San Francisco Chronicle. “These patients were transported without escorts; without prior arrangements for a responsible party to receive them at their destination; (and) without adequate provisions of medication or food.”

Twenty-four of the patients who were sent to San Francisco were indigent, homeless, or suffering from mental illness, which forced the city to cover the costs of further care, according to Herrera.

The psychiatric hospital “understood and expected that the bused patients would rely on San Francisco’s public health resources,” Herrera added, noting that some of the patients were directed to seek medical care at public health clinics in their new cities.

The actions of the San Francisco Attorney General’s office are the culmination of a four-month investigation into Nevada’s practice of ‘patient dumping,’ which is sometimes referred to as ‘Greyhound treatment.’

The practice was first exposed by the Sacramento Bee, which told the story of a 48-year-old man who ended up in Sacramento, disoriented and confused about his whereabouts. The patient, James Flavy Coy Brown, had been sent away by Rawson-Neal on a Greyhound bus, even though he had no friends or family in Sacramento. Hospital staff left him with nothing more than a few peanut butter crackers and a three-day supply of medication for schizophrenia, anxiety, and depression. When the former psychosis patient arrived at a Sacramento homeless shelter, he was hearing voices that were telling him to jump off a bridge or get himself arrested just so he had a place to sleep, Brown recalled. 

“I said, ‘I don’t want to leave Nevada,’” Brown told ABC News in May, recalling the day that he was sent away without his Social Security card, food stamps, or Medicaid card. “[The doctor] said, ‘California sounds like a really nice state. I think you’ll be happy there.’”

This month, Brown filed a federal civil rights lawsuit in Nevada, which seeks class-action status on behalf of the 1,500 people that were allegedly bused to other states. Herrera’s letter was filed shortly thereafter. While there is evidence that more than 1,000 patients at Rawson-Neal were sent away, Herrera believes the practice may have also occurred at other state hospitals.

“We do have reason to believe that this occurred elsewhere in Nevada,” he wrote. “It would be premature to say how widespread it is in other facilities. Our investigation is continuing.”