Sides discussing settlement in lawsuit over busing of Nevada mental patients

From a Report in the Las Vegas Sun

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Settlement talks have emerged in a class action lawsuit accusing Nevada of misusing public funds for busing mentally ill patients to California.

The talks are the latest in a 16-month legal battle between Nevada and the city and county of San Francisco. A successful negotiation would end one of three busing-related lawsuits facing Nevada. Any money would compensate California for harboring indigent patients who were discharged from Nevada psychiatric facilities and given one-way bus tickets with directors to seek help in California. The settlement also would aim to outline new rules for transporting patients across state lines.

California officials say the busing cost San Francisco at least $4 million to treat 21 patients from Nevada, according to legal documents in a San Francisco district court. The San Francisco City Attorney’s Office said it has the names of 500 patients who traveled to California from Las Vegas’ Rawson-Neal Psychiatric Hospital between 2008 to 2013. It’s unclear how many of the 500 sought treatment once they arrived in California.

Officials from both states declined to comment on the details of the settlement negotiations — a standard practice during legal settlements.

“Those are confidential by mutual agreement,” said Matt Dorsey, spokesman in the San Francisco City Attorney’s Office.

Officials in Nevada’s Attorney General’s Office declined to comment for the story.

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The news first broke after the Sacramento Bee newspaper uncovered that James Flavy Coy Brown, a Rawson-Neal patient, was sent on a 15-hour bus ride to Sacramento with no arrangements for care, housing or treatment. Hospital staff allegedly gave Brown a one-way bus ticket, peanut butter crackers and a three-day supply of medication to treat his schizophrenia, depression and anxiety. He had no family or friends in the area and was reportedly told to call 911 when he arrived.

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They solved their budget problems by shipping the patients out of state.

Nevada tried to save money by bussing psych patients out of state for treatment

As reported in the Las Vegas Sun

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.

Judge sealed cases against psychiatrist - Two lawsuits among hundreds kept secret

As reported in the Review Journal

Prominent Las Vegas psychiatrist Robert L. Horne was the target of two lawsuits in four years, and both cases were sealed from public view by the same judge, according to newly unveiled court records.

Those lawsuits were among the hundreds of cases, many involving wealthy or well-known individuals, that Clark County judges shielded from scrutiny for unknown reasons.

The existence of the Horne lawsuits and District Judge Michelle Leavitt's role in sealing them is among details of Nevada court business newly revealed as District Court clerks re-examine 298 sealed cases, dating back to the 1990s. They are unsealing some entirely and "properly sealing" others in accordance with the judge's original instructions.

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Both the new rules and the current District Court review were prompted by Review-Journal stories last year which showed some District Court judges believed they had unbridled discretion to seal lawsuits, and did seal many without explanation.

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As for the Horne lawsuits, Leavitt inherited one case shortly after she took the bench in 2003. She sealed the entire case from the public, even though the previous judge sealed only individual records from the 1999 lawsuit.

A separate lawsuit was filed against Horne in 2003. Again, Leavitt sealed the entire case from public view before it was settled out of court in January 2007.

While those sealed cases remained in District Court without the public's knowledge, the state Board of Medical Examiners in April 2005 filed a confidential complaint against Horne charging him with malpractice, according to board records.

Horne couldn't be reached for comment.

A licensed psychiatrist in Nevada for 23 years, Horne is a former member of the state's Commission on Mental Health and Developmental Services and is executive director of the International Scouting Museum in Las Vegas.

A summary of the Medical Examiners complaint says his conduct "fell below the appropriate standard of care when he engaged in a relationship with a former patient" in violation of state law.

Horne fought the complaint, but the board in March approved a settlement agreement with Horne, said Ed Cousineau, deputy general counsel for the board.

"Dr. Horne is in a position of prominence in the state and he debated (the complaint) back and forth, but we had enough to take it to a public hearing" before Horne agreed to settle the complaint, Cousineau said.

The settlement requires that a letter of reprimand be issued against Horne, that Horne pay a $2,500 fine and that he submit for 18 months to monthly monitoring and evaluations at his own expense.

State law prohibited Cousineau from disclosing information about the board's investigation of Horne, or whether the complaint was prompted by a malpractice lawsuit filed in 2003 by a woman named Patricia Ambrosio.

However, Cousineau did say that state law requires physicians, the courts and a physician's malpractice-insurance company to notify the board when a malpractice lawsuit is filed and when it is settled.

The 2003 case filed by Ambrosio was properly sealed by the courts, and the newly available records don't provide much information about the complaint.

The 1999 lawsuit against Horne was filed by Vincent Gulino and Gulino's parents. The complaint and all documents in the case remain sealed.

However, based on minutes of court hearings, motions filed and other information made available recently, the case appears to involve payment of a $750,000 settlement to Gulino.

Among other cases partially unsealed was a medical malpractice case in which the judge's intention was to seal only the confidential settlement. The suit was brought by a California man, Albert R. Peraza, against the now-closed Lake Mead Hospital and Medical Center in North Las Vegas and emergency room physician Richard C. Green Jr.

The doctor diagnosed Peraza as simply suffering from hyperventilation before the man was driven home to Southern California, where another hospital determined hours later that Peraza had suffered a stroke, according to the lawsuit.

The lawsuit accused the hospital of violating a state law that requires hospitals to provide emergency care to all patients regardless of their ability to pay. It appears the case was settled out of court and dismissed in June 2005.

On the Web site for the state Board of Medical Examiners, which licenses physicians, there is no mention of any discipline handed down in response to the lawsuit or settlement.

The case was assigned to District Judge Jessie Walsh.

One of the properly sealed cases was against the Creative Beginnings child-care center on East Bonanza Road.

The lawsuit involved ex-employee Kimya Winbush, serving a life sentence for sex crimes committed outside the center on two boys he met there.

The attorney for former Lt. Gov. and Clark County Commissioner Lorraine Hunt asked that the public be cleared from the courtroom before hearings on her lawsuit against former Clark County Public Administrator Jared Schafer.

The case appears to involve her ex-husband's estate. Hunt's attorney asked District Court Judge Jackie Glass to seal the case.

Minutes in the case state that Glass urged the parties to settle their differences "rather than have the family history laid out for everyone to hear" in court

Paxil implicated in another murder

From the Nevada County Local News section of the Union newspaper

The murder trial of Richard Williams, accused of killing his estranged wife with a nail gun, is postponed as the court addresses several motions - including the defense attorney's push to exclude testimony from Williams' jail mates, as well as a possible conflict of interest.

According to court records, defense attorney Stephen Munkelt wants to prevent prosecutors from calling former Grass Valley residents Frank Zupan and Larry Watson to the stand during the trial.

For the prosecutors, the testimony of Zupan and Watson is expected to cast doubt on Williams' "unconsciousness" defense: He allegedly killed his wife and attempted to kill himself as a result of withdrawal from the anti-depressant drug Paxil, according to court records.

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