Fixes sought as ERs flooded with mental patients

LAS VEGAS — A governor-appointed mental health advisory council asked state officials to find solutions for overflowing Southern Nevada emergency rooms, after some Las Vegas-area hospitals started turning away ambulances because they were inundated with psychiatric patients.

The Behavioral Health and Wellness Council heard this week that four hospitals had declared internal disasters Tuesday night, sending ambulances looking for space in other facilities, according to the Las Vegas Review-Journal.

“The need continues to outpace the available resources, especially for the underserved,” said Brendan Bussman, a spokesman for Sunrise Hospital and Medical Center in Las Vegas, in a statement issued Thursday.

The region’s emergency rooms sometimes hold up to 200 mentally ill patients at a time, far more than the 120 they were regularly housing in 2004 when Clark County declared a state of emergency over the issue. The backlog means psychiatric patients are taking up beds that might otherwise be used by patients with other acute conditions.

It’s not clear what exactly the state will do to fix the problem.

“It’s not an easy answer,” said state Health and Human Services Director Mike Willden. “We are working every day.”

Some relief is expected when 21 additional beds become available at Rawson-Neal Psychiatric Hospital by April 1, Willden said.

Another option is enlisting help from private hospitals. Medicaid reimburses those facilities at a rate of about $460 per day for psychiatric patients, although the hospitals have sought about $1,400 per day.

Officials are negotiating on what might be an acceptable Medicaid reimbursement for those services, Willden said.

Other potential fixes include opening more triage centers that divert psychiatric patients away from the ER. One clinic already running in Las Vegas has 36 beds and fills up every day, Willden said, but building a new one would take at least six months and would require additional staff.

Last summer, the state had opened a walk-in clinic on the campus of Rawson-Neal where patients were either stabilized on-site or referred to inpatient care. But that facility closed in January, after the Centers for Medicare and Medicaid Services declared the clinic needed to be upgraded to full emergency room standards or the entire Rawson-Neal complex would lose its Medicare funding.

About 16 people per day were taking advantage of the walk-in clinic at the time it closed.