- Associated Press - Tuesday, December 9, 2014

LAS VEGAS (AP) - Southern Nevada hospital officials announced that they’re adding dozens of beds this month for psychiatric patients, less than a year after a glut of patients seeking mental health care in Las Vegas emergency rooms prompted overcrowded hospitals to turn away ambulances carrying other patients.

Members of the governor’s Behavioral Health and Wellness Council were told Tuesday that Valley Hospital is opening up 20 beds on Wednesday for psychiatric patients, and plans to ramp up its staff in coming weeks to increase the capacity to 48 beds.

In February, when emergency rooms suffered a crowding crisis, the state health director said the region needed 100 more psychiatric beds. The state has since doubled the money it pays hospitals to care for psychiatric patients on Medicaid - a move that has encouraged more hospitals to start offering care - and has added dozens of beds at Rawson-Neal Psychiatric Hospital in Las Vegas and at a mental health triage center.

The announcement was one of several positive updates provided to the council, which was set up to improve mental health services in the wake of an embarrassing patient busing scandal in 2013, subsequent lawsuits, and the loss of an outside accreditation at Rawson-Neal.

Other updates from the meeting:

- The state’s mental health court, which provides specialized services and accountability to defendants with mental illness, is now serving 322 clients after cut state funding was restored. However, council chairman Joel Dvoskin noted that the program has reached capacity and is not accepting new participants.

- State officials have requested a bill that would allow additional medical providers to initiate a Legal 2000, an involuntary hold on a suicidal or homicidal person. In addition to doctors, physician’s assistants would be allowed to start the process. The bill draft request also seeks a process so a variety of medical personnel could end the involuntary hold once a patient has been stabilized.

- A mobile crisis team that responds to children having psychiatric episodes is operating in southern Nevada and expanded into northern Nevada in mid-October. Program officials said that of the 230 incidents the teams have responded to, fewer than 9 percent ultimately had to be admitted to a psychiatric hospital.

In spite of the good news, the state is far from resolving the problems plaguing its mental health system.

The state Board of Examiners on Tuesday authorized another $400,000 to fend off a “patient dumping” lawsuit filed by the county and city of San Francisco. The funds are on top of the $1.5 million Nevada already designated to fight claims that patients were discharged from Nevada psychiatric hospitals, then put on buses and directed to seek further care in California.

Another challenge is addressing a nationwide shortage of psychiatrists that hits Nevada especially hard.

A report from the Guinn Center for Policy Priorities, a bipartisan think tank, shows that Nevada ranks 50th in the nation for the number of psychiatrists per 100,000 residents, and 47th for the number of psychologists. The shortage makes it difficult for people to access mental health services, even if the recent Medicaid expansion means many are newly covered - 77 percent of people receiving behavioral health services in Nevada are now enrolled in Medicaid, up from 27 percent before the expansion.

Part of the workforce shortage could stem from low pay. Nevada psychiatrists earn an average of about $177,390 a year, below the national average of $182,660 and even further below the rate of neighboring Arizona, where psychiatrists earn an annual average salary of $229,740.

The council suggested raising pay or creating signing bonuses so the state can hire full-time workers, rather than fill gaps with more expensive, temporary contract workers. The Guinn Center also recommends changing requirements so psychiatrists licensed in another state can more easily begin practicing in Nevada.

“Nevada’s laws make it difficult and time consuming,” report author Victoria Carreon said. “You wait four months when we already have a shortfall in the workforce.”

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