State scrambling to come up with forensic beds after deal with Las Vegas went south

The Nevada Division of Public and Behavioral Health (DPBH) is turning to alternative measures to provide more forensic beds and services after a deal with the City of Las Vegas soured, leaving DPBH to pay a $500 fine  for each day a person in need of mental health treatment is in jail instead of under care. 

The deal would have created 44 new forensic beds at the Las Vegas Detention Center, with $55.4 million in American Rescue Plan Act funds earmarked for the project. Now the state must reallocate those funds by the end of the year or lose them. The state is working to reassign those funds to new programs including those highlighted at the DPBH Commission on Behavioral Health meeting earlier this month that divert people to services outside of forensic hospitals. 

Delays in getting people into forensic psychiatric care can exacerbate mental health conditions. Forensic psychiatric beds aim to provide mental health care in a correctional setting and reduce the risk of recidivism in the least restrictive manner, stabilizing a person who is waiting for their case to be adjudicated or an assessment for competency to stand trial.

As of  Feb. 15, 123 individuals needed competency-related services in jails in Nevada, waiting an average of 103 days from the time they receive a court order for admission to one of the two appropriate state facilities, according to DPBH. 

One of the programs highlighted at at this month’s Commission on Behavioral Health meeting includes a diversion program operated by Lake Crossings, one of the two state hospitals serving court-ordered patients. 

Program staff visits people on the waitlist at Washoe and Clark County jails for alternative services outside of forensic hospitalization, said Drew Cross, the statewide coordinator of forensic programs, during a DPBH Commission on Behavioral Health meeting last week. 

DPBH has also allocated some  $4.9 million of ARPA funding to Stein Forensic Hospital in Las Vegas, the other state hospital providing court-ordered mental health services, to refurbish 20 beds, which should be ready by July 2025, according to DPBH. 

The remaining ARPA funds need to be allocated by Dec. 2024 and used by Dec. 2026, otherwise, the funds will return to the federal government. 

The 2023 Nevada Legislature approved funding to design a new forensic hospital building that is currently slated to add 282 forensic beds. Funding for construction will be considered in the next legislative session, according to DPBH. 

The jail conversion program was originally slated to be ready last summer, state officials told the Legislative Interim Finance Committee in October 2022. 

After delays, DPBH hoped renovations of the jail would be completed by December 2024. But cooperation between the city and state quickly turned to squabbling. DPBH reported that the two government entities “were unable to reach a mutually acceptable lease agreement for use of the jail space.” 

In his 2023 State of the State Address, Gov. Joe Lombardo described the need for additional forensic mental services as “critical,” and noted his budget included funds for the Las Vegas jail conversions as well as upgrades to the Rawson-Neal facility in Las Vegas, which has a portion of its hospital dedicated to forensic beds, and the creation of the new facility in Southern Nevada. 

The governor’s office did not respond to inquiries about the failure of the Las Vegas jail conversion, the fines paid by DPBH, or the delay in creating new beds.