Blind, Deaf Homeless Man: The Face of Patient Dumping?

Aug. 23--Timothy Martin is deaf, blind and homeless, and in April he stumbled off a one-way ride from a Reno mental hospital onto the streets of San Francisco.

He found his way to a bar in the Castro neighborhood where, he says, he was thrown out and wound up crying on the sidewalk until an ambulance took him to San Francisco General Hospital.

Since then, the 47-year-old Martin has lost a leg, run up hundreds of thousands of dollars in emergency medical bills, and landed in the city's Laguna Honda long-term rehabilitation hospital.

City investigators suspect this is an extreme example of "Greyhound therapy" -- the alleged practice by medical officials in Nevada of dumping indigent or homeless patients on the city.

Martin's case is part of a city investigation into whether hospitals in Las Vegas and Reno shipped patients incapable of caring for themselves to San Francisco with one-way bus tickets, City Attorney Dennis Herrera said this week.

Martin and his relatives say they have no doubt that's what happened to him.

"The doctor in Reno wanted me to leave the hospital. ... He told me to come here to San Francisco," Martin, who in addition to being deaf and blind cannot speak, said through an interpreter. "They bought my ticket.

"I never want to go back to Nevada. I hate it there."

Martin's 50-year-old sister, Theresa Mellen of Santa Clara, said her brother lived in Nevada for almost two decades and has been shipped to San Francisco by medical centers in Reno "at least six times in the past couple of years."

"It's messed up that he gets sent all over," she said. "It's just messed up. He can't see, hear or even speak words, and needs a home with other people like him. He needs a solid life -- and this kind of thing doesn't help at all."

The private mental health center that Martin says shipped him out in April, West Hills Hospital in Reno, did not respond to requests for comment. The other hospital in Reno that Herrera is investigating for possibly dumping Martin into San Francisco in a separate, earlier trip this year, Renown Regional Medical Center, denied in a statement that it would engage in such a practice but would not discuss specific cases.

Martin's sojourns to and from Nevada constitute a story both of courage and despair.

Born deaf in San Jose, he suffered from diabetes and macular degeneration that finally claimed his eyesight two years ago. But even as his vision was failing, he was able to travel and hold down odd jobs in an effort to make his own way.

In the 1990s, he moved in with his mother in Carson City, Nev., and for a while his situation was tolerable.

"She was my guardian and helped me manage my money and places to live when I went up to Reno and Sparks to work," Martin said. "We had a good life."

When she died of lung cancer in 2010, however, Martin's life began to skid.

"I became very scared, very lonely, very depressed, and the rest of my family couldn't really help much," he said.

In and Out of Hospitals

He began going in and out of hospitals on emergency visits for diabetic and high blood pressure difficulties, Mellen said. She and her three siblings tried to place him in group homes or government-subsidized apartments, but Mellen said her brother would become restless or unhappy with the arrangements and strike out on his own.

Mellen said Martin has no severe mental illness, but often ended up in psychiatric care wards -- sometimes involuntarily -- because of his range of disabilities.

"We just want him to be happy, maybe in a board-and-care home," Mellen said. "Believe me, if I could buy him a house or just make all his medical troubles go away, I would -- but I and my family can't afford that."

Martin said sometimes he would pay his own bus ticket to the Bay Area, but other times the hospitals would.

"I liked to travel," he said. "I want a life. I don't want to just be my disabilities."

Gabriel Zitrin, a spokesman for the San Francisco city attorney, said "the investigation is ongoing" into the payment for and timing of Martin's multiple departures from Reno. Public and private medical officials in Nevada have sent nine people by rail or bus from northern Nevada to California -- two to San Francisco -- since 2008, none of whom could take care of themselves, Herrera's lawyers suspect.

The Martin case arose as part of Herrera's investigation into hundreds of patients allegedly being shipped one-way to California from a state-run psychiatric hospital in Las Vegas.

Herrera said 24 of those patients came to San Francisco. This week he sent a letter to the Nevada attorney general threatening a lawsuit unless that state reimburses cities and counties for treatment and care costs.

$500,000 in Care, Housing

The city attorney said San Francisco has spent about $500,000 on medical care, housing and other aid on people shipped from Las Vegas. A spokeswoman for Nevada Attorney General Catherine Cortez Masto said Thursday she could not comment on pending litigation or cases associated with it.

Martin is not part of the threatened lawsuit -- "we're still working on that," Zitrin said -- but his costs alone apparently dwarf what the city has spent on the Las Vegas patients.

In the instances the city is probing, Martin first came here from Reno in early winter after being discharged from a hospital -- probably Renown Regional Medical Center, San Francisco officials believe. He was in temporary homeless housing in San Francisco before landing in a psychiatric ward at the California Pacific Medical Center, said the officials, who spoke on condition of anonymity because of health privacy laws.

Martin then went back to Reno to face a hearing for a minor criminal charge stemming from a fight at a group home, the outcome of which Nevada court officials were unable to determine Thursday.

By the spring he was back, allegedly courtesy of West Hills Hospital. How he wound up in the Reno hospital is unclear.

Not knowing where to go once the bus dropped him off in San Francisco, Martin sought comfort at a bar in the Castro.

"The doorman wanted me to leave, and it made me cry, so I just sat outside and cried," Martin said. "Then an ambulance came and took me to San Francisco General Hospital."

Soon he was in the hands of the city's Homeless Outreach Team, which placed him in the residential Baldwin Hotel on Sixth Street until staffers could find permanent lodgings. He stayed there until late May.

"Tim -- he's cool, real smart," hotel clerk Paulette Broughton said one day in May as she helped Martin along the hallway. "He spells out in your hand what he needs, and he's no trouble. Your heart goes out to him -- I would be very frustrated if I were him. But he's great."

Trouble Living on His Own

Martin spelled out, "I like having my own room," as he sat and ate a lunch of fried chicken in his unit that day.

City in-home support services workers got him meals, made his bed and helped him with other tasks. City-funded translators visited, and homeless outreach counselors checked on him several times a day.

Then, in late May, he slipped in the shower, cutting his left leg. The cut became badly infected, and Martin had to go to San Francisco General to have the leg amputated.

"Tim almost died from that infection -- it was terrible," said Mellen, his sister. "They saved his life."

City and state health authorities estimated that Martin's taxpayer-funded medical care cost as much as $1 million. Government rules prohibit the hospital from revealing the actual tab.

A month ago, he was transferred to Laguna Honda, which costs about $700 a day, also picked up by taxpayers. His stay there is open-ended, and the staff plans to fit him with prosthesis.

Others Not Getting Services

City Human Services Agency chief Trent Rhorer said patching up the broken lives of homeless people who end up in San Francisco is an obligation the city freely accepts -- but that if Nevada is dumping its patients here, the costs should be shared.

"If we are taking care of their patients, there are likely other homeless people here in San Francisco who are not getting services because of the money being spent," he said.

Jason Albertson, supervisor of the Homeless Outreach Team, took the lead in helping Martin and sees his journey as anything but hopeless.

"Tim shows the indomitable will to live the life he wants to live," he said, and that desire collides with "the way we pay for the care of people who are poor with a high level of disability."

As for Martin: He wants to live in group home. And he has moments of despair.

"This is a wonderful place," he said through a translator this week, sitting in his tidy room at Laguna Honda. "But I need to be around other people like me. I'm blind. I'm deaf. I'm stuck."

He buried his face in his hands.

"I want to see my mom up in heaven. I'm tired of being poor. I want to die," he said.

Then he brightened. "At least it's nice here."

San Francisco Chronicle staff writer John Cote and Chronicle photographer Brant Ward contributed to this report. Kevin Fagan is a San Francisco Chronicle staff writer. E-mail: kfagan@sfchronicle.com

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