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Published December 12, 2010, 12:00 AM

Psychiatric care priority in proposed North Dakota budget

Governor’s plan modernizes funding
Prairie St. John’s in Fargo has seen its charitable care for North Dakota psychiatric care quadruple in the past four years to $250,000 a month.

By: Patrick Springer, INFORUM

Prairie St. John’s in Fargo has seen its charitable care for North Dakota psychiatric care quadruple in the past four years to $250,000 a month.

That level of uncompensated care is unsustainable, according to its top executive, but would get a huge boost if Gov. Jack Dalrymple’s budget recommendations are approved.

Dalrymple wants to provide

$6.1 million in the 2011-13 budget to pay for inpatient psychiatric care to stabilize crisis patients and chemical dependency treatment.

If funded by the North Dakota Legislature, which convenes in January, Dalrymple’s proposals would be the most comprehensive in years, mental health advocates said.

“I have not seen a governor make these priorities before,” said Susan Helgeland, executive director of Mental Health America of North Dakota, who has been an advocate for more than 20 years.

“It appears to me that he listened to the concerns of the people, and I’m very happy about it,” she added. For years, she said, there has been a funding disparity for medical care between mental health and physical health illnesses.

Dalrymple’s 2011-13 budget plan also recommends spending:

  • $1 million for suicide prevention efforts, including outreach, education and administrative support to communities.

  • $100,000 through the Department of Indian Affairs to help fight youth suicide on reservations.

  • $900,000 for campuses and high schools to address mental health problems, including campus mental health officers and to fund the “STOP the Violence” program through the Department of Public Instruction.

Nancy McKenzie, director of state regional human service centers, said $4.26 million in funds would be available for inpatient psychiatric care for patients referred from North Dakota’s eight regional centers, including Southeast Human Service Center in Fargo.

“It’s a $3.4 million increase to help fill that gap,” McKenzie said. “Over time, the private hospitals have let us know the amount of uncompensated care is growing,” with mounting concerns about sustaining access to services.

A case in point is Prairie St. John’s in Fargo, which, with an average of 70 inpatients a day, is North Dakota’s largest private psychiatric hospital.

“We’re very pleased to see that the dollars really fit with the Department of Human Services recommendations,” said Dr. Emmet Kenney, Prairie St. John’s chief executive officer and co-founder.

“We have had an increasing demand in our local hospitals,” which have suffered from reimbursements that don’t adequately cover their costs, Dalrymple said.

“They’ve been just sort of living with that,” the governor recently told The Forum’s editorial board. “They’ve just reached the point where they can’t keep doing that. We’ve got to step up and do more on the reimbursement.”

Dalrymple’s budget would modernize and make uniform a “hodge-podge” approach to state funding for mental health services that evolved over decades, he said.

The new approach places an emphasis on supporting community-based care, Kenney added. It places less reliance on the North Dakota State Hospital in Jamestown.

“Sometimes people literally are sitting in jails waiting for transportation to the state hospital,” Kenney said. Also, he added, if patients must travel far from home for treatment at the state hospital, it can complicate their reintegration into their community.

The $1 million recommended for suicide prevention would fund regional coordinators that can work with communities to set up programs to fight suicide, which last year claimed 89 lives in North Dakota.

“With that amount of money, we should be able to do more than awareness,” said Gail Erickson, the suicide prevention director for the North Dakota Department of Health. “That’s where it begins.”

Helgeland and Kenney said they will be working to win support from legislators for Dalrymple’s proposals.

“They will make the decision at the end of the day,” Helgeland said of lawmakers.

Readers can reach Forum reporter Patrick Springer at (701) 241-5522