Decision on D. Dix Hospital is imminent; politicos pointing fingers already

From an AP story on WRAL.com:

"County legislators who want to delay closure at the hospital that opened in 1856 will need the support of other colleagues during the 2011 session. Many argue Dix exemplifies the failings of mental health reforms in North Carolina that haven’t made up for a 44 percent reduction in the number of institutional beds."

“Several years ago the mental health reform process was assumed to work, and it hasn’t,” said Rep. Deborah Ross, D-Wake, who plans to file a bill to try to prevent the closure if she’s re-elected.

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The Perdue Administration’s statement:

"Department of Health & Human Services (DHHS) is following the statutory procedure, as it relates to Dorothea Dix hospital. Without funding for operating the facility this Agency has no other options; we cannot continue to operate." (Statement on behalf of DHHS Secretary Lanier Cansler from Renee McCoy at DHHS media office via email October 26, 2010)

From an earlier AP report: “…with a modern replacement for Dorothea Dix Hospital in Butner already taking patients and the state facing a potential $3.5 billion budget gap next year, Gov. Beverly Perdue may have little choice but to close Dix.”

“The bottom line is there are no new moneys. There are very few resources,” Perdue said in an interview. “I don’t believe that given the current fiscal environment, North Carolina can afford to keep Dix open. Patients will be transferred and they will be given great, great care.”

From a member of the NC House of Representatives and the Wake County delegation Rep. Deborah Ross of Raleigh replied via email October 25, 2010:

“There was a provision in the budget to close Dix with no public process. The NC House of Representatives removed the provision and allowed Dix to stay open.

We can file a disapproval bill after the Secretary files a closure plan. We have not received the plan yet.”

More from the AP article by Gary Robertson:

Wake County legislators who want to delay closure at the hospital that opened in 1856 will need the support of other colleagues during the 2011 session. Many argue Dix exemplifies the failings of mental health reforms in North Carolina that haven’t made up for a 44 percent reduction in the number of institutional beds.
“Several years ago the mental health reform process was assumed to work, and it hasn’t,” said Rep. Deborah Ross, D-Wake, who plans to file a bill to try to prevent the closure if she’s re-elected.

From an advocate for mental health services:

Letter to the Editor from Louise Fisher of Raleigh, to the Raleigh News and Observer, published Sat. October 23rd. Fisher is a long-time advocate at the NC General Assembly on mental health issues.

“Despite a critical shortage of psychiatric beds in North Carolina, state leaders want to close Dix Hospital.

“The N.C. legislature in the last session passed a bill to keep Dix open and was applauded by the media. Little did we know that the same legislature would pass a budget that eliminated funding to keep Dix [operating]. Their contradictory actions have caused some to question their sincerity and motives - especially in an election year. “
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Anyone on this blog want to comment? I have already asked Rep. Verla Insko, but she did not respond to a request for a comment. Same for several other Wake delegation members besides Rep. Ross.

NAMI Wake,led by Ann and Gerry Akland,and NAMI Moore Co. plan a protest in downtown Raleigh on Thursday. Several political leaders from Wake and the NCGA have been invited to join the event.

MARTHA BROCK
Politics and Government Writer
Examiner.com/Raleigh

Comments

Dix Hospital needs to stay open

The decision to close Dix Hospital at a time when North Carolina is critically short of having enough psychiatric beds is short-sighted, to say the least. I will work with Rep. Debra Ross, if I am elected to the NC Senate on Nov. 2, 2010, to restore the option to keep Dix Hospital open.

If the State of North Carolina can finance huge prison hospitals like the one opening up at Central Prison in Raleigh, which will be full of mentally ill prisoners, it should find a way to finance the restoration of Dix Hospital to do the work necessary to keep the mentally ill out of prison, in the first place.

www.charlesmalonencsenate.com

Charles Malone

The more I learn, the more I agree Dix should be kept open

I attended the Legislative Oversight Committee on MH/DD/SAS (Mental Health) which is responsible for advising the NC General Assembly members and committees on issues related to facilities, Local Managing Entities, and other DHHS issues on Wed. 12-08.

An interesting and unexpected (for me, at least) exchange took place between a Republican Senator from Hickory, Sen. Allran, a member of the LOC and Sec. Lanier Cansler of DHHS. Cansler was giving a report and included remarks on Dix Sen. Allran prefaced his questions on Dix by saying folks were asking him why the reason given by the Perdue Administration and Cansler for closing Dix was the budget and saving state operating expense.

Aa Allran said at the LOC meeting, Dix has the lowest operating cost of the state psychiatric facilities, and why would the state in dire fiscal straits close the least expensive facility to move patients to higher cost ones. One reason Dix has had lower costs is that the largest part of the DHHS facilities' budget is salaries and related costs. Dix had contract employees and state employees for the most part

Cherry and other hospitals are forced to use "traveling" nurses who get a premium for working as contract employees around the country. There are problems with this from a management view, too and not just an accounting ledger (Lanier Cansler's) point of view. But just from a cost aspect, this problem favors keeping Dix open as an admitting hospital.

Medical professionals do not want to work in backwater towns like Butner or Goldsboro. Disability Rights NC proposed moving Cherry Hospital to Greenville and allying it with East Carolina Unversity's Medical School for that reason. That idea never got political traction, because the politics of jobs and certain Senator's desires very much received more attention than the practicality in the long-run of attracting superior professional talent.

The bottom line should be the best option for patient care but in the past 8 years in North Carolina the patients have been the last concern for Legislators and the Governors. Jobs and land sales prospects ranked much higher on the priority list of the NC leaders. Patient care considerations would require keeping Dix Hospital open at least until all options are evaluated from a best patient care aspect and not just whether Dix should remain open based on a dollar and cent basis.

But only a temporary restraining order from a court can save Dix now. That may happen. But it may not. And a great tradition of patient care in NC will end, if it does not.

Martha Brock