The state mental health division wants to start moving mentally ill patients from Dorothea Dix hospital in Raleigh to a new hospital in Butner, even though the division has not met conditions set out in state law for the transfer.

The law required assurances that the new hospital, Central Regional in Butner, would be accredited by two agencies before Dix patients move in, reports Lynn Bonner.

But one of the agencies, the Joint Commission of Accreditation of Healthcare Organizations, has said it will not even visit Central because Dix patients and staff are not there.

That set up a Catch-22, said Dr. Michael Lancaster, co-director of the state Division of Mental Health. Central Regional cannot be accredited because Dix staff and patients are not there, but staff and patients aren't there because it is not accredited.

Lancaster said he would recommend to his boss, state Department of Health and Human Services secretary Dempsey Benton, that Dix patients start moving, and leave the decision up to Benton.
Tomorrow, Dix will stop accepting patients to its geriatric ward. Central Regional will take them instead.

More after the jump.

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Pat McCrory says the state should not certify its own hospital.

The Republican gubernatorial nominee said that he objects to the decision to strike a provision from the state budget that would have required a new Central Regional Hospital in Butner to be approved by outside inspectors before it opened.

The decision also means that Dorothea Dix hospital in Raleigh could be closed sooner.

"In another secret back room meeting, the political establishment in Raleigh has arrogantly dismissed the welfare of mental health patients and decreed through the budget that the state does not have to comply with the same regulations it places on everyone else," he said in a statement.

He noted that hospitals normally have to pass "rigorous reviews," but not mental hospitals run by the state.

"The Department of Health and Human Services, which is racked with scandal and over $400 million misspent in mental health, will now move forward with closing Dix Hospital and opening Central Regional without independent review," he said.

Earlier this morning, Democratic gubernatorial nominee Beverly Perdue said she also objects to the decision.

Beverly Perdue says the state should not certify its own hospital.

In a statement, the Democratic gubernatorial nominee said that she "strongly" disagrees with the decision to strike a budget provision that would have prevented the new Central Regional Hospital in Butner from opening until outside inspectors approved it.

She also said that N.C. Secretary of Health and Human Services Dempsey Benton should not allow patients into the Butner hospital until it meets those standards.

"Secretary Benton should not authorize transfer until Central Regional meets those standards – the long-term safety and care of both patients and staff must not be compromised," she said.

A faster opening at Butner would also mean that Dorothea Dix hospital in Raleigh would close sooner.

A last-minute change to the state budget will make it easier to close Dorothea Dix.

The final budget headed to Gov. Mike Easley was stripped of a provision that would have required the new Central Regional Hospital in Butner to be approved by outside inspectors before it can accept patients. It's unclear who wrote the provision.

Advocates for the mentally ill decried the change, which effectively lets Secretary of Health and Human Services Dempsey Benton certify that the new hospital is safe.

"They watered it down to where no certification by a third party will be required," said John Rittelmeyer, the director of legal services for the advocacy group Disability Rights North Carolina. "We are disappointed because we are adamant about protecting the safety of patients, and we just don't believe that an internal assurance that standards are being met is sufficient." 

The opening of the new hospital has been delayed at least four times in the past year amid concerns about projected staffing shortages and internsal safety reviews that found problems in the building. Most new hospitals are required to undergo rigorous testing, but hospitals run by the department are exempt. (N&O) 

Pat McCrory has called for Dorothea Dix to remain open for another year.

In a letter sent Monday to Gov. Mike Easley, Lt. Gov. Beverly Perdue and other top Democratic leaders, the Republican gubernatorial nominee urged them to keep the Raleigh mental hospital staffed until the next governor could implement mental health reforms.

"I believe that the present problems are not a result of the legislatively passed reforms to provide local care for mental health patients," he wrote. "The scandal is a result of poor planning and implementation of the reforms. The next governor should be given the opportunity to bring new leadership to this area."

In the letter, McCrory says that the recent beating of a nurse at Dix shows there are continuing problems with the state's mental health care system.

During a June 2 news conference, McCrory called on the legislature to keep Dix open. He wrote that he was now asking top state leaders to intervene. 

The opening of a new state mental hospital has been postponed.

According to a release from the N.C. Department of Health and Human Services, patients from Dorothea Dix Hospital and John Umstead Hospital will not be transferred in mid-June.

Instead, patients and staff from Umstead will move to the new Central Regional Hospital in Butner from July 14-18, and patients and staff from Dix will move from July 28-Aug. 1.

Administrative offices will move to the new hospital this week, as planned.

The adjusted schedule provides an additioanl 30 days for Umstead staff to get trained and another 44 days for Dix staff to receive training.

Questions about the new hospitals' safety, staffing shortages and lack of training have led some legislators and Republican gubernatorial nominee Pat McCrory to call for a delay in the opening.

Republican candidate for governor Pat McCrory wants Dorothea Dix and John Umstead mental hospitals to stay open until mid-2009.

McCrory will call for the extended operation of those two state mental hospitals at a news conference this afternoon, according to his spokesman, V. Tom Gardner. Most patients are set to move out of the two hospitals this month and into the new Central Regional Hospital in Butner, Lynn Bonner reports.

But questions about the new hospital's safety, staffing shortages and lack of staff preparation have some Dix workers and legislators calling for a delay.

Gardner said McCrory thinks the next governor should have a chance to examine the situation before patients and staff move.

Design and staffing problems have delayed the opening of a $120 million state psychiatric hospital.

Dempsey Benton, secretary of the state Department of Health and Human Services, said Thursday that repairs resulting from design flaws were being made to the new Central Regional Hospital in Butner.

The building had been designed with 30 categories of hazard that could allow patients to hang themselves.

The announcement means that Dorothea Dix Hospital in Raleigh will remain open longer.

Most of the campus had been scheduled to close when Central opens, except for 60 beds that the state will operate jointly with Wake County. Minutes from recent meetings of the Central hospital management team show that they felt the May 1 opening date was unrealistic.

The hospital will now open on July 1 or later. (N&O)

Some legislators say they want to delay the planned closing of two state hospitals, including Dorothea Dix in Raleigh.

The state Department of Health and Human Services wants to move patients from Dix and John Umstead hospitals into new Central Regional Hospital in Butner in February, Lynn Bonner reports.

Legislators said the department was moving too fast and questioned whether there would be room for people needing help.

Mike Moseley, director of the state mental health division, told legislators that the state planned to keep a 36-bed "overflow" unit at Dix that would be open to patients from the region, in addition to 24 beds for patients from Wake County.

Even if the department finds space for patients in hospitals, overflow units and state alcohol treatment centers, it doesn't mean there are enough people working in those places to properly care for them, said Rep. Jennifer Weiss, a Cary Democrat.

"You can have physical beds," she said. "That doesn't mean you can take care of people."

Three members of the Council of State are undecided on Dix Hill.

Attorney General Roy Cooper, Insurance Commissioner Jim Long and Agriculture Commissioner Steve Troxler have not yet decided what should happen to the Dorothea Dix hospital campus.

A spokeswoman for Cooper said he will "examine the issue" when it comes before the Council of State.

Representatives of the other two said they had not given it much thought yet.

Chrissy Pearson, a spokeswoman for Long, said that he "generally will err on the side of leaving things open." But she also said Long, who is on vacation, has not talked specifically about Dix.

And Brian Long, a spokesman for Troxler, said that his only concern so far had been that plans for the site not adversely affect the state Farmer's Market nearby.

Update: A spokesman for Labor Commissioner Cherie Berry said she's also undecided.