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A report to legislators from the state Department of Health and Human Services puts one-time start-up costs for a fourth state psychiatric hospital at $137.2 million. Yearly operating expenses would be about $78 million, with about $61.9 million paid by the state.

Legislators asked DHHS to determine the cost of building a state hospital for use by a dozen counties including Mecklenburg, Union and Davidson. A state hospital in this region would be the smallest, at 200 beds, the DHHS study says.

Legislators asked for the study because patients wait an average of more than two days in emergency rooms for openings in state hospitals. The state has 866 beds in its three psychiatric hospitals, and the hospitals are considered full.

The state is building two replacement psychiatric hospitals in Goldsboro and in Morganton. The new Cherry Hospital in Goldsboro, set to open this year, will have 124 more beds, bringing its total to 314. The new Broughton Hospital in Morganton will have room for 85 additional beds.

Maximizing space at the new buildings and using the old John Umstead Hospital in Butner could add 271 beds in 2015, the report says.

Salima Mabry and her severely autistic 13-year-old son have camped in a waiting room for eight days waiting for a bed in a state mental hospital. The state budget cut $155 million from an already struggling system, resulting in the loss of 354 jobs at state hospitals. There are plenty of available beds at the children's ward in Central Regional Hospital in Butner, but not enough staffers to run it. (N&O)

President Barack Obama will try to get past rocky times for the nation and himself tonight in his first State of the Union address, offering a skeptical public repackaged plans to energize the economy, stem a tide of red ink and strengthen anti-terror defenses.

He'll also be trying to revive his own "yes we can" image. (AP)

Texting while driving is now a federal offense for anyone behind the wheel of a bus or a big truck. The federal penalities for commercial drivers much tougher than those imposed by a state law that bans texting behind the wheel for all drivers. (N&O)

After working for nearly a decade to close Dorothea Dix Hospital, state mental health administrators now intend to keep a sizable number of staff and patients at the aging Raleigh facility for years.

Lanier Cansler, secretary for the state Department of Health and Human Services, said this week that he plans to move about half of Dix's more than 200 patients to Central Regional Hospital in Butner when it opens fully in October.

But he said Dix will remain open as a stand-alone psychiatric hospital, with its own director and administrative staff. It will no longer serve as a satellite campus for the new Butner facility.

State legislators affirmed that decision earlier this month when they approved a state budget that restored $6 million in funding for operations at Dix for the next year. That move came as legislators made $155 million in spending cuts for other mental health programs in the 2010 budget.

The move to continue operating Dix as a state mental hospital will hamper efforts to turn the more than 300 acres between downtown Raleigh and N.C. State University into a major park operated by the City of Raleigh or a nonprofit foundation.

It also offers evidence that the sweeping 2001 mental health reform plan has failed. A centerpiece of that effort, which was passed by the legislature and carried out by the administration of former Gov. Mike Easley, was a plan to reduce the need for beds at mental hospitals. Instead, there would be more private, community-based treatment. (N&O)

Central Regional Hospital passed an important safety inspection Friday, allowing it to continue drawing federal insurance payments for patients, reports Lynn Bonner.

The hospital, with campuses in Raleigh and Butner, had been in danger of losing $1.2 million a month in federal payments because of dangerous conditions.

Five workers at a state mental hospital who violated rules by strapping a patient face-down to a bed charged this morning that they were being treated as scapegoats for the hospital's management problems.

The five — a nurse and four health care technicians — are on paid leave of up to 30 days from their jobs at Central Regional Hospital while state officials conduct an internal investigation, Michael Biesecker reports.

The incident occurred early Wednesday morning at Central Regional after a 24-year-old man resisted having his blood drawn for tests and made verbal threats, according to a staff report.

The employees admitted this morning that they had restrained the man-face down, instead of placing him on his back as required by hospital procedures. The face-down position can be life-threatening, causing the person to panic and making it difficult to breathe.

But they said they were short-handed and had not been given sufficient training to handle the patient, whom they described as hostile.

"The patient was very aggressive," said Tim Strong, a health care technician. "We did the best we can."

A state judge has stalled the plan to shut down Dorothea Dix hospital.

Wake County Superior Court Judge Allen Baddour issued a temporary restraining order Thursday that bars the N.C. Department of Health and Human Services from moving the bulk of Dix's patients to the new Central Regional Hospital.

That had been sheduled to start on Oct. 1.

The judge acted in response to a class-action lawsuit filed Tuesday on behalf of patients by the advocacy group Disability Rights North Carolina, which has been monitoring conditions at Central Regional.

"We are pleased with the decision, obviously," said Vicki Smith, the executive director of Disability Rights. "What the danger is when courts get involved is that the lawyers start arguing small points and we forget why we're there, which is to document that patients are safe."

It is not clear how long Baddour's order will last. (N&O)

A legal advocacy group has asked a judge to stop the pending closure of Dorothea Dix.

In a class-action lawsuit filed Tuesday, lawyers for Disability Rights North Carolina detail 15 safety issues at Central Regional Hospital, the new Butner facility where the bulk of Dix's patients will soon be transferred.

The nonprofit group has a federal mandate to investigate conditions independently in state hospitals, and it has been monitoring Central Regional for months. Its suit asks that a Wake County Superior Court judge issue a temporary restraining order to stop the transfer of Dix patients.

"The new hospital has significant issues regarding the safety and care of patients," said Vicki Smith, the advocacy group's executive director. "The [state] continues to provide assurances they will fix the problems, but to date, serious problems still exist."

Tom Lawrence, spokesman for the state Department of Health and Human Services, said he could not comment on the lawsuit, citing a policy.

In a separate development, investigators for the Centers for Medicare and Medicaid Services showed up at Central Regional to look into multiple complaints. (N&O)

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.

With yet another state mental hospital in danger of losing federal funding following a patient death, Dempsey Benton, head of the state Department of Health and Human Services, has tapped a familiar face to help fix the facility.

Patsy Christian, who was forced to resign in June as director of Central Regional Hospital in Butner after she commissioned a portrait of herself with money intended to benefit patients, was dispatched to Cherry Hospital in Goldsboro Tuesday following a critical report issued by regulators, reports Michael Biesecker.

Though an SBI investigation requested by Benton to determine whether Christian violated state purchasing laws is still unresolved, Benton said through a spokesman Wednesday that her 30 years as a nurse and hospital administrator qualified her to troubleshoot the problems at Cherry.

After she stepped down as director at Central, Benton created a new administrative position for Christian that kept her on the state payroll to “improve quality management and compliance with regulatory requirements.” Her salary is $114,056.