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Rural North Dakota hospitals called on to manage mental health crises. Can they handle it?

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Rural North Dakota hospitals called on to manage mental health crises. Can they handle it?


BISMARCK — North Dakota’s plan for closing gaps in psychiatric care depends partly on guaranteeing rural hospitals can absorb sufferers affected by a psychological well being disaster to allow them to be stabilized and transferred for remedy.

The shortage of behavioral well being professionals and persistent staffing shortages plaguing rural hospitals, nevertheless, will make the state’s plan that rather more tough.

There are different issues as nicely, together with offering hospital rooms which are designed to securely home psychiatric sufferers, who can current a threat to themselves or others when unstable.

The “protected” rooms require protected ligatures, home equipment and even a sure type of lighting fixtures, Erik Christenson, chief govt officer of Coronary heart of America Medical Middle in Rugby mentioned.

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“They don’t seem to be low cost to put in,” he instructed state well being and human providers officers. “All of that prices cash.”

“Staffing is totally a problem at this level,” Christenson added, a degree made by others.

Christenson was amongst hospital representatives who lately offered suggestions to a guide’s suggestions for bettering behavioral well being providers throughout the state, together with a contemporary, new State Hospital in Jamestown.

The enter will likely be introduced to an interim legislative committee that’s learning the states’ psychological well being system and is anticipated to make suggestions within the upcoming session, which convenes in January.

North Dakota’s 37 crucial entry hospitals, which serve rural communities, would profit from having an outlined set of procedures for coping with psychological well being disaster circumstances, Christenson mentioned. “It ought to be far more uniform, I believe, the method,” he mentioned.

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Shari Saxerud, care coordinator at CommonSpirit in Lisbon, mentioned it takes hours on the cellphone to discover a psychiatric hospital mattress for a affected person, a remark echoed by many suppliers and law-enforcement officers across the state.

“It is rather onerous to discover a mattress for adults and pediatrics,” she mentioned. Then, even when the affected person has insurance coverage, typically the mattress is unaffordable, Saxerud added.

Transporting sufferers to a medical heart with an obtainable psychiatric mattress can be an issue, she mentioned. Legislation-enforcement officers generally are referred to as upon to move sufferers in marked squad automobiles — a apply that inaccurately implies the affected person with psychological sickness is a felony, psychological well being advocates have complained.

Making certain one-on-one look after unstable psychiatric sufferers is tough for crucial entry hospitals, which lack specialty workers and whose workers members are stretched skinny, mentioned Mike Delfs, chief govt officer of Jamestown Regional Medical Middle.

“I believe that’s an enormous problem,” he mentioned, including that rural hospitals should on the similar time care for his or her medical sufferers.

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Minnesota experimented with so-called “micro hospitals” to deal with psychiatric sufferers in neighborhood hospitals, however the effort rapidly proved unworkable, largely due to staffing issues, Delfs mentioned.

Insurance coverage reimbursement additionally poses a big impediment, mentioned Todd Forkel, chief govt officer of Altru Well being in Grand Forks.

In partnership with UHS, the corporate that owns Prairie St. John’s in Fargo, Altru has been attempting to broaden its psychiatric mattress capability from 16 to 48 beds, with further beds later.

However that effort has run into a big barrier as a result of the companions have been unable to acquire a Medicaid waiver permitting enlargement past 16 beds — which suggests the added beds could be ineligible for Medicaid funds, Forkel mentioned.

Forkel pleaded with state officers to assist remove regulatory and monetary limitations, however applauded the state’s effort to broaden providers and shut service gaps.

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“This is a matter that’s solely rising,” Forkel mentioned. “We’re what we will do to satisfy this vital want.”

Rachel Sem, director of nursing at Sakakawea Medical Middle in Hazen, in contrast the necessity for specialised psychiatric care to the necessity for specialty care to deal with strokes and different medical emergencies — sufferers that rural hospitals ship to city medical facilities.

“They nonetheless want these specialty providers,” Sem mentioned, including that telehealth could be useful. “Psychological well being isn’t any totally different. It’s nonetheless a specialty. They nonetheless want these specialty providers.”

A disaster heart serving as a “one cease store” may assist rural hospitals deal with psychological well being emergency circumstances, together with help find a switch mattress for the affected person, Sem mentioned.

Rural communities in southwestern North Dakota don’t at all times have the assist providers wanted to maintain psychological well being sufferers secure, mentioned Karen Goyne of Southwestern District Well being Unit in Dickinson.

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In consequence, they proceed to current as disaster circumstances in emergency rooms, the place workers usually give first precedence to sufferers with medical emergencies, comparable to coronary heart assaults or trauma.

“Generally psychological well being and substance use points get type of placed on the again burner,” Goyne mentioned. “That’s nothing in opposition to anyone, that’s what occurs within the ER.”

Truly, emergency rooms are ill-equipped to deal with psychological well being crises, mentioned Lisa Wilson, director of behavioral well being at CHI St. Alexius in Bismarck.

“Behavioral well being sufferers don’t belong in an ER,” she mentioned.





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North Dakota

Colorado’s opener with North Dakota State has most bets in 2024

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Colorado’s opener with North Dakota State has most bets in 2024


Colorado football is set to return to the Big 12 in 2024 with heightened expectations and a revitalized roster. Head coach Deion Sanders is preparing to capitalize on a significant influx of talent, with 41 transfers and six high school signees joining the squad. This influx provides an opportunity to improve upon last season’s 4-8 record and establish a stronger presence in the competitive Big 12 conference.

The release of the Big 12’s 2024 schedule has highlighted several pivotal matchups that could determine the success of the Buffaloes’ season. However, the non-conference schedule is equally critical, featuring challenging games that will test Colorado’s readiness for Big 12 play. Notably, the Week 1 game against North Dakota State (NDSU) stands out as a potential trap game that the Buffaloes cannot afford to underestimate.

Betting odds reflect the high interest in this matchup, with 82 percent of bets favoring Colorado, according to BetMGM. Despite Colorado being favored by 8.5 points, the narrow margin indicates a level of respect for NDSU’s capabilities. The Bison, although an FCS team, have a storied history of success, having won nine national championships since 2011, including two of the last five. Even with the departure of head coach Matt Entz, NDSU remains a formidable opponent under new head coach Tom Polasek.

The Buffaloes’ modest favor by just a touchdown at home underscores the challenge posed by NDSU. Polasek, formerly Wyoming’s offensive coordinator, brings a wealth of experience and a winning mentality to the Bison. The uncertainty surrounding NDSU’s starting quarterback adds intrigue, with Cam Miller’s potential return for a graduate year hanging in the balance. Miller’s impressive performance last season, with 32 total touchdowns and only four interceptions, makes him a critical factor. Additionally, wide receiver Eli Green, who averaged nearly 20 yards per catch in 2023, poses a significant threat to Colorado’s secondary.

Coach Sanders is acutely aware of the threat NDSU poses, emphasizing the need for his team to remain focused and prepared. “Don’t underestimate North Dakota State,” Sanders stated on FS1’s Undisputed. “Those guys come to play and they can play.” As the season approaches, Sanders and his squad will need to channel their motivation and talent to navigate both their non-conference and Big 12 schedules successfully.





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In RNC speech, North Dakota Gov. Doug Burgum says Trump will unleash American energy dominance

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In RNC speech, North Dakota Gov. Doug Burgum says Trump will unleash American energy dominance


MILWAUKEE — Serving as North Dakota governor under former President Donald Trump was like having “a beautiful breeze at our back,” Doug Burgum said Wednesday, July 17, at the Republican National Convention in Milwaukee.

The GOP governor, who was considered a top contender to be Trump’s vice president, contrasted that to President Joe Biden, saying being governor during the Democrat’s administration was like “a gale force wind in our face.”

“Biden’s war on energy hurts every American because the cost of energy is in everything that we use or touch every day,” Burgum said.

The governor took to the stage Wednesday night at the Fiserv Forum during the third day of the RNC. The governor from the second top-producing oil state in the U.S. criticized Biden’s policies on energy, claiming they have raised the price of gas, food, clothes and rent.

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“Biden’s green agenda feels like it was written by China, Russia and Iran,” Burgum said.

Burgum was passed up on Monday as Trump’s vice president pick for U.S. Sen. J.D. Vance of Ohio, though there is speculation the North Dakotan could be a part of Trump’s administration.

The governor has spent time campaigning for Trump and looks to continue that. Burgum praised Trump as a friend of energy and a champion of innovation over regulation.

“Unleashing American energy dominance is our path back to prosperity and peace through strength,” Burgum said. “Teddy Roosevelt encouraged America to speak softly and carry a big stick. Energy dominance will be the big stick that President Trump will carry.”

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North Dakota Governor Doug Burgum takes the stage on Day 3 of the Republican National Convention at the Fiserv Forum in Milwaukee, Wisconsin, July 17, 2024. REUTERS/Jeenah Moon

Jeenah Moon/REUTERS

Burgum joked that the last time he was in Milwaukee, he had to stand on one leg behind a podium for the first Republican presidential debate for the 2024 election. The night before the August debate, which was also held in the Fiserv, Burgum tore his Achilles tendon during a pickup basketball game, sending him to the emergency room and putting him in a walking boot.

During the speech, he asked who would make America energy dominant, to which the crowd yelled twice, “Trump!”

On the third time, he asked the crowd to yell it loud enough to wake Biden up, an insult playing into reports that the Democrat is a 10 a.m. to 4 p.m. president and is in cognitive decline. The crowd replied “Trump” loudly.

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“When Trump unleashes American energy, we unleash American prosperity and we ensure our national security,” Burgum said

Burgum, who is from the small town of Arthur, North Dakota, also said rural America and small towns feed, fuel and defend the world.

“Rural America is Trump country,” Burgum said.

In a statement issued after the speech, North Dakota Democratic-NPL Party Chair Adam Goldwyn called Burgum “a billionaire cosplaying as a cowboy with an undirected Carhartt.”

“Burgum signed one of the strictest anti-abortion laws in the country, and that is wreaking havoc on North Dakotan women,” Goldwyn said. “After supporting bills to promote equality in North Dakota, he threw LGBTQ folks under the bus when he signed laws that discriminate against them. Will Burgum finally return to North Dakota now, or will he continue to neglect his gubernatorial duties? Either way his time in the national spotlight is over and he is no longer a ‘top priority.’”

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Trump secured the Republican nomination for president. He is expected to face Biden in the general election.





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Plain Talk: 'I'm bringing people together'

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Plain Talk: 'I'm bringing people together'


MINOT — Sandi Sanford, chair of the North Dakota Republican Party, joined this episode of Plain Talk from the GOP’s national convention in Milwaukee, where, she said, “the security plan changed drastically” after the attempted assassination of Donald Trump.

Republicans have been focused on unity at this event — two of Trump’s top rivals during the primaries, Gov. Ron DeSantis and former ambassador Nikki Haley, endorsed him in speeches at the convention — but Sanford acknowledged to my co-host Chad Oban and me that this may be a heavy lift.

“People know that what we’re dealing with in North Dakota with the different factions,” she said, initially calling the populist wing of the party the “far right” before correcting herself and describing them as “grassroots.”

The NDGOP delegation to the national convention

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wasn’t necessarily behind Gov. Doug Burgum potentially being Trump’s running mate

(Burgum himself was passed over for a delegate slot by the NDGOP’s state convention), but Sanford said she felt the delegates were “really confident in Donald Trump and his pick.”

“It gets dicey,” she said of intraparty politics. “It can get cruel,” but Sanford said her job is to keep the factions united. “I’m bringing people together.”

Sanford also addressed a visit to the North Dakota delegation from Matt Schlapp of the American Conservative Union (the organization which puts on the Conservative Political Action Conference). In March, Schlapp paid

a nearly half-million settlement

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to a man he allegedly made unwanted sexual advances toward. “My delegation wanted to hear from CPAC,” she said, adding that Schlapp was “on a speaking circle” addressing several state delegations.

Also on this episode, we discuss how the assassination attempt on Trump might impact the rest of this presidential election cycle and whether Democrats will replace incumbent President Joe Biden.

Want to subscribe to Plain Talk? Search for the show wherever you get your podcasts, or

click here

for more information.

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Rob Port is a news reporter, columnist, and podcast host for the Forum News Service with an extensive background in investigations and public records. He covers politics and government in North Dakota and the upper Midwest. Reach him at rport@forumcomm.com. Click here to subscribe to his Plain Talk podcast.





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