5 hours Ago By Peyton Haug
BISMARCK — With a few weeks left of North Dakota's legislative session, plans to build a new State Hospital in Jamestown are in limbo as the House and Senate look for a compromise on what the project is worth and who will oversee it. North Dakota's statewide mental health bed shortage inspired the top-level push for updating related health care facilities, including a $300 million recommendation from Gov. Kelly Armstrong to build a new state hospital.
That price tag sits between what the House and Senate chambers individually settled on, with the House proposing the state spend $330 million on the project within the Department of Health and Human Services budget, House Bill 1012, and the Senate proposing $285 million under the Management budget, House Bill 1015. According to Pam Sagness, executive director for behavioral health at the North Dakota Department of Health and Human Services, the House's plan would support 165 beds, which is 43 more than what is available in the existing State Hospital, and the governor's recommendation would support approximately 140 beds. Both approaches would allow the project to be "shovel-ready" by July, Sagness said.
Under the Senate's plan, however, Sagness said the department would have to delay construction, likely until the next biennium, and reconsider the number of beds that could be added. It would also have to reevaluate the entire design, which the Legislature spent more than $12.5 million on during the last legislative session.
"There comes a certain place where, to save a little bit of money, you actually add new barriers," Sagness said. "No one piece of this alone is going to solve the problem." The department doesn't take a stance on which agency oversees the project, Sagness added, emphasizing that the need for a new facility is "significant.
" Since the beginning of the 2025 legislative session, lawmakers have worked with architects, consultants and state agencies to finalize the design and costs to build the new facility. At just under 300,000 square feet — nearly half the size of the existing 140-year-old, 550,000-square-foot facility — the new hospital is designed to be more efficient, trauma-informed and welcoming, Sagness said. It would be built with some amenities, like courtyards and single-occupancy rooms, and modern safety measures.
Those housed at the State Hospital are often court-ordered to be there and stay for 72 days on average. Some patients are there for decades, according to the Department of Health and Human Services. "There is a subset of population that we provide service to (at the State Hospital) that no one else does," Sagness said, pointing to the hospital's inpatient sex offender program.
"We're providing not just a therapeutic environment for them, but we're providing public safety," she said. "The $300 million is not without being conservative with our thinking." One senator says increasing the availability of beds and services could be achieved at approximately one-third of the cost.
Sen. Tim Mathern, D-Fargo, suggested the Senate amend the bill to use $100 million to renovate and add to the existing hospital instead of building a new one. The existing campus is set to be handed to the North Dakota Department of Corrections and Rehabilitation, which would receive $750,000 from the state to examine renovating some of the buildings under its proposed budget.
The addition could also free up money for addressing loss of federal funds or for other projects, Mathern said, maintaining that decentralizing mental health care is a more informed route. “I know, and experience, when you take people out of their community and send them some place else for treatment — the chances of being able to maintain one’s health are better if your family, if your employer, if your support group is involved in that treatment,” Mathern, a social worker, said. Sen.
Robert Erbele, R-Lehr, introduced Mather's suggested amendment to the Senate Appropriations Committee in an effort "pump the brakes" on the pricey project, he said. It failed Monday, April 21, by a 4-12 vote. Since each chamber housed the State Hospital funding under different agency budgets, there will be two separate conference committee meetings where lawmakers will decide the state contribution and what agency will oversee the construction.
Those committee assignments have not been determined, as neither budget has been finalized..
