RALEIGH, N.C. — North Carolina's oldest state mental hospital could be shuttered for good by this summer now that statewide elected leaders agreed Tuesday that the nearly two dozen remaining forensic patients can be moved to a more modern location.
The Council of State – comprised of Gov. Beverly Perdue and nine other elected officials – voted to give its formal blessing to the Department of Health and Human Services to close Raleigh's Dorothea Dix Hospital on Aug. 10. The legislature could still block the closure when lawmakers return in May, but a key Republican legislator suggested that's not likely.
Dix first opened in 1856, and many campus buildings still in use are several decades old and would be need in upgrades to continue serving patients. Activity there has been winding down recently as Dix patients were moved to a new hospital in Butner and the legislature ceased funding specifically to operate Dix.
"So many families have depended on the care here so, without question, it's the passing of a very important era," said Debbie Dihoff, state director for the National Alliance on Mental Illness.
The first patients arrived at new Central Regional Hospital in July 2008, but Dix patients were delayed for a year while litigation by Disability Rights North Carolina led to safety improvements at the new hospital.
Central Regional Hospital also now cares for about 90 medium- and maximum-security forensic patients committed because of crimes but previously would have been served at Dix. Acting department Secretary Al Delia said 22 minimum-security forensic patients left at Dix would go to Butner.
"The transfer of the patients to Butner will result in improved patient treatment and care," Delia told council members, adding that without the closing, his department "would have to continue to bear the additional costs of housing and treating those patients at Dix."
None of the Council of State members present voted against giving the authority to close the hospital. Perdue said after the meeting it makes sense to shift the remaining patients to Central because it will create a more positive outcome for their mental health.
"There's no money in the budget to keep Dix open," Perdue told reporters. "It's a decision made by the legislature, and I support that decision."
Several Wake County lawmakers have delayed the closure with mixed success in recent years by filing or passing legislation to slow the process. Democratic House and Senate members filed bills last year to disapprove of the Dix closure, but they weren't acted upon. Additional bills could be introduced this spring. With the council's action, current state law permits the closing if one of the bills is rejected formally or isn't approved before the budget-adjusting session is adjourned.
Rep. Deborah Ross, D-Wake, said the state's mental health system has been broken for 10 years, and there aren't enough beds as it is.
"Until we know what the solutions are going to be for mental health overall, taking away a valuable mental health service shouldn't be on the table," Ross said.
Rep. Nelson Dollar, R-Wake, co-chairman of the House Appropriations Committee, said that decisions by previous Democratic leaders in state government to scale back Dix are bringing a level of inevitability to the hospital's closing. Dix needed $34 million during the 2010-11 fiscal year to operate, a legislative document said.
"There are a lot of members of the General Assembly that wish that Dorothea Dix could stay open," Dollar said. "The problem is there's simply no money at this time to keep that hospital open. So, any desire on behalf of folks to keep Dix open as a mental hospital is sort of unfortunately more of a moot point."
Delia said the hospital closing is separate from two future decisions – the future of the Dix campus and potential privatization of treatment for some or all of the state's forensics patients.
Many want the 300-acre Dix campus turned into an urban park, while others are interested in the state selling part of the land, with proceeds going to benefit public mental health treatment. Perdue, who backs the park idea, said the state is seeking outside help to provide recommendations.
The land is appraised at as much as $86 million. Dihoff says any proceeds from a Dix sale should go straight to the mental health trust fund for community support.
"Make that directed toward improving the quality of lives of those who live with mental illness in North Carolina. It's time," she said.
Roughly 1,250 employees will still be working on the Dix campus, nearly all of them within DHHS. About 80 workers who currently work with the forensic beds at Dix are being offered jobs at Central Regional Hospital.
Delia said his department is talking with a Florida company that's interested in providing the privatized forensic treatment. The legislature in 2011 directed DHHS to go forward with privatization if Delia believes the change would result in cost savings and ensure enough safety and care for patients, but Delia said he's not yet persuaded those objectives can be reached. He said he expects some decision by early fall.
Dix once housed 600 patients, but before the transfers the number was fewer than 200, officials said. The state also operates Broughton mental hospital in Morganton and Cherry Hospital in Goldsboro.