Rural Health Report
Building Healthy Communities Building healthy communities means building a healthy future. Throughout my public service career, I ve focused on building-out our health care infrastructure so North Dakotans can have a higher quality of life. This means building state-of-the-art health care facilities so people have access to the highest level of care, constructing quality long-term care options so our seniors can stay closer to their families, and partnering to provide wellness and emergency service centers so our rural areas remain attractive places to live and work. The North Dakota 2.0 initiative identified the need to address our rural health care system, including emergency services and aging facilities. Through strong partnerships, USDA has helped meet this need by building quality hospital, clinic and long-term care facilities across the state. USDA has also embraced technology by financing IT equipment for telemedicine and telepharmacy. This enables medical professionals to deliver services from one site to another via broadband infrastructure. In totality, USDA has invested more than $178 million in projects since 2009 to ensure that rural North Dakotans have access to quality health care options. The contributions provided by rural health providers are critical, but the economic contribution is also important to note. Often hospitals, clinics and long-term care facilities are the number one employer in a rural area. Not only do these services provide jobs, but they help retain and attract businesses and residents. Our medical facilities are the foundation of our communities and critical components to supporting population and industry growth. USDA is a proud partner in building up communities and helping plan for a healthier future. Jasper Schneider, State Director USDA Rural Development Investment in North Dakota Health Care Projects Since 2009 is More Than $178 Million Clinics and Hospitals: $125.65 Million Long-term Care: $44.82 Million Emergency Vehicles and Facilities: $2.93 Million Wellness: $4.05 Million Telemedicine: $574,400
USDA RURAL DEVELOPMENT PROGRAMS & RESOURCES A ccess to rural health services is critical to growing a sustainable community. As North Dakotas s population continues to increase, added pressure is put on medical facilities and emergency services. By providing access to capital, USDA is helping rural residents receive the high-quality care they deserve. Through the programs listed below, USDA can finance projects to construct, expand or improve hospitals, clinics, nursing homes, wellness centers and fire halls. Financing may also be obtained to purchase emergency vehicles and medical equipment. Community Facilities Loan, Loan Guarantee or Grant: the program is used to develop essential community facilities for public use. Applications for projects relating to health care, education and public safety are given priority. Eligible applicants may be public entities such as municipalities, counties, special-purpose districts, non-profit corporations and tribal governments in rural areas and communities up to 20,000 in population. Rural Economic Development Loan or Grant: the program provides funding, through electric and telephone utility companies, to local businesses in order to encourage economic development. Under the REDLoan program, USDA provides a zero-interest loan to a utility company which they, in turn, pass on to a local project. Under the REDGrant program, USDA awards a grant to a utility company. The funding is then used to establish a revolving loan fund for the support of local projects. Business and Industry Loan Guarantee: the program aims to improve and develop businesses and the economic climate of rural communities. Partnering with private lenders, USDA guarantees loans for projects in communities with up to 50,000 in population. Distance Learning and Telemedicine Program: is designed specifically to meet the educational and health care needs of rural America. Through loans, grants and loan/grant combinations, advanced telecommunications technologies provide enhanced learning and health care opportunities. Financing may be used for equipment, radiology, x-ray scanners and physician consultations. Eligible applicants may be incorporated entities, including municipal corporations that operate educational or health care facilities in rural areas with up to 20,000 in population. Photos on this page are of the Jamestown Regional Medical Center. Under the community facilities program, USDA financed construction with a $31 million direct loan and a $15 million loan guarantee through AgStar Financial.
USDA Rural Development Investments in Health and Medical Projects from Fiscal Years 2009 2014 CLINICS & HOSPITALS City Project Grant Loan Total Funding Ashley Purchase new heating and cooling system for medical center $446,992 $446,992 Bowman Construction of new Southwest Healthcare hospital/clinic $15,000,000 $15,000,000 Crosby Northwest Communications Co-op establishes revolving loan fund, initial loan to expand St. Luke s Hospital $300,000 $300,000 Crosby Remodel and expand St. Luke s Hospital $6,842,000 $6,842,000 Elgin Purchase electronic medical equipment for Jacobson Memorial Hospital $500,000 $500,000 Fort Totten Purchase medical equipment $50,000 $50,000 Garrison McLean Electric Co-op establishes revolving loan fund, initial loan for renovation at Garrison Memorial Hospital $300,000 $300,000 Jamestown Construction of new Jamestown Regional Medical Center $46,000,000 $46,000,000 Larimore Construction of new Valley Community Health Center clinic $540,000 $540,000 Northwood Purchase and replace hospital facility equipment $1,800,000 $1,800,000 Tioga Construction of new Tioga Medical Center clinic $8,000,000 $8,000,000 Walhalla Watford City United Communications establishes revolving loan fund, initial loan to renovate clinic and dental building Reservation Telephone Co-op establishes revolving loan fund, initial loan made to equip Anova Family Health Center $172,318 $172,318 $113,517 $113,517 *Watford City Construction of new McKenzie County hospital and clinic $39,250,900 $39,250,900 Williston Construction of new Trinity Health Clinic $5,500,000 $5,500,000 Wishek Purchase mammography equipment $18,750 $106,250 $125,000 Wishek Purchase and replace hospital facility equipment $715,000 $715,000 TOTALS $954,585 $124,701,142 $125,655,727 *Financing is pending on project LONG-TERM CARE City Project Loan Total Funding Aneta Remodel and expansion of Aneta Parkview Health Center $2,000,000 $2,000,000 Devils Lake Remodel and expansion of Heartland Care Center $7,724,000 $7,724,000 Dickinson Construction of new St. Luke s Home $13,690,000 $13,690,000 Napoleon Remodel and expansion of Napoleon Care Center $2,342,000 $2,342,000 New Rockford Remodel and expansion of Lutheran Home of the Good Shepherd $6,000,000 $6,000,000 Richardton Construction of new Richardton Health Center nursing home and clinic $5,500,000 $5,500,000 Rolette Construction of new Rolette Community Care Center $6,970,110 $6,970,110 Wishek Expansion of Wishek Home for the Aged $600,000 $600,000 TOTALS $44,826,110 $44,826,110
EMERGENCY VEHICLES & FACILITIES City Project Grant Loan Total Funding Almont Purchase an ambulance $13,650 $15,350 $29,000 Almont Construction of new fire and ambulance hall $98,490 $55,060 $153,550 Columbus Purchase fire truck and equipment $64,050 $8,100 $72,150 Kulm Purchase extrication vehicle $16,500 $58,500 $75,000 LaMoure Mohall New Rockford Dakota Valley Electric Co-op establishes revolving loan fund, initial loan for new emergency services building SRT Communications establishes revolving loan fund, initial loan for new emergency services building Northern Plains Electric Co-op establishes revolving loan fund, initial loan for new ambulance facility $300,000 $340,000 $640,000 $300,000 $300,000 $83,333 $83,333 Powers Lake Purchase a fire truck $34,000 $50,000 $84,000 Rolla Purchase a police vehicle $10,300 $10,300 Velva Verendrye Electric Co-op establishes revolving loan fund, initial loan for the purchase of a fire truck $160,000 $160,000 West Fargo Construction of new fire station $1,268,000 $1,268,000 Wing Purchase an ambulance $21,856 $33,144 $55,000 TOTALS $1,102,179 $1,828,154 $2,930,333 WELLNESS City Project Grant Loan Total Funding Crosby Construction of health and wellness center $1,800,000 $1,800,000 Belcourt Construction of health and wellness center $50,000 $2,200,000 $2,250,000 TOTALS $50,000 $4,000,000 $4,050,000 TELEMEDICINE Counties Served Project Grant Total Funding Grand Forks, Pembina, Red Lake, Polk and Rosseau McLean Burleigh, Divide, Dunn, Grant, Kidder, LaMoure, Logan, McHenry, McIntosh, McKenzie, McLean, Mercer, Mountrail, Rolette, Sheridan, Sioux and Ward Altru Health System implements digital imagining in rural clinics Garrison Memorial Hospital purchases equipment for telepharmacy St. Alexius Medical Center expands telemedicine network to connect 22 rural medical facilities $220,000 $220,000 $196,400 $196,400 $158,000 $158,000 TOTALS $574,400 $574,400
UNDER DEVELOPMENT: RURAL HEALTH PROJECTS Economic opportunity in North Dakota, particularly in the oil impacted counties, has brought an influx of workers to the state. This population boom has put a greater demand on rural health services. To help alleviate the strain on health care infrastructure, USDA Rural Development is partnering with the private sector to renovate, expand and build new medical facilities. The following projects are currently under development. TIOGA MEDICAL CENTER The Tioga Medical Center campus, which serves North Dakota s Divide, Williams, Burke and Mountrail counties, has seen a steady increase in patient numbers, from about 6,000 in 2010 to over 24,000 today. First built in 1953 and expanded in 1985, the Tioga clinic sits at the bottom of a 100-foot grade from the hospital. The physical location down the hill has caused water damage and made it difficult to transfer patients to and from the hospital. Overall, the facility has several structural issues and can not be updated to accept modern diagnostic equipment. The increased caseload associated with the oilfield workforce as well as the area s aging base population have amplified the barriers to providing first-rate care in a timely manner. To help address this issue, USDA Rural Development provided a $6.5 million loan and a $1.5 million loan guarantee through the Bank of Tioga for the construction of a new clinic. The 15,000-square-foot clinic, slated to be finished in 2015, will be attached to the existing hospital. The project will double the size of the current clinic, offering ample space. Outpatient services will also be consolidated and there will be easier access to hospital departments. The Tioga Medical Center is the fourth largest employer in the area, only coming in behind three oil field companies. The expansion will allow for six additional health care jobs at the new clinic. RICHARDTON HEALTH CENTER For over 60 years, Richardton Health Center has been providing medical services in Stark County. The current nursing home, originally built in 1950 as a hospital, sits across the street from the clinic. To provide proper care and meet the needs of patients, the center is building a new facility. The 22,000-square-foot nursing home and clinic will be financed partially by a $5.5 million USDA Rural Development loan. To be located on the northwest edge of Richardton, the health center will split space with 19,000-square-feet dedicated to a 24-bed skilled nursing home and the other 3,000-square-feet for the new clinic. The current occupancy rate at the nursing home remains steady at 95 percent or higher with a waiting list. To address demand, the new nursing home will add four additional rooms. All rooms will be private to accommodate the changing level of care for residents.
The facility will also offer several advantages by bringing the nursing home and clinic under one roof. Medical professionals, equipment and staff will be shared between the health care entities. As a one-story structure, resident rooms, therapy, kitchen services and staff offices will conveniently be located on the same level. More importantly, nursing home residents will not need to leave the building to visit the clinic. SOUTHWEST HEALTHCARE SERVICES Southwest Healthcare Services provides care to a population of 3,200 people and growing, which includes all of Bowman County. Delivering care from separate campuses, the hospital and clinic are co-located while the long-term care facility and independent living apartments are on a different campus. Built over 60 years ago, the layout of the existing hospital lacks adequate space, has structural deficiencies and is inaccessible due to design. Therefore, Southwest Healthcare is building a new hospital and clinic with the help of a $15 million USDA loan. More than doubling the size, the planned 59,000-squarefoot hospital and clinic will be attached to the existing long-term care facility. Combining all services at one central location, Southwest Healthcare will be able to provide more efficient and convenient care to patients. The additional space will be used to increase the number of emergency rooms and will allow for state-ofthe-art equipment to meet patient needs. During the project, the nursing home will be remodeled as well as adding on a new memory care unit. When complete, the project will be a two-story structure allowing for expansion to go upward with future growth. Southwest Healthcare Services employs more than 180 people with plans to hire more after construction is done. MCKENZIE COUNTY HEALTHCARE The population in Mckenzie County and Watford City has exploded with the increase in energy development. This has brought thousands of new workers to the area who are at high risk for injury. As a result, there has been a greater demand on the local health care facilities. The aging and undersized hospital in Watford City can no longer provide quality care to the growing volume of patients. Consequently, McKenzie County Healthcare Systems is building a new hospital and clinic to be located on the same campus as the existing long-term care facility. The project will construct a two-story, 79,200-square-foot hospital and clinic. The long-term care facility will also expand by 25,500-square-feet and another 13,000-square-feet will be renovated. To complete construction and support efforts in delivering quality health care, McKenzie County Healthcare has put in an application with USDA Rural Development for a $39.2 million loan. When finished, the project will provide needed additional space, expanding all medical and emergency treatment areas. The new design will also transfer all the nursing home rooms to private in order to offer more of a neighborhood environment. Heartland Care Center U ntil recently, the City of Devils Lake was without specialized care for individuals with dementia. The closest facility with a memory care unit was 45 miles away from the community. Thus, there were many residents forced to leave their hometown to receive proper care. Due to the need in services, Heartland Care Center expanded their long-term care facility. The traditionally designed nursing home did not offer a safe and secure environment for residents with Alzheimer s disease and other related dementia. Therefore, the care center added more than 16,000-square-feet to the 74- bed nursing facility. The additional space was mostly dedicated to a 16-bed memory loss unit designed to provide optimum care in a supportive setting. In conjunction with the expansion, 17,000-square-feet was remodeled to provide structural upgrades and efficiencies. To help complete the project, USDA Rural Development financed a $3.8 million loan and a $3.8 million loan guarantee through Ramsey National Bank and Trust of Devils Lake and the Bank of North Dakota. The memory care unit opened at the end of 2012 and has been full ever since. Maintaining over a 95 percent occupancy rate in the nursing home, the center has added eight more beds to the facility. Heartland Care Center is the second highest employer in Devils Lake, providing services to the local community and surrounding region to include the Spirit Lake Nation Indian Reservation.
USDA Rural Development Offices in North Dakota For more information on programs, visit our website at http://www.rurdev.usda.gov/nd or email us at info@nd.usda.gov. North Dakota State Office 220 East Rosser Ave., Room 208 Bismarck, ND 58502-1737 Toll Free: (800) 582-7584 Voice: (701) 530-2037 Fax: (701) 530-2111 TTY: (800) 366-6888 Bismarck Local Office 916 E Interstate Ave, Suite 3 Bismarck, ND 58503-0548 Voice: (701) 250-4367, Ext. 4 Fax: (855) 813-7557 TTY: (800) 366-6888 Devils Lake Area Office 706 8th Ave. SE, Suite 5 Devils Lake, ND 58301-3749 Toll Free: (800) 688-2279, Ext. 4 Voice: (701) 662-8634, Ext. 4 Fax: (855) 289-5184 TTY: (800) 366-6888 Dickinson Area Office 2493 4th Ave. West, Room B Dickinson, ND 58601-2623 Toll Free: (800) 688-2251, Ext. 4 Voice: (701) 225-9168, Ext. 4 Fax: (877) 492-4990 TTY: (800) 366-6888 Minot Area Office 1920 13th St. SE Minot, ND 58701-6059 Toll Free: (800) 765-9476, Ext. 4 Voice: (701) 852-1754, Ext. 4 Fax: (855) 289-5186 TTY: (877) 366-6888 Valley City Area Office 110 Winter Show Road SW, Suite 2 Valley City, ND 58072-4034 Toll Free: (800) 688-2293, Ext. 4 Voice: (701) 845-5150, Ext. 4 Fax: (855) 814-3102 TTY: (877) 366-6888 June 2014 USDA is an equal opportunity provider and employer. If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form (PDF), found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov.