Bismarck Tribune

By GORDON WEIXEBy GORDON WEIXEL

New Salem is again facing the loss of its clinic, and Morton County commissioners are hoping they can help save the facility that they say is crucial to the community.

Morton tax director and New Salem resident Leon Samuel represented the clinic at Tuesday's commission meeting. He said after Medcenter One closed the clinic in 2003, a group of individuals formed a board and managed to reopen it.

"We were here two years ago and requested economic development funds, and we want to thank you for that. We had expected to get grants, but that didn't happen as soon as we thought," Samuel said. "We're asking for more economic development funds for the clinic, but it's more for the community. Nobody is making any money from the clinic, but the community is benefiting from it."

The clinic's board is requesting $25,000 in economic development funding usually afforded the county through the Bismarck-Mandan Development Association. The board has already secured $5,000 from the New Salem Lions Club and has submitted an application to Montana-Dakota Utilities for a grant. Other local and regional clubs also are being approached, Samuel said.

Tom Nehring is the CEO for the Beulah-based Coal Country Community Health Centers, which manages the New Salem clinic along with health centers in Halliday, Beulah and Glen Ullin. He said the physician serving New Salem is donating his time to treat patients, making himself available to the clinic on his off day, Wednesday, from 3 to 8 p.m. Nehring said that Coal Country Community Health Centers is also providing its management services for no charge.

"Primary care clinics in rural North Dakota are basically facing a significant dilemma. Medcenter One, as well as St. Alexius, have had a number of clinics in the outlying areas but have chosen to close them - I'm assuming because they were losing money," Nehring said. "But all of you (the commissioners) recognize the importance of having primary care in outlying areas. You can't expect people to drive 30 minutes, up to two hours, for primary care."

Nehring estimates the New Salem clinic will lose about $45,000 a year, adding that many of the rural clinics across North Dakota are facing the same problems. Samuel said that with the $25,000 from the economic development grant, the clinic could raise the rest of money.

"By keeping the clinic open, we're helping our other businesses," Samuel said. "If we lose the clinic, we're worried we'll lose our pharmacy. The grocery store is right there, and people stopping at the clinic often stop there. People coming to town for the clinic are also spending their money at the service stations. We really feel it is a vital part of our community, and we're trying to keep it open."

Nehring said he believes there is a light at the end of the tunnel, and if the clinic can stay open for the next year or two, it will eventually receive funding through the New Access Points program.

He said President Bush allocated $34 million for New Access Points, but because of the Sept. 11, 2001, attacks and the many natural disasters affecting the country, those funds have not been available. And because the New Salem clinic has been run so efficiently through donated time and money, it hasn't received the Medicare payments it should be receiving.

"We've been told New Salem is first on the list for New Access Points, and if the program gets any money, there will be plenty of federal money to make up the deficit on an annual basis," Nehring said. "I've talked to the doctor providing the service, and he admits he would like to be compensated but is willing to continue donating his time until the problem is resolved."

The clinic has one doctor and one nurse practitioner who splits time with the Glen Ullin clinic. It also employs three additional part-time people who receive no benefits and what Nehring says is a minimum salary.

"Those part-time employees volunteer a lot of their time as well," Nehring said. "The more efficiently we run the clinic, the less money we get. That's the dilemma we have when filing cost reports with the federal government for what's paid us through Medicare."

Commissioners agreed on the importance of the New Salem clinic and their willingness to help. They approved a motion that the economic development grant be given to the clinic. Auditor Paul Trauger said the clinic must next apply for the grant from the BMDA.

"I feel there are two cornerstones for rural communities - schools and health care," Nehring said. "Take one away, and a community's ability to thrive is compromised."

(Reach reporter Gordon Weixel at 250-8255 or gordon.weixel@;bismarcktribune.com.)