The community's 10 parish nurses have been informed by Medcenter One that its parish nurse program funding will end Jan. 7.

Thirteen local churches employ parish nurses to provide care to parishioners through Medcenter One's program, said Kathy Nordquist, parish nurse at Trinity Lutheran Church in Bismarck.

Medcenter One cited a $3.5 million shortfall in Medicare funding as the reason for discontinuing funding for the program, which was established in 1999.

Up to six years ago, Medcenter funded the program 100 percent, Nordquist said. At that time, Medcenter asked the parishes to contribute half the nurses' salaries, while Medcenter picked up the other half plus benefits, Nordquist said.

James C. Cooper, president and CEO of Medcenter One, said that the critical thing for people to know is that Medcenter considers the parish nursing program important and is not abandoning it - "we just can't financially support it any longer," he said.

The program is costing Medcenter about $150,000 per year, he said. Cooper said that North Dakota has been chronically underpaid by Medicare, and the gap is only getting worse. While hopeful that the state's congressional delegation can make some headway on this issue, that trend won't reverse in the short term, Cooper said.

The state faces some special challenges, he said, including distances that people must travel for health care, higher costs for technology and equipment, and the struggle to attract and compete for talent.

"On the good side, what's really held our systems in North Dakota to such high standards are our people," Cooper said. "We have a work ethic that's second to none and we won't compromise on quality of care."

So programs must be examined to see if they can be continued, he said.

Medcenter is offering to continue to have the nurses as part of its health care system, Cooper said. This would give nurses access to networking and continuing education, Nordquist said.

Picking up the remaining salary and benefits will be a significant cost to parishes, which pay nurses' office expenses and mileage in addition to the salary for the number of hours of nursing it uses, said the Rev. Paul Schauer. Schauer, pastor at Sunne Lutheran Church, rural Wilton, estimated that picking up the entire cost for its 15-hour-a-week nurse's services will cost his parish about $15,000.

Medcenter has nothing but good to say about the parish nursing program, Nordquist said.

"It all boils down to the very unfair way we (in North Dakota) are reimbursed by Medicare," she said. "And a high percentage of our patients are Medicare patients, so we lose every time."

Parish nursing is a wonderful program, "nobody's arguing that," Nordquist said. "It all boils down to Medicare."

Nordquist is hoping that the parishes will want to retain their nursing programs and look to their budgets and designated giving to support the program, even for some perhaps at reduced hours, she said.

"We're hoping and praying that churches will look at the program and really give it serious consideration in trying to fund it," she said.

Parish nurse coordinators have been in meetings with Medcenter; the next step is for Medcenter staff to meet with parish representatives next week, she said.

Statistics show that parish nurses cumulatively make about 1,500 patient contacts a month, Nordquist said. The nurses visit people, help with medications, communicate with physicians and families, accompany people to clinic visits, refer people to services such as Meals on Wheels or monitoring programs, teach health programs, give flu shots and offer grief support among other benefits, she said.

Parishes participating in the parish nurse program are, in Bismarck, First Presbyterian, Bismarck Baptist, Good Shepherd Lutheran, First United Methodist, St. Mary's Catholic, First Lutheran, Faith Lutheran, McCabe United Methodist and Trinity Lutheran; in Mandan, First Lutheran and Mandan United Methodist; in Wilton, First Presbyterian and Sunne Lutheran.