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STATE HOSPITAL
[Authorized: Constitution, Article IX, Section 12; NDCC Chapter 25-02]

A legislative act in 1879 by the Territorial Legislature provided for the construction of a hospital to care of the insane.  It also set up the Board of Commission of Insanity for each of the established counties in Dakota Territory (T. L. 1879, Ch. 23). The institution named the Dakota Hospital was located near Yankton (DT) and was governed by a Board of Trustees consisting of five residents from within the Territory of Dakota.

In 1883 the State Hospital was authorized by the Dakota Territory Legislative Assembly (T. L. 1883, Ch. 7) to be located in Jamestown. It could be no more than four miles from the county courthouse. On May 1, 1885 the State Hospital at Jamestown opened. At the time of statehood in 1889 North Dakota took control of the Hospital along with a land grant of 20,000 acres provided by Congress. Support for the institution came from the land grant income and legislative appropriations. Known originally as the Hospital for the Insane, the Hospital was governed by a Board of Trustees consisting of five members appointed by the Governor and confirmed by the Council to serve two-year terms. The Board of Trustees had general control and management of the Hospital and made all laws and regulations (S. L. 1891, Ch. 132).  The Board was responsible for administration of the Hospital, admission and discharge of residents, and employment of a superintendent, physicians, a steward, and a matron (S. L. 1905, Ch. 119). In 1907 a non-resident patient could be admitted only if payment for lodging and treatment was received in advance and until the legal residence was identified and transportation had been arranged for the patient to be returned home (S. L. 1907, Ch. 137). If a person had no official residence they were provided treatment. Counties levied taxes in order to pay for the expenses of the admitted patient. Another means of payment came from the estate of the patient. In 1911, the Board of Trustees was abolished (S. L. 1911, Ch. 62), and in that same year, administration of the Hospital at Jamestown, became the responsibility of the newly created Board of Control. The Board of Control managed all charitable and reformatory institutions in North Dakota. Another reorganization in 1919 eliminated the Board of Control and placed administration of the State Hospital (and other state institutions, colleges, and the university) under jurisdiction of the Board of Administration.  

Another insane asylum was authorized to be constructed in Rugby in 1915. The asylum was never built due to a failure to appropriate funds by the State Legislature. Voters passed a proposed amendment to the state constitution (Article XXI, Section 216) that provided for establishing a state hospital for the insane (S. L. 1915, Ch. 85) to be constructed in Rugby (S. L. 1917, Ch. 146). The Legislature failed to appropriate funds and the asylum was never built (S. L. 1931, Ch. 263; S. L. 1983, Ch. 82). 

In 1945 (S. L. 1945, Ch. 205) the Board of Administration established by-laws, rules, and regulations in order to provide care for patients at the State Hospital. Other legislation in 1945 allowed for the recovery of expenses experienced from institutionalization by means of an estate, veterans’ compensation, or pensions, but only after the patient’s death (S. L. 1945, Ch. 204). In 1951 the Hospital for the Insane was renamed the State Hospital (S. L. 1951, Ch. 182). In 1961 the Mental Health Authority within the State Department of Health was created with the responsibility of cooperating with state and local and agencies in providing services that would assist with the dissemination of information and educational services, and consulting services to schools, courts, health, and welfare agencies (S. L. 1961, Ch. 208). The Mental Health Authority helped with treatment services, provided out-patient diagnosis, and assisted in rehabilitation programs. The Board of Administration governed the State Hospital until the Mental Health and Retardation Division (formerly the Mental Health Authority) assumed control in 1965 (S. L. 1965, Ch. 203).  In 1969 the Hospital came under the control of the Director of Institutions (S. L. 1969, Ch. 468). In 1981 the administration and control of the State Hospital was transferred from the jurisdiction of the Mental Health and Retardation Division of the State Health Department to the Mental Health Division within the Department of Human Services (S. L. 1981, Ch. 486).   

When the State Hospital was established the role of the superintendent was to be a physician. Qualifications changed as the responsibilities of the Hospital changed. Legislation in 1953 required the superintendent be a licensed physician with at least five years of experience in the field of mental health or a competent administrator with at least five years experience in hospital administration (S. L. 1953, Ch. 185). If the superintendent was qualified as an administrator, a medical director could also be appointed, and if the superintendent was a physician, an administrator was chosen. In that way the two positions were filled by staff who met the qualifications required by law. This was amended in 1961 when the superintendent had to be a certified psychiatrist who appointed an assistant superintendent of administration (S. L. 1961 Ch. 208). In 1981 the executive director of the Department of Human Services (DHS) appointed the superintendent of the State Hospital and had responsibility for selecting the professional staff. The superintendent of the State Hospital had to be either a certified psychiatrist or eligible for that certification. With the approval of the DHS executive director, the superintendent selected an assistant with qualifications and experience as an hospital administrator. Every physician on the professional staff at the Hospital had to be licensed by the State Board of Medical Examiners (S. L. 1983, Ch. 479). Legislation in 1987 required the psychiatrist to be board certified or eligible for certification with a date of completion taking place within three years of the appointment (S. L. 1987, Ch. 572). In 1995 the law changed again and the superintendent was no longer required to be a psychiatrist (S. L. 1995, Ch. 266). Later the superintendent was required to be a skilled health care administrator with professional training in managing a facility for the mentally ill or chemically dependent patient. The medical director was to be a licensed and board certified psychiatrist who appointed and employed all physicians and clinical staff (S. L. 1995, Ch. 266). Since 1999 all physicians and clinical staff appointments have been approved by the governing board (S. L. 1999, Ch. 250).
 
As the institution caring for the mentally ill, the State Hospital focused on the diagnosis, evaluation, treatment, and rehabilitation of patients. Laws were amended in 1965 (S. L. 1965, Ch. 201) to allow patients who were hospitalized involuntarily to be released at their own request, or by written request of a guardian, spouse, or adult relative. The superintendent, county judge, and mental health service board determined when release would be safe for the patient. Legislation required that care be the same for all patients (S. L. 1965, Ch. 203), however, friends or relatives of a patient could pay an additional payment to provide for additional or special care. This law was eliminated in 1981 (S. L. 1981, Ch 486) when all patients were given the care and treatment as needed. The superintendent made evaluations of patients frequently and determined the needs of committal or release. In 1987 law required the Department of Human Services to develop a continuum of service for the chronically mentally ill (S. L. 1987, Ch. 572). This included a range of services provided by state agencies, private or public mental health professionals, residential care facilities, or admittance to an inpatient psychiatric hospital unit. In 1989 the Legislature defined the role of the State Hospital as the service provider for the mentally ill and for patients who suffered from a drug addiction or alcoholism (S. L. 1989, Ch. 334). The State Hospital was required to be a resource to community based treatment centers. As the number of residents transferred from the state correctional facilities to the State Hospital increased a renovation of the facilities at the State Hospital in Jamestown has taken place.   

In 1991 legislation required the Department of Human Services to seek appropriations and resources sufficient for the institution to maintain the accreditation of the Joint Commission on Accreditation of Health Care Organizations (S. L. 1991, Ch. 292). This entailed employing master’s level counselors who completed advance training or had two years supervision under a psychiatrist or psychologist. In 1995 the executive director of the Department of Human Services, in consultation with the State Hospital superintendent, created a governing board for the State Hospital (S. L. 1995, Ch. 266). The governing board consisted of the executive director of the Department of Human Services, the director of the DHS Division of Mental Health Services who served as chairman of the governing body, and the State Hospital superintendent.  Other members from the State Hospital included a medical director, the performance improvement coordinator and a representative from fiscal management. Also a mental health services consumer selected by the North Dakota Mental Health Association, and a legislator chosen by the Legislative Council served on the governing board. The same law required the executive director of the Department of Human Services to appoint the State Hospital superintendent and the medical director after a consultation with the governing board. The governing board has been charged with the responsibility of selecting the hospital’s professional and medical staff.  

A resolution by the Legislative Assembly in 2003 (S. L. 2003, Ch. 607) required the Legislative Council to study the needs of individuals with mental illness, drug or alcohol addictions, or physical or developmental disabilities. The study was to include analysis of the long term needs for care of patients at the State Hospital and also at the Developmental Center at Westwood Park. The 2007 Legislature requested the Legislative Council to study the feasibility of transferring custody of the State Hospital from the Department of Human Services to the Department of Corrections and Rehabilitation (S. L. 2007, Ch. 649).

CHRONOLOGY

1879       An act of the Dakota Territorial Assembly provided for the establishing of the Dakota Hospital for the Insane located near Yankton, Dakota (T. L. 1879, Ch. 23).

1883       An act authorized the issuing of bonds to construct the Hospital for the Insane near Jamestown in Dakota Territory and provided that the grounds were to be located no more than four miles from the courthouse (T. L. 1883, Ch. 7).

1889       After statehood, all territory lying north of the seventh standard parallel became known as North Dakota (S. L. 1889, Ch. 99).

1891       Amended legislation established the Hospital for the Insane to be located at Jamestown and it repealed any previous acts or parts of the acts as needed. The Board of Trustees had general control and management of the Hospital (S. L.1891, Ch. 132).

1905       The Board of Trustees made all the laws for the Hospital and appointed a superintendent who was required to be a physician. Others appointees included an assistant physician, steward, and matron and all were resident officers who lived on the Hospital campus (S. L. 1905, Ch. 119).

1907       Non-residents were admitted to the Hospital upon payment of first costs for treatment and lodging. Hospital resident lodging and treatment was charged to the patient’s county of residence (S. L. 1907, Ch. 137).

1911       The Board of Control was established to provide for the governing and control of all charitable, reformatory, and penal institutions in the state (S. L. 1911, Ch. 62).

1913       Revisions from the 1905 Century Code, required the Board of Control to administer and control the State Hospital as stated in the session law (S. L. 1913, Ch. 58).

1915       By concurrent resolution the State Constitution was amended and the requirements for an unspecified portion of land was offered by the US government for the purpose of providing facilities that were to be used for either educational, charitable, or institutional purposes. Another hospital for the insane was included in that resolution (S. L. 1915, Ch. 85).

1917       The city of Rugby in Pierce County was selected as the location for the asylum for the insane (S. L. 1917, Ch. 146).
 
1919       The Board of Administration replaced the Board of Control to govern and control institutions including the State Hospital at Jamestown.

1931       The state Board of Administration was to investigate sights suitable for a hospital for the insane near Rugby. A specific portion of land (no less than 370 acres and no more than 640 acres) was required for the facility at Rugby (S. L. 263, Ch. 263). The powers and duties relating to the Board of Administration and general supervision and administration of the State Hospital were defined (S. L. 1931, Ch. 265).

1945       The Board of Administration was authorized to establish the by-laws and rules and regulations necessary for running the State Hospital. This included admissions, parole, and discharge of patients (S.L. 1945, Ch. 205). Recovery of expenses for institutionalization could come from the estate of a patient, veterans’ compensation, or payment from pensions after the death of the patient (S. L. 1945, Ch. 204).

1949       The superintendent had to be a graduate of a reputable medical school and a knowledgeable and skilled physician charged with responsibility to appoint an assistant superintendent and one or more assistant physicians who were required to live on the grounds of the Hospital (S. L. 1949, Ch. 314).

1951       The North Dakota State Hospital for the Insane was renamed North Dakota State Hospital (S. L. 1951, Ch. 182).

1953       Legislation relating to voluntary admittance, committal, or release was established for residents older than 16 years who wanted to receive treatment at the State Hospital (S. L. 1953, Ch. 186).

1957       The Legislature addressed the powers and duties of each of the counties concerning the formation of mental health boards. Legislation amended the powers and duties of the superintendent as they related to the county mental health boards (S. L. 1957, Ch. 196).

1961       Established within the State Health Department was a Mental Health Division with specific duties and powers.  The superintendent was required to be a certified psychiatrist (S. L. 1961, Ch. 208).

1965       Transferred from the Board of Administration to the State Health Department, the Mental Health and Retardation Division was given responsibility of administration for the State Hospital. Also with an additional payment a patient could request special care (S. L. 1965, Ch. 203), and an involuntarily hospitalized resident could, upon request in writing, be released (S. L. 1965, Ch. 201). 

1969       New sections to the Century Code examined concerns over record keeping, equipment, and supplies. The office of the Director of Institutions was set up as a state agency to supervise all institutions including the State Hospital (S. L. 1969, Ch. 468). 

1981       The Mental Health and Retardation Division of the State Department of Health became a division within the newly created Department of Human Services. The law regarding additional special care for residents (for an additional cost) was repealed (S.L. 1981, Ch. 486).

1983       The Legislature again addressed but did not provide funding for the construction of a hospital to be located in Rugby (S. L. 1983, Ch. 82). Every physician on the professional staff at the State Hospital had to be licensed by the State Board of Medical Examiners (S. L. 1983, Ch. 479).

1987       The Department of Human Services developed a continuum of services for the chronically mentally ill and a plan of care for the residents either at the State Hospital, or the residential treatment facilities, or other treatment facilities (S. L. 1987, Ch. 572).

1989       New legislation required that the State Hospital serve the mentally ill and drug and alcohol addiction residents.  The Hospital staff served as a resource for the regional community based treatment facilities (S. L. 1989, Ch. 334). The regional human service centers conducted all evaluations and regional and community based centers were encouraged over institutionalization (S. L. 1989, Ch. 335). Qualifications for the superintendent of the State Hospital were changed (S. L. 1989, Ch. 336).

1991       The Department of Human Services requested appropriations from the Legislature in order to employ licensed professional counselors and to provide educational resources for maintaining the accreditation of the State Hospital.  Standards were set by the Joint Commission on Accreditation of Health Care Organizations (S. L. 1991, Ch. 292).

1995       Legislation increased the qualifications for the Hospital administrator to include training in the fields of mental illness and chemical dependency. The Legislature requested that a unified mental health system be developed for the state.  A governing board for the State Hospital was created. The supervising officer was authorized to appoint the superintendent and a medical director with the approval of the governing board (S. L. 1995, Ch. 266).

1997       The Hospital governing body was authorized to approve the newly hired physicians and medical staff, and the superintendent appointed the medical director (S. L. 1997, Ch. 241).

1999       The performance improvement coordinator no longer served on the governing board (S. L. 1999, Ch. 250).         

2003       The Legislative Council was requested to study the needs of the chronically mentally ill and residents with drug or alcohol addictions. The study was to include the physical or developmentally challenged and also a review of the long term needs of the State Hospital and Development Center at Westwood Park was to be conducted (S. L. 2003, Ch. 607).         

2007       The Legislative Council was directed to study the feasibility of transferring the State Hospital from the Department of Human Services to the Department of Corrections and Rehabilitation (S. L. 2007, Ch. 649).

SERIES

30820 Hospital Committee Minutes and Reports.
30821 Hospital Policies and Regulations.
30822 Monthly Financial Reports.
30823 Audit Reports.
30824 Property Appraisals.
30835 Property Inventories.
30826 Balance Ledger, Payment and Collection Record, and Check Register.
30828 Journal.
30827 General Ledger.
30829 Architectural Drawings.

SOURCES

Gray, David P.  Guide to the North Dakota State Archives, 1985.
Laws of Dakota Territory.
North Dakota Century Code.
North Dakota Department of Human Services Website.
North Dakota Secretary of State Blue Book.
North Dakota State Legislature Session Laws.

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