In light of the recent controversy at the Department of Veterans Affairs (“VA”), now is a good time to highlight
some of the agency’s efforts to improve services to Veterans. Notably, the VA is planning to create an integrated environmental
impact statement (“EIS”) for proposed
improvements to and reconfiguration
of the VA Black Hills Health
Care System (“VA
BHHCS”) services in the Hot Springs and Rapid City, South Dakota, vicinities. The VA’s proposal includes reconfiguring existing services and expanding points of access health care
within the VA BHHCS service area in order to better serve the health care needs and distribution of Veterans over
the next 20 to 30 years in parts of South Dakota, northwestern Nebraska,
and eastern Wyoming. The VA’s proposal
will impact issues identified in 40 CFR 1508.8 (e.g. ecological, aesthetic, historic, cultural, economic,
social, and health, whether direct, indirect, or cumulative). The VA seeks
public comment on the importance of these environmental
concerns, and ideas about other environmental
impacts that should be evaluated.
The
VA’s EIS will address the following potential issues: physical and biological
resources, cultural and historic resources, cultural environment as perceived
by Veterans, their families, Indian tribes and communities of the area, impacts
on the cultural values ascribed to the Hot Springs and Fort Meade campuses by
Veterans, local residents, Indian tribes and others, impact on historic properties,
land use, impacts to ongoing or traditional cultural uses of such locations, socioeconomics,
impacts on archaeological, historical, and scientific data, community services,
transportation and parking, and cumulative effects.
Operating
small, highly rural facilities located in communities with populations smaller
in number than the number of Veterans who need care raises concerns about safety,
quality of care, sustainability over time, recruitment and retention of staff,
and cost of operations and maintenance and upgrades to the facility. These facilities have difficulty complying
with rules and laws governing handicapped access. In addition, there is the increasing age and
cost of operating, maintaining and improving buildings ranging from 40 to over
100 years old.
The
purpose of the VA’s December 2011 proposal to
improve and reconfigure the VA BHHCS services was to: enhance
and maintain the quality and safety of care for Veterans in the 100,000 square-mile
VA BHHCS service area; replace aging buildings for Veterans in Residential Rehabilitation and
Treatment Programs (RRTP) and Community-Based
Outpatient Clinics (CBOC); increase access to care closer to
Veterans' homes; and reduce out-of-pocket expenses for Veterans' travel.
There
are a number of factors that suggest the need for reconfiguring these
services. The Veteran population centers
are currently not in the same location as VA facilities. VA also struggles to recruit and retain
qualified staff at the Hot Springs facility.
This makes it difficult to maintain high-quality, safe and accessible
care. There are also limits to the kind
of care available to Veterans and long travel times for specialty care. To complicate factors, operating costs are
higher than the facility’s financial allocations.
The
VA has identified the following seven potential action alternatives that
will be analyzed in the EIS:
- Alternative A would involve building/leasing a CBOC in Hot Springs and a Multi-Specialty Outpatient Clinic (MSOC) and 100-bed RRTP in Rapid City.
- Alternative B would involve building/leasing a 100-bed RRTP in Hot Springs and a MSOC in Rapid City.
- Alternative C would entail renovating Building 12 for a CBOC and the Domiciliary for a 100-bed RRTP at Hot Springs and building/leasing a MSOC at Rapid City.
- Alternative D would involve building/leasing a CBOC and 24-bed RRTP at Hot Springs and a MSOC and 76-bed RRTP at Rapid City.
- Alternative E would involve implementing a proposal put forward by the “Save the VA” committee, a Hot Springs public interest group, to repurpose VA Hot Springs as a multifaceted national demonstration project for Veterans care in a rural environment.
- Alternative F would be an as yet unidentified alternative use that might be proposed during the EIS process.
- Supplemental Alternative G would entail repurposing all or part of the Hot Springs campus through an enhanced-use lease or other agreement with another governmental agency or private entity in conjunction with Alternatives A through F.
- In addition to the above seven action alternatives, the EIS also will evaluate the impacts associated with the No Action or “status quo” alternative (Alternative H) as a basis for comparison to the action alternatives.
Interested
parties are invited to submit written comments (referencing: “VA BHHCS Notice
of Intent to Prepare an Integrated EIS”) by June 16, 2014 by one of the
following methods:
- Website: through www.Regulations.gov
- Email: vablackhillsfuture@va.gov OR
- Mail: to Staff Assistant to the Director, VA Black
Hills Health Care System, 113 Comanche Rd., Fort Meade, SD 57741.
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