The reconfiguration of the Black Hills VA Healthcare system remains on hold while the federal government reviews its nationwide strategy.
“We are in a holding pattern,” said Sandra Horseman, director of the Black Hills VA during a town hall meeting in Chadron Jan. 10. The town hall meeting followed the first-ever Veterans Stand Down in the community.
The Stand Down offered services to 54 veterans and four spouses, according to VA records and was followed by the question and answer session with Horseman. During that session, she was questioned about the proposed reconfiguration status. The Department of Veterans Affairs approved a plan to reconfigure the Black Hills VA system in January 2017, a move strongly opposed by many veterans in Nebraska and in Hot Springs, S.D.
The plan calls for constructing a multi-specialty outpatient clinic and 100-bed rehabilitation facility in Rapid City, a community-based outpatient clinic in Hot Springs and discontinuing the use of most of the current VA campus in Hot Springs..
However, roughly a month after approval, new VA Secretary David Shulkin called for a review of the entire VA system and the development of a nationwide strategic plan. Horseman said there is no timeline as yet to when that plan will be completed. In the meantime, the only piece of the reconfiguration the Black Hills system can move forward with is the construction of an MSOC in Rapid City. That project, which will see the VA contract the construction in order to lease the space from the owner, is currently in the design phase. Horseman said it will likely take three to five years to have the MSOC in operation.
While the reconfiguration is stalled, operations continue as usual in Hot Springs, Horseman said, which is fully staffed with physicians and was recently approved to expand its laboratory staffing. The Hot Springs site also has telehealth opportunities available, allowing veterans to access expanded services, she continued. The VA is always looking to the future, and telehealth will play a large role in that, particularly in rural areas such as western Nebraska and South Dakota.
“We’re constantly looking for ways to expand services,” Horseman said.
The Stand Down was designed as an outreach program, with the goal of connecting veterans with a variety of services.
“We were able to help several veterans,” Horseman said, including one who re-enrolled with the VA after realizing he is still eligible for benefits.
The complexity of the VA system and what veterans are eligible for was among the concerns expressed by the town hall audience.
Karl Storjohann of Chadron suggested the VA publish a document with step-by-step instructions for veterans. Referred to the Mayo Clinic for treatment, Storjohann said he didn’t know that his follow-up appointment to Mayo required a second order from his VA doctor. Without that order, he was stuck paying the bill out of pocket. In another instance, facing an emergency, Storjohann was taken by ambulance to Rapid City and paid for the visit himself.
Horseman took the chance to clear up what she calls a misconception about veteran healthcare. Not everything is covered for every veteran. While some veterans are considered 100 percent disabled and have comprehensive coverage, others fall lower on the scale of disability. Those veterans’ are eligible for care only if it is directly related to their specific condition, no matter where that care is received.
There is a veterans’ manual that addresses those issues, she said, but noted it could be made easier to understand. Another option for veterans is to contact the VA’s patient advocates, who can answer questions and help veterans navigate the system.
As a final reminder, Horseman said veterans need to remember that the Hot Springs facility is an urgent care facility and does not handle emergency situations. In the latter, it’s best to seek care at the most appropriate place rather than stopping in Hot Springs only to be referred elsewhere.
“Do not waste time and your health and possibly life possibly. Go where the care is available,” she said.