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Secretary of Veterans Affairs Robert McDonald, shown during a December visit to Hot Springs, on Friday made the VA decision final to close much of the Hot Springs VA medical campus and build a new clinic in Rapid City.

HOT SPRINGS | The people of this small Southern Hills community tried, but the bad news was made official Friday.

The U.S. Department of Veterans Affairs said it has finalized its decision to reconfigure the VA Black Hills Health Care System and close a major part of the historic VA hospital in Hot Springs. The closure could cause severe damage to the economy of Hot Springs, which could see as many as 290 local health care and related jobs eliminated.

About 100 health care jobs would then be created at a VA inpatient residential treatment facility to be built in Rapid City.

The VA said in a statement Friday that the decision had been made by VA Secretary Robert McDonald and came after years of study and public input.

"With today's decision in hand, I am honored to lead this health care system from the uncertainty of the past into the future," said VA Black Hills health care director Sandra Horsman. "Veteran and community feedback was so important throughout this lengthy process."

She said public feedback caused the VA to change its initial plan. The biggest change is to repurpose part of the Battle Mountain Sanitarium into a VA call center, which is now underway and is expected to include the hiring of 120 people.

Building 12 will house the outpatient and dialysis clinics.

As promised, McDonald visited the complex in November and heard veterans and community leaders make impassioned pleas to keep the center open before making the decision. And the three members of the South Dakota congressional delegation wasted no time deriding it.

In a joint statement released by U.S. Sens. Mike Rounds and John Thune and U.S. Rep. Kristi Noem, the trio said:

“We are deeply concerned by the Obama VA’s decision, which is the direct result of a flawed process and continued data discrepancies. The Hot Springs campus, supported by a dedicated medical staff and compassionate community, is critical to the veterans it serves. We are committed, as we have always been, to finding a solution that puts our veterans in the best possible position to receive the high-quality health care and support they deserve. The delegation will continue to work together and with veterans and community stakeholders to determine the next steps.”

Reducing the Hot Springs VA workforce will leave about 67 full-time equivalent jobs, separate from the 120 new jobs that could be created when the call center is opened.

Despite multiple public comment opportunities, the final recommendation is much the same as those the VA has been pushing since the reconfiguration process began. The preferred alternative for VA officials has long been known as Alternative A (now A1), which included constructing a multi-specialty outpatient clinic and 100-bed rehabilitation facility in Rapid City, building or leasing property for a community-based outpatient clinic in Hot Springs and discontinuing the use of the current VA campus in Hot Springs.

The new alternative — “A2” — calls for all of the components of A1 except building or leasing property for a community-based clinic in Hot Springs. Instead, Building 12 on the current campus would be renovated for use as the community-based clinic.

A1 is still the least expensive, according to the environmental impact statement, with a price tag of $149 million, but A2 has become the new preferred alternative for the Black Hills VA System at an estimated cost of $217 million. The rest of the proposed alternatives, which range from taking no action to a complete overhaul and expanded use of the Hot Springs campus, were estimated to cost anywhere from $168 million to $230 million. However, the final EIS determined that most of the remaining options did not meet the needs of the VA system.

The Black Hills VA system believes the proposed restructuring will allow the VA to provide safe locations and facilities for care that comply with accessibility requirements, support current standards of care and can be well-maintained within available budgets and resources. With already unacceptable travel times for veterans to access care, the Black Hills VA also hopes to reduce travel and out-of-pocket expenses for veterans by allowing them to receive care closer to home from other providers.

The Black Hills VA contended that the Hot Springs campus cannot recruit and retain qualified staff, that the facilities require expensive upgrades and that the care provided there is limited by those challenges. The EIS also says that most of the veterans served by the system reside in Pennington County, making Hot Springs an inconvenient drive.

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