12th, 2011, the community of Hot Springs faced a life changing
situation. That night administrators
from the Black Hills VA Health Care System announced to a “standing room only”
crowd that a new vision for VA services in the Black Hills meant a significant
reduction in services provided by the Hot Springs VA facility. Many jobs would either be lost or transferred
from the community. The domiciliary,
which had housed veterans for nearly 100 years, would most likely be moved 50
miles away; and most of the historic VA facility would most likely be
among community residents, many of whom are veterans served by the Hot Springs
facility, was immediate and intense.
Shock, outrage, and anger filtered through the theater where the meeting
was held. Questions about the accuracy
of the data were asked and, to most attendees, inadequately answered. A community with a 100 year legacy of
veterans care was told that legacy meant little if it stood in the way of the
VA vision of progress.
To be fair,
the announcement was not a complete surprise.
Services at the Hot Springs facility had been systematically reduced for
nearly 20 years. Facilities that once
housed and cared for several hundred veterans in the domiciliary had been
reduced to 100. Many medical services
had been relocated to Ft. Meade, and many professional staff were on temporary
rather than permanent contracts. Rumors
had persisted for some time that the facility would most likely be closed in the
signs of eventual closure, in retrospect, were evident, the community continued
to believe that the community wide investment in caring for veterans of our
nation’s wars ultimately was more important than the VA’s concept of
consolidation and efficiency. A national
reputation for superior PTSD and substance abuse treatment surely meant
something. They learned that evening
that it meant little.
matter of days the community, veterans and non-veterans alike, began to
organize. The most obvious place to
start was to counter what the community believed were both inaccurate
assumptions and data about the services provided by the Hot Springs
facility. Toward that end, a community
open meeting was held and a recommendation made for a series of work groups to
be formed to gather information about all aspects of the impact of the Hot
Springs facility. This information was
to include medical services, the current and future needs of veterans, the
historic facility, the impact a closure would have on the community and much more.
group was tasked with developing a white paper outlining their research and
recommendations coming from that research.
The intent was for the white papers to form the background information
for a community-based proposal to counter what had been presented by the Black
Hills VA Health Care System administrators.
The “Save the VA” campaign had begun.
hundred people volunteered for tasks ranging from serving on the work group
committees, making signs, fundraising, publicity, and much more. Community forums were held, and parades were
organized. The community responded to
this challenge in a way deeper and more profound than any previous challenge in
As the work
groups progressed it became apparent that the effort was bigger than saving one
community. It was ultimately about
conflicting visions of care for our nation’s veterans. It was also about the importance of providing
care for rural veterans. Veterans care
facilities were first placed in rural locations such as Hot Springs because of
the quiet and caring environment. More
and more the country is seeing veterans care relocated and consolidated in
urban centers. The campaign questioned
whether urban settings were appropriate for many veterans suffering from PTSD
and substance abuse problems. The
campaign learned from many rural veterans how important the Hot Springs
facility has been to their care.
Finally, the campaign further questioned the overall economic impact
such consolidation had for rural communities with long traditions of serving
veterans. Hot Springs certainly was not
the first rural community to be threatened, and all indications were it
wouldn’t be the last.
the vision of the campaign grew. It grew
beyond only Hot Springs and the veterans within the catchment area. Although both the community and service for
regional veterans remains at the core of the campaign, the mission grew to
encompass a larger purpose. And that
purpose was to address several questions:
- Can services be provided in a rural location like Hot Springs using strategies that can result in cost savings for the system?
- Can a partnership be created between the VA system and a community like Hot Springs that can impact both the quality of veterans care as well as having a positive impact on community revitalization?
- Could Hot Springs serve as a demonstration model for veterans services provided in rural settings across the country?
concept grew from a local concern, to a national concern. The concept of a counter proposal grew from
addressing only the local issues but also national issues. The focus grew from simply a counter proposal
to a national demonstration project that
would address these and many more questions with the results helping to serve
as a blueprint for rural veteran’s health care for years into the future.
The complete Save the VA proposal for a National Demonstration Project at the VA in Hot Springs can be read here: National Demonstration Project Proposal.
A collection of each of the committee's white papers, the collection of data upon which this proposal is founded, can be found here: Proposal Appendices.