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The Announcement

vaproposalOn December 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 abandoned.

The reaction 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.

vacircleTo 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 near future.

Although 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.

The Reaction

Within a 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. 

workinggroupEach work 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.

Several 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 its history.

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 Proposal

Therefore 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?


So, the 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.

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