The Department of Veterans Affairs has released its Final Environmental Impact Statement for its plan to move its main Black Hills Health Care System facility from Hot Springs to Rapid City. The VA offers the following rationale for its project:
The purpose of VA’s proposal to reconfigure health care services in the BHHCS is to provide high-quality, safe, and accessible health care for Veterans well into the twenty-first century by:
- Providing locations and facilities that support VA’s efforts to enhance and maintain quality and safety of care in the 100,000-square-mile catchment area.
- Ensuring facilities for Veterans receiving any services comply with accessibility requirements for handicapped individuals, support current standards of care, and can be well-maintained within available budgets and resources
- Increasing access to care closer to where Veterans reside
- Reducing out-of-pocket expenses for Veterans’ travel
VA has identified a need to reconfigure health care services in the BHHCS catchment area because:
- VA has difficulty maintaining high-quality, safe, and accessible care at the Hot Springs Campus.
- Existing locations and facilities constrain the care, range of services, and access to care VA offers to Veterans in the catchment area [Department of Veterans Affairs (VA) Black Hills Health Care System, Final Environmental Impact Statement, November 2016, p. xix].
The VA says the best option is to build a new multi-specialty outpatient clinic and a 100-bed residential rehabilitation treatment program in Rapid City while converting Building 12 on the Hot Springs campus to a community-based outpatient clinic. VA estimates the cost of that plan at $217.1 million. That’s only a couple million more expensive than taking no action—i.e., keeping all current functions at the Hot Springs campus—but $68.5 million more expensive than moving the big functions to Rapid City and building a new, cheaper clinic in Hot Springs.
But money will be no object under the new fact-free fascist who will occupy the White House come January 20. Trumpist policy, to the extent that such policy exists, appears ready to explode our deficit thanks to a combination warface/veteran sloganology and fiscal cluelessness. If our Congressional delegation is nervous about the VA’s move taking pork away from Hot Springs (and the VA acknowledges that its preferred option will have “Adverse minor to moderate impact to housing and employment” and “adverse major impact to wages” in Hot Springs while having “beneficial negligible impact to housing, employment, and wages” in Rapid City), they should be able to wave a banner reading “Veterans!” under the Führer’s nose and get him to write a billion-dollar check and come for the grand opening of two new Black Hills VA hospitals linked by a new federally-subsidized railroad running coal-fired trains.
The VA EIS notes that the new VHA national pharmacy call center is bringing 120 new jobs to Hot Springs and using “underutilized or vacant” space on the historic VA campus. In bringing this call center to Hot Springs and keeping a clinic on the historic Southern Hills campus, the VA seems to be making an extra effort to include local economic preservation goals with the main mission of providing the best care anywhere. It remains to be seen whether that accommodation will satisfy our Congressional delegation or whether they will stick their buckets in for more of the new reckless deficit spending likely to flow from the new White House.