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Votes and Noem’s Consulting Firm Bite Back as VA Proposes Closing Hot Springs, Fort Meade, Wagner Facilities

Our members of Congress and our Governor are really, really mad that the Department of Veterans Affairs proposal to “realign and modernize VA health care facilities to improve Veteran health care access and outcomes” may involve closing facilities in Hot Springs, Sturgis, and Wagner.

But why are Senator John Thune* and Governor Kristi Noem surprised? They all voted for the VA Mission Act in 2018 to set this review and realignment in motion.

Robert McDivitt, VISN 23 Network Director, and Lisa Curnes, Medical Center Director at VA Black Hills, made the announcement to Fort Meade and Hot Springs employees in a meeting Friday afternoon.

“The secretary asked that we brief you on the market assessment process, AIR Commission process and preliminary recommendations from that process prior to the recommendations going out for public comment,” McDivitt said. “That’s fairly unusual in the VA.”

McDivitt said the Asset and Infrastructure Review report will be released to the public March 14, along with “thousands” of pages of data.

He said the preliminary recommendations that would be presented to President Joe Biden in 2023 after a year-long public comment period will be to relocate the outpatient mental health services to a new Rapid City facility and transition both Fort Meade and Hot Springs into community-based outpatient clinics.

The review report stems from the VA MISSION Act, which was approved in 2018. It established a new process to develop, review, approve and implement a list of recommendations to modernize and realign the Veterans Health Affairs medical facilities.

The review included looking at the changing needs of veterans, where needs are going in the next 10 to 20 years, how health care delivery can change including in ambulatory care, virtual care and telecare, and other methodologies [Siandhara Bonnet, “VA to Recommend Reducing Hot Springs, Fort Meade Services, Building New Rapid City Facility,” Rapid City Journal, 2022.03.04].

Gee whiz: Thune, Rounds, and Noem all brought this review upon themselves with their own votes in Congress? That’s got to sting.

Making the sting worse for Noem has to be the source of this specific recommendation, Guidehouse Consulting:

McDivitt said a team from Guidehouse Consulting is proposing a plan for the Black Hills.

“The Guidehouse team is recommending essentially that we build a new VA in the Rapid City market and add services to that facility,” he said.

McDivitt called it a “multi-hundred-million-dollar” concept. Noem said the plan includes replacing the VA hospitals at Hot Springs and Sturgis with clinics [Seth Tupper, “Noem Slams Federal Proposal to Realign Veteran Health Care in South Dakota,” SDPB, 2022.03.04].

Guidehouse! That’s the same outfit that got $10 million from Noem to mismanage the state’s coronavirus relief dollars and make sure plenty of relief reached Noem’s friends and family. Kristi privatizes coronavirus relief to Guidehouse make a big profit, and Guidehouse repays her with this flaming sack of political poo? Ingrates!

Guidehouse LLP received $681 million in federal contracts in Fiscal Year 2021. $681 million could probably keep the Hot Springs, Fort Meade, and Wagner VA facilities open for a couple years. Congress gave the VA just $621 million in this year’s budget to prevent opioid abuse.

Veterans Affairs will publish the actual plan on March 14.

Correction 15:53 CST: Oops! I originally reported that Senator Mike Rounds supported the VA Mission Act; my link to the votes above shows he was one of five nays in the Senate in 2018. I regret the error!


  1. CA Escapee 2022-03-07 15:48

    A correction…according to the Roll Call vote on this bill, Senator Rounds voted “NAY”.

  2. larry kurtz 2022-03-07 16:15

    There is a growing movement among Democrats and others to fund Medicare for all but I like the idea of rolling the funding for Obamacare, TRICARE, Medicare, the Indian Health Service and the Veterans Health Administration together then offering Medicaid for all by increasing the estate tax, raising taxes on tobacco and adopting a carbon tax.

  3. Cory Allen Heidelberger Post author | 2022-03-07 17:42

    Whoever pays for veterans’ healthcare, we have to answer the question of how to provide that care most efficiently and fairly. It seems the VA keeps turning to us and saying that Hot Springs, a remote site far removed from veteran population centers, cannot deliver care as efficiently as a more central facility in Rapid City. Can we get bang for the buck providing VA health services in Hot Springs? To what extent are Noem, Thune, et al. using VA dollars to subsidize the local economy in Hot Springs?

  4. Tom 2022-03-07 17:49

    Hot Springs VA would make a nice resort and bring more money into the community…time to consolidate medical services for all…not just those ridding the sick call line…but, as taxing religions, it shall never come to pass…

  5. John 2022-03-07 17:54

    Clearly snowjob noem and Moscow Murdo Thune are pandering to voters. They are ignoring government efficiency.
    Once again, noem shows she lacks ANY vision for SD, for improving lives, for making a better future.
    Which of snowjob noem’s policies caused a rush of veteran resettlement to Hot Springs, to Sturgis? Would snowjob noem retain the ill-used facilities, foregoing the proposed Rapid City facility?

  6. Mark Anderson 2022-03-07 18:17

    Well Cory, that about Rounds it out. Rapid City would be a much better location, but why not Chamberlain? Midstate would be better for driving. Keep it on the interstate with zoom driving. Murdock and Mitchell would be easy to remember. Maybe throw a small one in Mobridge for three Ms. You know those hard rock buildings are hard to expand. Let the legislature decide, they do things so well.

  7. O 2022-03-07 18:18

    Perhaps if our leaders were more “conservative” or “efficient” in their deployments of US troops into foreign entanglements, this would be less fo an issue.

  8. Bonnie B Fairbank 2022-03-07 20:04

    Frankly, as a poor veteran providing transportation to an even poorer veteran who needs someone to drive him home after sedation, maybe this would be A REALLY GOOD TIME for the Black Hills VA Health Care System to re-institute travel pay. Last two times I drove round trip to Sturgis from Hot Springs the VA swore they’d send me travel vouchers to submit. HA-HA! Just kidding. No. One. Cares.
    All this blah-blah-blah is meaningless unless you’re the person who made $8252 in 2021 and gas is $3.79 a gallon.

  9. John 2022-03-07 20:29

    Tom, a vision of Hot Springs developing into a veterans mecca site is stillborn – thanks to George Bush.
    New applicants for VA benefits are means tested. Thus, Hot Springs would not attract veterans of means that could invest and spend in the local Hot Springs economy. Fixed income lower-middle class and poorer veterans are not the target for economic developers.

  10. DaveFN 2022-03-07 20:40

    My 100 year old veteran mother who lives in Rapid City (and yet lives in her own home alone) was told by the Ft. Meade VA that her coming optometry appointment will be in Rapid City. But the fitting of her new glasses would have to be at Ft. Meade.I

    Go figure.

  11. John Silas 2022-03-07 21:14

    There are huge conflicts regarding VA health services between veterans who need them and politicians and community leaders who value them only for the pork they bring. The coming report will have to explain the financed involved in closing down some facilities and building new ones as well as how medical services and resources will be improved and maintained. Many veterans in South Dakota have not found the services adequate.

  12. All Mammal 2022-03-07 22:44

    After sitting at a temporary traffic sign on a trailer to get on hwy 85 in Belle Fourche the other day, I was disappointed of how crappy and dangerous the highways still are in the center if the US. Why doesn’t Belle Fourche flaunt that fact and offer the masses hauling drilling pipe and whatnot to the Bakken, North x South, Coast to coast truckers and travelers AND our Veterans a world class hub in the middle of nowh-no, middle of the U.S. of A?!
    That road is so hurt and sad when it should be touted as THE hub. Truck stop emporiums, top trained auto technicians and tech training campuses, diesel mechanics, state of the art veteran services*, walk-in clinics, dining and lodging, heck get a beautiful kid park and dog park for stretching out the legs, drive in theatre, AND the safest, best designed and constructed and maintained roads to let everyone know they chose the right route to travel through the USA. Get on it Belle Fourche, because nobody else can say they are the center of America. They will come, spend, and come on back because of the convenience and amenities. And maybe even the hospitality.
    If vets are going to have to travel to get their medical services, they should have smooth sailing. And what better location for avant-garde VA care than smack dab in the center? That would make shuttling and car pooling possible.
    At least get a better intersection light signal so travelers don’t fear having to traverse through the grimy, narrow, wrung-out core of America.

  13. jerry 2022-03-07 22:58

    Fort Meade is the absolute best and has been my go to place 40 many years. The new Rapid City VA would be a game changer for veterans as we would have the specialty doctors right here. Of course, we go through this every time it’s election season to drum up the big money in Fall River and Custer County for Thune and NOem.

  14. Arlo Blundt 2022-03-08 00:19

    Well…my Dad’s three purple hearts included one for a Japanese gun shot wound to the lung and spinal cord received on Luzon, and a shrapnel wound to the groin and white phosphorus burns from Guadacanal. He received services from the VA for the rest of his in Hot Springs (Malaria relapse in 1953) Sioux Falls and Fort Meade. He died in the Tucson VA. Our family was very relieved that when he needed those services, he could receive them. Were the services adequate?? I don’t know, but I do know that as a combat veteran he had special medical needs which the VA seemed to have the resources and, most important, the commitment to treat. Money shouldn’t be the issue…the issue should be providing the services veterans need, when they need them. Costs become a secondary consideration. I do tend to support a new hospital in Rapid, but wonder about accessibility to East River veterans.

  15. V 2022-03-08 06:55

    Bonnie, I empathize with you and all veterans. I empathize with anyone who has to travel the roads in SD to get to medical centers. Mark Anderson mentioned Mobridge as a hub for a VA facility. Our Avera Mobridge Hospital is expanding many services because we are 100 miles away from Aberdeen, Pierre, and Bismarck. Imagine all the people in that 100 mile radius who have to travel for medical care.

    The American Legion in Mobridge is now advertising for drivers to take vets to the hills or Sioux Falls. The older vets who drove are not easily replaced and traveling that far and back in one day takes it toll during some rough winters. I understand that the gas money is reimbursed but the driver’s time is volunteer.

    Unfortunately, politicians in general, unless they served in the armed forces, have no empathy for our veterans and what should be their life long care. For goodness sakes, less than 1% of the population are veterans. Why is this country so incompetent with this issue? I don’t know one single person who doesn’t have a veteran in their immediate family and SD seems to have a high number, especially on the reservations.

    It’s an election year and the democrats needs to point out when this inquiry was made and that Thune and Noem voted yes.

  16. Loren 2022-03-08 09:08

    Smaller, efficient government is a GQP bumper sticker… well, unless it effects YOUR district!

  17. jerry 2022-03-08 09:30

    Non veterans travel the same highways to local and distant medical centers. East River veterans could go to Minneapolis as it is less miles than Rapid City for a center of excellence as well. I had a heart procedure done in Minneapolis, twice. I drove from Rapid City to Minneapolis in the winter both times.

    This is all political theater. Dirty Johnson voted against the burn pit bill for veterans. This is probably one of the most important bills to be dealt with since Agent Orange. Dirty was AWOL on this. Don’t let them drag us vets into an ambush that gives us little or no relief whatsoever.

    If NOem was serious about veterans issues, she would legalize marijuana.

  18. cibvet 2022-03-08 10:38

    The VA has tried to move hospital operations to Rapid City for 30 years because that is the population center of west river. I have use Ft. Meade for 40 years as did my father before me. No complaints as it is a great health care system. I would like to see Ft. Meade stay open, but as a progressive person, I know change is inevitable. Here is a list of VA services in SD.

    Fort Meade: VA Black Hills Health Care System – Fort Meade Campus
    Hot Springs: VA Black Hills Health Care System – Hot Springs Campus
    Sioux Falls: Sioux Falls VA Health Care System
    Community Based Outpatient Clinic
    Aberdeen: Aberdeen VA Clinic
    Dakota Dunes: Sioux City VA Community Based Outpatient Clinic
    Eagle Butte: McLaughlin VA Clinic
    Mission: Mission CBOC
    Pierre: Pierre VA Clinic
    Pine Ridge: Pine Ridge VA Clinic
    Rapid City: Rapid City VA Clinic
    Watertown: Watertown CBOC
    Winner: Winner VA Clinic
    Vet Center
    Rapid City: Rapid City Vet Center
    Sioux Falls: Sioux Falls Vet Center
    Wagner: Wagner Outreach Clinic

  19. Mark Anderson 2022-03-08 17:59

    O, I was semi serious about Mobridge, but distance is everything. Sarasota County has built a wonderful brand spanking new hospital, less than three minutes away from where I live, just opened this year. I switched my primary and heart doctor to the practice who set up right next to them. I had six bypasses less than three years ago from an amazing doctor from that practice.Every day is gravy but I’m going to eat alot of gravy and I’m not stupid.

  20. Joe 2022-03-13 19:19

    This is also about siting healthcare facilities in places that are attractive to potential staff, in a labor market that will probably remain tight for a long time. Hot Springs is in a lovely setting but it’s probably a tough sell for many docs, nurses, psychiatrists etc.

  21. leslie 2022-04-22 17:04

    John Thune—this is in your lap. But can veterans trust your political judgment?

    Well…for example, “The president’s behavior on Jan. 6 had been utterly beyond the pale, Mr. McConnell said. “If this isn’t impeachable, I don’t know what is,” he said.
    In private, at least, Mr. McConnell sounded as if he might be among the Republicans who would vote to convict. Several senior Republicans, including John Thune of South Dakota and Rob Portman of Ohio, told confidants that Mr. McConnell was leaning that way.”

    Later he switched horses: Sen. John Thune, explained what would get in the way of the GOP’s campaign message for 2022.

    “A lot of our members … want to be moving forward and not looking backward,” he said. “Anything that gets us rehashing the 2020 elections, I think, is a day lost on being able to draw a contrast between us and the Democrats’ very radical left-wing agenda.”

    So now Thune tweets incessantly, during a pandemic, when USA democracy is imperiled by Republican corrupting purposeful disinformation, after traveling to Moscow during Putin’s hot war (July 4th) w/Ukraine, during the resulting failure of Senate Republicans to convict Trump with Impeachment and the war now raging white-hot on NATO borders, that IT’S BIDEN AND THE DEMOCRATS:

    President Biden wants to:
    ✓ Force Americans to wear masks on planes after a federal judge ruled it was government overreach
    ✓ Lift COVID border restrictions, inviting a surge of illegal immigration with no plan to deal with it
    Confused and concerned? You’re not alone.

    2. @SenJohnThune
    Apr 20
    After a federal judge struck down Biden’s airplane mask mandate, the CDC is now pushing Biden’s Justice Department to actively fight in court to reverse the ruling and bring the mandate back. End the mandates.

    3. @SenJohnThune
    •Americans should be able to keep more of what they earn.
    •It is the responsibility of the federal government to spend taxpayer dollars responsibly – without waste or excess.
    My Republican colleagues and I believe these truths. Washington Democrats clearly don’t. April 18

    4. @SenJohnThune
    Apr 14
    Hardworking Americans are experiencing a de facto pay cut as rising costs continue to erode wage growth. When will Dems stop focusing on their radical agenda that is full of expensive, government-knows-best policies?

    5. Same day:

    Family farm and ranch operations are the backbone of SD’s economy. With inflation at a 40-year high, the last thing producers need is Washington regulators cutting off their access to capital in an effort to push Dems’ radical environmental agenda.

    6. @SenJohnThune
    Apr 13
    This is absurd and incredibly out of touch. The Biden admin is extending the mask mandate for Americans on planes, but it’s planning to end Title 42 pandemic restrictions at the border. You can’t have it both ways,

    7. And yet, both ways Thune says:

    Apr 12
    Glad @POTUS listened to my repeated calls to extend #E15 sales this summer to offer consumers a more affordable fuel option & displace Russian oil. It should be a permanent option at gas pumps and one of many steps to leverage American agriculture as an energy & enviro solution.

    Thune’s claimed hot-button pushing “very radical left-wing agenda”?

    Or his own “radical, forced, absurd, right-wing, out-of-touch, unqualified federal judge struck-down-CDC-masking, have it both ways, Sen. McConnell-dictated last-grasp-of-political power, as the GOP dives it’s “death spiral”?

    Do vets trust Thune to save Hot Springs VA once again? He’ll do what ever Mitch deems will serve his power. That’s it.

    Yes, the VA it is located where vets are, way down in beautiful Fall River; yes, bean counters might find efficiencies; yes the small town staff boasts uncommon kindness and courtesy, and qualified care. For health care for 89 year old Korean combat veterans! And the rest.

  22. leslie 2022-04-24 14:36

    Another cite for above: New details lay bare GOP’s
    post-Jan. 6 cravenness — and
    By Aaron Blake
    WaPost (4/22 perhaps. Apple no longer attaches convenient links for such ‘free’ downloads!)

    So much for device auto-updating!
    Yesterday at 10:06 a.m. EDT

  23. leslie 2022-04-24 14:58

    Further bump!

    Note Thune said this: “A lot of our members … want to be moving forward and not looking backward,” he said; at about the same time McConnell rationalized his own having it both ways/switching horses mid-stream:

    — as McConnell did recently, regardless whether MORALLY RIGHT — “as dutifully supporting their party’s chosen leader [Trump], regardless of what he does.” As the Times quotes McConnell as saying, “I didn’t get to be leader by voting with five people in the conference….”

    They are both willing to play for power at home rather than confront Putin. This goes back at least to 2016 McConnell’s protection of the significant Russian meddling/hacking of our presidential election. Thune likely is headed toward Senate Leadership, someday. Absolutely trained as Mitch’s ball boy. Lucky us. Honor Veterans’ service???

  24. jerry 2022-04-24 17:06

    Thune is not fit for duty. Simple as that. He lost it all when he and his 6 other clowns went to Russia on July 4th to break bread with Putin. Thune can take those 6 and that skank Tulsi Gabbard along with the Red Sparrow that got Dirty Johnson all hair triggered about and go straight to the nether region. Yeah, Thune is a traitor.

  25. leslie 2022-04-25 08:57

    “On April 14th and again on the 18th Thune railed about Dems being the fiscally irresponsible. But, Au Contraire:

    “Nobody Wastes Taxpayer Money Like the Republicans” (4.22.22) I just love this headline


    Nancy Pelosi
    Apr 23
    If Republicans were “good on the economy,” the last 3 Democratic Presidents that followed one wouldn’t have had to:

    🔹Drag us out of recession — Clinton
    🔹Enact emergency Recovery aid — Obama
    🔹Rescue our economy from freefall — Biden

    Thune is no more truthful about spending taxpayers’ dollars than the other typical crazies in the Republican Party.

    Just as dangerous as Thune are the
    right-wing foundations associated with the Koch brothers, Richard Mellon Scaife, the Bradley family, and others have been using a secret finance network to support extremist right-wing groups. Most of these groups are associated with the State Policy Network, a band of corporate apologists who have made careers denying everything from the dangers of smoking cigarettes to the existence of climate change.

  26. leslie 2022-04-25 10:35

    Cory asks: “why are Senator John Thune* and Governor Kristi Noem surprised? (about saving the Hot Springs VA). Enter the GOP morass of Thune’s world.

    Thune said: “I’m extremely disappointed by the Biden administration’s proposal to close these facilities. I’m frustrated, and I’m angry, and I know these communities are too. Let me put this as plainly as I can: The VA is wrong, period. This is a massive mistake….”

    Similarly, stooge Thune’s boss, Senate Minority Leader Mitch McConnell is … warning that the Biden administration is “continuing to erode norms and our institutions.”

    Rich! Blame Biden!?

    “The Biden administration’s continued attacks on norms and institutions will have a cost,” McConnell said.

    Really? What cost did McConnell/Thune incurr?

    Biden has expressed opposition to expanding the Supreme Court. *** [T]he White House last year created a bipartisan commission of 36 members that held public meetings to evaluate court reforms. The panel had 180 days from its first meeting to complete its report on the pros and cons of potential court reforms.

    In December, the commission sent a report to the president, rejecting the idea of court packing.

    “No serious person, in either major political party, suggests court packing as a means of overturning disliked Supreme Court decisions, whether the decision in question is Roe v. Wade or Citizens United,” the report stated.

    Biden picked Judge Jackson as the next SCOTUS Justice to replace retiring Justice Breyer. McConnell denied the Senate constitutional duty of Advice and Consent for Obama’s SCOTUS nominee Merrick Garland for 8-9 months and then quickly installed Neil Gorsuch, Judge Kavanaugh and finally Amy Coney Barrett packing the conservative court majority to a 6-3 imbalance, threatening the very “norms and institutions” he cries about. Talk about a cost!

    Thune is in lock-step with McConnell’s authoritarian scorched earth attack on democracy. Owned “lock, stock and barrel” by corrupt billionaires. Putin/Trump/McConnell/Thune/Noem. Yikes!

    Aside: I wonder if Stooge Thune knows of the VA mask mandate?

    Apr 6
    President Biden, enforce our border laws, not playground mask mandates.

    Apr 6
    Can you spot the contradiction? Dems want more COVID funding, for certain toddlers to wear masks, & to extend student loan deferrals, but they’re lifting COVID policies that will lead to a border crossing surge. The pandemic is over at the border, but thriving on the playground.

    Apr 6
    President Biden, enforce our border laws, not playground mask mandates.
    Thune: Administration’s Policies Make Biden Border Crisis Worse

    Apr 5
    While the Biden admin rolls back COVID policies at the southern border, toddlers in Head Start programs are still required to wear masks – even on the playground.

    Apr 5
    The president’s latest response to skyrocketing gas prices is releasing oil from the Strategic Petroleum Reserve, which is there for emergencies – not giving cover for his flailing energy strategy. To lower gas prices, Biden needs to reverse his assault on American energy.)

    Summarizing: Assault on American energy. Toddler masks. Erode norms and institutions. Flailing energy strategy. Contradiction. Evil student loan deferrals. Fear. Enforce our border laws. Hyperbole. That’s our Stooge John Thune. He’ll say anything!

  27. Ken Delfino - U.S.Navy (Ret) 2022-06-30 04:18

    A final salute to USMC WWII veteran, 98-year-old Warrant Officer 4 Herschel “Woody” Williams who passed away yesterday. He was the last WWII Medal of Honor recipient.
    Fair Winds and Following Seas Marine…you have served your Corps and our Country well.
    Semper Fi!

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