In light of the recent controversy at the Department of Veterans Affairs (“VA”), now is a good time to highlight some of the agency’s efforts to improve services to Veterans. Notably, the VA is planning to create an integrated environmental impact statement (“EIS”) for proposed improvements to and reconfiguration of the VA Black Hills Health Care System (“VA BHHCS”) services in the Hot Springs and Rapid City, South Dakota, vicinities. The VA’s proposal includes reconfiguring existing services and expanding points of access health care within the VA BHHCS service area in order to better serve the health care needs and distribution of Veteransover the next 20 to 30 years in parts of South Dakota, northwestern Nebraska, and eastern Wyoming. The VA’s proposal will impact issues identified in 40 CFR 1508.8 (e.g. ecological, aesthetic, historic, cultural, economic, social, and health, whether direct, indirect, or cumulative). The VA seeks public comment on the importance of these environmental concerns, and ideas about other environmental impacts that should be evaluated.
The VA’s EIS will address the following potential issues: physical and biological resources, cultural and historic resources, cultural environment as perceived by Veterans, their families, Indian tribes and communities of the area, impacts on the cultural values ascribed to the Hot Springs and Fort Meade campuses by Veterans, local residents, Indian tribes and others, impact on historic properties, land use, impacts to ongoing or traditional cultural uses of such locations, socioeconomics, impacts on archaeological, historical, and scientific data, community services, transportation and parking, and cumulative effects.
Operating small, highly rural facilities located in communities with populations smaller in number than the number of Veterans who need care raises concerns about safety, quality of care, sustainability over time, recruitment and retention of staff, and cost of operations and maintenance and upgrades to the facility. These facilities have difficulty complying with rules and laws governing handicapped access. In addition, there is the increasing age and cost of operating, maintaining and improving buildings ranging from 40 to over 100 years old.
The purpose of the VA’s December 2011 proposal to improve and reconfigure the VA BHHCS services was to: enhance and maintain the quality and safety of care for Veterans in the 100,000 square-mile VA BHHCS service area; replace aging buildings for Veterans in Residential Rehabilitation and Treatment Programs (RRTP) and Community-Based Outpatient Clinics (CBOC); increase access to care closer to Veterans’ homes; and reduce out-of-pocket expenses for Veterans’ travel.
There are a number of factors that suggest the need for reconfiguring these services. The Veteran population centers are currently not in the same location as VA facilities. VA also struggles to recruit and retain qualified staff at the Hot Springs facility. This makes it difficult to maintain high-quality, safe and accessible care. There are also limits to the kind of care available to Veterans and long travel times for specialty care. To complicate factors, operating costs are higher than the facility’s financial allocations.
The VA has identified the following seven potential action alternatives that will be analyzed in the EIS:
- Alternative A would involve building/leasing a CBOC in Hot Springs and a Multi-Specialty Outpatient Clinic (MSOC) and 100-bed RRTP in Rapid City.
- Alternative B would involve building/leasing a 100-bed RRTP in Hot Springs and a MSOC in Rapid City.
- Alternative C would entail renovating Building 12 for a CBOC and the Domiciliary for a 100-bed RRTP at Hot Springs and building/leasing a MSOC at Rapid City.
- Alternative D would involve building/leasing a CBOC and 24-bed RRTP at Hot Springs and a MSOC and 76-bed RRTP at Rapid City.
- Alternative E would involve implementing a proposal put forward by the “Save the VA” committee, a Hot Springs public interest group, to repurpose VA Hot Springs as a multifaceted national demonstration project for Veterans care in a rural environment.
- Alternative F would be an as yet unidentified alternative use that might be proposed during the EIS process.
- Supplemental Alternative G would entail repurposing all or part of the Hot Springs campus through an enhanced-use lease or other agreement with another governmental agency or private entity in conjunction with Alternatives A through F.
- In addition to the above seven action alternatives, the EIS also will evaluate the impacts associated with the No Action or “status quo” alternative (Alternative H) as a basis for comparison to the action alternatives.
Interested parties are invited to submit written comments (referencing: “VA BHHCS Notice of Intent to Prepare an Integrated EIS”) by June 16, 2014 by one of the following methods:
- Website: through www.Regulations.gov
- Email: firstname.lastname@example.org OR
- Mail: to Staff Assistant to the Director, VA Black Hills Health Care System, 113 Comanche Rd., Fort Meade, SD 57741.
This post was originally published on the legacy ABA Section of Administrative Law and Regulatory Practice Notice and Comment blog, which merged with the Yale Journal on Regulation Notice and Comment blog in 2015.