The issue of inpatient care at the local VA Hospital has been a hotly debated topic for over three years now. The debate was triggered by the conclusion in May of 2004 of a system-wide process begun in 1998 with a pilot Capital Asset Realignment for Enhanced Services (CARES) draft analysis. The purpose of the CARES Commission report was to prepare the Veterans Administration (VA) to meet the current and future health care needs of veterans in modern health care facilities.
The CARES report addressed the appropriate clinical role of small facilities, vacant spaces, the potential for enhanced use leases and the consolidation of services and campuses. It was considered the most comprehensive analysis of VA’s health care infrastructure that had ever been conducted. But there was a major problem – the data was flawed. The report worked with data gathered from 1998 to 2003 – prior to significant military losses, injuries, and needs assessment of returning physically and psychologically wounded veterans from Afghanistan and Iraq.
The May 2004 Decision Document identified 18 sites for additional analysis and studies – Fort Wayne was not one of those additional sites fortunate enough to survive the cut. Relying on a flawed report, Anthony Principi, the then VA Secretary, chose to accept the CARES Commission recommendation to close inpatient care at the local VA Hospital. The decision touched off a firestorm of protests and activities within the region served by the Fort Wayne VA Hospital.
The nearest hospitals in our Veterans Integrated Services Network 11 (VISN 11) were Ann Arbor, Michigan (150 miles) and Indianapolis, Indiana (124 miles). The two sites range anywhere from 2 hours to 2 1/2 hours drive. After three years of fighting to keep the inpatient care option available to area veterans, a new study was ordered by the new Secretary of the Veterans Administration, Jim Nicholson. Last November, Booz, Allen & Hamilton(BAH), a global strategy and technology consulting firm, undertook the new study.
BAH was to reassess the needs of the Fort Wayne area veterans based on new data and to prepare a list of recommendations from which Secretary Nicholson would select one. BAH interviewed representatives from various veterans’ groups during the day and held an open public meeting in the evening. As Director of Veterans for Better Health Care, I was fortunate to be involved in the private meetings with BAH as well as the public meeting held on November 29, 2006.
The BAH members were prepared and even drove the route to Indianapolis and back to get a sense of the distance issue so often raised. They agreed that the drive was lengthy and tiring and would be especially so for a sick veteran who was being transported by a family member. The additional concern was the support needed by family members: the more distant the location of the hospital, the more hardship imposed on family members who want and need to be with their veteran family member. At the conclusion of the visit, we were given an expected report date of May of 2007 – six months after the visit.
The six months came and went as we anxiously waited for some news about our VA Hospital. That update finally came this past Monday, July 2nd. A meeting was scheduled by Congressman Souder’s office to be held at the Memorial Coliseum from 1:00 p.m. to 3:00 p.m. to update area veterans not only on the VA Hospital study but also on veteran-related legislation in the 110th Congress and a new Community Based Outpatient Clinic (CBOC) in Elkhart County.
The Study with its recommendations is anticipated to be released in August. The options that Secretary Nicholson will likely be provided by BAH are the following:
- End inpatient care as originally planned
- Keep inpatient care open and possibly expand, adding beds to the local hospital
- Dedicate one wing at a local hospital to veterans’ care
- Send veterans to any hospital in the area
Of all four proposals, the one that, of course, is foremost in the minds of area veterans is keeping the inpatient care at the local VA Hospital and increasing not only beds but also services. Ending patient care as orignally planned deprives veterans in the area served by the Fort Wayne Hospital of a close, quality facility in which to receive care and to which access for the veteran and family members is reasonable.
The VA Hospital is “home” to veterans whose psychological health is just as important as physical well being. I have visited the local VA Hospital on a number of occasions, and, as soon as entering, I have sensed a feeling of comraderie among the veterans that would not be present in an area hospital. The veterans and the staff understand each other. This aspect of veterans’ health care is just as critical sometimes as the type of care received.
Providing veterans the option of going to any area hospital sounds good in theory, but the issue becomes payment for services received by the veteran. Area hospitals are none to thrilled to deal with the VA’s process of reimbursement which entails waiting on payment, often for an extensive period of time. The dedicated wing at an area hospital would, more than likely, create some of the same issues of payment responsibility raised by sending veterans to their choice of area hospitals such as Parkview, Lutheran, or St. Joe.
At the end of the meeting, I felt hopeful. Fort Wayne is the second largest city in Indiana, and the Fort Wayne VA hospital serves not only northeastern Indiana but also northwestern Ohio. When it comes to our veterans, I think of a saying, “Keep Alive the Light of Justice.” Justice for our veterans requires keeping not only inpatient care available at our VA Hospital but also increasing services to our veterans – past, present, and future.