Rapid City is staying neutral on a proposed reorganization of Veterans Affairs health care facilities in the Black Hills, even though the city's economy would benefit from the plan.
"It doesn't make sense for us to go to the federal government and say, 'Hey, we would like you to relocate folks from one part of the Black Hills to the other,'" said Tom Johnson, CEO of Elevate Rapid City.
"So we're just not taking a position on it and we're not actively lobbying for these kind of government jobs," he said.
Johnson said Elevate usually works with Rapid City-based companies or out-of-state companies that are interested in relocating to Rapid City — not recruiting jobs away from its neighbors in the Black Hills.
He said Elevate regularly cooperates with other Black Hills economic development groups to improve the entire Black Hills region, not just Rapid City.
The Rapid City government is also not endorsing or opposing the proposed plan, said Mayor Steve Allender.
The VA's plan would lead to a large construction project for a new medical campus in Rapid City. The changes would also mean new employees and visitors who would contribute to the economy.
Meanwhile, Hot Springs, Sturgis, their respective counties and various local organizations are fighting the proposed changes, which they say would hurt their economies and veterans.
The proposal
Hot Springs and Fort Meade, near Sturgis, both have VA Medical Centers that provide inpatient, outpatient, nursing home and rehabilitation services. Those operations would be reduced to clinics.
"Retaining two VAMCs in the small communities of Fort Meade and Hot Springs with nearly the same service offerings ... is not sustainable," according to a VA report released last month.
The report also says it expects the veteran population in the Black Hills region to decline in the next decade.
The proposal says it makes more sense to replace and consolidate services by building a new VA Medical Center in the Rapid City area.
"The Rapid City VAMC will become a primary location in the market for delivery of specialty care, drawing referrals from rural areas surrounding the city," the report says.
The plan also calls for referring veterans to non-VA facilities for surgeries, emergency care, some mental health care and other services.
Some of the veterans who usually visit the Hot Springs and Fort Meade VAs would need to travel farther to Rapid City. But a larger portion of Rapid City area veterans would receive care closer to home.
Rapid City and Pennington County have an estimated 10,482 veterans, according to 2020 Census data.
That's nearly three times the amount of veterans in Sturgis, Hot Springs and their respective counties combined.
The VA would still provide some care in the those areas by opening two new Community Based Outpatient Clinics that offer primary care, outpatient mental health and specialty care services.
The report says the clinics will be located "in the most sustainable location" within "the vicinity" of the Hot Springs and Sturgis/Fort Meade areas.
That means the clinics might not be located within the scenic and historic multi-building campuses in Hot Springs and Fort Meade.
The VA will host public meetings to collect feedback on its plans and might make changes to its proposals.
It will submit its final recommendations to the president in 2023. The president will then decide whether he wants to submit the plan to Congress, which would approve or reject the changes.
Hot Springs, Sturgis gear up for action
The Sturgis and Hot Springs governments and their respective county governments and economic development groups are lobbying against the proposal.
Hot Springs also has the Save the VA Committee, which formed in response to previous proposals to close or reduce services at the local VA.
The change would harm veterans and the local economy, said Olivia Mears, executive director of the Hot Springs Chamber of Commerce.
It's a "double punch in the face," she said.
The Hot Springs VA has has 197 full-time employees, according to the agency.
But Patrick Russell, co-chair of the Save the VA Committee, said there are many more employees who work for and support the medical center.
Either way, the VA is one of the largest employers — if not the largest one — in Hot Springs, said Mayor Bob Nelson.
Nelson is a Navy veteran and member of Save the VA. He worked at the VA for 36 years until he retired in 2011.
Many of the VA workers and veterans live in the Hot Springs area where they contribute to the local economy, Nelson said. Patients from the Pine Ridge Reservation and northwest Nebraska also contribute.
He said a 2011 study found the Hot Springs VA provides tens of million dollars in salaries and economic output.
"Our focus is not what's in the best interest of the city of Hot Springs," Nelson said. "It's what's in the best interest of the veterans and how can we help heal them and get them on to the next phase of their life."
Russell said the committee is fighting the proposal by educating the public, fact-checking the VA, and organizing stakeholders to write opinion articles in local newspapers and lobby the VA and congressional delegation.
The committee will also make sure stakeholders attend future VA town hall meetings by publicizing the meeting dates and offering rides to those without transportation.
The Sturgis Economic Development Corp. will also lobby against the VA's plan, said Executive Director Amanda Anglin. She said the city and county governments are also getting involved.
There are 789 full-time employees at the Fort Meade VA, which is near Sturgis and serves the Northern Hills and Rapid City area.
SDPB asked the VA if there are any programs to help veterans who will have to driver farther if its plan is approved.
The VA has a travel reimbursement program for veterans who can drive to their appointments, the agency said. There are also VA and community programs that provide transportation.
Other proposed changes
The VA is also proposing changes in eastern South Dakota:
- Close the Wagner clinic, refer patients to the Indian Health Service in Wagner and the VA in Yankton or Mitchell.
- Turn the Sioux Falls emergency department into an urgent care center.
- Expand the Sioux Falls nursing home.
- Allow Sioux Falls VA staff to provide inpatient care and surgery at other facilities. If that is not possible, veterans will be served by non-VA doctors.
Other VA facilities across the country are also facing possible changes.
These proposals stem from the MISSION Act, a 2018 law passed by Congress. It required the VA to undertake an Asset and Infrastructure Review.
