Central South Dakota News

WASHINGTON – U.S. Senator Mike Rounds (R-S.D.), a member of the Senate Committee on Veterans’ Affairs (SVAC), discussed the expansion of VA facilities in Hot Springs, South Dakota, and the allocation of additional personnel to Fort Meade near Sturgis, South Dakota, at an SVAC hearing. The hearing, titled “Frontier Health Care: Ensuring Veterans’ Access No Matter Where They Live,” highlighted health care needs for rural veterans. Senators heard from a panel of witnesses including Dr. Peter Kaboli, Executive Director of the VA’s Office of Rural Health.

“Dr. Kaboli, I’d briefly like to talk about the need to appropriately resource VA facilities in rural America,” said Rounds. “I'm encouraged that the department is expanding facilities in Hot Springs, South Dakota and allocating additional personnel to Fort Meade, which is near Sturgis, South Dakota.”

“If we would have allowed the AIR [Asset and Infrastructure Review] Commission to move forward, it would have been devastating to some of our rural hospitals,” said Rounds. “And in fact, on a bipartisan basis, we were able to stop the recommendations that were found within that report. And now today, we're talking about what we can do to actually improve rural health.”

In June 2022, Rounds and his colleagues on SVAC successfully stopped the reduction in services at VA facilities in Hot Springs, Sioux Falls, Sturgis and Wagner by halting nominations to the AIR Commission. Without the approval of nominees by SVAC, no Commission was established and the process of reducing these services as outlined did not move forward.

Rounds: Thank you Mr. Chairman. First of all I want to thank our guests for joining us here today and for your service to our country. Dr. Kaboli I’d briefly like to talk about the need to appropriately resource VA facilities in rural America I'm encouraged that the department is expanding facilities in Hot Springs South Dakota and allocating additional personnel to Fort Meade which is near Sturgis South Dakota Can you talk about the importance of appropriately resourcing VA facilities in locations such as these in South Dakota?

Kaboli: Yes thank you for that question Senator Rounds Happy to So I'm also in VISN 23 in Iowa So Hot Springs and Fort Meade are obviously in our VISN you know And I know you were involved with the AIR Commission and reports that came from that Yeah I think we all are looking at better ways to provide services and you know places like Hot Springs and Fort Meade their being 90 miles apart you know what are things that need be one location what can be shared what needs be both locations The other thing you know I think talking more broadly even outside South Dakota is identifying where there gaps care either use Care Community or establish new sites care We've been working USDA try identify locations ripe adding either VA sites care partnering We're looking Craven County North Carolina which you're familiar with Senator Tillis But that's one fits all needs both distance how far veterans travel already live there what facilities around there It also allows partner local hospital FQHC has space That's something lease especially some new appropriation new abilities but also whether partner FQHC There's another Polk County Texas just sort fits perfect circle where not care fill something

Rounds: Well just your point if allowed AIR commission move forward devastating some rural hospitals fact bipartisan basis able stop recommendations found within report Now today talking actually improve rural health AIR commission opinion hurt shutting down emergency rooms places severely restricting access rural veterans In fact Dr Kaboli significant number receive acute critical access hospitals Bennett County Hospital Martin only non-IHS emergency room nearly 100 miles remains busy caring average 250 patients monthly How important make sure critical access hospitals Bennett County Hospital appropriately resourced impact care veterans areas closed?

Kaboli: Well thank question Senator great example why critical access hospitals play important role not only community but also veterans live community because distance otherwise travel cared somebody like me hospitalist For hospital care 80% get hospitalizations outside half those urban lot residents close urban center come But those absolutely important community We need partner couple things doing One starting pilot program patients those hospitals veterans transferred take efficiently More importantly sometimes keeping continue pay keep their They're their community

Rounds: And agree don't mean interrupt one more question really want ask leading right line I've heard say disrupted repeatedly received prior authorizations community appointments requests take weeks sometimes seemingly denied no apparent reason What doing certain aren't experiencing extra hurdles receive chosen aware problem getting literally go back through repeated authorizations?

Kaboli: Yeah thank Senator—

Rounds: Answer yes aware?

Kaboli: Aware going ask colleagues help two things first physician providing seriously patients eligible locally fine make sure authorizations managed office Community Care office times expire new condition renewed get better referral coordination initiative amazing things Ann Arbor Michigan example make sure handles gets into provide can't make sure

Wade Vlosich: Department SEOCs episodes reevaluating periodically see long last adjusted lengthened focusing improve experience Oklahoma City initiatives started called chat phone computer provider put chat staff respond immediately turnaround authorizations experienced rules allowed staff locally look reenact easier

Rounds: Really glad work around chances rule may not right place Mr Chairman used time Thank allowing extra time

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