Buffalo chosen for VA facility  

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By Ramsey Scott

Wyoming Tribune Eagle

Via Wyoming News Exchange

CHEYENNE — Lawmakers have named Buffalo as the site for a potential subsidized long-term treatment facility for veterans in Wyoming. The home of the Veterans' Home of Wyoming beat out Sheridan and Casper for the potential new facility after hours of debate Tuesday.

Wyoming is the only state without a VA skilled nursing facility, which provides long-term care to veterans, their spouses and Gold Star families, and is partially subsidized by the VA. The sites are built through a VA grant program, which pays for 65 percent of the cost of construction.

One of the biggest benefits of a skilled nursing facility is it allows veterans who qualify to receive a $107.16 per diem from the VA. That assistance is only available if the veteran stays at one of those facilities.

Sheridan, Casper and Buffalo all pitched to lawmakers why they were the perfect spot for the new facility, and in turn, why the other two communities were the wrong choice. For the most part it was a civil affair, but some not-so-subtle critiques of the competition made its way into the discussion during the Joint Transportation, Highways and Military Affairs Interim Committee meeting.

Buffalo eventually won the day by arguing that placing the new facility on the same campus as the Veterans' Home made both logistical and financial sense. By sharing administrative and support staff, Wyoming's operating budget for the potential facility would be lower than it could be elsewhere.

"(The physical infrastructure) is already there for the expansion of the current facility. Sewer, water, electrical, fiber optics, level building sites are just waiting for you guys to authorize it," said Bill Novotny, chairman of the Johnson County Commission. "Already in place is a caring and outstanding staff, and an administrative team experienced in working with veterans and their special needs."

While the cost to construct the facility in Buffalo was the lowest of all three sites - $7 million for Wyoming's portion - there are logistical issues to placing the facility there. A major hurdle is a substantially smaller workforce in Buffalo to fill certified nurse positions.

But by the end of the debate, lawmakers thought the benefits of placing the skilled nursing facility next to the Veterans' Home, and the economic benefit the new facility could bring to Buffalo, outweighed any of the negatives.

Some lawmakers argued Wyoming didn't even need to build a brand-new facility to provide veterans and their families with a skilled nursing facility.

Sen. Dave Kinskey, R-Sheridan, argued extensively that instead of a brand-new building, Wyoming should convert an unused wing of the Veterans' Home in Buffalo to be used as a skilled nursing home. He pointed out that the facility was built for almost 120 patients but currently only houses about 70.

Instead of trying to get a grant from the VA for a new building, Kinskey said the state could provide veterans right now with skilled nursing by just an administrative move and very little investment.

"It's possible to simply designate an unused portion of (the Veterans' Home) as a skilled nursing facility for veterans at little or no cost. They already have nurses on staff. They already have CNAs on staff. All they have to do is contact the Veterans Administration and sign a contract for skilled nursing," Kinskey said.

Some members of the committee argued that the Veterans' Home was in no shape to accommodate a new mission. Both a study and task force in recent years had recommended the Veterans' Home needed to go under extensive repairs, or a complete rebuild, to address multiple issues with the building.

"I guess it's a matter of degree or a matter of opinion. To me, it looks like a beautiful facility. It will continue to serve until a different facility is built," Kinskey said. "I'm not an engineer. It looks like a great facility to me, full of people that seem to be content. And the engineers say you need to tear it down and build anew. Who am I to disagree? But it if it was unsafe, it would be bulldozed already. It's certainly safe."

Some lawmakers liked the idea, and the subsequent savings for the state, of using an existing building to create skilled nursing beds for veterans. But that move could put Wyoming at risk for losing out on limited funding, said Steve Kravitsky, director of the Wyoming Veterans' Commission and a retired U.S. Air Force colonel.

"I don't see how today we can say - again I'm not a health professional or an expert - but how we can have a facility that's in need of such repair, and then tomorrow add a skilled nursing component to it," Kravitsky said.

The VA uses multiple factors to decide which projects should qualify for available grants. By adding even a small amount of skilled nursing beds for veterans at an existing facility, or repurposing an existing building as a nursing home, Kravitsky said Wyoming could lower its chance of securing a grant.

Now that Buffalo has been picked, the bill to fund the project will move on to the Legislature. If a bill eventually passes, the state will submit its application to the VA this spring. If Wyoming's application is approved, the earliest the funds could be released by the VA is 2021, but it could also take until 2023. The deadline for the application is April 15.

Talks with the VA grant program have been extremely promising, said Kravitsky. The design of the potential nursing facility is based off an idea referred to as a "Green House" model. That design creates a more home-like atmosphere for patients to live in, and the VA has been encouraging new projects to incorporate it in their plans.

Kravitsky said he's been told by the VA that Wyoming's plan would have the second-highest priority for funding, only behind projects that have a direct health and safety impact for veterans in the community.