After seven quiet decades on a back street of a small town, the Canandaigua VA Medical Center is generating some noise.
Actually, it's a public uproar. And it's directed at the federal Department of Veterans Affairs, which seems intent on closing the Canandaigua VA essentially to save money to spend elsewhere.
The VA doesn't put it quite that way, of course. In stiff bureaucratese, it claims to be addressing "imbalances between the size and location of health care facilities and veterans' demand for care tomorrow" and bowing to "medical advances, modern health care trends, veteran migrations, and other factors."
Tell it to the Canandaiguans.
But there's a caring attitude here --- at least on the level of the acronym.
Specifically, the VA is engaged in a process called "CARES," for Capital Asset Realignment for Enhanced Services. CARES, says a VA backgrounder, was developed to address problems identified in a 1999 study by the General Accounting Office. The GAO, says the backgrounder, determined the VA "was spending a million dollars a day on unneeded or unused facilities." That presumably includes the Canandaigua VA.
On one level, it all sounds sensible: shifting resources to meet changing needs. But on the human level, it could wreak disaster. As with military base closures --- not inherently bad --- CARES could disrupt communities by destroying jobs and the businesses that depend on local payrolls. And it could effectively deny vets much-needed care by requiring them to travel long distances to other VA hospitals. (Without the Canandaigua VA, for example, many vets would have to travel to Buffalo, Bath, or Syracuse --- the three VA hospitals closest to Rochester --- for outpatient services.)
By the Veteran Administration's own timetable, the next few months will be crucial. The CARES process is officially scheduled to be complete by year's end, and the official recommendations for Canandaigua will be disclosed at a public meeting in Syracuse September 19.
But much could happen before then. A powerful bipartisan coalition has formed to save the hospital and may yet be successful. The coalition includes US Senators Chuck Schumer and Hillary Clinton; US Representatives Louise Slaughter, Amo Houghton, Tom Reynolds, Jim Walsh, and Sherwood Boehlert; and a long list of state Assemblymembers and Senators and local officials.
Canandaigua isn't alone, either. Other regions are in the same boat --- even in the Sunbelt, where military spending flourishes. For example, people in Waco are fighting a plan to close their 70-year-old VA hospital; the closing would displace 800 workers. (But irony isn't dead, deep in the heart of Texas: The VA recently announced it would spend $16 million for two "veterans' nursing home facilities" in El Paso and McAllen.)
Merely as a piece of architecture and landscaping, the Canandaigua VA is significant.
The main building, says public affairs officer Dan Ryan, opened in 1933. The 150-acre campus, he says, has a nine-hole golf course (open to the public and maintained in part by volunteers); a laundry; a sewage treatment plant; and its own fire station, which also provides assistance to the city of Canandaigua. Moreover, around 725 people hold jobs at the hospital.
The hospital, says Ryan, originally housed as many as 1,600 vets. But today the inpatient population is just 275, he says. "It's gone down considerably in recent years." Why the big drop? It's been widely noted that the World War II and Korean War veteran population is declining. But some of the drop has been dictated by shifts in the practice and philosophy of medicine, not to mention economics. Many Canandaigua VA vets, says Ryan, "have moved into the community and residential houses and come into the facility for care." That lowers the number of inpatients but not the number of vets served overall.
How does the Canandaigua VA rate on quality of care, as opposed to quantity? "We have been rated number one in the nation," says Chris Grachus, a Honeoye resident who works in the hospital's dietetics department. "How can they turn around and pull the rug out from under us?" she asks.
"This is an area-wide issue," says Grachus, noting that her fellow employees are organizing to keep the hospital from being axed.
No matter what you think of America's current and expected wars, it's a certainty they'll generate more vets who need care.
This was brought home July 23, when some ordinarily polarized groups got together on behalf of vets. The occasion was a public talk sponsored by Metro Justice and hosted by the Patchen Briggs VFW Post on South Union Street. The speaker was Major Doug Rokke, an Army reservist with expertise on "DU" (depleted uranium) weapons.
Rokke, now on a national speaking tour sponsored by the Massachusetts-based Traprock Peace Center, has been hammering away on DU's health hazards. DU is prized for its density (greater than that of lead), which makes it a state-of-the-art armor-piercing substance. But despite the comforting "depleted" label, DU generates dangerous, inhalable particles on impact. The radioactive particles find their way into the lungs, with potentially disastrous results for soldiers and civilians alike.
DU munitions have been used widely, even promiscuously, in recent "theaters." The Pentagon says, in essence, not to worry about this. But veterans' advocates are not buying it. They're also saying that as-yet-unknown health effects from DU and other high-tech weapons (including older things like Agent Orange) could make institutions like the Canandaigua VA just as vital as they have been in the past.
Denise Nichols, a nurse and Gulf War vet who's vice-chair of the Colorado-based National Vietnam and Gulf War Veterans Coalition, has worked with Rokke and shares his concerns. She also connects the dots to health care and the VA. "We're losing the World War II population, but now we're seeing people with [exposure to] nerve agents," she says. "It's still early on," she says, in the process of detecting these new conditions. (There's speculation that recent cases of pneumonia among US troops in Iraq could mean a new variant of Gulf War Syndrome is on its way.)
"What we see in the VA hospitals today is conventional medicine," says Nichols. But in coming years, she says, there will be more call for "detoxification from DU poisoning" and from the effects of chemical weapons that permeate the environment.
"If you look at spending on veterans," says Nichols, "it's a black eye on the whole United States." Nichols clearly wants some unprecedented political action on veterans' issues across the board. But she turns philosophical --- and laughs ---when asked why her coalition endorsed George W. Bush in 2000. "We had lived through eight years of President Clinton" without getting enough action, she says. "I was willing to try anyone else."
Tony Torrelli is quartermaster of the Patchen Briggs VFW Post. He says he's a fan of Hillary Clinton --- now that she's "fighting for Upstate" over keeping the Canandaigua VA open, among other things.
Closing the Canandaigua VA, says Torrelli, "would be a drastic thing." A Vietnam combat vet himself, he's in close touch with vets from that war, World War II, Korea, Desert Storm, Grenada, Kosovo, and others. "We cannot cut away any more from the VA," he says. He notes Canandaigua serves vets with Alzheimer's, PTSD, and severe drug and alcohol problems. You can't just pick up and move people with conditions like Alzheimer's, he says.
Up the chain of command, there's worry that a number of vets could lose health benefits altogether --- if federal spending on such programs declines in the wake of massive tax cuts and deficits. VFW national commander Ray Sisk recently charged that "without [the] needed funding, over one million veterans will be turned away or pushed out of the VA health care system." He noted that at the end of July, the House of Representatives had passed an appropriations bill that supposedly contained $1.4 billion more for vets' health care --- but actually meant cutting $2 billion from a previously approved budget resolution.
"We call on Congress to do the right thing and restore the $2 billion cut when the conference committee on VA-HUD funding convenes this fall," said Sisk. Such a restoration could save the Canandaigua VA, of course, and a few more like it.