Battle Mountain Sanitarium Faces Uncertain Future

"I feel what I get here is mine. That the government owed me a debt, contracted 25 years ago, the consideration for which was the weary march, the deperate fight and the hopeless imprisonment."

Penned by Civil War veteran N.A. Hunt in 1891, these words summarized the value countless American volunteer soldiers placed on an institution established by Congress and signed into law by President Abraham Lincoln. Between 1865 and 1930, eleven National Homes for Disabled Volunteer Soldiers (NHDVS), or Homes, would be established across the country to provide for the American soldier, whose numbers had increased by 2500% by the end of the Civil War. Thousands faced unprecedented problems, and modern firearms, disease, and trauma took tremendous physical and psychological tolls. At these places veterans could find free medical and spiritual care, a place of residence, opportunities for vocational rehabilitation, education, entertainment, and if necessary, an honorable burial. The Homes’ carefully considered architectural and landscape designs reflected multiple goals. They were to physically represent the Federal government’s commitment to its veterans and serve as a source of pride to those veterans. The imposing design of the properties served to generate public respect for veterans, and for both the public and the members, the Homes established a sense of community and security.

The Homes also represented a policy of veterans’ benefits that directly influenced the development of a national system for veteran health care in the United States. That system is provided today through the Department of Veterans Affairs (VA). The Homes were a notable departure from the previous Federal focus on care for professional soldiers and officially set forth the concerns and commitment of the Federal government for the well-being of the civilian, or volunteer, soldier. From an initial admission policy directed towards Union Army volunteer veterans with service-related disabilities, membership at the Homes would eventually expand to all veterans of all wars who could not live independently for any reason, regardless of the nature of their disability. The focus on care also changed over time, shifting from an original goal of quickly re-integrating veterans into society, to geriatric care, to providing medical care for new influxes of young veterans with specific injuries and conditions.
Tall brown building with a dome and red roof.
Administration building at Battle Mountain Sanitarium NHL in Hot Springs, South Dakota.

Photo courtesy of Dena Sanford, National Park Service.

The feelings behind the words written by Hunt in 1891 are being echoed today by many veterans in response to proposed changes to one of the former Homes, the Battle Mountain Sanitarium, in Hot Springs, South Dakota. Battle Mountain was opened in 1907 as the only Home to function as an independent medical facility. Within its collection of striking red sandstone buildings, staff treated musculoskeletal conditions and respiratory ills. The primary complex features a prominent administration center connected to an innovative circular hospital complex that placed wards in rectangular spokes, and used ramps rather than stairs to facilitate accessibility. Battle Mountain Sanitarium was declared a National Historic Landmark (NHL) in 2011. That same year, the VA proposed a reconfiguration of the Black Hills Health Care System, which is located at the former sanitarium. The proposal entailed construction of a new Community Based Outpatient Clinic in Hot Springs, and closing the existing medical center there. Additional reconfiguration would include construction of a 100-bed Post Traumatic Stress Disorder (PTSD) treatment center in Rapid City, and closing the remaining buildings at the Hot Springs campus, where PTSD and substance abuse patients receive treatment.

In May 2014, the VA initiated a planning process in accordance with the National Environmental Policy Act (NEPA), and the National Historic Preservation Act (NHPA). The VA cites consideration of quality, safe and accessible health care as reasons for the reconfiguration. The age of the Hot Springs buildings, and accessibility challenges are reasons necessitating the need for a reconfiguration. Other issues are a desire to increase access to care closer to veterans’ homes, and to reduce out-of-pocket expenses for veterans’ travel. Under NEPA, the VA must develop a range of alternatives to address these issues, and prepare an Environmental Impact Statement (EIS) that provides a comprehensive analysis of the environmental, cultural and historic, and socioeconomic effects of the proposed reconfiguration of health care services. The VA must also identify reasonable measures to avoid or minimize the environmental harm. Following NEPA and NHPA, the VA must consult with the public, Federal and state agencies, American Indian Tribes, key stakeholders and other interested parties. Per Sections 106 and 110 of NHPA, the VA must also identify issues and resources associated with a proposed alternative, identify impacts to the historic resources, and undertake actions to avoid impacting the NHL.

The public scoping process began on June 11, 2014 with comments accepted until August 16, 2014. Following additional development of the alternatives, a second round of public meetings was scheduled for the fall of 2014. After a preferred alternative is selected and a draft EIS produced in the spring of 2015, a third public comment period and consultation is to be scheduled, and the final EIS produced in the fall of 2015. Information on the NEPA process is available at the VA’s website, www.blackhills.va.gov/VABlackHillsFuture/.
Preliminary proposed alternatives include a variety of actions, including reuse of some or all of the historic buildings; closing the VA campus; replacing services at new or other existing facilities outside of the community of Hot Springs; and no action. One alternative, derived from the 2012 work of the Hot Springs “Save the VA Committee,” entails use of the facilities as a national demonstration project focusing on treatment and research for PTSD and substance abuse, creation of a Compensated Work Therapy program, and a strong partnership with the community for ongoing patient support. The “Save the VA Committee” is composed of Hot Springs citizens, both veterans and non-veterans, who organized in reaction to the VA’s 2011 reconfiguration announcement. Members collected information about all aspects of the impact reconfiguration would have on veterans and the community, prepared a counter-proposal, and aggressively networked to bring attention to the proposed closing of the Hot Springs campus.

Public town hall meetings held between 2011-2012, and the more recent public scoping meetings during the summer of 2014, have generated passionate responses by veterans, local businesspeople, the public, elected officials, and preservationists. Media attendance at the public scoping meetings, held at nine communities in South Dakota, Nebraska, Wyoming and the Pine Ridge Reservation Area, indicate that the majority of public comments did not support closure of the Hot Springs medical facility. A number of veterans gave emotional testimony about the personalized care proved to veterans at the VA campus, and the outstanding services provided by the medical staff. Some noted the increased economic and physical stresses attendant on travel to other, more distant VA hospitals, while others were critical of services that could be provided at local facilities.

They overwhelmingly voiced opinions in favor of retaining medical services at Hot Springs. Hot Springs community residents expressed fear of the impacts closure would mean for the vitality and viability of their town. Tim Jurgens, the newly elected state commander of the American Legion in South Dakota, stated at one meeting that the American Legion does not support the hospital’s closure.

Following the 2011 VA announcement for proposed reconfiguration, elected officials from three states strongly urged retaining Battle Mountain as a fully operational VA medical campus. On May 17, 2013, South Dakota U.S. Senators Tim Johnson and John Thune, U.S. Representative Kristi Noem, Wyoming U.S. Senators Mike Enzi and John Barraso, Wyoming U.S. Representative Cynthia Lummis, and Nebraska U.S. Representative Adrian Smith wrote a strongly worded letter to VA Secretary Eric Shinseki. They requested that the VA seriously consider incorporating the “Save the VA” proposal into any final decision regarding reconfiguration. This followed a meeting earlier in the year involving the South Dakota delegation, representatives of the “Save the VA Committee,” and Secretary Shinseki to discuss the future of the Hot Springs VA facilities. The South Dakota KOTA television station reported on May 13, 2014, that Senator Thune condemned the VA decision to move forward with the NEPA process, given recent revelations on national reports of secret VA wait lists and preventable deaths. Senator Thune introduced Senate Bill 2316 the previous day, to require the VA’s Inspector General to report on national veteran wait times, “and prohibit the VA from proceeding with any closures.” He continues to raise concerns about how the Hot Springs VA closure would impact wait times, quality of care, access to specialized health care services, access to rehabilitation programs, travel distances, and access to medical care for tribal veterans.

The South Dakota KELO radio station reported on June 24, 2014, that Senator Johnson has held meetings with VA officials and in Congressional hearings, actively fighting against the VA’s proposal to realign the VA Black Hills Health Care System. Senator Johnson observed that “The Battle Mountain Sanitarium is a prime example of living American history and must remain open for our veterans’ health care needs and for insight into our nation’s past.” Senator Johnson’s conviction that services should remain in Hot Springs has prompted him to include language in the Fiscal Year 2015 Senate Military Construction and Veterans Affairs Appropriations Bill to put the closure of the Hot Springs VA on hold.
The Rapid City Journal reported on June 24, 2014 that Representative Noem wrote a letter to Representative Jeff Miller, Chairman of the House Committee of Veterans Affairs, formally requesting a field hearing at the Hot Springs VA hospital. Representative Noem cited data discrepancies on VA information and unanswered requests from Congress on additional data. “Many have also raised concerns,” she wrote, “about the systematic reduction of services provided at the hospital, which could later be used to justify closure.”

Her colleague, Congressman Adrian Smith, R-NE, Co-Chair of the Rural Veterans Caucus, has also written letters of concern regarding the impact a reconfiguration would have on Nebraska veterans. He hosted an open house in July, 2014 for veterans to voice their concerns about the potential closing of the Hot Springs facility. A compilation of these and other media reports on the proposed action can be found at www.theveteranstown.com/breaking_news_15.html.

Organizations and agencies concerned about Battle Mountain’s preservation have also spoken out against the facility’s closure, and are involved in the NEPA/NHPA consultation process. In addition to the efforts of the “Save the VA Committee,” the South Dakota Historic Preservation Office (SHPO) has voiced its opposition to closure of the facility, as has the National Park Service (NPS) Midwest Regional Office. On February 8, 2014 the Rapid City Journal quoted Ted Spencer, Director of Historic Preservation for the SHPO, that “Battle Mountain Sanitarium has a rich history of serving our nation’s veterans, and the long line of veterans that have passed through those doors represent all that is good and honorable about our state’s service and treatment of veterans.” The NPS has repeatedly encouraged continuing use of the historic resources, following rehabilitation guidance provided by the Secretary of the Interior’s Standards to successfully address accessibility issues. Bringing additional focus to the Hot Springs facility, the National Trust for Historic Preservation named the Battle Mountain Sanitarium NHL among its 2014 “Eleven Most Endangered” list, signifying the property as one of the most endangered historic resources in the nation.

In the fall of 2013, the Trust produced a report on VA historic properties that garnered national attention. Entitled “Honoring Our Nation’s Veterans: Saving Their Places of Health Care and Healing,” the report described a crisis in the condition of hundreds of neglected or deteriorated historic buildings owned by the VA, including the Battle Mountain Sanitarium. The report recommended a strong commitment from VA leaders to save its historic buildings, expand its two-member VA preservation staff, and to work with private developers and preservationists to better reuse and protect buildings.

Both the NPS and the Trust have suggested application of existing authorities to achieve historic preservation goals. The VA’s Enhanced-Use Lease authority and the VA’s Building Utilization Review and Repurposing Initiative support the VA’s goal to end Veteran homelessness. Success with an earlier version of the Enhanced-Use Lease authority has been demonstrated at the Western Branch of the NHDVS (the Dwight D. Eisenhower Medical Center) in Leavenworth, Kansas, and at the Northwestern Branch of the NHDVS (the Clement J. Zablocki Medical Center) in Milwaukee, Wisconsin. Also available to the VA is the leasing authority as established in Section 111 of the NHPA, which authorizes Federal agencies to lease or exchange historic property to any person or organization, if the agency head determines the lease or exchange will adequately ensure the preservation of that property. Other preservation successes, such as at the award-winning Henry Ford Health System in Detroit, Michigan, and the Northern Arizona VA Medical Center in Prescott, demonstrate that rehabilitation of historic hospitals can be undertaken in a manner that achieves the dual goals of quality medical care and historic preservation.
Originally published in "Exceptional Places" Vol. 9, 2014, a newsletter of the Division of Cultural Resources, Midwest Region. Written by Dena Sanford.