You may listen to this conversation in its entirety here:
Lori Walsh: Today we're touching base with various organizations to see how veterans are still accessing services and how facilities are coordinating to keep coronavirus out and veterans safe. We're going to start today with Aaron Pollard. He's Deputy Secretary of the South Dakota Department of Affairs. In a few minutes, we'll hear from folks from the Michael J. Fitzmaurice State Veterans Home in Hot Springs. Then a little bit later we'll talk with the VA Medical Center in Sioux Falls for a federal perspective about how patients there are going through the process. So first up, Aaron Pollard. Welcome. Thanks for being here.
Aaron Pollard: Thanks, Lori. Good to talk to you again.
Lori Walsh: Yes, nice to talk to you. So let's talk about some business as usual first, which is people still need services. Veterans still need to file claims, people still need to transition from being in the service. Are those things all still going on or have there been pauses and halts?
Aaron Pollard: Well, I would say that it's not business as usual, but we're still doing business. So, there's been a scale back of public contact at most federal facilities, which our folks at the Sioux Falls office, who process claims for veterans, aren't able to do necessarily public contact in the building. But they're working to make sure claims are getting filed and we have contact information on our door, that way veterans can call us and if they need something we're there to provide that for them. Also, we have an army of county and tribal veteran service officers that are spread out through the state. Although every county's doing things a little bit differently, to the best of my knowledge, there aren't any counties or tribes that aren't able to assist veterans right now with their claims, concerns, or just any of the full gamut of benefits that we assist veterans with. So, like I said, it's not business as usual, but we're still getting it done.
Lori Walsh: Tell me a little bit about benefits that are already coming to veterans, disability payments, GI bill benefits, are those still in force?
Aaron Pollard: Yes they are. We haven't received any notification. The VA is funded on a two year continued resolution, so there shouldn't be any issues or interruptions in benefits, as far as from what I've heard. If there's any veterans that are concerned about that, I know the president signed S.3503, which that'll continue GI bill payments for those students that have to take classes online versus in person. Those payments are still continuing for those GI bill recipients. I don't think you'll notice an impact there necessarily.
Lori Walsh: All right. I want to bring some other folks onto the conversation now. We have representatives of the leadership team from the Michael J. Fitzmaurice State Veterans Home in Hot Springs. Brad Richardson is Superintendent. Welcome, Brad. Thanks for being here.
Brad Richardson: Thank you for the opportunity, Lori.
Lori Walsh: Also with us, Susan Wilcox who is Director of Nursing and Kay Patton who is Assistant Director of Nursing. Susan and Kay, thanks for being here as well.
Susan Wilcox: Thank you.
Kay Patton: Thank you.
Lori Walsh: So Brad, I'm going to start with you and I want you to talk about your staff for a moment because clearly most of us who have been following the news saw what happened in Kirkland, Washington and are immediately keyed in to what's possible in a nursing home, how quickly it can devastate a population. What did you learn from that event and how is your staff really responding to keep Corona virus out of the Fitzmaurice Home?
Brad Richardson: That's a great question. First of all, as one the veterans told me they're very fortunate to have the level of professionalism that we have. We've got some fantastic clinical and nonclinical folks that are here to support our veterans andSouth Dakota. What's even greater is that that Curry Whitlock and the rest of the top quarter leadership continue to give us what resources are needed to be able to mitigate any ongoing potential shortfalls, for example. Most certainly this virus that we're looking at, you mentioned Kirkland, Washington. Certainly a tragedy. As I read that report a little bit more thoroughly yesterday, a lot of those clinicians and nursing staff were thinking that they had cases of influenza. Not only have we learned from that, but we're doing lots of secondary and tertiary things to make sure that we are screening those folks and I know probably Susan and Kate can talk to you specifically about some of the clinical things that we're running through now to make sure that we don't see any signs or symptoms creep into the facility.
Lori Walsh: And Susan, my first question for you is something that many people might not be thinking of, which is a lot of this stuff you do anyway even though this is a new challenge. Tell me a little bit about how this is different than what you normally do and how you're responding.
Susan Wilcox: Well, right now it's business as usual. We always follow the State guidelines and Department of Health guidelines for PPE, personal protective equipment, our staff are trained from day one on how to follow those guidelines. So, that's not really any different. The main difference is that we're screening people when they come the building. We have one entrance in and out, that's staffed 24/7 that's about the only difference right now. Some of the CDC guidelines change every day, if not every hour, so we're keeping up on those. We have an excellent Infection Preventionist, Rachelle Bottler. She's done a great job here in training staff. So I think everything is business as usual like I said. We're just adding a little bit of layer of security on to those things.
Lori Walsh: Kay, tell me how the residents are responding. Because you have people who are in memory care and then you also have people who normally could come and go from the facility in an independent living scenario. Well, what are you hearing from residents and from their families?
Kay Patton: Everybody's working together to tried to keep this virus from coming in and they realize how serious it is. They're all complying and willing to help us try to keep it secure here. We're not allowing any residents or staff to leave the facility grounds, for residents I mean.
Brad Richardson: Lori, it's Brad. I think it's important to add onto that the community, the greater community of Hot Springs, being the veterans town, has been focused for decades as a healthcare-centric community and our community is really responding and picking up in terms of helping to support not only the VA here in town, but certainly the Veterans Home and of course Fall River Hospital.
Lori Walsh: Brad, what services have you been able to reduce in order to eliminate extra people coming into a facility?
Brad Richardson: Well, obviously we are following CDC and Department of Health guidance from South Dakota. [inaudible 00:08:00] our infection control and then both Susan and Kay implemented early on at the beginning of the month, screening procedures too slow and then very quickly call anybody that was nonsensical coming into the facility. Be it different vendors or visitors. Most certainly visitors. Our social workers reached out to all the family members of all the residents to make sure that they understood what was happening within the first days and very nice to know that those family members were most appreciative of hearing from us, making sure that their loved ones were being cared for and that we were taking this very seriously. We continue to reach out to those families often and we certainly want our veterans to have frequent communications with their loved ones to let them know that all is well here.
Lori Walsh: Susan, for people who are just tuning in and they're saying, why are you talking to the Veterans Home in Hot Springs. Just to confirm, you don't have any potential cases at this point in the facility? All is currently well, we're really talking about preparation at this point and efforts by the staff to make sure it stays that way. Correct?
Susan Wilcox: Correct. Like Brad said, we started limiting visitors almost a month ago in preparation, so we were ahead of the game.
Lori Walsh: Susan, how are the residents holding up to that change? Because it's a change in their lifestyle as well. What are you hearing from them?
Susan Wilcox: Like Kay said, they're all very concerned and we do have an in-house television stations, so we're [inaudible 00:09:45] videos and offering a lot of communication and information about the virus and what they can do to stop it. We're doing some creative things with activities, we have the Never Too Late and music and memory things that we already are using, or ramping those up a little bit. The veterans are used to challenging situations. So I think everybody's doing a great job there. Like Kay said again, they're all very compliant and very concerned and our staff are doing a great job trying to just do things on the household, not getting together in big groups like we normally do.
Lori Walsh: Are they isolated in their rooms right now or are they free to move about and take meals? How are we kind of working that internally?
Susan Wilcox: We're set up in households of 13 and the residents there they're not confined to their rooms at this point, that may be down the line if things do happen. Right now everybody can still come out. We do some social distancing. We're trying to keep people at least six feet apart for meals and any activities that they're doing.
Lori Walsh: Brad, do you feel like you're getting the support from the State of South Dakota that you need for the days ahead? And for what you've had to go through so far?
Brad Richardson: Absolutely. We kid each other that we're on 13 or 14 different State and federal telecoms each week. As well as talking to our neighbors here in Hot Springs. I can't be happier right now with meeting our anticipated mission objectives and being able to look forward to seeing an end of this virus as soon as possible.
Lori Walsh: Aaron Pollard, if you're still with us, any thoughts on how this planning and preparation has gone at the Fitzmaurice Home for Veterans in Hot Springs? Anything you wanted to add, Aaron?
Aaron Pollard: Well, what Brad and Mary and Susan have said that they planned early and often and I think it's been put into place and we've done a very good job with mitigating the best that we can.
Lori Walsh: Plan early plan often. Brad, one of the things we've been saying on this show is every decision you make has a 24 hour expiration date or even sooner. Are you finding that you have to be particularly nimble to make one decision and then reevaluate it quickly?
Brad Richardson: Yes. I joke with my staff, especially those of us that had served in the military, that this is at a wartime setting, this is like pre deployment. We're getting ready to deploy in the [inaudible 00:12:45]. That's about how fast I'm going here. Again, I wouldn't be able to do it if I didn't have the two ladies sitting in front of me and all the other staff that are really picking up the ball and running with it and anticipating the needs and requirements, are asking the what if question, it just gels to make what really is a fabulous team here.
Lori Walsh: Brad Richardson is Superintendent of the Michael J Fitzmaurice State Veterans Home in Hot Springs. You also heard there from Susan Wilcox, Director of Nursing and Kay Peyton, Assistant Director of Nursing, and Aaron Pollard, who is Deputy Secretary of South Dakota Department of Affairs. We're going to move on and talk about veterans care on a federal level. So gentlemen and ladies, thank you so much for your time. We really appreciate that. Up next is hospitals across the state are preparing for a potential influx of patients. What does coronavirus care look like for the state's veterans? Lisa Simoneau is the Director of the Sioux Falls VA Healthcare System. Lisa, welcome. Thanks for being here.
Lisa Simoneau: Thank you.
Lori Walsh: Tell us a little bit about how veterans who normally get their care access their tests if they need a coronavirus test and a treatment if they need it. What does that process like?
Lisa Simoneau: Right now we're asking veterans to call the medical center before they report. We want to make sure that we're keeping them safe and our staff. If they call they'll be able to talk to a healthcare professional who can determine what their symptoms need attention-wise and ensure that they get the testing for their conditions.
Lori Walsh: A lot of VA patients are by nature are elderly or immunocompromised. This is a population with a lot of regular underlying health conditions. Tell me a little bit about in Sioux Falls, at the Medical Center, how you're prepared to meet capacity if that is required.
Lisa Simoneau: They're looking at all the resources that we have available. We do have space to expand our capacity. We've got a team of healthcare workers looking at the best options right now, but we've been fortunate that so far our veterans have been able to self quarantine and stay in their home environment. It's always better to keep people in their homes if we can. It makes them more comfortable and I think it helps them in their healing.
Lori Walsh: How about folks from rural areas, veterans who normally drive in to VA and what kind of challenges does that pose?
Lisa Simoneau: We are encouraging them to call ahead. We don't want them to take a long road trip if they don't need to. A lot of their healthcare needs can be met through telehealth technologies and telephone calls, but if they are getting more severe and need more assistance, we are directing them to report to their local emergency rooms, rather than drive all the way to Sioux Falls.
Lori Walsh: Does that become a benefit that gets worked out later on, where the payment for that is sorted out?
Lisa Simoneau: That is available through the Mission Act. We do have arrangements with local emergency rooms, because even in day to day situations, if someone breaks their leg, we don't want them driving all the way here. Go to the local emergency room. We'll work it out on the back end.
Lori Walsh: Right. Good point. That's a procedure already in place. Is the VA working with hospitals, like Avera and Sanford in Sioux Falls, to just share capacity one way or the other? What is that coordination looking like?
Lisa Simoneau: At this point we are partnering where we can but for now we are on our core mission of helping veterans. If the situation would accelerate, we would call into action the VA's Fourth Mission of being an emergency responder for the community and we are preparing for that.
Lori Walsh: Are administrative staff members in Sioux falls being allowed to work from home because we understand the U.S. Veterans Health Administration has banned most administrative staff from telework because of server availability. Are you able to get everyone and from a staffing standpoint to working remotely if they can or is there a sticking point there?
Lisa Simoneau: They have resolved the sticking point. They have managed to get more servers online and expand the capacity, but as a hospital we are limiting the amount of telework because if we do go into a search capacity with patients coming in, it will be all hands on deck. You could be an accountant, but you could also be needed to move patients, run laboratory tests. So we have to be aware of what our future needs are before I can send people home to work on telework.
Lori Walsh: Do you source the same supplies for your personal protective equipment and your ventilators and your hospital supplies in general? Does that come from the same spot where a Sanford or Avera supplies come from or is there a different supply chain?
Lisa Simoneau: No, it's the commercial supply chain. We have contracts already in place that we draw upon, but it's some of the same vendors that the community hospitals used.
Lori Walsh: Lisa Simon, anything else that we should ask you about how the Sioux Falls VA health care system is meeting this potential pending crisis? Any further thoughts?
Lisa Simoneau: We'd just like to share that we have ceased visitation in the building. So if you have a loved one that's an inpatient and you want to talk to them, we encourage you to call 336-3230 and the operator will connect you to your loved one and to keep following us on social media at @VA Sioux Falls. That's where we're keeping all our latest information.
Lori Walsh: Lisa, thank you so much. We appreciate your time.
Lisa Simoneau: Thank you.
You can access all of SDPB's COVID-19 coverage at www.sdpb.org/covid