FORT MEADE — Focusing on the quality of care and continuous improvement, suicide prevention, outreach, and alternatives for opioids are several of the goals of the Veterans Administration (VA) Black Hills Health Care facility for 2019. 

“I see the VA Black Hills continue to try to grow its veteran population. We have done a lot this year in veteran outreach, and we will continue on that path to insure the viability and stability of VA Black Hills, here in western South Dakota,” said Sandra Horsman, VA Black Hills Health Care System director. “A big piece of what we are focused on, and has been for the past couple years, and will continue to be, until we get to our goal of no more suicides by veterans.”

The goal is zero suicides, and Horsman shared that is clearly a lofty goal, it is a focus worth pursuing, and the VA will continue down that path and put funding and effort into it. 

A suicide prevention team was established that is really focused on the issue, not only to the veterans, but also to the community. 

“At the time of their passing, only six of 20 veterans were receiving care from the VA, so those other 14 are a big challenge, and we can’t do it without our community partners,” Horsman said.

About 19,000 veterans living in South Dakota, and portions of Nebraska, North Dakota, Wyoming, and Montana receive care from the VA Black Hills facility. Although not a complete list of every service, the VA Black Hills offers dental, mental health care, primary care, emergency care, urgent care, audiology, cardiology, dermatology, gastroenterology, gynecology, ophthalmology, optometry, orthopedics, and urology.

“We have a very dedicated group of veterans who we serve, and I think that is one of the reasons they do come, they are our family, friends, neighbors, and even when they are not, that is how we feel about them, and we want to keep that relationship,” said Horsman.

The other big focus being talked about by the secretary of the Veterans Administration is providing additional care for those veterans in the rural communities.


Horsman commented on the VA’s efforts on the opioid crisis facing the country. 

“The VA has been focused on opioid crisis for some time. I would say we are a leader in the nation on controlling the need for an access to opioids,” she said. “We are just not cutting people off of opioids, we are looking at and assessing each individual veteran’s need and what may or may not work for them.” 

The VA has pain management teams on station, as well as a hub in Minneapolis for more complicated cases. A program called Whole Health that deals with complimentary medicines is a way for veterans to control pain through alternative medicine, massage therapy, battle field acupuncture, yoga, and tai chi. The VA is trying to find ways for the veterans to deal with the pain and so they can control it themselves. 

“The pain management team goal is to find ways to alleviate or mitigate the pain through other means,” Horsman said. 

2020 budget

Horseman commented on the President Donald Trump’s 2020 Veterans Administration budget. 

The request includes a total of $220.2 billion in fiscal 2020 for the U.S. Department of Veterans Affairs, a 9.6 percent increase above Fiscal 2019. 

“One of the things that is coming out of the president’s budget, is the fact that the proposed increase really comes to the VA’s budget itself, for improving services, increasing services, and hopefully we will be able to do more outreach through innovative ways,” said Horsman.

The VA is searching for ways to reach very rural veterans, including tribal veterans at Standing Rock, Pine Ridge, and Rosebud. Having the ability to do partnerships in the community through community-based outpatient clinics, whatever services are, could be one solution to this issue. 

“A challenge we face is how do we find a way to provide more services in an era where resources have to be very focused,” she added.

How many days to get an appointment for primary care

The VA has been pushing and monitoring the number of days it takes a patient to get an appointment, with a goal of as quickly as possible and in less than 30 days. 

“I think we are very competitive with other VA facilities on the number of days wait for an appointment, and we are very proud of that,” Horsman said. “Some veterans can get in the same day access, we try to accommodate our patients.”

For a non-urgent appointment, a new veteran, who hasn’t been to this location, likely will have to wait an average of 18 days. For an existing patient for a non-urgent appointment, wait time will average around four days.


New facilities that have helped improve quality of care and additional services are being built and remodeled as funds become available. Before the new wing was built, the outpatient surgery area was one open room with five beds, with limited privacy for the patient. Now the 10 bays are separated by walls with a curtain to the front and contain a bed, recliner and another chair for family members.


Volunteers are critical to the success of the VA; presently nationwide, there are over 75,000 volunteers, 12 million volunteer hours, saving the VA more than $232 million annually. 

“Yes, we have volunteers here, and for those folks that want to volunteer, they can go to our voluntary services office and complete an application, then a background check is completed, and we try to marry up the need with the individual,” said Horsman. “We could not do here what gets done without our volunteers, they are amazing and dedicated, they make us what we are, that environment that is a little different than a private hospital.”

Area economic impact

The economic impact to Hot Springs and Sturgis area is big. There are 405 employees at the Hot Springs, VA Medical Center, and 857 employees at the Fort Meade Medical Center. The total budget for VA BHHCS is $181.5 million, of which $119 million is projected for salaries. In addition, $46.1 million is allocated to our Care in the Community program and $6 million is projected for our sterile processing service and endoscopy procedure room construction project. 

Who is eligible for medical services?

The very basic eligibility for service is, if veterans served in the active military, naval, or air service and are separated under any condition other than dishonorable, they may qualify for VA health care benefits. Current and former members of the Reserves or National Guard who were called to active duty, other than for training only, by a federal order and completed the full period for which they were called or ordered to active duty may be eligible for VA health care as well.

Anyone is welcome to stop by our Patient Services office or call 347-2511. The staff can work the application when they walk in.

Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) veterans

Every VA medical center has a team ready to welcome OEF/OIF/OND service members and help coordinate their health care and other services. For more information about the various programs available for recently returned Service members, log on to the returning service members website at

Veteran who served in a theater of operations after Nov. 11, 1998, are eligible for an extended period of eligibility for health care for five years after their discharge. In the case of multiple call-ups, the five-year enrollment period begins on the most recent discharge date. This special eligibility includes cost-free health care services and nursing home care for conditions possibly related to military service and enrollment in PG 6 or higher for five years from their date of discharge or release from active duty, unless they are eligible for enrollment in a high priority group.

Combat veterans who enroll with VA under this enhance combat veteran authority will continue to be enrolled even after their enhanced eligibility period ends, although they may be shifted to a lower priority group, depending on their income level, and be required to make applicable copayments. Additionally, for care not related to combat service, copayments may be required, depending on their financial assessment and other special eligibility factors.

Service members with other than honorable discharges

To reduce suicide and treat mental illness of former service members, the VA will provide crisis intervention services to any former service member who presents for VA care in a mental health emergency. Former service members may present or be referred for services via the Veteran Crisis Line or visiting the VA emergency room, or Vet Center.


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