Read two articles from the Boston Globe. The first is by the Globe Editorial Board, Holyoke veterans deserve more than a new building, from April 8. The second is the published letter (April 14) in response, In pushing old-style approach for a new soldiers’ home, Mass. abandons key blueprint for care, from Paul Lanzikos. Both are reprinted below:
Holyoke veterans deserve more than a new building
What ails the Soldiers’ Home won’t be solved without a change in how it is led and governed.
Boston Globe – By The Editorial Board Updated April 8, 2021, 4:00 a.m.
Fixing what’s wrong at the Soldiers’ Home in Holyoke — and what’s wrong, generally, when it comes to providing health care services to Massachusetts veterans — will take more than a new building.
Yet, even as a legislative oversight committee prepares an in-depth report, with a detailed list of policy recommendations, Governor Charlie Baker is moving ahead under the old rules to hire a superintendent to head the Holyoke facility. Lawmakers are also being pushed by Baker to approve a $400 million bond bill by April 15, in order to secure federal funding to replace a tired and worn facility.
Given what we already know about the deaths of 77 veterans from the coronavirus last year, just putting money into bricks and mortar, without also fixing structural governance problems, is a recipe for future disaster. According to the report done last year by attorney Mark Pearlstein at Baker’s behest, a muddled chain of command and poor communication contributed to the crisis. In the aftermath of that tragedy, Bennett Walsh, the former superintendent, and Dr. David Clinton, the former medical director, were indicted on criminal neglect charges; and Francisco Ureña, the state secretary of veterans services resigned. Different people are in charge, but the old governance structure remains.
Under Massachusetts law, the Holyoke facility is overseen by a seven-member board of trustees, each appointed by the governor. The trustees appoint a superintendent to run the facility and have the power to remove that person. Massachusetts law also provides that the superintendent and board of trustees “shall serve under the governor and shall be subject to such supervision as the governor deems necessary and proper.” At the time of last year’s COVID-19 outbreak, the Department of Veterans’ Services, an agency within the Executive Office of Health and Human Services, had direct supervisory responsibility for the Soldiers’ Home — and still does.
Earlier this month, the facility’s board of trustees selected a new superintendent to run the home. The board, which has three new members appointed by Baker, voted to appoint Rick Holloway, administrator for the Idaho State Veterans Home in Boise — also a licensed nursing home administrator — to take over Holyoke. That sounds like an improvement over Walsh, who had no health care experience. According to a spokesperson, the Baker administration is “finalizing the appointment of the person they [the trustees] chose.”
For now, the Holyoke superintendent continues to report to the Department of Veterans’ Services, where an assistant secretary added by the Baker administration has direct responsibility for the facility. But questions remain about whether that’s the best agency to oversee a long-term care facility. The governance structure at Holyoke also differs from that at the Chelsea Soldiers Home, where by separate statute, the superintendent of the facility is appointed by the secretary of health and human services, with the approval of the governor. A board of trustees at Chelsea is also appointed by the HHS secretary, with the approval of the governor.
Last year, Baker filed legislation that would make the governance structure consistent between the two facilities, and expand the boards of each to include the secretary of veterans’ services and secretary of health and human services as ex-officio members. The bill was not acted upon and, according to a spokesperson, the Baker administration is now waiting for the oversight committee to submit its governance recommendations.
Coleman Nee, who served as secretary of veterans’ services from 2012 to 2015, suggests eliminating the two governing statutes and combining them to one; and creating one statewide board to oversee both facilities, with trustees representing all regions of the Commonwealth. That board, he said, should have oversight of the Chelsea and Holyoke homes, as well as aging services for all veterans throughout the Commonwealth. Veteran demographics are shifting, said Nee, and there’s a need to provide for underserved populations of minority, women, and LGBTQ vets. Meanwhile, there’s no means-testing at the Chelsea or Holyoke facilities, and the conventional wisdom is that who gets in is often a case of who you know.
Meaningful reform should be the priority here. Individuals were responsible for bad decisions that led to the COVID-19 deaths in Holyoke. But the structure of governance was also to blame. There was not clear and consistent communication or accountability, and that needs to change. Veterans in Massachusetts deserve nothing less than a system that works to meet their needs.
Editorials represent the views of the Boston Globe Editorial Board. Follow the Globe on Twitter at @GlobeOpinion.
In pushing old-style approach for a new soldiers’ home, Mass. abandons key blueprint for care
Letter to the Boston Globe April 14 by Paul Lanzikos
Re “Holyoke veterans deserve more than a new building” (Editorial, April 8): Dignity Alliance Massachusetts urges the Commonwealth to put aside the current proposal to construct a 235-bed congregate care facility as a replacement for the Holyoke Soldiers’ Home and, instead, follow the US Department of Veterans Affairs’ Small House Model Design Guide. This model would create smaller, resident-oriented care centers geographically dispersed around Western Massachusetts that are focused on the personalized needs and preferences of veterans.
Instead of building a monument to our past failed efforts at institutionalization, the Commonwealth should develop and operate a living memorial in the form of supportive living options and related services that reflect our collective concern for and gratitude toward those who have served in our military. Given the Commonwealth’s efforts to rebalance its long-term services and supports away from nursing facilities and toward home- and community-based programs and services, it makes little sense to abandon that blueprint when it comes to the care of the state’s veterans.
A crisis is too valuable to waste. The many veterans and others who died during this pandemic should not have died in vain. Veterans deserve the investment of $400 million, but not in ways rooted in the 19th century. They deserve a 21st-century state-of-the-art system of care and services. Reverting to the old ways without reform dishonors those who have died.
Paul J. Lanzikos, Beverly
The writer is the former Massachusetts secretary of elder affairs and a former member of the Massachusetts Public Health Council. This letter was cosigned by L. Scott Harshbarger, former state attorney general; Charles Carr, former commissioner with the Massachusetts Rehabilitation Commission; and Richard T. Moore, former state senator and former Senate chair of the Joint Committee on Health Care Financing.