State likely to take over troubled vets homes

Twenty years ago, massive problems at the Minneapolis Veterans Home led the Legislature to strip governance from the Department of Veterans Affairs and set up a separate board to run the home.

After a new series of crises at the Minneapolis home, a commission appointed by the governor said Tuesday that the board has failed and recommended that the system that now includes five homes across the state should go back to the department.

"I think we will be sending a strong message that offers a new vision for what our veterans homes can become," said commission chairman Dale Thompson. "The homes are important now, but we think they can serve more veterans."

After a formal vote expected on Nov. 19, the recommendations will go to Gov. Tim Pawlenty. Any change in governance would require legislative action. Several legislators who are ex-officio members of the commission said they expect the changes will be approved.

The commission will recommend that the executive director of the veterans homes become a deputy commissioner in the Department of Veterans Affairs.

Under the proposal, the board would become an advisory panel of experts -- "critically important, since the department has no expertise in long-term care," said Veterans Affairs Commissioner Clark Dyrud.

The homes would widen their services to help veterans still living in their own homes, not just the 863 who live in the facilities. Establishing stronger ties with federal Veterans Affairs medical centers in Minneapolis, St. Cloud, Sioux Falls and Fargo, and with other agencies, the state homes would offer services to help aging veterans and their spouses who remain in their homes.

More duties, higher cost?

Expanding the work of the homes might require additional money, the commission said.

But the system's $70 million budget is adequate to achieve stable, strong leadership with excellent care at the Minneapolis home, commission members said. Half the budget comes from the state and the rest from the federal government or residents. The other four homes have not had major care or regulation problems.

In a letter to the commission last week, commanders of the four dominant state military service organizations endorsed the broader role for the homes and moving the system back to Veterans Affairs.

The letter described the current board as shifting from "effective to disconnected/ineffective, to advisory, to operational and micromanaging." It was signed by commanders of the American Legion, Veterans of Foreign Wars, Disabled American Veterans and Military Order of the Purple Heart.

The commission's report "represents a wonderful opportunity for the Legislature to improve the way we serve veterans," said Sen. Sharon Erickson Ropes, DFL-Winona, a former Navy nurse and ex-officio member of the commission. "We haven't done what we should for our older veterans, not to mention new vets coming back from Iraq."

She said she wants the new top executive for the veterans homes to be the deputy commissioner for veterans health, with broad responsibility to help veterans of all ages.

Series of crises

The commission's preliminary report Tuesday summarized the problems at Minneapolis this way:

"Failures in clinical systems have placed the Minneapolis facility's license at risk. Morale is low, operational systems are ineffective, and sustainable improvements seemingly evade the best efforts of senior managers and the board of directors. Communications between the board and staff have broken down, and the veterans and the public are getting mixed messages about conditions at the Minneapolis home."

In a series of regulatory crises since 2005, the state Health Department has cited the Minneapolis home for 66 rule violations and fined it $42,300 when nine of the violations were not corrected on time. The federal Veterans Administration found 33 violations last year, but far fewer in a new inspection a month ago.

The system could spend close to $1.4 million over two years for consultants, monitors and fines -- an amount the Veterans Homes Board said it can manage.

Pawlenty set up the commission last spring after inspectors found scores of problems at the Minneapolis Veterans Home, including some infractions connected to the deaths of three veterans.

Improvement seen

Problems appear to have eased at the home, regulators said. But Veterans Board Chairman Jeff Johnson said that several clinical and organizational systems "are broken and that we're working very hard to fix them."

On Thursday, Johnson said his board will continue its work to improve conditions at the Minneapolis home and "will follow whatever direction the Legislature sets for the homes. We're all here to serve veterans." Johnson is a Vietnam veteran and the county veterans service officer and emergency management director in Jackson County. This month, after working with an interim executive director for more than a year, the board hired a new executive who will start early in January, a move applauded by the veterans groups.

The home has been in trouble off and on for decades.

In 1975, governance switched from a board to the Department of Veterans Affairs because care at the home was becoming more complex.

But the Legislature later cut funding for the home, leading to staff shortages and several years of massive regulatory problems, including some deaths blamed on poor care and neglect.

In 1988, the Legislature established the nine-member Veterans Homes Board to run the homes, by then in Minneapolis and Hastings, and funding was significantly increased. Later, homes were added in Luverne, Fergus Falls and Silver Bay.

Warren Wolfe • 612-673-7253

Warren Wolfe • wolfe@startribune.com