MAXWELTON — More than 200 veterans, dignitaries and other interested people gathered Friday to hear what the U.S. Secretary of the Department of Veterans Affairs had to say about the future of the local Community Based Outpatient Clinic that was removed from its leased quarters five months ago.

But the big announcement came not from Secretary Robert McDonald, but from Beckley VA Medical Center director Karin L. McGraw, who told the crowd that a temporary clinic will be sited in Lewisburg, perhaps as early as Dec. 1. Thunderous applause greeted the news.

McGraw said the temporary CBOC will be situated in a modular building that the VA is acquiring for that purpose. She said she could not yet reveal the exact site or predict with any certainty the date for the clinic's re-opening in its temporary quarters, although Dec. 1 is the "target." A larger, leasable space is still being sought for the CBOC's permanent home, she said.

"Today is a momentous occasion for a variety of reasons," McGraw said, noting that a VA Secretary has not been in the Beckley area since 1994. Billed as a "Town Hall Discussion," Friday's event was held in the W.Va. Army National Guard Armory near the Greenbrier Valley Airport and just across the street from the now-shuttered CBOC offices in the Rahall Building.

VA regional director of communications Bruce Sprecher also made note of the weight of the occasion, which saw not just the secretary but also two U.S. Senators — Joe Manchin and Shelley Moore Capito — and U.S. Rep. Evan Jenkins, all sharing the same podium. "There's some very high-powerful ears here today," Sprecher said in introductory remarks.

Manchin, who served as McDonald's host during a two-day sweep of West Virginia, emphasized that the effort to resolve the CBOC issue was "truly nonpartisan" rather than bipartisan. Gesturing toward his congressional colleagues and the VA Secretary, Manchin said, "All of us have been working on the CBOC, to make (the reopening) happen.”

After receiving a standing ovation upon his introduction, McDonald almost immediately apologized to the assembled veterans for the air quality issues that beset the local CBOC, for the clinic's subsequent closure and for the sluggishness of the process to re-open the facility in another space. "We know that we have a commitment to you," he told the veterans.

The Greenbrier Valley CBOC, which falls under the oversight of the Beckley VAMC, began caring for patients five years ago, in January 2011, but during its final year of operation was open only sporadically before finally closing for good in April. During that 18-month span, the 1,700 veterans served by the CBOC usually had to travel to the Beckley VAMC for health care, while it appeared that little was being done to keep the local clinic open, either in Maxwelton or at a new site.

That timeline led Rainelle VFW Post 4484 Commander Kelly Goddard to tell McDonald, "For a year and a half, we've had labor pains. I think it's time for the baby.”

McDonald agreed, laughing with the audience at Goddard's quip.

In a more serious vein, Vietnam veteran Don Brown asked why the CBOC, when it reopens, will have only one physician for its 1,700 registered patients, when those same 1,700 had two physicians in the CBOC's original configuration.

McGraw responded that, when the CBOC first opened, the expectation was that between 2,400 and 2,600 veterans would register for care there, qualifying the clinic for two doctors. But barely over 1,700 was the maximum who ever actually registered, and that meant only one physician can be assigned, unless more vets register.

McDonald said he is trying to "make VA health care so good, we'll attract more patients." He pointed out that veterans nationwide currently use the VA for only 34 percent of their health care, with much of that coming in the form of hearing aids, eye care, prescriptions and joint replacements.

"Let's get that census up, and hire more physicians," McDonald urged.

But, he cautioned, if the percentage rises even as much as a single point, from 34 to 35 percent, that will mean the VA will need an extra $1.4 million in its budget to meet the cost of the increased demand for services.

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Taking up the secretary's statement about the excellence of the VA's joint replacement work, local veteran Sonja Velez said she has been waiting for a knee replacement for five years now. She said female veterans often don't receive the health care they need, because the VA doesn't provide such services as mammograms or complete physicals for women.

A 1969 graduate of Greenbrier East High School, Velez said when she had a heart attack, she was the only female patient in the VA hospital where she ended up, her dignity disregarded until she demanded curtains be drawn around her glass-walled room.

McDonald acknowledged the need for system-wide reforms to meet the needs of female veterans, noting that 11 percent of today's vets are women. He said one of the biggest issues facing the VA is "to transform facilities and services" to accommodate female veterans.

An effort is already under way, the secretary said, to build women's clinics and renovate other facilities, including administrative offices that currently have only unisex rest room accommodations. But a $1.4 billion cut in the last budget the VA requested may mean no money is available for further construction, he said.

When The Register-Herald caught up with Velez following the town hall event, she said, "I know they can only work so fast, but they need to understand female veterans' issues. We love our country, too.”

Referring again to the lack of privacy she encountered while in treatment after her heart attack, Velez added, "They'll fix it, but they need to know what the problems are, from a woman's perspective. I'm willing to speak for the women veterans.”

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McDonald said the single greatest challenge for today's Department of Veterans Affairs is not the nation's constant state of war for more than a decade, but addressing the needs of an aging veteran population. Where once the VA received a million claims annually, now that figure has more than tripled, he said.

He said he's trying to "teach Congress" that the VA needs to build today for tomorrow's aging veterans from the wars in Iraq and Afghanistan. But McDonald finds himself at odds with another philosophy, being pushed by the well-heeled Koch brothers, that the VA should be privatized.

"We can't do that," McDonald said, pointing to the value of VA research that has yielded medical advances that help "every single American." The VA, he said, "trains 70 percent of the doctors in the country," and employs and trains more nurses than any other entity does.

McDonald said he has put together a 90-day plan for the VA that relies on three mandates: to rebuild trust in the agency, to improve access to services and to set the right course for the future.

The secretary said his goals include improving the experience of veterans in their encounters with the VA, while at the same time improving the experiences of VA employees. He said he also wants to "create a culture of continuous improvement" in the VA workforce, saying he understands that employees want to change ungainly processes and procedures but can't because of the burden of bureaucracy.

That last point was spotlighted in the comments of Beckley VAMC employee Darren Dowdy, who said he took a day off work Friday to speak directly to the federal officials on the podium. Dowdy noted that he and several other employees at the Beckley hospital are veterans themselves, and when they felt their complaints were not being heard locally, they "started to use (their) chain of command.”

He said the group found that they needed to contact members of Congress to "get anything done." The process is frustrating, he said, especially when a highly-placed official just shoves a request off to a lower-level staffer.

Dowdy urged the officials present, "When employees come to you (with a concern), take more of a look; come see about it in person.”

McDonald responded, "That's the reason we're here.”

He said the VA is now taking surveys in its various facilities to gather information from employees about the conditions at those sites and suggestions for improvements.

"We've got to know if we've got ineffective leadership," McDonald said.