TO TRANSFORM THE YOUNTVILLE VETERANS HOME FOR THE BENEFIT OF ALL VETERAN-MEMBERS AND THEIR FAMILIES
This report provides a bold, innovative and aggressive proposal to transform the 615-acre Yountville Veterans Home campus into a major Medical Center for Veterans in Napa County and neighboring counties as well as our Veterans statewide.
The Little Hoover Commission (LHC) in their March 1, 2017 report #237 “A New Approach to California’s Veterans Homes” identified critical infrastructural issues on the historic Yountville Veterans home campus that pose a public safety risk to residents and others. On its first visit to the Yountville Veterans Home in, November 2015, the LHC learned that deferred maintenance and infrastructure neglect at Yountville “has created an unsafe and undignified living environment for Veterans.” So, appalled at what it learned and saw, the LHC in December 2015 wrote the Governor and Legislative Leaders, alerting them to serious deficiencies at the Yountville campus and calling for urgent maintenance repairs.
In their September 5, 2017 report #240 “Transferring the Yountville Veterans Home Campus” the LHC Chairman, Pedro Nava, states that “despite rich amenities the Yountville Campus has to offer, the Veterans at the Yountville Home for too long have lived in decrepit buildings that, at times, put their health and safety at risk. Year after year, California devotes hundreds of thousands of dollars for deferred maintenance that patch, but do not solve, the Yountville Veterans Home’s significant infrastructure problems.”
On January 29, 2019, the California State Auditor, Elaine Howle, provided the Governor and Legislative Leaders, with a report (#2018 – 112) requested by the Joint Legislative Audit Committee. This audit report concerned the California Department of Veterans Affairs (CalVet), Department of General Services (DGS) leases, and other third-party uses of Veterans home property. This report concludes that CalVet and DGS entered into agreements with third parties that are inconsistent with the home’s best interests and allowed third parties to lease property for decades in violation of state laws. The report further stated that CalVet and DGS mismanaged the Veterans Home property. In fact, neither department had developed criteria for determining whether a lease is in the best interests of a Veterans’ Home.
The Yountville Veterans Group, LLC (YVG) has been reporting and exposing the substandard living conditions of the Veterans at the Home and requesting the assistance of CalVet and local politicians to correct the unacceptable conditions. As the LHC and State Audit reports have conveyed the deferred maintenance and mismanagement of the property by CalVet and DGS have persisted for decades.
BOLD AND INNOVATIVE SOLUTIONS
It is time to take a very different approach and the YVG recommends a bold, aggressive and innovative solution to the management of the Yountville Veterans Home.
The West Los Angeles Veterans Home comprises 11 acres and is located on Federal VA property. The Federal property is known as the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS). The VAGLAHS is spread across 388 acres and treats over 95,000 Veterans. The VAGLAHS serves Veterans residing throughout five counties: Los Angeles, Ventura, Kern, Santa Barbara, and San Luis Obispo. There are 1.4 million Veterans in the VAGLAHS catchment area. The VAGLAHS is affiliated with both the UCLA School of Medicine and the USC School of Medicine, as well as more than 45 colleges, universities and vocational schools in 17 different medical, nursing, paramedical, and administrative programs.
The YVG recommends that the 615-acres of the Yountville Veterans Home be modeled similarly on the VAGLAHS campus. The YVG solution would require CalVet to allow the Federal VA to take ownership of the majority acreage of the campus, with CalVet maintaining a much smaller “footprint” comprised of the Veterans Home. (See Appendix A – History of Property Sales and Acquisitions at Yountville) In turn the Federal VA would build a new Veterans Hospital and provide healthcare services to upwards of 50,000 Veterans residing in the neighboring five counties as the VAGLAHS provides their neighboring counties. The Yountville Veterans Home property is zoned “Public Facilities” and therefore would not need to be rezoned as a medical center.
There have been many recommendations by various individuals and groups as to how the campus should be reconfigured or maintained such as the following:
- Build a new, $300 million, Skilled Nursing Facility (SNF)
- Invite hotel owners to construct
- Allow the building of a Casino
- Add greater employee housing
- Add housing for Yountville Town residents
The above proposals, except for a new SNF, would require rezoning of the property. The Yountville Town Council would face tremendous public opposition to any proposal of rezoning for those purposes.
The YVG rejects these and other proposals that have been presented, because they do not realistically consider the current and historical realities of the campus nor do they provide a solution for the future that would be practical for the Yountville area.
CalVet has failed miserably for decades to manage the facility even after receiving $100 million from the legislature in the 1970s to revitalize and refurbish the resident buildings. With this funding CalVet was able to gut each building, rewire, replumb, and add rooms and elevators in all resident buildings from 1985 to 2003. Since those renovations were accomplished, CalVet has allowed those same buildings to deteriorate due to deferred maintenance and neglect. We are not confident that CalVet has the management capability to properly operate a new SNF, as they are planning to establish sometime in the not so foreseeable future. A new SNF, under CalVet management, could easily end up resembling the Home’s current resident buildings and skilled nursing facility, in no time at all, due to their decades-long history of deferred maintenance and neglect.
Hotels and Casinos would not be solutions for the campus. The additional traffic that they would generate would only aggravate and overwhelm the current traffic congestion. Traveling north and south on Highway 29 is frequently congested especially during commute hours. The weekend traffic on Highway 29 is even slower than weekday commuting hours traveling north from Napa to St. Helena and beyond.
Adding significant employee housing would also grow into a major problem in the future as the campus expands.
A much more practical and cost-conscious solution is to base future development of the campus with the original premise in mind. The Veterans Home was always meant to be a home and haven for Veterans of all wars who have served since the early part of the 19th Century.
With a new Federal VA Hospital, located on the Yountville campus, available to serve the more than 50,000 Veterans, residing in Napa, Butte, Colusa, Lake, Sonoma and Yolo counties, the campus would provide a valuable benefit for thousands of Veterans now and in the future.
(See Appendix B – Napa County and neighboring counties)
Like the VAGLAH’S affiliation with the UCLA and USC medical schools, the new Federal VA Hospital could be affiliated with the “Hospital Joint Operation” recently established between St. Helena and Queen of the Valley hospitals to integrate clinical services and activities.
CALVET TO RENOVATE THE HISTORICAL BUILDINGS INCLUDING HOLDERMAN
Instead of building a new Skilled Nursing Facility, as some have recommended, that will take a minimum of five years to complete, all historical residential buildings, including the Nelson Holderman building, should be renovated to current building code standards, on an aggressive construction schedule.
The first building to be renovated would be the McKinley building that has been licensed for skilled nursing care. After renovation, the McKinley building would be utilized as a swing space and accommodate Holderman residents from individual Wards. As each Ward’s renovation is completed, the Veteran-Members in McKinley would return to their Ward and the Veteran-Members from another Ward would move to McKinley so their Ward could be renovated and brought up to current building code standards.
At the time the renovations are taking place at Holderman, the James Madison building would be utilized as “swing space” and be occupied by Veterans from a domiciliary residential building that is being renovated, the Veterans occupying Madison would return to their original residential building.
CALVET MUST HIRE NEW MANAGEMENT
With a new renovation program to restore residential and nursing buildings to current building code standards it is imperative that CalVet revamp their hiring program for engineers, supervisors and higher management positions. CalVet needs to find new management, at all levels, in Sacramento and Yountville, that have the experience, work ethic, and compassion to operate and provide oversight to the Veteran-Members at Yountville.
EXAMPLE 1: In November 2018, 42 Veteran-Members in Section D, the Theodore Roosevelt building, lost their hot water. This was a re-occurring problem, which had existed for over 5 years, occurring 2-3 times per year, and for periods, each lasting 1-8 weeks. However this time, the Veteran-Members (average age 80) were told the proper parts (which were never , on hand in the past) had been ordered in early 2018 by Yountville’s management and would finally and permanently solve this problem: they were asked to , “please be patient”.
After 45-days without hot water, and with numerous complaints from Veteran-Members, a resourceful Yountville State employee was able to track down the earlier work orders and found them sitting on the desk of a State employee, in Sacramento. The work orders had never been processed nor had any of the critical parts been ordered. Seeing this, he demanded and received immediate action. However, it took another 53 days before parts began to arrive and hot water was finally restored.
Veteran-Members had been without hot water for over three months.
During this period, elderly Veteran-Members in Section D, one undergoing treatment for cancer, one requiring chemotherapy and others with significant health conditions, were required to walk over 300 yards round trip (the length of three football fields) or go to a neighboring building, sometimes in the cold and rain, in order to shower.
Example 2: Loss of Air Conditioning at the Yountville Veterans Home
On March 15, 2019, residents of the Yountville Veterans Home were notified that the “Chillers” were currently down, which means loss of all air conditioning to all buildings throughout the facility.
The Chiller is a large piece of equipment located in the central boiler room, which cools to 44 degrees Fahrenheit and sends it vis underground pipes throughout the facility to provide cold water to each building.
Again, all Veteran-Members were asked to “please be patient”; as plant operations are aware and are doing what they can to quickly resolve the problem.
It has been learned that the Chiller was actually shut down on March 15, 2019 for cleaning. During this process, the outside firm that completed the job and Plant Operations both realized that the “Cooling Tower” (located behind the boiler room building) that supplies water to the Chiller was extremely dirty, needing cleaning and possible repairs before the Chiller could be re-activated and put back on line.
See Appendix F for the history of deferred maintenance and false economy of purchasing a chiller with no ability to be maintained.
Knowing this, an “Urgent Work Order”, was signed and approved by the Yountville Home, was sent to CalVet headquarters in Sacramento on or about March 15, 2019, to seek final approval for this additional work which is estimated to take 2-3 days at a approximate cost of $200,000.
On Wednesday April 10, 2019, at the Veterans Allied Council meeting, Fred Just, the Yountville Veterans Home Administrator, announced that the air conditioning system would not be repaired and functioning until sometime this fall.
It has now been learned that the Urgent Work Order sent to CalVet headquarters in Sacramento, in mid-March, is either sitting on someone’s desk, or being ignored and remains unprocessed.
Why does it take so long to authorize and complete this urgent work? Do we have another situation like the recent loss of hot water for over 3 months, in the Section D domiciliary, where paperwork for a new water heater was lost for over 8 months in the bureaucracy of CalVet?
The Administrator’s announcement raises significant concerns for the Veteran population.
- What measures have been established to protect the Veteran-Members averaging 80-years of age?
- What is the evacuation plan in case of a severe heat wave?
- Where will the evacuees be sent?
- How will overheated residents be treated during evacuation?
- Are there treatment centers available close by?
- What procedures are implemented for residents on oxygen and CPAP devices?
- How are residents living in rooms that receive the afternoon sun to be monitored and protected from the rising temperatures?
- Are there enough ambulances, on call, to evacuate large numbers of Veteran-Members suffering from heat prostration in Skilled Nursing?
- Is there an established plan to protect the nurses and caregivers while they are performing their responsibilities?
- What is the plan to protect the State workers undergoing unacceptable working conditions?
IT’S THE LAW
CODE OF FEDERAL REGULATIONS – U.S. DEPARTMENT OF VETERANS AFFAIRS – Subpart D – STANDARDS
CFR 51.60 STANDARDS APPLICABLE FOR PAYMENT OF PER DIEM
The provisions of this Subpart are the standards that a State Home and facility management must meet for the State to receive per diem.
CFR 51.100 QUALITY OF LIFE
The facility management must care for its residents in a manner and in an environment that promotes maintenance or enhancement of each resident’s quality of life.
- The facility management must provide – (6) Comfortable and safe temperature levels. Facilities must maintain a temperature range of 71 – 81 degrees Fahrenheit.
The unacceptable behavior of neglect and incompetence by CalVet management cannot be tolerated any longer. CalVet must find the right management team and workers to guarantee the proper treatment and Quality of Life of Veterans and their families. We hope the new Governor will take action soon to appoint a new professional management team to take on the responsibilities of the present with a strong and energetic leadership of the future.
EMPLOYEE HOUSING MUST BE REPLACED
Employee housing is in substandard condition. Some buildings are abandoned and those that are occupied are in disrepair. The current policy of patchwork instead of renovation is very costly in the long run and does not provide a solution for the future. We recommend that employee housing be razed to their foundations and prefabricated buildings be installed to provide comfortable and acceptable housing. This solution would be cost-effective and be easier and quicker to install than constructing new buildings. Employee housing should be reserved for top administrative and nursing management as well as for engineers necessary for critical operations such as the boiler system that serves the entire campus on a 24-hour basis.
YVG Research has identified 1,200 square foot prefabricated homes at an approximate cost of $50,000 each.
A PROPOSAL TO SERVE HOMELESS VETERANS
After the complete renovation of all resident buildings and the Holderman facility, to enhance the Quality of Life and living conditions of the current Yountville Veterans Home residents, separate housing could be designated to accommodate homeless Veterans. Veteran homelessness not only affects those who experienced the Iraqi and Afghanistan wars, but also includes people who served in Vietnam, Korea and World War II.
Veterans serving in the Vietnam and post-Vietnam era have the greatest risk of becoming homeless, according to the National Alliance to End Homelessness. Veteran homelessness is mostly faced by returning male Veterans, but females make up about eight percent of homeless Veterans.
About 40 percent of homeless Veterans are African American or Hispanic. African Americans account for just over 10 percent of the Veteran population while Hispanics represent less than 4 percent of the Veterans in the United States.
This proposal would require the support and management of a Homeless Patient Aligned Care Team (H-PACT) Program. Located on the campuses of VA medical centers (VAMCs) community-based outpatient clinics and Community Resource and Referral Centers, H-PACT clinics provide a coordinated “medical home” tailored to the needs of homeless Veterans. They integrate clinical care, social services, enhanced access and community coordination. There are approximately 500 unsheltered homeless Veterans in Butte, Colusa, Lake, Napa, Sonoma and Yolo Counties.
A SOLUTION TO TRAFFIC CONGESTION NOW AND FOR THE FUTURE
To avoid a severe growth of traffic congestion in the Yountville area on Highway 29, traveling north or south, the new facility would employ a shuttle service based on the model developed by high-tech companies in Silicon Valley.
The following high-tech companies have established free shuttle service for their employees from San Jose and Mountain View to San Francisco: Apple, Electronic Arts, ebay/Paypal, Evernote, Facebook, Genentech, w
Travel distance to these cities may be as far as 40 miles one-way. The companies’ employ 20-passenger shuttles, equipped with geo-locating devices, so riders can track shuttle schedules using their smartphones. The shuttles also include bike racks and wheelchair lifts.
Due to the extremely high cost of housing in Silicon Valley, this program allows employees who live in neighboring towns to afford to work in very high cost areas without prohibitive cost of travel and parking, while avoiding severe traffic congestion. Google and other high-tech companies have established small shuttle systems throughout their campuses to allow employees to travel easily from building to building.
Offering the same solution for Yountville employees, as well as for visitors to the campus, would allow them to avoid commuting in highly congested traffic, benefit by a significant savings on gasoline, and enjoy a safe commute from their hometowns to the Yountville campus.
This solution to employee commuting would benefit CalVet in employee hiring, by enhancing its ability to attract a greater number of experienced and competent applications in the hiring process.
YOUNTVILLE CEMETERY SHOULD BE REDESIGNATED AS A NATIONAL CEMETERY
The Yountville Veterans Home Cemetery should be transferred to the Federal VA and be re-designated as a National Cemetery.
(See Appendix D – A National Cemetery at the Yountville Campus)
There is significant precedent for sale and acquisition of portions of the
Yountville Veterans Home campus, as listed in Appendix A. The YVG wishes to partner with Veterans organizations, to request the help of the United States Department of Veteran Affairs, in accomplishing major changes to the operations and control of the Home.
The YVG welcomes the responses from all recipients of this proposal.
The Little Hoover Commission (LHC), formally known as the Milton Marks “Little Hoover” Commission on California State Organization and Economy, is an independent state oversight agency.
By statute, the Commission is a bipartisan board comprised of five public members appointed by the Governor, four public members appointed by the Legislature, two Senators and two Assembly members.
In creating the Commission in 1962, the legislature declared its purpose:
“to secure assistance for the Governor and itself in promoting economy, efficiency and improved services in the transaction of the public business in the various departments, agencies and instrumentalities of the executive branch of the state government, and in making the operation of all state departments, agencies and instrumentalities, and all expenditures of public funds, more directly responsive to the wishes of the people as expressed by their elected representatives”
The LHC provided the following history from its research of the Yountville Home property sales and acquisitions in their September 5, 2017 Report – – – “Transforming the Yountville Veterans Home Campus”:
TIMELINE: PROPERTY SALES AND ACQUISITIONS
The following timeline includes a selection of property sales and acquisitions of the Yountville Veterans Home property. It is not intended to be a comprehensive list but is as inclusive as records allow.
1884: A San Francisco Veterans organization opened a residential and care facility for Mexican and Civil War Veterans in Yountville, California.
1897, March 11: Legislation was enacted to authorize the Governor and State Attorney General to acquire the property on behalf of the State of California, with the specification that it would “continue to be used as a home for aged and indigent United States ex-soldiers, and Marines.”
1899, January 17: The Veterans Home Association sold the land and facilities on the Yountville campus to California Governor Henry Gage and Attorney General Tirey Ford for a 10-dollar gold coin. The deed again reiterated that the property would be maintained as a home for Veterans.
1905, June 14: The Department of Veteran Affairs acquires a 1,78-acre parcel from the Veterans Home Associates for $3,000.
1939, April: The Department of Veterans Affairs acquires 10-acre parcel from the Hotchkiss Estate Co. for $1,020.
1956, September 11: The State sold a parcel containing approximately 298 acres of the Yountville property to H.L. Page, Dan S. Page, and Sidney I. Volz for a sum of $3,900. This sale included an easement and right-of-way across the Veterans Home campus in order to establish roads to access the property.
1958, October 20: The Department of Veterans Affairs transfers a 14.051-acre parcel of the Yountville property to the Department of Public Works, Division of Highways and a utility easement for $31,270.30 in order to widen and improve the existing state highway located adjacent to the property.
1959: The Department of Veterans Affairs transfers a 0.925-acre parcel of the Yountville property to the Division of Highways.
1974, July 1: The Department of General Services quitclaims a portion of the property (does not specify size of parcel) to F.R. Didion. A quitclaim deed is a legal vehicle used to transfer real estate property ownership.
1975, March 13: The Department of General Services quitclaims a portion of the property (does not specify size of parcel) to the Town of Yountville under the condition that the property be “used only for public park recreational purposes for a period of 25 years”. The deed specifies that any violation may result in the reversion of property to the State.
1978, January 13: The Department of Veteran Affairs quitclaims a parcel of 6.88-acres, including several easements, to the Town of Yountville to be used to develop a sewer facility. The quitclaim deed specifies that “the real property herein conveyed shall be used for public purposes”, and the property may be reverted to the State should there be a violation of this stipulation.
2017: The Department of General Services Statewide Property Inventory indicates that the Yountville Veterans Home Property comprises of three parcels totaling 615.67-acres.
A NATIONAL CEMETERY AT THE YOUNTVILLE CAMPUS
The Los Angeles National Cemetery is adjacent to the VAGLAHS campus. The cemetery was dedicated on May 22, 1889. It is directly connected to the Los Angeles Veterans Home facilities by Constitution Avenue’s underpass below the freeway. 87,000 American warriors and their loved ones are commemorated on 114 acres. Fourteen Medal of Honor recipients are buried at the cemetery. The cemetery has been closed to new interments since 2002, except for spouses of those already buried.
In order to address future needs the United States Department of Veterans Affairs has acquired 13 acres to permit the cemetery to expand. Future interments will be in urns of cremated ashes placed in columbarium walls built on the new land. By eliminating ground burials, the new acreage will permit about as many new interments as are in the existing 114 acres.
The YVG recommends that the United States Department of Veterans Affairs assume ownership of the cemetery at Yountville. 5,700 American warriors are commemorated on 11 acres. Four Medal of Honor recipients are buried at the cemetery. The United States Department of Veterans Affairs would enhance and expand the cemeteries’ current condition and establish and maintain the appropriate dignity for those presently commemorated and for future interments.