Frequently Asked Questions

 

Why is The Coalition involved?

 

In the wake of one of the greatest tragedies in our state – the worse outbreak of COVID-19 of any facility in New England and one of the worse in our nation – we are members of a coalition of Veterans, family members, veteran services representatives and concerned citizens who believe we can and must move forward.

 

We want to be part of the solution to take advantage of a major opportunity to make things right: right for the families of the Veterans who died, right for the incredibly dedicated staff who had to work in those conditions and right for future generations of Veterans who will need the Soldiers’ Home in Holyoke.

 

What is the goal of The Coalition?

 

Our goal is to preserve the Soldiers’ Home in Holyoke for future generations of Veterans to receive the care they have earned and to provide an environment in which the staff can efficiently provide the loving care they are known for and deserve. The legacy of outstanding care for the Veterans who use the home must be protected.

The COVID-19 outbreak has been the deepest wound and the saddest of chapters in the history of the Soldiers’ Home that opened in 1952.

We must ensure our Soldiers’ Home for Western Massachusetts is preserved and improved to meet the 21st century needs of those it serves.

We call on our state to remember the words of Governor Paul Dever.

 

“The scissors of false economy will never be used to cut the appropriations needed for the maintenance of this outstanding institution erected for the veterans of Massachusetts,” said Governor Dever on the day of the dedication of the Soldiers’ Home in Holyoke in 1952.

 

It is our Coalition’s belief that Governor Dever’s words are as important today as ever before.  Our Veterans must not be victimized by any administration that does not adequately fund their needs.  We, a coalition of Veterans, family members of Veterans and concerned citizens demand that our Commonwealth commit to providing care with honor and dignity for our most senior Veterans.  This is a moral obligation.

 

What is your Call to Action and what do you believe needs to happen?

​​First, regarding the Department of Veterans’ Services Oversight of the Soldiers’ Homes.

We recommend that both the Soldiers’ Home in Holyoke and the Soldiers’ Home in Chelsea be aligned under the Massachusetts Department of Public Health, Bureau of Hospitals.  The bureau currently provides oversight of four multi-specialty care facilities, including Western Massachusetts Hospital in Westfield.  Their focus is on the “delivery of health care services to special populations.”  Veterans are a special population with multiple physical and behavioral health challenges distinct from the general population, and DPH is far more capable in overseeing and providing regulatory guidance to the two homes than the appointment of an individual in the Department of Veterans’ Services.

Second, regarding changes to the Soldiers’ Homes’ Board of Trustees.

While we agree with an approach that builds consistency with the governance of the two Homes, we propose that the Trustees’ model be much more closely examined and be overhauled.  We propose that there be an independent Advisory Council that represents the Veteran community in Western Massachusetts. The appointment of representatives to this council can and should be from our Coalition and include members of the Congressionally Chartered Veterans’ Services Organizations and major Veteran representative groups in Massachusetts (Veterans of Foreign Wars, Disabled American Veterans, American Legion, AMVETS, Vietnam Veterans of America, Military Order of The Purple Heart and the Western Massachusetts Veteran Service Officer Association). 

 

We strongly support the current board structure for the Soldiers’ Home in Holyoke, which mandates a voting representative from the four counties of western Massachusetts in providing a voice for citizens in our region. We further propose that Worcester County also have a voting member on the Board of Trustees.  We also propose that the chairperson of the Board of Trustees be chosen by a vote of the other board members. 

We strongly oppose the addition of the Secretary of the Executive Office of Health and Human Services and the Secretary of Veterans’ Services as ex-officio members.  This proposal is contrary to the intent of the citizens of the Commonwealth to create the Homes as independent agencies with a board of trustees chartered by law to ensure the proper resources for the care and well-being of Veterans, independent of the administration.

To have the administration place two of its governor-appointed secretaries on the board would further destroy the autonomy of the board and would subject the Homes to the political and fiscal priorities of the administration, resulting in continued underfunding and understaffing as has been the case over the past several years in Holyoke.

Further, our Coalition has noted a direct correlation between DVS micro-management of the Board of Trustees of the Soldiers’ Home in Holyoke as demonstrated by DVS directing a 1 percent increase to the Home’s budget for fiscal year 2021. This administrative control has resulted in dire consequences for the Veterans the Trustees are chartered to serve.

Third, regarding the hiring of a Designated Occupational Health Nurse.

The Coalition supports this proposal.  We further propose the creation and funding of the following positions:  a full-time geriatric physician as the medical director; a geriatric nurse practitioner; and a psychiatric nurse practitioner.  We are especially concerned, following feedback from family members, that the state must address the increased demand for geriatric psychiatric care given the population that the Soldiers’ Home serves.

Fourth, regarding the appointment of the Superintendent of the Holyoke Soldiers’ Home.

The Coalition strongly opposes the EOHHS Secretary as appointing authority.  Coalition members view this proposal as another attempt by the administration to further dilute the autonomy of the Board of Trustees, allowing for a political “at-will” appointment that would be subject to the removal of the governor at any time.  Such an appointment is perceived by the Coalition as a political maneuver to solidify loyalty to the administration. This would be to the detriment of the independence of the Board of Trustees, which was chartered by the citizens of our Commonwealth to ensure the interests of the Veterans it is entrusted to serve.

Furthermore, we recommend that the Chairman of the Board of Trustees be responsible for the annual performance appraisal of the superintendent to allow the superintendent to advocate for the true needs of the Soldiers’ Home without fear of retribution from the administration when he or she disagrees with the administration when supporting the objectives of the Board of Trustees and to eliminate the possibility of removal by the governor as an “at-will” employee.

Finally, the Coalition seeks to reinstate the former provisions of Massachusetts General Law, Part 1, Chapter 6, Section 71 which the Baker Administration advocated to change.  The law must be reinstated to protect the superintendent from the political whim of the governor.  A portion of the removed section stated: “The superintendent may be removed by said board of trustees for inefficiency, failure to perform duties properly or other good cause.”  The recent change to the law removed the provision thus making the superintendent subject to the desires of the governor, via the DVS secretary as opposed to the Board of Trustees.

Finally, before the next superintendent is appointed, we believe it is imperative that there be a community "vetting" process.  This should include an opportunity in a town hall style forum for members of the Veteran community to meet the candidates for the position and to ask questions.  The ability of the candidates to understand and listen to the Veteran community must be an important consideration in the hiring process.

Fifth, regarding capital improvements.

The Coalition seeks a commitment by the Baker Administration for the renovation and expansion of long-term care at the Soldiers’ Home in Holyoke while maintaining a minimum of 250 long-term care beds.  This is a necessity to meet the demand for long-term care in the Veteran population in our region and was part of the original 2012 design for a new Soldiers' Home in Holyoke.

All rooms must be in full compliance with federal U.S. Department of Veterans Affairs requirements, Uniform Federal Accessibility Standards and the Americans with Disabilities Act and must include a private toilet and shower in each one-person room.

All rooms must have a private toilet and shower to provide privacy and dignity for the Veterans as a key component to reducing the possibility of infection being spread and for increased fall safety. Community showers with an associated need for Veterans to walk at a distance to shower must not be in any new capital improvement plan.

The integration of ceiling lift rails must be included into any new design for construction to accommodate future generations of Veterans with amputations and other chronic conditions requiring lift assistance.

To meet the increasing needs of Veterans with Alzheimer’s disease and other forms of dementia, the Coalition strongly requests enhanced dementia care units.

There must be a greater awareness of the needs of women Veterans as the female Veteran population continues to increase. While most room provisions may be gender neutral, the addition of such necessities as a hair salon and other specific requirements must be considered. 

Finally, the renovation of the Soldiers’ Home in Holyoke should include the creation of an Adult Day Healthcare Program.

A plan for ADHC was submitted to the U.S. Department of Veterans Affairs and is listed on the state construction grant program list as Project FAI 25-080.  This construction project for the Soldiers’ Home was approved by VA for 65 percent reimbursement for funding in 2016.  Yet, the project, which would allow Veterans to age in place in their community with loved ones until they require admission into long-term care, remains on the list of projects with “No State Matching Funds.”  Such a program would further provide a per-diem payment for each day of care provided, helping to offset the state funds needed for this proven program.

What needs to happen next?

We are working to educate and inform individuals throughout our state to support a new and greatly improve Soldiers’ Home in Holyoke that will meet the needs for future generation of Veterans in Western Massachusetts and from throughout our Commonwealth.

We look forward to working with the state-assigned Payette architectural design team during a rapid planning phase this fall.  This phase will include a further needs assessment, preparation of an expedited project plan and conducting a designer procurement.  We further support the Administration’s proposal for a subsequent design phase that would ultimately result in a submission for the federal U.S. Department of Veterans Affairs (VA) State Home Construction Grant program by an April 15, 2021 deadline.

On September 16, 2020, the Coalition made the following recommendations to the Payette team in their rapid planning phase for a new Soldiers' Home:

1. Build a New Home with a 2020 Design to accommodate 120-room addition plus maximum possible LTC in main building with all single rooms and private shower & toilet IAW Small House Design with provisions for long-term care, a secure behavioral health unit, a secure dementia special care unit, and end of life care.

2. Create an Enabling Outdoor Environment to meet requirements for a dementia special care unit, Adult Day Health Care, and the needs of all Veteran residents.

3. Create an Adult Day Health Care area

4. Creation of a Family Contact Area

5. Ensure optimal clinical space requirements for essential on-site specialty care necessary for LTC

6. Accommodate service animals & pet therapy

7. Renovate and modernize “canteen” recreation center with movie screen, space for community events

8. Sustain Green House and Recreation Room areas

9. Build in sensory stimulation

10. Create gaming center with both traditional recreation and virtual technologies

11. Create areas for quiet reflection

12. Redesign outdoor courtyard

 

13. Retain Canteen with snack bar for in-between traditional meals and to support large events

14. Create Gift Shoppe

15. Keep Multi-Denominational Chapel

16. Upgrade elevators

 

Why is a new Soldiers’ Home in Holyoke needed?

Capital improvements for a greatly improved Soldiers’ Home in Holyoke, a state-run facility, must match current federal VA standards and incorporate trends toward a “small house” concept that promotes greater independence for our Veterans to have the best quality of life for the longest period of time possible.

Such a concept has been shown to help offset the spread of viruses like influenza and could have helped offset the spread of COVID-19 during the current situation.

Our veterans and their family members in western Massachusetts deserve a profound statement of support as a memorial to the veterans who died. Our state needs to express in a significant way that their sacrifice resulted in positive and lasting change. The answer must be significant capital improvements to the existing Soldiers’ Home in Holyoke that would demonstrably improve the quality of life for future generations of veterans in western Mass.

Why is the Soldiers' Home in Holyoke important to our state?

Our state must preserve the Soldiers’ Home in Holyoke for future generations of Veterans to receive the care they have earned and to provide an environment in which the staff can efficiently provide the loving care they are known for and deserve. The legacy of outstanding care for the Veterans who use the home must be protected.  Our Coalition includes Veterans who may someday require care in the Soldiers' Home. We and our families are asking our state to get this right and build a home that will last for 70 to 100 years and meet the needs for all future generations.

How does the Coalition imagine the future Soldiers' Home in Holyoke?

When COVID-19 hit earlier this year, all of us with loved ones in senior living were in great turmoil.  Nursing homes have been hit the hardest.

We believe the next Soldiers' Home should incorporate a small house design where the emphasis is on private rooms where Veterans live among a small grouping of fellow residents and where they live essentially in their own autonomous neighborhood that follows strict adherence to infection control protocols.

Small home designs are much better equipped to deal with the pandemic than larger environments and have fared much better than their counterparts in the mitigation of COVID.

The Green House – a small house model – is a concept that needs to be reviewed when designing the new Soldiers' Home.    Conceived in 2003 by Dr. William Thomas, a Harvard-trained geriatrician, the focus is on providing elders with more autonomy and deeper social interactions but within a close-knit family-style, household setting.   The Green House also has its own private entrances, like you’d find with your own home, and doesn’t have the foot traffic, open floors and corridors you find in traditional nursing homes with all the touchpoints that can spread disease.

The model also results in higher satisfaction levels and there are fewer health problems such as depression, a big factor when you are working with the Veteran community, which has higher incident rates.

When our coalition recently conducted a “reimagining” exercise to jot down what we would like to see in a new Soldiers’ Home in Holyoke, we noted the necessity for a small house model with private rooms, private bathrooms, homestyle features and amenities that appeal to a diverse veteran population.  

Constructing a new Soldiers’ Home will not be an easy feat, considering the scope of services needed for a veteran population that today predominately ranges from an aging legion of Vietnam-era baby boomers to future generations of Post 9/11 veterans, many of whom have experienced multiple combat deployments.

State planning for a future Soldiers’ Home that will last for the next 70 to 100 years is now, we are told, starting to take place.  Getting it right, in the aftermath of the COVID-19 tragedy in Holyoke, is our coalition’s top priority.

What we want to see is the best design to prevent any future outbreak of infectious disease and that enables veterans to live with the greatest quality of life possible.  A Green House design would be ideal. 

A design put forth in 2012 by Paul Barabani, the former superintendent of the Soldiers’ Home, used many of the Green House concepts.  The state never acted on spending the matching funds for a federal U.S. Department of Veterans Affairs construction grant.  Our coalition has asked the state to now take that 2012 design and upgrade it even further to leverage today’s latest Green House trends along with an enabling outdoor environment and an adult day healthcare program.

Green House homes come in many different styles to fit either rural, suburban or urban design settings.  They can be one-story or stacked in multiple levels.  Regardless, of the size, the key is a small home concept where residents live in “homes” or “neighborhoods,” each with their own living accommodations with unfettered access to outdoor space.  Each “home” comprises, on average, 10 private bedrooms and bathrooms clustered around an airy and open-style kitchen and dining and living areas. 

The concept focuses on each resident’s level of care, and homes can be dedicated for people with shared disorders, such as those with multiple sclerosis, Alzheimer’s or Parkinson’s.

Here is the rub, though.  As you might expect, the designs cost exponentially more than traditional facilities, largely because of spaciousness, kitchens in each home, and technology features. Cost nationwide has been the number one reason why more Green Houses are not built.

 

Once you get past the building costs, however, operational costs for Green Houses are comparable to those of traditional nursing homes and can even help in cost savings in such areas as food and laundry services because the care concept shifts those day-to-day living items to caregivers.

 

Is there other feedback the Coalition would like to provide regarding the Soldiers' Home in Holyoke capital project?

 

 

The renovation and expansion of long-term care at the Soldiers’ Home in Holyoke should maintain a minimum of 250 long-term care beds, which was the number originally in the 2012 Payette design and which meets the current and significant demand for long-term care in the community.  This is a necessity to meet the future demand for long-term care in the Veteran population in our region, which with the aging population of Vietnam Veterans and soon post 9/11 Veterans will only increase.

 

All rooms must be in full compliance with federal U.S. Department of Veterans Affairs requirements, Uniform Federal Accessibility Standards and the Americans with Disabilities Act and must include a private toilet and shower in each one-person room.

 

All rooms must have a private toilet and shower to provide privacy and dignity for the Veterans as a key component to reducing the possibility of infection being spread and for increased fall safety. Community showers with an associated need for Veterans to walk at a distance to shower must not be in any new capital improvement plan.

The integration of ceiling lift rails must be included into any new design for construction to accommodate future generations of Veterans with amputations and other chronic conditions requiring lift assistance.

The outcome must result in the highest standards of privacy and personal independence:

  1. Private rooms with a television, 2 chairs in every private room for visitors to include a recliner in the event a family member needs to stay overnight with WiFi capability, a table to work off of and eat with a secure storage in each room for personal items.

  2. Windows for views and sunlight in each room.

 

To meet the increasing needs of Veterans with Alzheimer’s disease and other forms of dementia, the Coalition strongly requests enhanced dementia care units.

There must be a greater awareness of the needs of women Veterans as the female Veteran population continues to increase. While most room provisions may be gender neutral, the addition of such necessities as a hair salon and other specific requirements must be considered.

The elevator system must be greatly upgraded.  Transportation and parking needs must also be met: Parking and valet parking considerations and ADA drop-off standards.

Finally, the renovation of the Soldiers’ Home in Holyoke should include the creation of an Adult Day Healthcare Program.

A plan for ADHC was submitted to the U.S. Department of Veterans Affairs and is listed on the state construction grant program list as Project FAI 25-080.  This construction project for the Soldiers’ Home was approved by VA for 65 percent reimbursement for funding in 2016.  Yet, the project, which would allow Veterans to age in place in their community with loved ones until they require admission into long-term care, remains on the list of projects with “No State Matching Funds.”  Such a program would further provide a per-diem payment for each day of care provided, helping to offset the state funds needed for this proven program.

Adult Day Health care is a necessity for improving care for Veterans in our community and for providing support to family members.  A physically or cognitively impaired family member at home, 24-hours per day, 7-days per week, can be one of life's most difficult challenges.

ADHC permits caregivers to meet professional and family obligations or take a well-deserved rest while their loved one attends the program.

ADHC would provide the socialization, stimulation that elder Veterans need and would maximize a participant's independence while enhancing quality of life.

With ADHC, medical, nursing and personal care services can be provided -- a model of care before a Veteran requires admission as a long-term care patient at the Soldiers' Home.

What would improve the quality of life for residents at the Soliders' Home in Holyoke?

A “Green House” design with neighborhood pods, homelike qualities, familiarity with care providers as extension of the family for greater continuity of care and eating and socializing as a unit to provide greater autonomy and purpose. 

Throughout the entire campus complex, there should be a focus on improved wayfinding.

There should also be improved lighting that is conducive for dementia residents and that takes into consideration visual impairment and complies with ADA requirements.

What additional services do you think it would be helpful to provide on-site at the Soldiers' Home in Holyoke?

1) Adult Day Health Care and Outdoor Recreation Space is a necessity: An enabling outdoor environment with natural stimuli, gardening, year-round greenhouse, recreation

2) Renovated and modernized recreation center with movie screen, space for community events, with stage area with quality sound system

3) Expanded gaming center with virtual technologies, sensory stimulation as well as traditional recreation with comfortable seating, billiards tables, card tables, puzzle tables

4) A "Snoezelen Room" for stimulation – especially important for those with cognitive impairment and to assist with sundowning, soft music.  A Snoezelen room is a controlled multisensory environment used for therapy for people with disabilities, dementia or brain injury. It consists of placing the person in a soothing and stimulating environment.

5) A canteen and store for purchases throughout the main hours of the day and in between traditional meal times

6) A family contact area with virtual technologies when quarantining or social distancing protocols prevent direct family visitation

7) A family respite area for palliative/hospice care with private rooms, showers, chairs, recliners for families to stay overnight

8) A reflection area: quiet room

9) Library with comfortable seating

10) Veteran Assistance Center

11) Veteran History Project Room

12) Women Veteran Health Clinic

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