managers from outside of Chicago, headed by the director of the Central Arkansas Veterans Healthcare System. The committee considered six alternatives and, in September 1999, chose one that would save $188 million per year by consolidating most inpatient services at the Lakeside VAMC (U.S. House of Representatives, 1999). In its report, the VISN 12 Delivery System Options Study, the committee recommended that inpatient care at the NCVAMC be ended and shifted to Lakeside and that the center provide only outpatient care along with long-term and residential treatment (domiciliary) care. The VA undersecretary for health found that the committee’s findings and recommendations provided a good foundation for further study, but were significantly limited because they did not account for (1) the geographic location of veterans living in VISN 12, (2) the modeling of future demand for health care services, (3) objective evaluation criteria to assess the value of each option, and (4) the lack of stakeholder input into the process.

Veterans groups in North Chicago strongly opposed the proposed changes, objecting to having to travel 60 minutes or more to Lakeside or Hines for hospitalization. Local unions representing NCVAMC employees also protested (Kuczka, 1999a). Senator Richard Durbin and Representative John Porter, the local congressman, told veterans that they would fight to keep the NCVAMC open (Kuczka, 1999b). The save-the-NCVAMC campaign was followed closely by the Chicago-area press (e.g., Flink, 1999).

1999–2000: Saving the North Chicago Veterans Affairs Medical Center

Within weeks of the leak of the VISN 12 options report in September 1999, Durbin and others in the Illinois congressional delegation developed a plan to save the NCVAMC. Rather than have the Navy spend millions of dollars to renovate or replace the 40-year-old NHGL, they proposed that the Navy use the nearby VA facility instead (O’Matz, 1999). In February 2000, Durbin was able to announce that agreement had been reached that the NCVAMC would provide psychiatric inpatient care and certain outpatient services to Navy personnel stationed at Great Lakes, and that the NHGL would provide certain surgical procedures and some diagnostic testing to veterans being seen by doctors at the NCVAMC. He characterized the agreement as “a first step toward what we hope will be a very positive partnership that is good for veterans, active-duty personnel and taxpayers” (Presecky, 2000).

Porter retired in 2000 and was succeeded by his longtime legislative assistant, Mark Kirk, who made saving the NCVAMC a major part of his election campaign. Soon after his election, Representative Kirk told local veterans in a meeting at the NCVAMC that the best way to keep the center



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