We have all heard the adage, “Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.” In Caribou, Maine we have experienced that reality.
Just recently we were reminded of what can be done when people come together for a worthy cause. In 1979 a small group of veterans, from WW II, Korea and Vietnam, met at the Caribou VFW Post to discuss the issue of veterans health care. They were considering the plight of their fellow comrades many with disabilities, chronic illness, and just getting older, who were required to travel to the Togus VA Hospital, some 500 miles round trip, even farther for veterans in the St. John Valley, if they required health care services to be covered by the VA.
These men were all volunteering their time, many traveled to meetings from 50 miles away or more, often in bad weather. They represented multiple Veterans Service Organizations but truthfully, in this instance, they represented all veterans. They took their individual hats off at the door. These men were hardened from experience in war, they knew what it was like to go up against the odds but they also knew the sacrifices that many of their comrades had made to keep our nation free.
In spite of many setbacks, frustrations, being told there was no chance, they pursued their goal of a VA Community-Based Clinic in Aroostook County. In 1987, nearly 10 years after their struggle began, the first VA Community-Based Outpatient Clinic in the nation was opened on the campus of Cary Medical Center. Today the clinic serves nearly 5,000 veterans with some 10,000 care visits annually, and provides primary care, mental health services, home-based care, tele-health, lab services, and health and wellness programs.
The same group of Veterans advocates went on to develop the Maine Veterans Home and Residential Care Center all connected to the Community-Based Clinic and the hospital. It was a heroic, monumental accomplishment that has changed the course of health care for veterans in northern Maine and beyond.
Many of the original group of veterans along with a woman who served as historian have passed but their legacy remains. With primary care and long term care in place veterans who came after took up the torch for in-patient and specialty care. In 2011 Project ARCH (Access Received Closer to Home) was established. A Pilot program, it would allow eligible veterans to receive specialty care, including hospitalization at Cary Medical Center.
The model of having the VA Clinic on site, VA ARCH case managers working together with their counterparts at Cary, proved to be a winning scenario. When the pilot project was to conclude Congress reauthorized the program for an additional year.
In the meantime the “Crisis” in VA Health Care erupted. Long wait times, and other complications, plagued the VA. Wanting a quick fix, Congress required that the VA establish a “one size fits all” program that could serve veterans on a national scale and the ‘Choice Program’ was born. While the ARCH program at Cary Medical Center in Caribou was demonstrating its effectiveness in providing high quality care, saving money and overwhelmingly satisfying veterans utilizing the program, ‘Choice’ was struggling and so were the veterans who attempted to use it. Veterans in Aroostook County learned that the ARCH program was set to expire in August of 2016.
Like their comrades who preceded them, our veterans responded. They held meetings, formed an Advocacy Committee, contacted their Congressional representatives, wrote letters, and began rejecting their Choice Cards. Our own U.S.Senator, Susan Collins from Caribou, who had been advocating for ARCH since its inception heard their voices, as did Congressman Bruce Poliquin.
Senator Collins and Congressman Poliquin have been advocating for the extension of Project ARCH but time was running short and there were risks involved with passing the legislation by both the Senate and the House. In an unprecedented move, Sen. Collins extended an invitation to the Under Secretary of Health for Department of Veterans Affairs, essentially the CEO of the VA Health System, to visit Cary Medical Center and the VA Community-Based Outpatient Clinic in Caribou. The Secretary accepted her invitation. It would be the first time in history that an individual at that executive level in the VA would visit Caribou. The Under Secretary oversees some 300,000 employees at more than 1700 health facilities.
On May 3, a cloudy, cool early morning in Aroostook, the Under Secretary, Dr. David Shulkin, and Ryan Lilly, director of the Maine VA Health Care System arrived at the VA clinic along with Senator Collins, Congressman Poliquin and their respective staffs. A meeting was held with the leadership team at Cary, including Cary CEO Kris Doody, RN, a passionate supporter of the ARCH Program, who had testified before Veterans Health Care Committee of the U.S. House of Representatives in Washington, DC.
During the meeting a plan was discussed that has the potential to save the best elements of the ARCH program as it is here in Aroostook County, and on a permanent basis. The Under Secretary communicated this exciting news to some 100 veterans gathered in the Chan Center at Cary for a Town Hall Meeting.
For more than an hour Dr. Shulkin took questions from a number of veterans and heard loud and clear that the veterans wanted to preserve the successful elements from the ARCH program and they shared their “horror” stories on the Choice Program.
Dr. Shulkin also made it clear that the VA had heard the voices of the veterans. He expressed the commitment of the VA to fix the problems with Choice and to incorporate the many lessons learned from the ARCH Program. Veterans felt respected and expressed their appreciation for the service provided by VA staff including an emotional and sincere send out to the retiring VA clinic physician, Dr. Robert Shaw.
At the conclusion of the meeting and on exiting the hospital the Under Secretary had high praise both for Cary Medical Center and the respectful way the veterans approached the meeting. He said that VA staff often are not treated so well at these kinds of meetings.
Dr. Shulkin, on multiple occasions, called the program established at Cary Medical Center and the relationship between the hospital and the VA a “model for the nation”, as did Senator Collins and Congressman Poliquin.
Now, more than 35 years since that first meeting took place with a few veterans gathered at the Caribou VFW Hall, their original vision has become a national model. Their legacy lives on through the lives of veterans who have served and regrettably will serve in future wars and who will benefit from health care close to home in the warmth of their loved ones, families and friends. One veteran called the ARCH program a “Miracle”. Do you believe in miracles — I do.
Bill Flagg is director of community relations and development at Cary Medical Center in Caribou. He can be reached at 498-1376 or via email at bflagg@carymed.org.
