The Veterans' Home of Wyoming sits just a couple miles outside of the center of Buffalo. Its property is 960 acres at the base of the Bighorn Mountains where Fort McKinney, a former U.S. Army post, once stood.
There's a fishing pond that's stocked every year with rainbow trout, and there's a small greenhouse not far from the main building where residents can grow different plants.
Lisa Osvold is the senior administrator of the Aging Division at the Wyoming Department of Health (WDH) and oversees the current veterans' home. She said its mission is simple.
"The responsibility is to care for those veterans who might need assistance with their daily living," Osvold said.
It's similar to an assisted living home and currently serves veterans from age 25 to 92, she said. Veterans come to live there when they might have medical and physical needs. The home also provides mental health care and help with substance abuse. The home usually has around 76 to 80 residents, but it can hold up to 103 in its current condition.
But it can't meet the needs of its residents who require more help, especially as they age. A new skilled nursing facility could help those who lose their ability to complete daily tasks, like bathing. The state says the new facility could also help people who need things like a ventilator or have mental health issues.
Wyoming is the only state without a skilled nursing facility for veterans. But Steve Kravitsky, executive director of the Wyoming Veterans Commission, said that's not the most important reason the state needs it.
"There is a benefit out there and unless we have this facility, they cannot get that benefit. To me, that's what's the priority and taking care of our veterans," he said.
Kravitsky is a veteran himself, a retired Air Force colonel. He said that benefit is a per diem allowance provided by the federal government. It's money that can't be used at either of the federal VA hospitals in the state, which have certain disability requirements to qualify for benefits for higher levels of care.
"Currently, it's about $109.63 a day. That offsets their cost of care. And you don't have to be 70 percent service-connected disabled to get into that facility. You just have to be an honorably discharged veteran," he said.
That's about $40,000 a year towards costs. On average, skilled nursing facilities range from $90,000 to $100,000 per year. So while the benefit doesn't cover everything, it definitely helps.
There should be 36 beds available in the new facility. The WDH has a plan to make sure the costs are affordable for the veterans, said Franz Fuchs, a WDH policy analyst who has been working on the project.
"In theory, you could build this place and sort of just take the per diem and just subsidize the operation without reducing the private rates. And our intent [is] really focusing on making sure the private pay rates are as low as possible so that financial benefit for long-term care is apparent and clear to the veterans who receive it," he said.
The project is an ongoing team effort. The Wyoming Veterans Commission, the Wyoming Department of Health and the State Construction Department have been working together to get a grant from the U.S. Department of Veterans Affairs that would provide 65 percent of the funding to build the facility. The Veterans Commission's Kravitsky said they are in the middle of the application process.
"This whole process is a marathon, not a sprint. And we have not been approved by the VA yet to build this facility," he said.
They started officially studying the issue in 2018 when the legislature gave them the go-ahead to complete a Level I and II study. From those studies, they narrowed potential locations to Sheridan, Buffalo or Casper. Some of the biggest factors for the final choice were access to quality medical care, the number of veterans it could serve, and continuity with existing care.
During the past legislative session, there was debate on whether the facility should be located in Casper or Buffalo.
Kravitsky said Buffalo was a good choice because of the continuity of care between facilities.
"About 10 percent of the veteran population who currently resides in that assisted living facility is eligible for skilled nursing care. So now you're going to have a population of veterans who can transition on the same property to another level of care," he said.
Wyoming lawmakers did agree to pass legislation that would provide 35 percent of the funding for the project.
Lisa Osvold, with the Department of Health, said a majority of the veterans at the facility now are estranged from their families, so their community at the home is important to them.
"This is their family. So when they have to get care somewhere else, they often feel estranged then again from another family. So really what is beneficial is the comradery they have with each other," she said.
Veterans at the existing facility in Buffalo also said they'd rather stay close to their friends.
In May, the VA approved the first step of Wyoming's application for funding. The team has already sent in forms that prove the state is willing to match funding. Kravitsky said now they'll be working on building plans and other documents needed for the next step of the application.
"Then the next phase, we have to do the Level III study. And then once we're finished with that, we will meet our gate for the final application. And that is detailed drawings, environmental impacts, number of veterans served. It's just a host of things," he said.
They plan to work on the study through April of next year. Then, the final application will be due in June of 2020.
