Paul Wellman

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When a long-awaited, new and upgraded Veterans Affairs (VA) outpatient clinic opens in Santa Maria this summer, Santa Barbara’s own VA outpatient clinic on Calle Real will begin incrementally sending its specialty care services there, until only general and mental healthcare remain in a pared-down version of the 27-year-old health center. VA officials say the transition will take about two months.

For Santa Barbara-area vets, the news is merely the other shoe dropping in the drawn-out saga involving veterans’ health services here. Rumors have swirled for years about what-if anything-would remain of the much-loved Calle Real clinic when Santa Maria’s opens. Jim Duvall, spokesperson for the Department of Veterans Affairs Greater Los Angeles Healthcare System, confirmed Friday that as soon as the North County clinic opens July 26, specialty services in Santa Barbara-including podiatry, optometry, dermatology, and physical therapy-will begin shifting north. However, Robert Gaines ( pictured above ), lead physician at the Calle Real site, said all the general practice doctors will remain.

“Ninety percent of what our patients need can be taken care of by primary care physicians,” Duvall explained. “We’re applying a hub-and-spoke model of service, trying to ensure that every veteran is within 30 minutes of a site that can care for 90 percent of their needs.” Toward that end, VA clinics in Oxnard and San Luis Obispo also provide only primary and mental healthcare, so that traveling substantial distances for medical appointments is now routine for Central Coast vets. Even in Santa Barbara, where a respectable array of specialist care is available, when a vet has a complex illness, he or she is sent to the VA’s sprawling Westwood-based hospital or its very large outpatient clinic on Sepulveda Boulevard in Los Angeles. Many opt to travel down on a VA-sponsored bus and return on it in the late afternoon. A similar bus will run to and from the Santa Maria clinic when it opens.

No matter how convenient the VA makes travel between Santa Maria and Santa Barbara, some South County vets will inevitably resent the journey. That’s because the new clinic was originally destined for their own backyard-a lot behind Goleta Valley Cottage Hospital. But a legal dispute between the owners, plus a zoning issue, delayed the project for three years. Finally, in 2004, the VA set its sights on Santa Maria. A survey completed by the agency during the delay revealed more vets were settling in the Santa Maria Valley anyway. Additionally, 1,500 vets currently drive from Lompoc to either the smaller San Luis Obispo clinic or to Santa Barbara when they need care, Duvall said.

Bob Hackett, a retired Korean War veteran and occasional candidate for Santa Barbara mayor, would be happier if the Calle Real clinic remained as it is today. “Santa Maria is a little over an hour away,” he said on the way to see one of his physicians. “That’s three gallons of gas going up and three gallons of gas coming back.” Joseph Narkeviz, a Vietnam vet who runs the Ventura Vet Center, offered a different perspective. “I try to look at the glass as half full,” he said. “Santa Maria will be a much bigger, much better clinic, and traffic-wise : Have you ever been through the San Fernando Valley at nine in the morning?”

People who work with the homeless say it’s this population of vets who will bear the brunt of the change. “You have to have the wherewithal to present yourself in order to access services with the VA,” said longtime social worker Ken Williams. “But if you’re battling your demons and suffering from post-traumatic stress syndrome and you run back to the streets, that’s awfully hard to do.” Dr. Mimi Doohan, a physician with Doctors Without Walls, said getting a homeless veteran onto a bus to a town an hour or more away is extremely challenging. “For every sick homeless veteran who takes the bus, how many don’t make it on board?” she wondered.

The question of soldiers and marines returning from Iraq and Afghanistan looms large in the minds of caseworkers and homeless advocates. John Jamison, program director at Santa Barbara Community Housing Corporation said, “I would suspect we’re going to see some of these guys go homeless just like any traumatized war veteran.”

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