TAMPA, Fla. (WFLA) – The first triage stop at James A. Haley VA Medical Center for veterans who are facing an emergency is a parking garage, about 400 yards from the indoor emergency room.

The temporary facility opened about a year ago and has drawn the ire of several veterans and their spouses who said it was cold in recent weeks, hot and humid last year, usually noisy and not private enough.

It is on the ground floor of the garage, just beyond a stop sign, inside a series of orange barriers on the concrete marked for parking: the garage ER.

Rafael Techera, a combat veteran who has gone there several times with severe pack pain, calls it “a complete embarrassment.”

“It smells and sounds like a parking garage,” Techera said. “You still have the car’s coming through. You still have the traffic. I can’t believe they would treat veterans who served their country this way.”

Techera and others who contacted 8 On Your Side said the garage ER was their first and only stop, with one patient saying they were there about four hours for triage and treatment.

Haley Director of Emergency Medicine Timothy McGuirk said the area is primarily used when the ER inside the hospital is full.

“We can do an EKG out here,” McGuirk said. “We have a crash cart. We even have X-rays out there.”

A veteran who was treated in the garage last year said it was “too warm.” Another who asked not to be identified for “fear of retribution,” recalled January sending the temperature the other way.

“It was so cold, it took longer to mix the medication,” he said. “It’s an embarrassment to be treated like this after serving your country. There’s no assumption of privacy when it’s open air and anyone walking around can see.”

Another veteran, who also requested anonymity, went to Haley with a respiratory issue and said he was “surprised” to be treated in the garage.

“Now that is a respiratory issue – in a garage filled with carbon monoxide,” he said.

McGuirk said a ventilation system cleans the air and a carbon monoxide detector monitors the area.

Most patients have been positive about the garage ER, according to McGuirk, but he understands it is not an “ideal” situation.

“Everything in medicine has a risk-benefit ratio,” McGuirk said. “An open area environment is certainly much safer in terms of preventing the spread of COVID disease.”

8 On Your Side contacted every Florida VA hospital and verified Haley VAMC is the only one doing emergency triage and treatment outside.

Bay Pines VAMC checks patients for COVID-19 in an outside tent, but Public Affairs Officer Anna Hancock said if the patient does not test positive for the virus, they’re triaged and treated inside.

Among the Tampa area’s public hospitals a few have conducted emergency triage work outside during the pandemic, but only for a short period of time last summer.

McGuirk and Haley VAMC Public Affairs Officer Shayna Rodriguez said Haley has the busiest emergency department in VA Integrated Service Network (VISN 8) which covers Florida, Southern Georgia, Puerto Rico and the U.S. Virgin Islands.

“Since the beginning of October 2020, we saw over 14,000 patients come through the emergency department,” Rodriguez said. “Three thousand more than the second busiest emergency department in VISN 8.”

McGuirk said there are ongoing discussions about deactivating the garage ER.

“I would love to be able to take it down tomorrow,” McGuirk said. “This is not my idea of an ideal place to work. but we feel we’ve been fairly successful at protecting our patients and protecting our staff by using this model.”