VA Secretary Robert Wilkie discusses his vision and questions about organization's power structure
By DREW BROOKS | The Fayetteville Observer, N.C. | Published: August 17, 2018
FAYETTEVILLE, N.C. (Tribune News Service) — Among all the Department of Veterans Affairs medical centers in North Carolina and Virginia, the Fayetteville VA has the largest and fastest-growing female veteran population.
And new Veterans Affairs Secretary Robert Wilkie, who still calls Fayetteville home, doesn’t see why the Fayetteville VA director, James Laterza, should have to reach into the VA’s massive bureaucracy to expand or add services for that growing patient population.
Instead, Wilkie told The Observer on Thursday, the people closest to veterans should be making the decisions that impact those veterans.
That’s a key tenet of Wilkie’s vision for a “bottom-up organization” at the VA, which he outlined during a wide-ranging interview that addressed his priorities, politics within the VA and questions about who wields power over the organization.
Two weeks after he was sworn into office, Wilkie has spent his initial days speaking to VA staff, veterans and veteran service organizations, with stops in Florida, Kansas City, Boston and Washington.
He plans to come home to North Carolina next month, he said, to tour VA facilities in Fayetteville and Durham.
“I really wanted to get out and show the flag,” Wilkie said of his early travel. “I think I’ve done that.”
After a tumultuous few years for the VA, he said his job is to calm the waters and assure veterans and VA staff that he will be at the helm of the organization long-term.
Wilkie also addressed recent reports of VA “shadow rulers,” comprised of three high-powered members of President Donald Trump’s Mar-a-Lago resort, that first appeared in a ProPublica report.
He said the allegations in the articles come from “instances long before I got here” and said he has not been pressured to act on behalf of any outside influences.
“I have a very different way of operating that’s in opposition to what those stories implied about this place,” Wilkie said.
Wilkie has brought his own leadership team with him to the VA. And the new leadership that joins him at the top of the organization was hand-picked, he said, not dictated.
He balked at the idea that politics would have anything to do with his decisions as VA secretary.
“I believe that there are two departments in the government that have to be above partisan rancor,” Wilkie said. “That’s the Department of Defense and this one.”
Wilkie worked for decades for Republican leaders in Congress and previously served in the administration of President George W. Bush.
But to the VA, he said he’s brought a new way of doing business, focused on cutting through bureaucracy, modernizing and increasing cooperation within the organization.
Wilkie outlined some of his goals for improving the VA.
One is improving customer service within the VA, not only between staff and veterans, but also within the VA itself, Wilkie said. Parts of the VA must do a better job of leveraging resources to improve the whole department.
Another goal is what Wilkie referred to as “business transformation.”
To accomplish that, he said he’s turning to experiences from his previous job in the Department of Defense and adopting best practices from the military to improve the VA supply chain.
And Wilkie said the VA must fix a broken system that has sometimes failed to timely pay back doctors and other care providers when a veteran receives care outside of the VA.
He said there’s no timetable for such improvements. But Wilkie wants them “as quickly as we can.”
Cooperation with the DOD is a big part of the new secretary’s plans for the VA.
“The benefit that I have is that I’m able to bring together, with the help of Defense Secretary (James) Mattis, DOD and VA,” he said.
Work is underway on a new, joint electronic health care record. And Wilkie, whose responsibilities within the DOD included oversight of the Defense Health Agency before he was tabbed as VA secretary by President Trump, said the ultimate goal is “a seamless experience” from the start of a military career to the transition to veteran.
In addition to health care records, cooperative efforts to address opioid addiction and mental health issues are also underway, he said.
Wilkie said Fayetteville stands out as an example of what the relationship between VA and DOD can produce.
“Fayetteville is sort of the incubator because of the presence of Fort Bragg,” he said.
The Fayetteville VA and Womack Army Medical Center at Fort Bragg already share doctors and clinical space, which saves money while also improving services.
Wilkie said he and others are paying close attention to his hometown VA, which had its own share of issues in recent years but has earned praise in more recent history for its cooperative efforts with Fort Bragg and other military installations in eastern North Carolina and its shrinking wait times, once among the longest in the nation, all while experiencing what is among the fastest growth for any VA patient population in the nation.
That’s why it’s important that the Fayetteville VA and other medical centers are empowered from that bottom-up philosophy, Wilkie said, instead of waiting for officials many miles away to make decisions.
Medical centers must be able to tailor services to their populations, he said. In Fayetteville, that means veterans who are on average younger than many other VA systems and more diverse, requiring different services than other VAs across the country.
According to the Fayetteville VA, that growth includes a population of female veterans that has grown by the thousands in recent years and now stands at nearly 16,000.
“Our female population in the Fayetteville area is exploding,” Wilkie said. “That VA director has to be given the leeway to address the changes in population in the community.”
He said he ultimately envisions a VA where local officials can manage their own budgets, recruit, retain and relocate staff to better serve their patient populations.
Making those changes will lead to a massive culture shift, Wilkie said. But it’s a shift that has been endorsed by Congress, veterans and President Trump.
“It’s not my daddy’s VA or my grandfather’s VA,” he said. “The old way of doing business just doesn’t work in the 21st century. To meet the changing needs of a changing veterans population, we have to modernize.”
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