Ronny Jackson fiasco may be the least of VA's worries
By LISA REIN | The Washington Post | Published: May 3, 2018
WASHINGTON — Dozens of senior staff members have left the Department of Veterans Affairs since January, an exodus that predates President Donald Trump's firing of VA Secretary David Shulkin in March and appears to have accelerated in the chaotic weeks since.
The departures — some resigned voluntarily, others say they were forced out — mark the latest sign of estrangement among VA's career civil servants, the professional staff recruited by Shulkin, and a cadre of Trump loyalists pushing for changes within a sprawling bureaucracy for which change has never come easily. Trump's failed nomination of Ronny Jackson to lead the agency has only heightened the sense of tension and disarray that took root in the months leading to Shulkin's removal, according to 17 current and former VA officials and lawmakers on Capitol Hill, where the turmoil has caused alarm.
Administration officials characterize the turnover as "minor personnel issues," saying the Trump team in place at VA has faced obstruction from employees deemed unwilling to embrace the president's agenda — principally his plan to outsource more health care for veterans, punish misconduct among career staff and disclose more data on VA hospitals performing poorly.
"Under President Trump, VA has had its most productive year in decades — we have made groundbreaking progress, particularly in the areas of accountability, transparency and efficiency across the department," said Curt Cashour, the agency's spokesman. Such change has "understandably shaken up VA's Washington bureaucracy, and in many cases employees who were wedded to the status quo and not on board with this administration's policies have departed VA — some willingly, some against their will as they were about to be fired.
"We understand," Cashour added, "that not everyone is ready for this level of reform."
Nearly 40 senior staffers have left since the year began. The upheaval has created voids throughout the organization's leadership structure in core areas including health care, benefits, technology and human resources.
Staff and veterans advocates say the loss of talent and institutional knowledge is impeding efforts to address significant challenges, from reducing the rate of suicide among former military personnel to modernizing VA's antiquated record-keeping system and eliminating its backlog of benefits appeals. Two high-stakes initiatives also have stalled: legislation to expand veterans' access to health care outside VA's network, and a $16 billion contract to synchronize veterans' medical records with systems operated by the Defense Department and private providers.
Those who have sought an exit describe an environment where political loyalty outweighs reasoned policy debate, according to current and former officials who spoke on the condition of anonymity, citing fear of reprisal or concern that speaking out publicly could jeopardize their employment prospects. Additional high-level resignations are expected in coming weeks, including VA's second-in-command, Deputy Secretary Thomas Bowman, a Trump appointee who fell from favor in the final weeks of Shulkin's tenure. Bowman declined to comment.
"It is not normal," said Rep. Tim Walz, Minn., the top Democrat on the House Committee on Veterans' Affairs. The precedent has been to have "a lot of continuity in these positions," but the Trump administration is intent on "dismantling the agency," he added. "I worry about institutional knowledge. Who wants to work there now?"
Allies of Shulkin who remain at VA have been sidelined and subjected to intense supervision from the Trump team, according to people familiar with the matter. Staff meetings and conference calls often are closely monitored, they say.
Some executives say they've been told a purge is underway. Experts Shulkin hired from the private sector are resigning just months into their new jobs, while a number of career officials have been relocated from the 10th-floor offices where VA's acting secretary, Robert Wilkie, is settling in for what could be an extended period after Jackson withdrew from consideration amid misconduct allegations — complaints that he and the White House dispute. Lawmakers from both political parties have said the Jackson fiasco exposes broader shortcomings with the White House's vetting process.
Although every administration appoints new political leadership to run the government's agencies, the churn among VA's high-level officials — including the permanent staff who traditionally ride out White House turnover — is considered extreme, observers say. Fifteen months into Trump's first term, the agency is widely staffed by interim personnel in key positions. It's a concern, observers say, because people serving in acting roles can be reluctant to take on new projects or make bold decisions.
Among those to leave is Scott Blackburn, acting chief information officer who in mid-April quit in protest. "It became clear that my help was no longer desired, which I understand and respect," said Blackburn, who last year served for seven months as acting deputy secretary. He holds degrees from Harvard and MIT, served as an officer in the Army Signal Corps and, while a partner at McKinsey & Co., worked closely with Fortune 500 companies.
A senior VA official, speaking on the condition of anonymity to discuss personnel matters, said Blackburn had "had no previous significant IT experience" and that his departure was planned.
The political appointee backfilling Blackburn while the White House considers a permanent replacement is Camilo Sandoval, a former data operations director for Trump's presidential campaign. Sandoval is named in a $25 million lawsuit brought by a former campaign colleague who has made accusations of harassment and gender discrimination. The lawsuit was first reported by Politico.
Sandoval did not respond to a request for comment. Cashour, VA's spokesman, referred requests about the lawsuit to the Trump campaign. A campaign official familiar with the matter said the allegations "lack merit and are being vigorously defended."
Other high-profile departures include Walinda West, formerly chief spokeswoman for VA's health system. She retired two days after Blackburn left, telling colleagues she felt sidelined by VA's public affairs staff. The senior VA official said West had "no decision-making role or authority on major VA communication issues." West declined to comment.
Christopher Vojta, a health-care executive and physician who arrived in January to run the Veterans Health Administration — the country's largest health system — resigned suddenly last week. His departure was announced internally without explanation, though he is said to have grown frustrated with the Trump team's involvement in day-to-day decision-making, telling others he felt pressured to fire a clinician over concerns that individual would receive unfavorable media attention.
The senior VA official said Vojta wanted to return to his family in Minnesota. Attempts to reach him were unsuccessful.
Amy Fahrenkopf, a physician and health-care executive whose father is a former chairman of the Republican National Committee, quit Monday as VA's acting deputy undersecretary for health and community care. She oversaw the agency's $14 billion private-sector programs, including 8,000 employees, and was the agency's point person on pending legislation to extend funding for VA's Choice program, which enables veterans to seek medical care outside the government's network. The program must be renewed by June or it will run out of money.
Fahrenkopf declined to comment but told colleagues she was troubled by Shulkin's firing and the administration's accelerating emphasis on outsourcing health care, according to a person familiar with the conversations.
The senior VA official noted that Fahrenkopf had served in the job about six months but otherwise declined to comment on her departure.
VA's human resources department has lost at least 10 senior officials who clashed with Peter Shelby, a Marine veteran and Trump appointee serving as chief human capital officer. Mike Haith, a retired Army colonel who worked as Shelby's executive assistant, said he was exiled from VA and ordered to work at home with no meaningful assignments after an uncomfortable confrontation between the two. Haith told The Washington Post that he observed Shelby yelling at an administrative assistant who had made a scheduling mistake, telling his boss that such behavior was inappropriate.
"I stood up for an employee who was being verbally abused," said Haith, who plans to retire this month. He called VA's working conditions "toxic."
John Fuller, a retired Army major who says he voted for Trump, retired in February after Shelby revoked financial support for a program Fuller led for eight years to improve race relations throughout the agency. "It really is an anomaly," Fuller said, "to see so many people who have such great records leave."
Attempts to reach Shelby were unsuccessful. Cashour provided testimonials from Shelby's colleagues who praised his leadership, dismissed the complaints against him and suggested his accusers were having trouble "letting go of the past" as the president's team brings "modernization and change" to the organization.
Other departures include VA's head of strategic partnerships, a political appointee brought in by Shulkin who left soon after the secretary's ouster. Five regional health system directors, each of whom oversaw dozens of VA hospitals, have retired in recent months, too. Meanwhile, VA's liaison to the veterans service organizations — groups such as the American Legion and VFW, whose millions of members form one of Trump's core constituencies — has been assigned to a less-prominent role, according to people familiar with the matter. Similar moves also were made against other career officials, they say.
Cashour declined to discuss complaints made by individual employees, saying VA personnel must sign a consent form before the agency can discuss personal information about them. Those interviewed by The Post declined to sign the consent form.
In a separate statement, Cashour said, "Any attempt to characterize this small handful of departures and minor personnel issues as having a significant impact on VA's operations is simply fake news."
Dan Caldwell, executive director of Concerned Veterans for America, a conservative advocacy group backed by the billionaires Charles and David Koch, said most people who have departed joined VA while President Barack Obama was in office, when some of the agency's most glaring problems were exposed.
"They believed they could fix the system by making cosmetic changes on the margins," Caldwell said. "The Trump administration wants more fundamental change."
The situation in Washington is indicative of a broader trend across VA, observers say. Nationwide, the agency has tens of thousands of full- and part-time vacancies, with key shortages of doctors, mental-health specialists, physical therapists, social workers and the custodial staff responsible for keeping hospitals clean. The administration says this underscores the need to outsource more care.
Critics fear that is a ploy to dismantle the agency, which serves 9 million veterans. Writing in the New York Times after his firing, Shulkin said the private sector is "already struggling to provide adequate access to care in many communities, [and] is ill-prepared to handle the number and complexity of patients that would come from closing or downsizing VA."
Even before Shulkin's ouster, VA's political climate made it difficult to fill key leadership positions. For instance, to staff the agency's health undersecretary role, which has oversight of 1,200 hospitals and clinics, officials convened three panels in the past year to interview candidates. Most either dropped out as the process dragged on or failed to win support from the administration.
The job remains vacant. It is being filled on an interim basis by Carolyn Clancy, whose tenure at VA is said to be vulnerable as her relationship with the Trump team has soured, according to colleagues. She declined to comment.
"The next secretary is inheriting a place with very low morale, no internal communications and an 'us-versus-them' mentality," said one senior leader who spoke on the condition of anonymity to speak candidly. ". . .There is complete uncertainty about what we're focused on," this person said, adding that the powerful mission of caring for veterans "is no longer a reason for people to stay."