In the wake of internal turmoil among political appointees at the Veterans Affairs Department, Secretary David Shulkin has told the agency he wants a clean start from the high-level members of his team, and anyone who doesn’t want to pursue the VA agenda should leave.
“I have very little tolerance for people who aren’t willing to focus on moving forward, and that’s exactly what we’re going to do,” Shulkin told reporters Tuesday morning at the American Legion’s annual conference in Washington. “I’ve made it clear that there’s only one agenda in the department and that is to get back on track, and anybody who doesn’t want to do that shouldn’t be in the VA.”
Shulkin wouldn’t say whether there were plans to fire top-level VA officials in the coming days or weeks. And though he said he wasn’t specifically looking for instances of “subversion” or beginning individual investigations, Shulkin said he knew who within his team had VA’s best interests at heart.
“I suspect some people right now are making decisions about whether they want to be part of this team or not,” he said.
When asked, Shulkin said he didn’t believe his comments would create a chilling effect for the department’s career employees.
“This is a mission-driven organization where everybody has to understand that we are focused on helping veterans and that we have a unified approach to that,” he said. “I am not arguing that people shouldn’t have diversity of opinions. That’s how organizations get better, when people bring new ideas to the table, and I’m not one who believes that I always have the right ideas.”
“This is not a chilling effect on ‘everybody better have group-think.’ [What] this is, is I will not accept people who are going around the process to try to hurt the momentum and the progress that we are having at the VA and working against the president’s agenda,” Shulkin added.
Shulkin insisted that his agenda, specifically the direction he wants to take the Veterans Choice Program, matches the White House’s agenda.
“The administration has a clear, consistent consensus on how we want to help the Congress, and I don’t see any roadblocks,” he said.
In his speech to American Legion members Tuesday, Shulkin described his vision for a future Veterans Choice Program. That program, he said, puts VA at the center of all decisions about when and where veterans see private health providers.
“Wherever there is a VA where the care quality is not up to standards — and we’re going to work hard to fix that — you shouldn’t be locked in to a system that’s not working for you,” Shulkin said. “That would be the ability to seek care in the community.”
Though both the House and Senate Veterans Affairs Committees spent much of 2017 working with the Legion and other veterans service organizations on a variety of ideas detailing a future VA Choice program, lawmakers in both chambers punted the issue to 2018.
Many of the committees’ discussions were bipartisan. The Caring for Our Veterans Act had the support of nearly all members on the Senate VA Committee. That legislation cleared the committee with a 14-1 vote.
Lawmakers have been unable to agree how to pay for the next iteration of the Choice program.
Both House VA Committee Chairman Phil Roe (R-Tenn.) and Senate VA Committee Ranking Member Jon Tester (D-Mont.) said Tuesday they would stand up against the prospect of the privatization.
“The reports of internal feuding over the future of the VA are so concerning to me,” Tester said. “Let me be clear, standing alongside the American Legion and millions of veterans across this country, I will always fight against every attempt to privatize the VA. I do not support starving the VA from financial or human resources.”
The American Legion, along with many other veterans service organizations, have spoken out against proposals that would move VA in the direction of a privatized health care system.
But for Roe, the premise that privatization is a looming possibility at the VA is a false one.
“Since 2006, the VA’s budget has increased 175 percent,” he said. “Anyone who reviews VA’s budget over the last decade can see that more and more resources are being provided for in-house services, especially health care and mental health care. Why in the world would we support such a strong investment in VA if our end game was privatizing the system? VA isn’t going anywhere. But we do need to take steps to ensure the department is focused on [its] mission and using resources wisely to serve veterans.”
For the American Legion and several lawmakers, VA has made progress over the past year. Congress passed eight major pieces of veterans-related legislation in 2017.
Shulkin said he wants to build off of that progress in 2018. Much of the priorities he named during his speech to the Legion remain similar to the previous year’s.
In addition to giving veterans more choice and increasing access to care, Shulkin said he’s still intent on focusing VA resources more efficiently and improving timeliness for the agency’s services.
Suicide prevention, he said, remains his top clinical priority.
The department’s electronic health record modernization, specifically VA’s plan to implement the same EHR as the Defense Department, is another top priority.
It’s also a top priority for the House VA Committee. Roe said he planned to provide ongoing support and oversight for VA’s IT initiatives this year.
VA will also focus on improving its own facilities and infrastructure. The department announced plans earlier this week to begin using simplified contracting and bidding documents to procure new spaces in the future.
The president’s 2019 budget also permits a new asset management program for VA, which the department has long asked for. Specifically, it would let VA keep the profits it earns by selling off or leasing under-utilized and vacant facilities, rather than requiring the agency to continue to return funds back to the U.S. Treasury.