The priority list for the Department of Veterans Affairs is seemingly never-ending.

The department is juggling a massive electronic health record modernization initiative and an overhaul of its financial business management systems.

It’s implementing several big pieces of legislation, including an expansion of the program that provides benefits to VA caregivers.

And it’s still, of course, grappling with the COVID-19 pandemic. Dealing with all of those big projects — and responding to the pandemic — are top priorities for Denis McDonough, the president’s pick to lead VA.

“Your chief responsibility during this unprecedented time is to save as many lives as possible,” Jon Tester (D-Mont.), the new chairman of the Senate Veterans Affairs Committee, said Wednesday at the confirmation hearing for McDonough. “That includes advocating within the administration for VA’s fair share of vaccines and ensuring timely and efficient deployment of those vaccines. And it includes efforts to ensure frontline workers have everything they need to take care of our sick veterans and protect themselves from coronavirus. How you care for your staff will mean everything.”

The department is currently tracking 11,210 active COVID-19 cases, including 453 VA employees. A total of 121 VA healthcare workers have died due to complications from the virus.

As of Wednesday, VA had administered at least one dose of the COVID-19 vaccine to 229,884 employees and 432,981 veterans, according to the department’s public data.

On multiple occasions, McDonough said he would approach all decisions as secretary by asking two questions: Will it give veterans greater access, and will it ensure better outcomes?

When it comes to securing vaccines for veterans and VA employees, McDonough said he will “demand a seat at the table” as the Biden administration tries to meet and exceed its goal of providing 100 million doses in its 100 days.

“We have to be serious about communicating clearly with the workforce, ensuring that the workforce has access to vaccinations and protection… and access to all the material that they’ll need to do their jobs safely,” McDonough said.

McDonough, who served as the chief of staff to former President Barack Obama, acknowledged he doesn’t have the usual background that most members of Congress and veterans service organizations typically expect of a VA secretary.

If he’s confirmed, he’ll be only the second non-veteran — VA Secretary David Shulkin was the first — to lead the department.

“I know and understand the federal government, from both ends of Pennsylvania Avenue,” McDonough said. “I can unstick problems inside agencies and across agencies. Especially an agency as large as VA, that’s an important skill, and in fact I’ve spent a lot of time working with many members of this committee on doing just that.”

“And then… going back to those attacks on Sept. 11 for 20 years I’ve been afforded in my public service something relatively few Americans are granted, which is to see up close the excellence, the execution and the talent of our armed forced,” he added. “I’ve been deeply moved by that.”

In introducing him to the committee, Sen. Amy Klobuchar (D-Minn.) described McDonough as an “adept manager” who makes himself available to his team and others.

“I know he will do two things so well. He will listen and then he will get things done for you,” she said.

Each of the last two administrations have tried to strike a balance between VA and the community, following a scandal at the department’s hospital in Phoenix that covered up how long veterans were truly waiting for care.

“What did you learn from these, and do you think that experience is going to help you?” said Sen. Dan Sullivan (R-Alaksa). “Is that a liability, given your background?”

McDonough said he believed Congress had since passed new legislation to ensure another Phoenix wait time scandal would never happen again.

“The lifeblood of a well-run, well-functioning organization or agency is timely, accurate information. That was not the case in Phoenix,” he said. “The life-blood of a well-run organization is accountability. Accountability happened in Phoenix, but it was slow.”

McDonough worked with lawmakers during the Obama administration to craft the VA Choice Act, which Congress later revised with the VA MISSION Act.

“Let me be very clear: Community care will continue to be a key part of how the department cares for our veterans, full stop,” McDonough said.

“I do not support privatization,” he said later. “I do recognize that community care will continue to be a part of how the VA provides care to veterans. We have to ensure that VA is being a good partner in the community, timely paying bills and maintaining an effective, vibrant network. At the same time we have to ensure that this integrated health model continues to draw on the success and excellence that is obvious throughout its workforce.”

Several Republican committee members said they would support McDonough’s confirmation. The committee will vote Tuesday on his nomination, Tester said.

“The next VA secretary needs to be an individual of honesty, integrity and vision, who listens to the veterans and puts their well-being above all else,” he said. “If you keep your head down and live up to that expectation you will be successful. In the end we all want you to succeed, because veterans across this country need you to succeed.”

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