Uncertainty at VA after nominee withdraws

White House physician Adm. Ronny Jackson briefs the press on President Trump's health Jan. 16, 2018.

Adm. Ronny Jackson, the White House physician nominated to lead the Department of Veterans Affairs, withdrew his name from consideration after multiple reports emerged of behavior and management problems.

The allegations included crashing a government vehicle after a boozy Secret Service party, pounding on the hotel door of a female colleague on an overseas presidential trip during the Obama administration, drinking on duty and creating a hostile work environment.

The Senate Veterans Affairs Committee probe led by ranking member Sen. Jon Tester (D-Mont.) reportedly heard from 23 individuals raising concerns about Jackson's fitness.

Jackson thanked Trump for the opportunity to serve in VA and said the allegations, which he denied, had become a distraction.

"The allegations against me are completely false and fabricated. If they had any merit, I would not have been selected, promoted and entrusted to serve in such a sensitive and important role as physician to three presidents over the past 12 years," Jackson said.

Jackson was a tough sell to lead the 370,000 person, $200 billion agency under the best of circumstances, given his lack of experience managing large organizations.

"All of us had questions before any of these recent allegations just on experience and qualifications," said Sen. Jeff Flake (R-Ariz.) in a Politico article published a day before Jackson withdrew.

The withdrawal leaves Trump without a candidate to lead the VA, and leaves agency watchers wondering about the fate of the promised $16 billion electronic health record modernization upgrade promised by ousted VA Secretary David Shulkin.

The agency also lacks Senate-confirmed leaders at many of its top posts, including the top technology job, which is currently being filled on an acting basis by a former Trump campaign staffer who is himself being sued by a former colleague for harassment and discrimination.

"President Trump's firing of Dr. David Shulkin created needless chaos and uncertainty at VA, and his rash decision to replace Dr. Shulkin with someone so clearly unprepared for the job only made the problem worse," said Sen. Tammy Duckworth (D-Ill.), who is herself a disabled veteran and former VA executive.

As the Jackson nomination foundered on April 25, VA press secretary Curt Cashour laid out the agency's current priorities in a news release that looked to project a can-do attitude and demonstrate strides being made under acting agency head Robert Wilkie, who has been detailed from his Defense Department post of undersecretary for personnel and readiness.

"Under VA's new leadership, which is now firmly aligned with President Trump and his priorities, the department’s operations have improved in many ways," the release stated. "In a number of cases, employees who were wedded to the status quo and not on board with this administration's policies or pace of change have now departed VA."

The release listed a "main goal" of restoring "regular order" at the agency "by working closely with the White House to implement the president's priorities for VA."

VA under Wilkie's leadership is looking to push for legislation to expand and reform the program that allows vets to receive care outside agency facilities and to "finalize a decision on the department's health record modernization."

Asked by FCW whether the language meant that there was a chance VA would not sign a sole-source deal with Cerner to obtain the same medical records software that is being onboarded by DOD, Cashour said, "VA doesn't typically comment on ongoing contract negotiations."

Former acting VA CIO Scott Blackburn told attendees at a tech conference that he expected the contract to eventually get signed. Two other former high-ranking tech officials contacted by FCW were split on whether the deal ever gets done.

Congress appears to be behind the plan to shift VA from its homegrown Vista record to a commercial system. Congress appropriated $1.2 billion in a special budget line to support electronic health record modernization in fiscal year 2018. The agency controls the funding for three years. The same funding level was proposed in the 2019 appropriations bill, which was released April 25.

There's no immediate frontrunner for the top VA job. Wilkie is said by VA insiders to be lobbying for the post. Current House Veterans Affairs Committee Chairman Phil Roe (R-Tenn.) is another possibility. Retired HVAC chairman Jeff Miller, currently a lobbyist on defense and veterans issues in Washington, D.C., was considered a finalist for the post before the unexpected pick of Shulkin, an Obama-administration holdover.

President Donald Trump, on an April 26 call to the show "Fox & Friends," said he had a nominee in mind. He didn't name his choice, but said "it will be somebody with political capability."

Trump also complained about the allegations of misconduct that led to Jackson's withdrawal.

"These are all false accusations," he said. "These are false. They're trying to destroy a man."

Senate Minority Leader Chuck Schumer (D-N.Y.) signaled that he was looking for the next VA head to have management experience.

"The VA's problems are management problems and we need someone at the helm with the experience and know-how to fix them," Schumer said.