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Veterans Affairs, a Trump Signature Issue, Is Facing Turmoil Again

Veterans Affairs, a Trump Signature Issue, Is Facing Turmoil Again

WASHINGTON — As President Trump enters his re-election year, his administration’s focus on the nation’s veterans has emerged as a centerpiece of the campaign. But the agency tasked with caring for more than nine million former service members, a department he claims to have transformed, is showing signs of disarray.

The mysterious firing last week of the deputy secretary of veterans affairs was only the latest in a string of incidents that have shaken the second-largest cabinet agency in the government as it embarks on ambitious changes to veterans health care.

The secretary of veterans affairs, Robert L. Wilkie, got into an unusual public confrontation last month with a senior House policy adviser on female veterans issues who said she was sexually assaulted at the Department of Veterans Affairs hospital in Washington. That led the House Veterans Affairs Committee to file a formal complaint with the department’s inspector general, charging that Mr. Wilkie tried to dig up dirt on the woman, a former reserve Navy intelligence officer.

Last fall, that same inspector general reported that a new office formed to protect whistle-blowers often retaliated against them instead.

A health program that is central to the Trump administration’s aggressive expansion of care outside the department’s health facilities, known as the Mission Act, has hit snags right out of the gate. Congressional officials were told that millions of dollars more would probably be needed to meet the plan’s coverage goals. Department officials admitted to lawmakers that they had no clue how much the outside care was costing or how many were seeking it.

Finally, a $16 billion overhaul of the veterans medical records system has been delayed amid technical and training glitches.

Several people who work inside or closely with the department attributed some of the issues to Mr. Wilkie’s inattention to the herculean tasks he was supposed to carry out at the long-troubled department as he is seen to be lobbying for other jobs in the administration, most notably secretary of defense, or ponders an eventual career in politics.

The perpetual turmoil has agitated members of veterans’ service organizations, which have sparred with Mr. Wilkie as their influence has waned. “There is a leadership challenge going on over there,” said Randy Reese, the executive director of Disabled American Veterans. “The fault of not changing the culture rests on his desk.”

More ominous for Mr. Wilkie is the increasing impatience at Concerned Veterans for America, a conservative organization with substantial backing from the billionaire Charles G. Koch that has had enormous influence on the Trump administration’s veterans policies. That influence is especially evident in the new program allowing veterans to seek health care outside the department’s traditional medical centers.

Leaders of Concerned Veterans for America, like many current and former veterans department officials, fear the problems could presage the return to a dark era when inattention to veterans’ health care led to scandals and tragedies.

“We are going to be really watching over the next six months,” said Dan Caldwell, the executive director of the group. The organization was instrumental in ousting the last secretary, David J. Shulkin, who was dismissed in 2018 by presidential tweet.

“We were supportive of Secretary Wilkie assuming the position of V.A. secretary and are pleased with a lot of things he has done,” Mr. Caldwell said. “Everybody needs to be focused on getting these new programs right and not scoring political points. If the Mission Act doesn’t work, if female veterans don’t feel comfortable getting care at the V.A., then that is doing harm to the brave people who served our country.”

Mr. Trump has long made veterans central to his political platform and considers them a key part of his base. The White House last week proposed a 10 percent increase to the Department of Veterans Affairs budget, to $243 billion, even as it seeks to scale back most other nonmilitary spending. Congress, ever mindful of the politics of veterans care, is almost certain to comply, in spite of the recent troubles.

While the department is second only to the Defense Department in size and budget, it operates with far less oversight of its spending and activities. And while the mission of the Pentagon is higher in profile, lawmakers are loath to cut services for veterans or lose facilities in their districts, and they rarely suggest cuts to the department, regardless of its inefficiencies or problems.

The department has suffered decades of scandals, and in 2014 investigators found patients waiting an average of 115 days for appointments at the Phoenix medical center, where workers fraudulently reported far shorter waits. The department has subsequently endured a variety of intrigue and political infighting and has had four secretaries over five years.

Last fall, Andrea Goldstein, a Navy veteran and the senior policy adviser for the Women Veterans Task Force on the House Veterans Affairs Committee, told The New York Times that she was assaulted while buying a snack at the medical center’s cafeteria in Washington. After investigating, the veterans department’s Office of Inspector General declined to bring charges.

Mr. Wilkie, against the advice of his staff, three people said, then sent a letter to Representative Mark Takano of California, the committee’s chairman, denouncing the claim as “unsubstantiated” and chastising Mr. Takano for bringing it to the fore.

In an unusual rebuke, Michael J. Missal, the inspector general, wrote to Mr. Wilkie to say that characterizing Ms. Goldstein’s allegation as unsubstantiated was incorrect.

Four people with direct knowledge said that Mr. Wilkie and his senior aides also embarked on a campaign to discredit Ms. Goldstein’s claims by suggesting that she had made similar accusations many times before. Mr. Takano received complaints about those efforts and referred the matter to the inspector general.

Senior aides to Mr. Wilkie flatly denied that he had orchestrated any effort to discredit Ms. Goldstein.

“The secretary is the most ethical, decent, honorable man I have ever known,” said Pam Powers, Mr. Wilkie’s chief of staff. “At no time did the secretary ever direct, discuss or insinuate that somebody should investigate Ms. Goldstein’s background.”

The dispute has surfaced as the department is aggressively seeking to increase the number of women, who are a growing percentage of veterans overall, using its medical centers. It also comes amid reports from female patients and staff members — in at least one case a medical director — of harassment and assault by male veterans at the centers.

“The general sense is outrage,” said Kristen L. Rouse, the founder of the NYC Veterans Alliance, who like many female veterans has received an outpouring of emails and calls from other female veterans who said they had experiences similar to Ms. Goldstein’s.

Christina Mandreucci, a spokeswoman for the department, said that “Secretary Wilkie acknowledges that describing the allegations as ‘unsubstantiated’ was a poor choice of words, and he withdraws that word.”

At the same time, the department is focused on the rollout of a broad expansion of health care from private physicians, many of whom are reluctant to do business with the agency because of its history of slow payments. Health care provider networks are scrambling to build capacity without really knowing how many patients they will need to serve in the 36 states where the program will begin in May.

“I’ve heard from a number of South Dakota providers, who contract with the V.A. to deliver health care services to veterans, who are owed millions of dollars in overdue claims,” Senator Mike Rounds, Republican of South Dakota, said at a recent hearing. “Because of this, they are now in the terrible position of possibly having to turn away veterans seeking care.”

A week ago, the deputy veterans affairs secretary, James Byrne, was asked to remain behind after a morning meeting. Mr. Wilkie then told Mr. Byrne that he had “lost confidence” in his No. 2 and that he needed to resign.

“For two and a half years I had the privilege of working with dedicated professionals at the V.A. providing care benefits and services to deserving veterans,” Mr. Byrne said.

No further explanation has been publicly offered by department officials for his dismissal.

“The second-highest person in the second-biggest agency in the federal government got fired, and no one knows why,” said Kristofer Goldsmith, the chief investigator for Vietnam Veterans of America. “It is mind-blowing.”

Those with an interest in the department saw this as another distressing sign of turmoil.

“The bottom line is that the current V.A. has a lot to be proud of,” said Mr. Caldwell of Concerned Veterans for America. “But there is a lot of work to do and if they don’t do it well, the V.A. could turn from a success story into a horror story for the administration.”


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