As President Obama's pick to lead the embattled Veterans Affairs Department out of its current crisis, Robert McDonald faces a tall order from the senators who will decide his fate.
Members of the Senate Veterans' Affairs Committee insist that he will need to overhaul the VA at once if he is confirmed. For lawmakers, that includes everything from installing new leadership and transforming the department's culture to restoring accountability and ensuring that veterans receive prompt medical treatment.
McDonald told lawmakers that if he gets the job, he would take action on reforms during his first 90 days in office.
"The No. 1 core value of the organization is integrity, so we've got to root out when that isn't upheld," he said.
McDonald said on his first day he would lay out his leadership vision to all VA employees and incentivize them to bring any concerns and problems to his attention so he has a full picture of what's wrong. He would also travel across the country in the first few months to meet with employees, veterans, and other stakeholders.
He also plans to restructure metrics for employees' evaluations. Veterans service organizations and lawmakers have long questioned if linking performance metrics to bonuses could encourage data manipulation.
"How does the VA — among other things — provide timely, quality health care?" committee Chairman Bernie Sanders of Vermont said in an interview just ahead of McDonald's confirmation hearing Tuesday. "How do we continue ... lowering the claims backlog? How do we make sure that the numbers that are coming out are accurate? How do we develop accountability at the VA? ... These are very difficult issues."
McDonald's confirmation process could see quick turn around from the committee. Sanders said committee members hope to vote on his nomination Wednesday.
The VA has been under fire in recent months after allegations of data manipulation at its medical facility in Phoenix that included reports of veterans dying while waiting for care.
Acting Secretary Sloan Gibson told lawmakers late last week that investigations into roughly 70 VA facilities are not expected to wrap up until mid-August.
Committee ranking member Richard Burr of North Carolina told McDonald that if he is confirmed, "it will be essential that you embrace the findings of these investigations."
The major hurdles McDonald faces are proving that the VA is being held accountable for its misdeeds and can turn itself around immediately by taking care of the millions of veterans under its charge, committee members stressed Tuesday.
"The biggest challenge is obviously getting the system nationally to be able to deliver much more rapid-response health care to our veterans," Democratic Sen. Mark Begich of Alaska said in an interview shortly before McDonald's hearing. "Second, I think he has a culture within the VA that he has to move kind of into this 21st century of how to respond to this very complicated health care delivery system that we have."
Begich added that McDonald faces not just a budget issue, but a recruitment challenge of hiring more doctors and other essential health care professionals.
"He has to kind of rebuild that image, rebuild that trust, and be able to deliver health care in a much more expedited way to veterans across the country."
Getting the American people — veterans in particular — to trust the VA must be his first order of business, some senators said. They added that this will require a significant housecleaning.
"First and foremost, making sure the information is accurate and truthful, getting good information" would be McDonald's top challenge, said Democratic Sen. Richard Blumenthal of Connecticut. "Second, changing the culture. Bringing tough standards to bear and making sure that they are met. And third, changing the people — making sure that there is new leadership and that they are part of the new culture."
Despite the laundry list of demands, McDonald is expected to have a smooth confirmation process. A handful of Republican senators — often tough critics of the VA — told McDonald that his confirmation is all but guaranteed. Lawmakers are hopeful that he can use the managerial skills he honed in the private sector — including during a stint as the CEO of Procter & Gamble — to whip the department into shape.
If confirmed, McDonald will replace Eric Shinseki, who stepped down as secretary in late May amid growing allegations of misconduct at VA offices across the country. Sloan Gibson has served as acting secretary since then.
But the scandal goes beyond the VA's health administration. On the other side of Capitol Hill, House Veterans' Affairs Committee members — led by Republican Rep. Jeff Miller of Florida — are looking into allegations that disability-claims workers cooked the books or destroyed information. Whistle-blowers across the VA have come forward and testified before Congress about allegations of retaliation.
Linda Halliday, the assistant inspector general for audits and evaluations, told lawmakers last week that the VA's Office of Inspector General is investigating data-integrity complaints with VA claims at its offices in Baltimore; Houston; Little Rock, Ark.; Los Angeles; Oakland, Calif.; and Philadelphia.
And though lawmakers on both sides of the aisle have missed little opportunity to criticize the embattled department, legislation that would provide extra funding and allow veterans greater access to private health care is stuck in a conference committee, with no break in the logjam in sight.
In a bit of political football, Senate Majority Leader Harry Reid has blamed Republicans on the conference committee, saying they are unwilling to provide extra funding for veterans, despite supporting the recent wars.
But with the monthlong August recess looming, Sanders and Miller have said they were still hopeful an agreement could be reached, despite the "tough negotiations."