Thread by @AbbieRBennett

New from @USGAO: In January 2017, Trump said he and VA would consult private citizens to help address VA issues. This raised questions about influence on VA’s decisions.
GAO found interactions between VA officials and private citizens in 2016 and 2018.
gao.gov/products/GAO-2…

@USGAO Background: connectingvets.radio.com/articles/congr…

@USGAO VA officials communicated with these 3 men with connections to the president about:
- Contract for a $16B electronic health record system
- Mobile app development
- Suicide prevention campaign
- Medical device registry
- Personnel decisions, including Under Secretary for Health

@USGAO "According to former VA officials, while the three private citizens had power and influence in part because of the connection of one of the three private citizens to
the president, VA officials ultimately made decisions independently of this influence.," GAO's report reads.

@USGAO "A former VA official told us that the three private citizens created a 'shadow reporting structure; in which they were stakeholders without a formal role," GAO report says.

@USGAO This created "confusion" for VA staff "who recognized the power and influence" of the men, "but were not given clear guidance on how to handle that power or make decisions under that influence," the report says.

@USGAO But one current VA official said the men had "no impacat" because their input did not require VA "to deviate from its planned strategy" for decision making on those issues.
That official said he was never directed to change anything to meet the desires of those men.

@USGAO Former VASec Dr. David Shulkin "acknowledged that seeking the advice of private citizens is not an unusual practice for government officials" but this was different because of "the president's expectation that he listen to them and make them happy."

@USGAO But Shulkin said he listened to their advice "in the same way he listened to advice from any other private citizens" and "always made decisions ... regardless of what these private citizens advised."

@USGAO Another former VA official told investigators he believed Shulkin made independent decisions, but Shulkin had to "bring along" the 3 men and "get their buy-in" on certain VA decisions, including the $16B electronic health record effort.

@USGAO GAO found:
- Input from the 3 men "may have contributed to to delays of EHR contract negotiations.
- Isaac Perlmutter arranged Shulkin's appearance at the NY Stock Exchange in November 2017.
- Bruce Moskowitz had weekly meetings with VA to plan a medical device registry summit

@USGAO GAO also found:
- The 3 men offered suggestions on candidates for positions at VA, including CIO and Under Secretary for Health " and that VA attempted to hire one of these potential candidates for the CIO position."

@USGAO Shulkin wrote in his book that he "interviewed" with 2 of the 3 men before he was nominated. Says the president called Perlmutter to say he agreed with Perlmutter's positive opinion of Shulkin.
Shulkin alleges Perlmutter coordinated his removal from VA. Perlmutter denies.

@USGAO The 3 men in 2018 denied influence at VA:
“Any decisions ... as well as the timing of any ... decisions, were independent of our contacts with the VA. We did not make or implement any ... policy,
possess any authority over ... decisions, or direct officials to take any actions.”

@USGAO In a review of 223 email exchanges, GAO found the 3 men: "acted as organizers by scheduling meetings with VA officials and helping to plan events ... at times, the emails show they acted as advisors by making recommendations."
cont

@USGAO - 28 of 223 emails were recommendations
- 70 of 223 were information on issues related to personnel, contracts, events and veterans' ability to seek health care outside VA
- Emails showed the men introduced other private citizens to VA, including business people and academics

Former VA official told GAO the men "held some degree of power and influence" because of connections to the president.
It was "clear at times that they did not understand the subject matter at hand or how government worked" though they on occasion offered "fantastic" advice

"While these 3 private
citizens thought they were more knowledgeable than they were, VA officials recognized
their power and tried to take the advice they offered that was valuable but disregarded
the advice that was not helpful," former senior VA official said.

A VA contractor told GAO that he was told by VA officials the 3 men "had an informal role (at VA) as trusted advisors to the White House from whom they had instructions and 'blessings' to be involved in VA" business.

- 67 of the 223 email exchanges were VA officials updating the 32 men, including personnel changes.

In 3 or fewer cases of the 223 email exchanges reviewed, GAO says the men asked for action from VA officials, or VA asked for action from them, or they praised VA decisions.

The 3 men were most involved with the electronic health record contract with Cerner, the GAO report says. That project totals $16B and has been delayed multiple times.

The 3 men interacted with "a number of senior VA officials" including Shulkin and Wilkie, the former DepSec, former Chief of Staff, former senior advisors to the VASec and more.
The emails were initiated both by the 3 men and by the VA officials themselves.

The men "interacted with VA and other federal officials frequently -- at times daily, according to former VA officials -- through email and phone or in meetings, some of which involved travel to D.C. or "West Palm Bach, Fla., where one or more of the (men) worked or" lived.

Emails led GAO to believe phone calls were frequent but investigators did not obtain phone logs or other records "because such records were not readily available to VA."

Unsure why.

In his book, Shulkin said he communicated with the men frequently, they would call him multiple times per day and "scold him for not communicating with them enough."

In February 2018, Shulkin and former Chief of Staff O'Rourke traveled to Florida to meet with the 3 men.
Wilkie also met with at least one of the men in April 2018 during a trip to Florida.

VA had no comment on the draft report.

More here: connectingvets.radio.com/articles/mar-a…

Full story: connectingvets.radio.com/articles/mar-a…