Washington (CNN)President Donald Trump made improving care for veterans a centerpiece of his campaign, and for the last year his VA Secretary, David Shulkin, has enjoyed bipartisan praise for the department's work on behalf of the men and women that serve the United States.
Who's calling the shots at the VA? Shulkin says he is, with the President's support
But in the last week, rifts over policy and tensions between White House insiders and those within the Department of Veterans Affairs have called into question who is really running the department.
Shulkin remains on the job nearly a week after a blistering inspector general report found that his chief of staff altered an email and made false statements to a department ethics official that led taxpayers to cover expenses for Shulkin's wife on an official trip to Europe. The inspector general report also called into question Shulkin's acceptance of pricy Wimbledon tickets and his use of an aide as what the report called a "personal travel concierge" to him and his wife.
Shulkin was at the White House on Tuesday for his second meeting with White House chief of staff John Kelly in a week. He told CNN in an interview that Kelly assured him that he still has the President's backing.
"I'm the secretary and we're moving forward in the way that the President wants us to," Shulkin told CNN, saying he remains in full control of the department.
"Anybody who is not moving in the same direction as I am, which is implementing the President's agenda, is going to find this is probably not the right place for him to be," he added.
White House press secretary Sarah Sanders said Tuesday she had "no reason to believe otherwise" when asked if Shulkin was still in good standing.
"As we've said many times before, if someone no longer has the confidence of the president, you guys will know," she said, adding that she was unable to comment further until a secondary review of the inspector general report was completed.
Underlying the political jockeying within the VA is a policy debate that could change the face of health care for the roughly 9 million veterans the VA health care system currently serves.
For his part, Shulkin has maintained that he did nothing wrong, though he wished he had asked more questions of his staff, but told CNN that he has repaid the US Treasury for his wife's travel as recommended by VA's Inspector General Michael Missal.
But the scrutiny over Shulkin's travel has opened a window into tensions between the agency and White House officials that have gone on since at least winter of 2017.
Members of the veterans community both on and off Capitol Hill said they'd been concerned for months about the roles of two former Trump campaign officials: Darin Selnick, the veterans affairs adviser for the White House's Domestic Policy Council who has ties to the Koch-backed group Concerned Veterans for America, and Jake Leinenkugel, the former brewer and now White House senior adviser on veterans issues.
Selnick and White House staffers have met with key veteran groups to discuss policy issues without the presence of Shulkin's key aides, according to two sources within the veterans community.
Veterans advocates and congressional aides were particularly alarmed by a December memo that Leinenkugel wrote that accused Shulkin's deputy, Thomas Bowman, of disloyalty and being at odds with Trump's agenda and recommended that both Bowman and Shulkin's then-chief of staff Vivieca Wright Simpson be replaced. Shulkin, according to the memo, which was previously reported by The New York Times and The Washington Post, should be "put on notice" to leave after more of the President's key VA initiatives were in place, Leinenkugel wrote.
The White House did not respond to CNN's request for comment about the memo, or Selnick and Leinenkugel's involvement with the department.
Two congressional aides said the memo "confirmed their worst suspicions" about the level of disconnect within the White House and said they weren't sure whether Shulkin would be able to ride it out. They also expressed concern that it could lead to a fundamental shift in how the nation's veterans receive care.
Asked about the reports of tension between administration officials and those within the VA, Shulkin told CNN on Tuesday that there "have been different people with agendas different than the one that I have and that has to stop."
"That's my job," he added, "to make sure we're focused on moving forward with the mission that we have."
Recent days have also seen a high-level staff shuffle, with Shulkin's former chief of staff, Vivieca Wright Simpson -- who was named in the critical IG report last week -- announcing her decision to retire.
Wright Simpson, a three-decade public servant and the third-most-senior official at VA "just didn't feel that it was the right thing for her and her family to continue in that type of environment," Shulkin said Friday.
Hours later, VA press secretary Curt Cashour announced that Peter O'Rourke, the head of the new VA Office of Accountability and Whistleblower Protection and a former Trump campaign aide, would fill the chief of staff role on a permanent basis.
The White House did not respond to CNN's request for comment on O'Rourke's appointment to one of the VA's top jobs. Shulkin told CNN that O'Rourke's selection as chief of staff was a "mutual decision" between himself and the White House as he said is standard practice for political appointees.
"We started to work together over the weekend and today," Shulkin said of O'Rourke Tuesday. "I think we are going to be very effective in getting this organization back on track with him in that role."
There also seems to be a broader messaging disconnect that exemplifies how much the department's secretary and the White House-aligned officials working in it are not on the same page.
Last week, when the inspector general report on Shulkin's 2017 Europe trip became public, the secretary released a statement in which he defended himself, saying that he had "done nothing wrong." In that same statement, Shulkin called the report "neither accurate nor objective" and characterized it as "a direct assault on my spouse, my character and my unblemished record of service to the Veterans Affairs Administration."
Hours later, Shulkin's statement no longer appeared on the VA's website. The statement was replaced by a significantly shorter one from the VA's press secretary that said, "Accountability and transparency are important values at VA under President Trump, and we look forward to reviewing the report and its recommendations in more detail before determining an appropriate response."
Cashour declined to answer questions about why he replaced the secretary's statement with one of his own.
Inquires about Shulkin made to the VA's press office have been referred to the White House; Shulkin has been communicating with reporters not with the involvement of the press office, but instead through his personal cell phone.
Over the weekend, a number of veterans service organizations released a statement supportive of Shulkin and condemning what American Legion National Commander Denise Rohan described as "political operatives [who] have taken active measures to undermine Shulkin, his deputy, his former chief of staff and their ability to lead."