New @StateDept Bureau to Take $26 Million, Plus 98 Staffers From the Medical Services  Bureau

Updated 1:24 pm PDT 
We just learned that the Under Secretary for Management Brian Bulatao is pushing for the formation of a new bureau called Crisis and Contingency Response (CCR) under the Management umbrella. This would expand the “M” family to 14 bureaus and offices (including a more recent creation called Office of Management Strategy and Solutions (M/SS). 
We understand that Mr. Pompeo has formally signed off on this new office.  CCR will reportedly take $26 million funding from the Bureau of Medical Services (MED). It will also  pull 98 positions from MED and it will share EX and IT services with the Medical Services bureau.   
We also learned that the “7th floor loves Dr. Will Walters” because he and his Directorate of Operational Medicine are reportedly not only “providing OpMed flights during COVID, repatriation flights, logistics flights, but have also provided the Secretary with medical support during his travels.”
“Very sexy stuff, whereas what MED providers do is the more mundane day-to-day care of diplomats and their families overseas.”
Many medical providers are said to be up in arms about the rapid formation of this new Bureau — which happened in a span of just four months — with apparently no input from the field.
“Medical services to diplomats and their families abroad may suffer.”
We asked what are the potential consequences to MED and its patients, and we’re given a quick rundown by Sender A:
    • Since MED and the CCR Bureau share EX and IT, there is widespread concern that MED staffing and funding will be given short shrift in this new configuration.
    • What might happen is fewer FS medical providers whom MED is allowed to hire, leaving positions overseas unfilled.
    • Other critical “back office” functions in MED, if not supported by the new shared EX, might become understaffed.
    • If sections such as MED Foreign Programs (authorization and funding of Medevacs and hospitalizations, referrals to WDC medical providers) do not have sufficient staffing and funding, service to FSOs and EFMs abroad will certainly be noticed in terms of delayed or denied authorization and funding cables.
    • If the MED/GSO section does not receive sufficient funding/staffing, delivery of essential medications and vaccines will be delayed or nonexistent.
Our source said that a town hall was held last week concerning this new bureau.  Many medical providers reportedly submitted questions ahead of time, but “the vast majority of the one-hour time slot was taken up my monologues from Bill Todd and Will Walters.” 
Source added that “both were very good at smoothly blowing by the concerns raised by MED.”
We understand that Todd did not explain why a separate Bureau was being created, but almost everyone in MED apparently viewed this as “the ultimate bureaucratic power play.”
Bill Todd is the Deputy Under Secretary for Management (formerly Acting M, Acting DGHR going back to Tillerson’s fun times in Foggy Bottom).  He is awaiting committee and Senate vote to be the next U.S. Ambassador to Pakistan. Time’s running out. 
Dr. William Walters’ February 2020 bio posted in congress.gov says that he is a member of the Senior Executive Service (and former US Army medical officer). His bio says he is the Acting Deputy Chief Medical Officer for Operations and the Acting Executive Director for the Bureau of Medical Services. Further, it says that “As the Managing Director of Operational Medicine, Dr. Walters is responsible for the Office of Protective Medicine and the Office of Strategic Medical Preparedness and manages the care of the Secretary of State and traveling delegation while traveling abroad.”
The MED Bureau was last inspected by State/OIG in mid 2000 and the OIG issued a report in June 2006. So it is due for a new review. According to OIG, in 2006 (lordy, that’s 14 years ago!), MED had the following:

“192 health units in embassies and consulates abroad. MED’s direct-hire overseas staffing includes 45 regional medical officers (RMO), who are physicians, 16 regional psychiatrists, 72 health practitioners, 10 laboratory technicians, and three regional medical managers, supplemented by 250 locally employed staff. […] Overseas, MED serves patients from 51 U.S. government agencies. This patient population includes approximately 50,000 direct-hire employees and family members who are full beneficiaries of the program and about 70,000 locally employed staff, for whom MED provides treatment for on-the-job injury and illness. In 2004, there were 230,000 health unit visits and MED facilitated 635 medical evacuations to the United States and 350 medical evacuations to overseas centers.”

We understand that current staffing includes 250 Foreign Service Medical Specialists ( RMO, MP, RMLS, RMO/P) plus LNA nurses and Social Workers in some posts. MED’s workforce reportedly also includes around 1000 LES staff who work in health units abroad. This staffing number does not include the Civil Service employees working for MED in Washington, D.C.
Under current staffing, how many employees will be left at MED after 98 employees are pulled to staff the new CCR bureau?
What will be the direct consequences of gutting MED’s fund by $26million in order to fund the new CCR bureau?
What is the rational justification for creating a new bureau like CCR separate from MED? Why now? Is this a case of strike now why the iron is hot, there may not be another mass evacuation due to a pandemic soon?
What is the issue with keeping the Directorate of Operational Medicine as the arm for crisis and contingency response under MED? 
Why are they calling this the Crisis and Contingency Response (CCR) Bureau and not the Medical Crisis and Contingency Response (MCCR) Bureau, hmmmn? Will this new bureau be headed by an assistant secretary level appointee subject to Senate confirmation?
Hey, wait, wait a minute –is some hombre considering this new bureau as the crisis and contingency response lead in medical and non-medical crisis? The name is kind of a tell.  We’d like to hear the big picture, tell us more.
You know, we’ve heard of the Crisis Management and Strategy arm that’s operating out of Ops Center for decades. They do great work. We’ve never heard those folks start a new bureau.
Update 1:24 pm PDT: 
It looks like the State Department needs to send Congressional notification to create a new bureau. In May 2019, the State Department merged the Bureaus of Public Affairs (PA) and International Information Programs (IIP) to create the new Bureau of Global Affairs. That merger did not happen overnight:
“In the summer of 2018, a task force of PA and IIP colleagues collaborated with bureaus and offices Department-wide to design a proposal for the new merged bureau. Extensive consultation with Congress as well as key leaders and organizations both inside and outside of the Department continued throughout 2018 and early 2019. Following State Department approval and congressional notification, the new Bureau of Global Public Affairs became a reality in May 2019.”
So how fast do you think State can do all that and its congressional notification obligation for this new entity? 
It’s 13 days, 8 hours, 31 minutes to Election Day. Go VOTE!

Secretary Pompeo Swears-In Brian Bulatao as Foggy Bottom’s New “M”

 

U.S. Secretary of State Michael R. Pompeo swears in Brian Bulatao as the new Under Secretary of State for Management with T. Ulrich Brechbühl, State Department Counselor in attendance at the U.S. Department of State in Washington, D.C., on May 17, 2019. [State Department photo by Michael Gross/ Public Domain]

Now that the new under secretary for management has been confirmed, it’s a good time to revisit Mr. Bulatao’s testimony before the U.S. Senate (see excerpt below).

The culture of empowerment created greater organizational agility and a workforce that was unleashed to take on problem sets in new ways. I certainly didn’t come up with every idea, instead I empowered our team to consider how we could do it better, fail faster, and take smarter risks. Across the board, we embraced a spirit of innovation in order to boost the speed and precision of a large organization operating in a dangerous and competitive environment.

If confirmed as the Under Secretary for Management, this is the same approach I intend to bring to the U.S. Department of State. The Department’s hard-working, patriotic, and dedicated teams deserve to have an organization that optimally utilizes their talents. And the American people must have confidence that the State Department makes the best use of their resources and provides the best practical support for our diplomatic initiatives that rely on the strength of our alliances, partnerships, and engagement.

If confirmed, I appreciate the broad management responsibility I will have for the Department’s more than 76,000 personnel – Civil Service, Foreign Service, and Locally Employed Staff – and my direct supervision over 12 bureaus and offices. These women and men serve our country in some of the most challenging places around the world, and risk their lives daily, whether serving in war zones, amidst criminal violence and disease outbreaks, and with the threat of terrorist attack. They work long hours, often separated from their families, to advance our nation’s foreign policy and support the work of diplomacy.

There is no question that the safety and security of our personnel and their families must be the highest priority. I know Secretary Pompeo cares deeply about and works hard to protect his people.

I will ensure that the Bureau of Diplomatic Security has the resources, tools, and technology and is fully integrated into Department decision-making, to most effectively perform this critical task.

I will work hard to ensure our people have secure new buildings where required, that are completed on time, on budget, and incorporate cutting-edge IT infrastructure to support the critical missions they execute globally.

If confirmed, I will seek more creative ways to staff the Department to meet today’s mission and be well positioned to meet the challenges of the future. This will include hiring the full range of expertise, from our diplomats and subject-matter experts, to our specialists in the field like medical services and facilities management, to our security personnel. Hiring the best of the best with diverse backgrounds and experiences is critical to our global mission and will be a top priority for me.

I am committed to advocating for a budget that fully funds the Department’s requirements and putting in place the appropriate oversight and metrics to ensure the Department meets its obligation to use taxpayer dollars wisely and effectively. I will support Secretary Pompeo in requesting funding that serves the national interest and will implement the appropriations law as passed by Congress.

Finally, if confirmed, I will help bring Department operations into the 21st century by modernizing its systems and programs. With so many challenges facing the United States around the world, our diplomacy demands every logistical, technological, and informational advantage we can muster. We must be aggressive in protecting our security, generating prosperity, and advancing our values. Having a State Department team that is empowered and equipped with the right tools to achieve the mission is an integral part of making that happen.

The full testimony is available to read in PDF here.

Related posts:

 

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@StateDept Gets Closer to Getting an Under Secretary for Management, Vacant Since January 2017

 

@StateDG Carol Z. Perez Takes Office as @StateDept’s New Personnel Chief

Posted: 1:13 am EST

 

In addition to the State Department not having a Senate-confirmed Under Secretary for Management (the position that has been vacant now since the departure of Patrick F. Kennedy in January 2017 following Rex Tillerson’s arrival in Foggy Bottom),  it also did not have a Senate-confirmed Director General of the Foreign Service and Director of Human Resources since Ambassador Arnold A. Chacón departed this position in June 2017. No Senate-confirmed personnel chief for 19 months. Imagine that.

On February 1, 2019, Ambassador Carol Z. Perez officially took office as Director General of the Foreign Service and Director of Human Resources.

So the former dual-hatted Acting DGHR Bill Todd and Deputy Under Secretary for Management, where is he going?

Related posts:

Wait – @StateDept Has a Deputy “M” Again, a Position Discontinued by Congress in 1978

Posted: 2:30 pm  PT

 

With vacant offices and multiple departures from members of the Foreign Service and the State Department, it is hard to keep track sometimes of what’s happening amidst the opportunities and chaos in Foggy Bottom.

Bill Todd, the Principal Deputy Assistant Secretary & Acting Director General of the Foreign Service & Acting Director of Human Resources apparently has a fresh new title to add to his Twitter profile: Deputy Under Secretary of State for Management, a position discontinued by Congress in 1978.

How did that happen?

Apparently somebody convinced the now outgoing Secretary of State to sign a memo reconstituting this title on March 4. Did anyone bother to inform Secretary Tillerson that the position of Deputy Under Secretary for Management was discontinued specifically since Congress established the permanent position of Under Secretary of State for Management in 1978? And if nobody informed him …

Yo. This is sad.

Since the discontinued title/position was made “live” again a couple of weeks ago, there were people wondering why this title was resurrected now, and without any official announcement. Today, of course, a day before Tillerson is set to exit Foggy Bottom, the first memo sent under this office is out, so it’s not a secret anymore (bland, routine memo with A Message From Deputy Under Secretary for Management Regarding Planning for a Potential Lapse in Appropriations). And our inbox lighted up from folks with “Whoa, did you see this?” or “State has a Deputy M? or “When was the last time the State Department had a Deputy Under Secretary for Management?”

Whoa, indeed! Not since 1978, my dears.

What we want to know is if Congress is okay with this given that it purposely killed this position when it created the  permanent”M” by legislation decades ago.

Trump’s nominee as the next Under Secretary of State for Management Eric Ueland was nominated last year, renominated earlier this year and was cleared by the Senate Foreign Relations Committee in February. The last Senate-confirmed “M” Patrick Kennedy retired in 2017 in the mass departures of top officials following the arrival of Secretary Tillerson and his aides in Foggy Bottom.  If Mr. Ueland’s nomination survives the current churn, he would be wise to seek assistance from Kennedy during his transition. Whether you like Patrick Kennedy or not, he was the longest serving M at State and no one who knows him questions his dedication to the institution. He also made Foggy Bottom run. The new secretary of state cannot focus his attention on the business of diplomacy if his own building and the people in it are in disarray.

In related news —

Stephen Akard, the nominee to be the next Director General of the Foreign Service has now been withdrawn. We are hearing that a career nominee for DGHR is forthcoming but we don’t have a timeframe for when the announcement might happen. We are guessing that the DGHR position could be among the first that will be announced in the next few weeks leading to Secretary-Designate Pompeo’s confirmation hearing.

Although Akard was a former FSO, his nomination as DGHR was fairly unpopular in the career service and even among retirees, and we understand that the State Department leadership, particularly the Deputy Secretary is aware of this. We think that the withdrawal of the Akard nomination and the announcement of a respected career diplomat as the new DGHR nominee could give the new secretary of state and the career service a fresh start without the baggage of bad feelings casting a shadow over Pompeo’s transition as the country’s top diplomat.

And for those not too familiar  with State, DGHR is one of the bureaus and offices that report to the Under Secretary of State for Management. We have to point out that when the next DGHR is nominated and confirmed, the Acting DGHR right now would presumably be overseeing the Senate-confirmed DGHR in his capacity as the new Deputy Under Secretary of State for Management.

Oh, lordy! We can’t wait to read all your oral histories!

image via imgur

Via history.state.gov:

Deputy Under Secretaries of State for Management

The Department of State by administrative action created the position of Deputy Under Secretary of State for Administration, after Congress authorized ten Assistant Secretary of State positions (two of which could be at the Deputy Under Secretary of State level) in the Department of State Organization Act of 1949 (May 26, 1949; P.L. 81-73; 63 Stat. 111). Between 1953 and 1955, the ranking officer in the Department handling administrative matters was the Under Secretary of State for Administration. The Department re-established the position of Deputy Under Secretary for Administration in 1955, after Congress authorized three Deputy Under Secretary positions in the State Department Organization Act of Aug 5, 1955 (P.L. 84-250; 69 Stat. 536). The Department of State by administrative action changed the title of the position to Deputy Under Secretary of State for Management on Jul 12, 1971.

The position of Deputy Under Secretary for Management was discontinued when an Act of Congress of Oct 7, 1978, established the permanent position of Under Secretary of State for Management (P.L. 85-426; 92 Stat. 968).

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