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Leadership-level org chart with named principals, acting designations, PEO/PAE structure, and PMO portfolio. Includes search, expand/collapse, and source attribution.

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Organizational Intelligence

Department of Veterans Affairs
Organizational Structure

Current as of April 30, 2026 • Secretary: Doug Collins (sworn in Feb 5, 2025) • RISE Initiative: 18 VISNs → 5 Operations Centers • Sources: VA.gov · Government Manual · Military Times
Acting / Performing Duties
Vacant
RISE Initiative
Office of the Secretary Executive Leadership
12th Secretary of Veterans Affairs
The Hon. Douglas A. Collins
Sworn in Feb 5, 2025 · Trump 2nd Term
Senate Confirmed
Deputy Secretary / COO
Dr. Paul R. Lawrence, Ph.D.
Confirmed March 27, 2025 · EHRM Program Lead for VA
Senate Confirmed
Chief of Staff
Curt Cashour
Effective Feb 13, 2026 · Iraq Vet · Bronze Star
General Counsel
Catherine Mitrano
Acting General Counsel
Acting
Three Administrations Primary Operating Pillars
Veterans Health Administration (VHA)
Under Secretary for Health
⚠ VACANT · No confirmed USH since Jan 20, 2025
Vacant · Senate Confirmation Required

No Senate-confirmed USH since Dr. Shereef Elnahal (Biden). Dr. Steven Lieberman served as Acting USH through January 2026, then moved to Executive Medical Center Director, VA New Jersey. The current acting official for 2026 has not been publicly confirmed. Dr. Thomas O'Toole serves as Acting AUSH for Clinical Services / Acting CMO.

170+ VAMCs · 1,200+ outpatient sites · 9M+ enrolled veterans · ~$65B annual healthcare budget

VHA Internal Structure
Deputy Under Secretary for Health (DUSH)
Principal deputy · reports to USH
Acting AUSH for Clinical Services
Dr. Thomas O'Toole · also Acting CMO
VHA Chief Operating Officer
⚠ BEING ELIMINATED under RISE Initiative
VHA Central Office (VHACO)
Policy, Financial Mgmt, Oversight, Compliance
RISE Initiative (Restructure for Impact & Sustainability Effort)
Announced Dec 15, 2025. Implementation: 2026 to 2027.

Key Structural Changes:
• 18 VISNs → 5 Operations Centers reporting directly to USH
• VHA COO position eliminated
• VHACO staff placed under USH, DUSH, or Associate DUSH
• Medical facility directors empowered with more local authority
• No RIF · staffing at VAMCs and clinics unchanged

Goal: Eliminate redundant bureaucracy, clearer accountability chain Secretary → front-line clinical leaders.
18 Current VISNs (Consolidating to 5 Operations Centers)
VISN 1 · New England
VISN 2 · NY/NJ VA HCS
VISN 4 · VISN 4
VISN 5 · Capitol HC
VISN 6 · Mid-Atlantic
VISN 7 · SE Network
VISN 8 · Sunshine
VISN 9 · Mid South
VISN 10 · Great Lakes
VISN 12 · Midwest
VISN 15 · Heartland
VISN 16 · S Central
VISN 17 · TX Valley
VISN 19 · Mtn States
VISN 20 · Northwest
VISN 21 · Sierra Pacific
VISN 22 · SW HC
VISN 23 · Midwest HC
Veterans Benefits Administration (VBA)
Acting Under Secretary for Benefits
Michael Frueh · Principal Deputy USB / Acting (confirmed Apr 2025; 2026 successor unconfirmed)
Acting · Confirmation Required

Michael Frueh (Principal Deputy USB) was confirmed acting as of April 2025. Karen Brazell (nominated June 2025) withdrew Oct 2025. Following her withdrawal, current acting status for 2026 is not publicly confirmed. Deputy Sec. Lawrence re-launched the search Jan 2026.

Manages nearly $200B in annual benefits. 56 Regional Offices nationwide.

Principal Deputy USBenefits · Michael Frueh
Acting USB (confirmed Apr 2025; 2026 successor unconfirmed)
Deputy US for Disability Assistance
Compensation · Pension & Fiduciary · Insurance · Benefits Assistance
Deputy US for Economic Opportunity
VR&E · Education · Transition Assistance · Loan Guaranty
Deputy US for Field Operations
56 Regional Offices · Records Mgmt Center · Appeals Mgmt Center
Board of Veterans' Appeals (BVA)
Chair: Cheryl L. Mason
National Cemetery Administration (NCA)
Under Secretary for Memorial Affairs
Sam Brown · Confirmed Aug 1, 2025
Senate Confirmed Aug 1, 2025

Nominated Jan 20, 2025. Confirmed 54 to 44. Sworn in by Secretary Collins.

150+ National Cemeteries (US & Puerto Rico)
State Cemetery Grants Program
State & tribal veterans cemeteries funding
Headstones, Markers & Presidential Memorial Certificates
Staff Offices Assistant Secretaries & Executive Directors
Assistant Secretaries
AS for Congressional & Legislative Affairs
Brooks D. Tucker
VA-Congress relationship, legislative engagement, GAO liaison
Confirmed
AS for Enterprise Integration
Melissa S. Glynn, Ph.D.
Cross-functional integration, strategic analysis, departmental planning
AS for Human Resources & Administration
Jacquelyn Hayes-Byrd
Acting · VA workforce 300,000+
Acting
AS for IT / Chief Information Officer
Gary Shatswell
Nominated April 21, 2026 (3rd nominee). Lawrence performing duties pending confirmation.
Nominated · Pending
AS for Management / CFO
Jon J. Rychalski
CFO · ~$350B total VA budget authority
AS for Public & Intergovernmental Affairs
Position Under Transition
Cashour moved to Chief of Staff Feb 2026 · role under review
Transitioning
Executive Directors & Independent Offices
Accountability & Whistleblower Protection
Kirk M. Nicholas
Employee accountability and whistleblower protections
Acquisition, Logistics & Construction (OALC)
Karen L. Brazell
Chief Acquisition Officer · withdrew VBA nomination Oct 2025, remains OALC
Chief Veterans Experience Officer
Lynda C. Davis
Veterans' experience, satisfaction, and access initiatives
Office of Inspector General
Michael J. Missal
Independent oversight of VA programs and operations
FEHRM Federal EHR Modernization · VA / DoD Joint Program

The Federal EHR Modernization (FEHRM) is jointly managed by VA and DoD (DHA). FEHRM Director Bill Tinston coordinates Oracle Cerner deployment across both enterprises. As of April 2026, VA has 13+ active deployment sites. Deputy Secretary Lawrence personally oversees the EHRM program for VA, appearing weekly on the “Federal Electronic Health Record Update” internal program.

⚠ Risk Flag: The DHA April 2026 reorg · PAE “Construct Pending” status and HCDS recompete · creates a governance gap for FEHRM coordination on the DoD side during the IOC to FOC transition (target: Jul 19, 2026). On the VA side, the vacant CIO position (Gary Shatswell pending confirmation) adds further coordination risk for the joint program.

Sources: VA.gov · US Government Manual · Military Times · Army Times · NextGov · Mission Meets Tech Research · Current as of April 30, 2026