Deputy Under Secretary for Health (DUSH)
About the Office
The Office of the Deputy Under Secretary for Health (DUSH) ensures the integration, effectiveness, and reliability of the systems and programs supporting the health and well-being of our Nation’s Veterans. The DUSH performs the duties of the USH in their absence and serves as the Chief Operating Officer for VHA. The DUSH provides leadership, guidance and strategic direction in support of the mission of the USH and VHA in collaboration with the Assistant Under Secretaries for Health; for Clinical Services; Patient Care Services; Integrated Veteran Care; Discovery, Education, and Affiliate Networks; Operations; Quality and Patient Safety; and Support Services.
The Office of the DUSH comprises several program offices that are critical to the mission of VHA, including the Office of Healthcare Transformation; the Office of the Chief Health Informatics Officer; the Office of the Chief Financial Officer; the Office of the Chief of Human Capital Management; and the Office of the Chief Strategy Officer.
Sub-office:
Assault and Harassment
Prevention Office
The VHA Assault and Harassment Prevention Office supports the Department of Veterans Affairs’ (VA’s) commitment to providing a safe, welcoming, and professional environment for all employees, Veterans, volunteers, and visitors.
Activities
Integrates programs and policies across VA’s National health care system as the immediate assistant to the USH.
Provides oversight and guidance for Assistant Under Secretaries for Health, Chief Officers, Network Directors, and program officials in VHACO and National health care facilities.
Leads VHA in defining the corporate code of ethics, vision, principles, policies, goals, expectations, and the lines of authority through which these will be actualized.
Establishes or approves standards for VHA research programs, emergency care, capital asset planning and management, and information management.
Provides innovative and forward-looking fiscal investment planning, programming, and budget execution oversight throughout VHA.
Develops policy, program initiatives, and management requirements that align with the VA strategic plan and enterprise-wide solutions.
Leadership
Lee Payne, MD, MBA, CPE, FACEP, Maj Gen (ret), USAF
Acting Deputy Under Secretary for Health (DUSH)
Dr. Lee Payne was named Deputy Under Secretary for Health in February 2026. In this role, he helps lead the nation’s largest integrated health care system with more than 1,400 sites of care. Dr. Payne provides executive oversight of all Veterans Health Administration (VHA) policies and programs, offering strategic direction and guidance in collaboration with the Assistant Under Secretaries for Health.
Dr. Thomas O’Toole
Associate Deputy Under Secretary for Health
Prior to this role, he served as Acting Deputy Under Secretary for Health (DUSH) within the Office of the DUSH. In this role, he delivered executive oversight for all policies and programs within the Veterans Health Administration (VHA). He has also served as Acting Assistant Under Secretary for Health (AUSH) for Clinical Services as well as Acting Chief Medical Officer, serving over 9 million enrolled Veterans annually at over 1,700 sites of care in the nation’s largest integrated healthcare system.