When he moved from Utah to Washington to become administrator of the Environmental Protection Agency two years ago, Mike Leavitt brought along a core group of advisers from his days as governor.
Now that he has settled in at the helm of the Department of Health and Human Services, he is once again luring the team to follow him.
With 67,444 employees and an annual budget approaching $600 billion, HHS is a big leap for Secretary Leavitt and his inner circle. At the EPA, they oversaw 18,000 workers and a budget of less than $8 billion. The budget for the state of Utah this year is about $4 billion.
Leavitt, 54, has created a command structure and policy blueprint to help him direct the sprawling department, which includes the National Institutes of Health, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the Medicare and Medicaid health programs for the elderly, poor and disabled.
He is surrounding himself with a group of "senior counselors," a new title at the department that gives his most trusted aides the visibility and latitude to tackle high-priority matters. The counselors meet several times a week, sometimes with Leavitt, and serve as gatekeepers to the secretary.
For a road map, they are relying on Leavitt's 500-day plan (www.hhs.gov/500DayPlan/500dayplan.html), an ambitious set of goals and some steps for tackling them. The plan includes obvious areas such as modernizing Medicare and Medicaid and protecting the homeland, along with newer ones such as "Protect Life, Family and Human Dignity" and "Improve the Human Condition Around the World."
"The first principle of Leavitt management is offensive or proactive rather than defensive," said Chief of Staff Rich McKeown. "He positioned himself as governor, as administrator of EPA and secretary of HHS by doing things he can uniquely do and that are the most important things."
In particular, Leavitt is devoting much of his time to promoting the use of information technology in the health arena, preparing for a possible flu epidemic and fulfilling President Bush's mandate to make the Medicaid insurance program for the poor more efficient, McKeown said.
Here is a brief look at the key members of Leavitt's inner circle at HHS:
* Rich McKeown, 58, chief of staff, was a Democrat until 2000 and once ran unsuccessfully for mayor of Salt Lake City.
His move to Washington to become Leavitt's chief of staff at the EPA was "an interesting round trip" for the D.C. native. McKeown spent his childhood in Arlington and taught in Fairfax County for four years.
Describing his 1995 mayoral bid as "an exercise in poor judgment," McKeown stressed that although he was a registered Democrat, the race was a nonpartisan election. The following year he was appointed as a Democratic nominee to the state tax commission, and in 1999 he became Leavitt's chief of staff.
These days, McKeown and his wife are empty-nesters, with all five of their children away at school or working. He is a graduate of Ohio University and the University of Utah College of Law.
* Natalie Gochnour, 43, counselor to the secretary, has worked for Leavitt since he was first sworn in as governor in 1993. Of the HHS counselors, she is "very much at large," she said, roaming across high-priority areas such as health information technology, the secretary's speeches and implementation of the 500-day plan.
An economist by training, Gochnour said she brings "fresh eyes" to a department dominated by medical experts. She received her undergraduate and master's degrees in economics from the University of Utah. Gochnour and her husband have two children.
* Charles Johnson, 69, worked in the private sector for 30 years before joining Leavitt's team in 1993. Currently chief financial officer at the EPA, Johnson is expected to be confirmed by the Senate as assistant secretary for budget, technology and finance at HHS.
A certified public accountant who has served on numerous public and private boards, Johnson ran Leavitt's 2000 reelection campaign. After retiring from the KPMG accounting firm in 1991, he did stints as the head of the governor's Office of Planning and Budget in Utah and then as Leavitt's chief of staff.
Johnson is a graduate of Brigham Young University. He and his wife have six grown children.
* Suzanne DeFrancis, 56, is awaiting Senate confirmation as assistant secretary for public affairs, a job currently held by Wisconsin-transplant Kevin Keane.
DeFrancis got her start in Republican Party politics as a speechwriter for Spiro Agnew. Her career has included speechwriting or communications jobs on Capitol Hill, at the Republican National Committee, and, most recently, in the Bush White House as deputy assistant to the president for communications.
During four years at the Porter Novelli public affairs firm, DeFrancis supervised several large projects for health industry groups, including the Health Benefits Coalition and the Pharmaceutical Care Management Association.
DeFrancis is a graduate of the National Cathedral School in Washington and the University of Colorado. DeFrancis and her husband have three children.
* Jennifer Young, 36, senior counselor for health policy, is a self-professed "Hill rat" with more than eight years' experience in Congress. She has worked for both the House Ways and Means Committee and the Senate Finance Committee, focusing on health programs such as Medicaid, Medicare and the State Children's Health Insurance Program.
She has also worked for the National Governors Association and Republican George V. Voinovich when he was governor of Ohio.
Young joined HHS in 2002, working in then-Secretary Tommy G. Thompson's legislative affairs office. There she helped push for passage of the drug bill in late 2003 and served as the Bush administration's principal liaison on HHS legislation.
Young, a graduate of Georgetown University, is spending much of her time on implementation of the new Medicare drug law, which will provide medication coverage to seniors beginning Jan. 1.
Young and her husband have twins, a son and a daughter.