WASHINGTON - The unexpected withdrawal of Dr. Charles W. Grim's nomination to direct the IHS for another four years left plenty of speculation in its wake.
The Sept. 5 announcement caught Washington's Indian affairs community by surprise. A number of health care professionals were waiting to know more shortly after word got around near midday. In the meantime Thomas Sweeney, director of public affairs for IHS, said Grim's withdrawal had to do with family needs.
Grim's advocacy for urban Indian health care, within an administration that has proposed the withdrawal of federal budgetary support for urban Indian clinics, played no role in Grim's withdrawal, Sweeney said. Nor did an apparent discrepancy between Grim and the Office of Management and Budget on the authority in federal law for Indian health care, as revealed at a July 26 hearing on his nomination of the Senate Committee on Indian Affairs. ''Absolutely not,'' Sweeney said.
His assurances didn't keep Washington political observers from wondering if Grim would have let things go so far as the July 26 hearing if the claims of his family, all smiles on that day, were in any way unsettled.
But by day's end, Grim himself had set the record straight. He himself asked that his name be withdrawn from consideration, he said. The White House and Secretary of Health and Human Services Mike Leavitt asked him to reconsider, and OMB didn't weigh in at all, he said. ''I didn't say something wrong at a hearing and then the president decided to withdraw my nomination.''
He said it's not fully appreciated that the presidential appointment process, even for someone who has cleared the background checks once already, as in his case, is prolonged. Six months ago he agreed to serve a second term as IHS director, and the Senate hearing came up suddenly. But over the months, a change of circumstance in the extended family he and his wife, who has a career of her own, relied on for assistance in running a household of five children between two and 20, forced him to reconsider.
On a recent 1,500-mile commute home to Oklahoma for the weekend, Grim said he could see it just wouldn't work out family-wise for him to be absorbed in the demands of a high-level post in Washington. His 2-year-old, for instance, has never really gotten to live in the same house with his father.
It was a tough decision even so, Grim said, given his admiration for IHS employees and the absence of any roadblocks to his reappointment as IHS director.
He's not sure about his immediate plans outside the home, he said. With a 2-year-old to provide for, he added that he won't be retiring. As a career IHS officer, he may return in some capacity with the IHS, or he may explore the private sector. In any case, he will certainly work in the field of Indian health. He has a passion for it that hasn't dimmed, he said.
After the surprise wore off, Indian country met his official announcement with an outpouring of praise for his tenure at IHS, and support for his decision to put family first. A lobbyist in the field of health care joined others in praising the four years Grim has already spent at the IHS helm, noting that the IHS budget increased in every year of his tenure while other HHS departments experienced setbacks.
Geoffrey Roth, National Council of Urban Indian Health, said Grim will be missed. ''He was for urban Indian health care, even when it wasn't good for him to be for it within the administration, politically.''
Grim said he will stay on as IHS director for 60 days, giving President Bush adequate time to appoint an acting director.