Political appointees at the Department of Health and Human Services include at least 16 staffers with ties to former Secretary Tom Price and at least 12 with connections to Vice President Mike Pence or Indiana, a review of 129 résumés of appointed staffers in the department shows.

Pence’s influence over the agency can be seen in the appointment of Centers for Medicare and Medicaid Services Administrator Seema Verma, who worked closely with the former Indiana governor to expand Medicaid in that state, and the appointment of Verma’s deputy Brian Neale, who currently oversees Medicaid and served as Pence’s health care policy director in Indiana. A number of staffers also have ties to conservative groups close to Pence, such as the Heritage Foundation and anti-abortion organizations.

It’s not surprising that Price, who was elected to seven House terms before being tapped as HHS secretary, brought a tribe of former staffers from throughout his career with him to HHS. During his tenure as a Republican congressman from Georgia, Price focused on health care issues and chaired the Budget Committee.

Alex Azar, President Donald Trump’s nominee to lead the department after Price stepped down in September amid scrutiny of his taxpayer-funded use of private planes, is set to appear at a confirmation hearing Tuesday before the Senate Finance Committee. He will likely be confirmed this year.

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The résumés were shared exclusively with Roll Call after being obtained through a Freedom of Information Act request by American Oversight, a watchdog group formed last year to track the Trump administration. The documents show that a bevy of appointees are HHS veterans from the George W. Bush administration. That will include Azar, who technically needs to be re-nominated by Trump since his nomination did not roll over into 2018.

Azar, who served as both general counsel and deputy HHS secretary during the Bush administration, likely already has a working familiarity with many agency staffers, including career employees and appointees, said Tom Scully, a former CMS administrator under President George W. Bush who also worked with Azar. Having previously led pharmaceutical company Lilly USA, Azar will likely bring people he knows well into the administration, but Scully said it was unlikely he would tap many people from the industry.

“He’ll have some people he knows well,” Scully said. “I’d be surprised if Alex had an army of people he wanted to bring in.”

Michael O. Leavitt, former HHS secretary under George W. Bush, agreed that Azar is unlikely to bring drug industry colleagues with him if he is confirmed. Leavitt nominated Azar to be general counsel at HHS, a position he held for five years before serving as deputy secretary from 2005 to 2007.

“I would be surprised if there were lots of changes, simply because they need the staff they have there,” Leavitt told Roll Call. “And I think Alex will find them to be competent and will want to get started.”

The secretary is often not involved with staffing decisions beyond those who immediately report to him, Leavitt added, and Azar will have to contend with competing interests from the White House and elsewhere as he fills vacant roles.

If he is confirmed, Azar will be the latest HHS employee with ties to Indiana, where Eli Lilly & Co. is headquartered.