Leadership Malpractice: Air Force Misinforms Thousands, Kills Medical Coverage for Transitioning Families

FM Pulse
Forget what AFPC says. You’re better off getting your FM “pulse” from a cadaver.

Just when it seemed the Air Force Personnel Center (AFPC) had hit bottom in its mangling of the service’s drawdown, it found a way to bore to new depths. After demoralizing participants in this year’s Force Management process with unexplained delays, opacity, and deceptive tactics that would make a used car salesman blush, AFPC inexplicably changed the rules midstream to feed deployment rosters and even tried to revoke approved retirements, necessitating corrective input from the Chief of Staff (CSAF). But, apparently unsatisfied that the collective psyche of departing airmen had been sufficiently torched, AFPC found a new way to injure people on the way out the door: by misleading them into believing they and their families would have 180 days worth of medical coverage only to revoke that coverage, without warning, when it was too late for airmen to do anything about it.

Thousands of people who trusted the Air Force to take care of them — or at minimum give them enough information to take care of themselves — are now confronted with a huge (in some cases, scarcely surmountable) financial crisis during an acutely stressful transition from military to civilian life.  There’s an unwritten rule that the Air Force should return America’s sons and daughters to civilian life in better shape than it found them.  This is an odd way of putting that rule into force.

The unfolding crisis takes a few different forms. Most of those impacted found out during final outprocessing that their believed eligibility was illusory. They’ll now be forced to purchase health insurance on the open market, incurring an unplanned $5,000 expenditure during a financially delicate transition where every dollar could make or break entire families. Others were actually issued medical coverage when they outprocessed but fortunately didn’t need it (yet). Like those discussed above, this crowd will now be pushed onto the market for insurance at personal cost. A third group is in a more precarious position, having been granted benefits to which they apparently were not entitled and having actually used those benefits to pay for treatment. These people will theoretically end up being billed for treatment they believed was insured. This could be financially disastrous. One airman posting on social media related having received a series of referred, service-related surgeries after leaving the Air Force voluntarily earlier this year. He thought those procedures were covered, and in all likelihood both he and Tricare were mistaken, meaning he will owe tens of thousands of dollars.

No matter which of these categories a given family falls into, there’s also the issue of gapped coverage while alternative insurance plans are put into motion. For families with expectant mothers, this could mean the absence of coverage for delivery and post-natal care. For those with sick children who were midcourse in treatment, a 2-3 week delay could rack up thousands in uncovered expenses.

This is a disaster creating crisis in many Air Force families, but you wouldn’t know it by reviewing official communications. As this piece goes to press, the service has not made an official statement about this issue, despite an article in Air Force Times that has been widely circulated become a lightning rod for outrage over the latest AFPC flub. Not without irony, both CSAF and Secretary of the Air Force (SECAF) Deborah Lee James have posts atop their facebook accounts honoring General Ron Fogleman, a former CSAF who would have long ago stopped tolerating the service’s malfunctioning personnel system. A few heads would have been on pikes months ago, and they wouldn’t belong exclusively to mid-level functionaries.

Ron Fogleman demanded that commanders be just as  accountable as those they're charged to lead.  The Air Force he reformed would do well to honor his example.
Ron Fogleman demanded that commanders be just as accountable as those they’re charged to lead. The Air Force he reformed would do well to honor his example.

So, how did this happen? Simple. Gross ineptitude. This is an incompetence bomb, with the safing pin pulled by Major General Margaret Poore, the official yet invisible commander of AFPC whose biography brags about her responsibility for 1.77 million airmen and families. She and her gang cooked up a real winner this time by releasing incomplete execution guidance for voluntary force management programs. Temporary medical coverage is not mentioned at all in either the basic guidance memo or its progeny. This omission left clue-starved clerks at base level free to fill the void with their best guesses and novel interpretations of applicable statutes. This in turn led to scores of airmen being told they were eligible for 180 days of medical coverage. Base personnel offices built separation orders with a special code reflecting the coverage, which led Tricare officials to believe airmen were eligible. This created a circularity that prevented the error from being detected, since airmen attempting to enroll at Tricare met no resistance, with no party having reason to distrust guidance received from either the base Military Personnel Section (MPS) or the centralized Total Force Service Center (TFSC), both of which are known to have reassured airmen of their eligibility.

Airmen picked up on the blurriness of the guidance. They could sense the people they were asking didn’t really seem certain about what they were providing. They pushed for clarification and were furnished sets of orders with codes that seemed to legitimize the guidance. Their questions never filtered back to AFPC, a damning reflection of the tortured design and garbled reality of the “communication” networks comprising the service’s personnel bureaucracy.  Designing a system to deflect and suppresses feedback is a recipe for single-point failures like this one.

Where was the chain of command in all this? AWOL by design. Gone are the days when commanders were responsible for their people in all relevant ways and expected to understand in detail the programs impacting them. Today’s Air Force cuts commanders out of many of the most critical processes impacting their people.  It is an Air Force of fire-and-forget emails, open loops, and unfiltered, un-prioritized information posing falsely as actionable communication. Everyone is more confused than they should be. Commanders are largely irrelevant to the human resource business, with personnel services memos sent directly to individual members and posted on websites rather than passed through a chain to ensure everyone is knowledgeable and information is filtered through the service’s own expertise base. Commanders have no built-in administrative capacity to spot and correct issues. All of this helps explains how this gargantuan failure could happen. With messages bypassing the chain of command, the tribal knowledge that might have raised enough critical questioning to trigger corrective action was unable to exert itself, not by accident but by design.

But the real crime here is the failure to put everyone on notice when the mistake was caught. It was obviously discovered at some point between the approval of separation orders for airmen leaving at the end of September and their actual separation. We know this because the problem has manifested since that time, and TFSC and local MPS offices have become suddenly consistent in telling airmen that (a) they’re not entitled to coverage, and (b) if they used coverage for treatment, they should expect a bill.  To those impacted, it feels like a sick joke.

The fictional manager Michael Scott was known for both his ineptitude and his inability to see the hurtfulness of his own jokes. Airmen tricked by the latest VSP debacle feel like recipients of one of his wayward jokes, but the consequences are all too real.

Failing to take reasonable steps to inform people of something that could cost them thousands of dollars if left unadvised is a horrific breach of all three of the service’s core values. General Poore is culpable for having failed to create an environment of honest and competent communication. Through the serial maladroitness of her organization, the Air Force has committed a grievous error. In a doctor’s office or a lawyer’s office, what occurred here would be called malpractice compounded by fraud. When committed by those in leadership roles, it should be known by the same name. This is leadership malpractice, and the only question is whether Poore is the senior-most officer on the liability hook, or whether by continually tolerating AFPC’s incompetence, the service’s senior leaders have themselves encouraged more of the same, and should thus be personally liable.  On some level, leadership is less about how individuals perform and more about how they respond when others fall short.  General Welsh and his fellow senior leaders have a mixed track record on this account, having tolerated toxicity and incompetence more than they should.  Here’s an opportunity to shore up that track record.

As it turns out, the guidance that mystified these alleged “personnel professionals” is not all that mystifying. 10 USC § 1175a (“Voluntary separation pay and benefits”) provides, in relevant part, that

“[a] member . . . shall be entitled to the benefits and services provided under chapter 58 of this title during the 180-day period beginning on the date the member is separated.”

Chapter 58 (10 USC §1145 – “Health benefits) in turn provides eligibility criteria separating servicemembers must meet in order to qualify. Setting aside a few narrow exceptions, the primary driver for eligibility is that members must be involuntarily separated from active duty. In other words, no one applying for voluntary separation programs was ever eligible for 180 days of health care coverage, that is unless AFPC is privy to secretly enacted legislation superseding these sections of the US Code.

How this basic interpretive exercise (a) escaped the comprehension of the self-labeled personnel experts at AFPC and (b) managed to make no appearance in the official memoranda guiding execution of this program is, well, mind-numbing. It’s also less relevant than what the Air Force now must do about it.

Fortunately for SECAF, the same statute that makes this problem real gives her the authority to address it. She can do this through two principal ways. First, she can read 10 USC §1145 to make eligible those airmen whose tours were extended so they could fill deployed billets. The statute makes eligible

“[a] member who is separated from active duty served pursuant to a voluntary agreement of the member to remain on active duty for a period of less than one year in support of a contingency operation.”

This is cryptic, and might not be elastic enough to cover airmen who were involuntarily extended to meet contingency requirements. Fortunately, SECAF has more expansive authority in subsection (c)(1), which provides that

“[c]onsistent with the authority of the Secretary concerned to designate certain classes of persons as eligible to receive health care at a military medical facility, the Secretary concerned should consider authorizing, on an individual basis in cases of hardship, the provision of that care for a member who is separated from the armed forces, and is ineligible for transitional health care . . .”

There’s no doubt that members who thought they had coverage but didn’t would qualify under the definition of “hardship.” The rationale is exceptionally strong in cases where treatment has already been rendered or will fall due before impacted families can obtain coverage (e.g. those families with late-term pregnancies). But SECAF should refrain from dithering and simply extend treatment eligibility at base clinics for 180 days to all impacted airmen. This is how “taking care of people” moves beyond sloganeering and earns substance.

But the response should not stop there. No more AFPC chicanery can be tolerated. It’s gone from amusing to heartbreaking to outrageous with a flash-to-bang duration that should have SECAF and CSAF awake at night wondering how things will be a year from now without fundamental reform. At some point, ineptitude crosses the line into misconduct. In this case, that line was crossed when AFPC discovered it had misinformed airmen but chose to obscure that mistake rather than energetically rescuing airmen from the disaster it knew or should have known was about to unfold. This has become an AFPC pastime, signaling a corrupt organization laboring within a climate of dishonesty and sanctioned negligence. AFPC is a burr in the saddle of the SECAF’s earnest wish to take care of people, and it must be reformed, starting with the emplacement of a new leader with enough operational experience and perspective to understand how policies translate into effects.

This is no longer about just AFPC. It’s about the Air Force itself. To leave an organization in control of the fates of airmen when it clearly isn’t up to the task is a breach of faith. It’s also how airmen end up desperate. If the service truly cares about preventing suicide and controlling stress, it has a grand opportunity to show it by acting decisively to reign in and reform AFPC.

Most things in life can be understood according to a Chevy Chase movie. This situation calls to mind the scene in Christmas Vacation when Clark Griswold learns that his boss, Frank Shirley, has decided to discontinue Christmas bonuses without telling his employees. Griswold, who has relied on his expected bonus to purchase an in-ground swimming pool, is understandably upset.

In the movie, Clark’s cousin Eddie hauls Shirley from his cushy lair and holds him to account for his neglectful actions. Who in the modern Air Force is willing to be so bold, so direct, and so visible in renewing the essential bond of accountability between AFPC and airmen? Who will make sure airmen expecting 180 days of health care coverage don’t instead get a subscription to the Jelly of the Month club? Who is our Cousin Eddie?

For thousands of airmen and families, the answer to that question is no laughing matter.

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