Monday, March 16, 2015

Tackling her toughest battle yet: a 'broken' VA system


COLORADO SPRINGS — Driving along the winding roads of the U.S. Air Force Academy, Allison Hickey looks out at the snowy forested mountains of the campus, a place she first came to by bus as a teenager almost 40 years ago, and admits it still haunts her.


Hickey, 57, now a retired brigadier general and one of the highest-ranking women at the Department of Veterans Affairs, was in the first class of female cadets to graduate in 1980. They endured frequent threats from male classmates, she recalled. She was once cornered by a male cadet yelling: "If I could take you behind a barn right now and beat the you-know-what out of you, I would."


Her time at the academy made her "very uncomfortable." It was a feeling that would stick throughout her trailblazing career, bedeviling her but making her stronger, a leader.


The feeling grew acute in the past year because, as the undersecretary for benefits, she has been at the center of the storm swirling around VA over the long wait times that veterans face for benefits and treatment. An influential member of Congress has called for her resignation.


As she deals with the fallout of the worst scandal in VA history - concerning the falsification of patient wait times - Hickey also is confronting another troubled legacy: the double standard and, at times, hostility that many female veterans say they face inside the VA system.


Their population has soared past 2 million, and Hickey has been wrestling with the bureaucracy to make VA more welcoming for them, for instance by getting disability benefits for female veterans who suffered sexual assault in the military.


Earlier this winter, she was in Colorado speaking to about 2,000 cadets about leadership. Nearly a quarter were women.


While she acknowledged some pre-speech nerves, Hickey charged into the cavernous auditorium, dressed in a black skirt and jacket over chunky pearls, her back straight. She stood before the sea of young people dressed in their crisp blues and prepared to warn them about some of the ugly realities they would confront as officers: post-traumatic stress disorder, military sexual assault and the suicide of fellow servicemembers.


"In the next few minutes," she started, in her creamy Southern drawl, "I hope to make you very uncomfortable."


When Hickey decided to take the VA benefits job in 2011, "every single person asked: 'Are you sure you want to do that job? That's a system that's broken, it's been broken for decades, and no one has been able to turn that problem around,' " she said.


During her first two years at the agency, the backlog of veterans awaiting benefits continued to grow, peaking at 600,000 cases in 2013. After more than a decade of war in Afghanistan and Iraq, veterans were streaming into the VA system, often with injuries that would have killed them in earlier conflicts, and they were filing claims at record levels. At the same time, new rules were making it easier to get benefits for conditions related to Agent Orange and post-traumatic stress.


And the agency was still using a 1950s-era system for processing paper claims. Some files, Hickey recalled, "were as tall as a young toddler." She embarked on an effort to computerize the claims.


Criticism of her operation continued to mount. VA Assistant Inspector General Linda Halliday found in a report released in July that regional offices in Philadelphia and Baltimore had bins of disability claims that had not been scanned for three years. Halliday also said VA, in a rush to get the backlog claims down, had paid out about $85 million in unsupported claims.


When Hickey testified at a House hearing last summer that VA had cut the backlog to about 275,000 claims, Rep. Jeff Miller, R-Fla., chairman of the Veterans' Affairs Committee, said he didn't "believe anybody at the table is telling the truth from the VA."


Miller has recently called for her to resign, saying in a statement this month that "the accuracy and data manipulation problems reinforce my earlier calls for new leadership."


But Hickey's supporters say she has survived VA's most difficult period and has made progress in modernizing the claims system.


"She's very passionate, dynamic. But she just faces a huge task, in a huge bureaucracy. Even if everything was going well, it would be a massive task to keep it that at way," said Garry Augustine, executive director of the Disabled American Veterans. "And while there's a way to go, we believe she's going in the right direction."


"Hi, y'all. Anybody around?" Hickey called out.


It was 8:30 a.m on a Saturday. Dressed in jeans and a sea-blue fleece, her blond hair well coiffed, she was peering around the cubicles of a Denver claims office, doing one of her "surprise pulse checks."


She was checking on the daunting effort to reduce the claims backlog. The local staff members, part of her national team of 21,000, were working "mandatory overtime" to whittle down the backlog.


This morning, Hickey was helping deliver Krispy Kreme doughnuts and doing some old-fashioned cheerleading. (Hickey was a cheerleader for the Air Force football team, "which taught me what to do to keep your people up when they're losing. Or just struggling.")


Claims officers — some of them young, bearded veterans of Afghanistan and Iraq — came out of their cubicles. "Oh, wow," said former Staff Sgt. Aaron Beaty, doing a double-take when he saw Hickey.


She moved through the room hugging the employees.


Some say they could use one.


"This job is just so freaking hard," retired Navy Petty Officer 1st Class Andrew Sermak told Hickey.


Later he said, sighing, "It's interesting she came by. You can tell she cares. At least that's something."


In an agency with a reputation for being closed and aloof, Hickey has become known as far more approachable than her predecessors.


At the end of last year, between Thanksgiving and New Year's Day, about a dozen suicidal veterans emailed her, some threatening to take their lives if they did not get their benefits, she recounted. She addressed each one personally, she said, calling in therapists and personally checking on each of the cases.


"Everyone in my inbox is alive today, because I took it seriously," she said.


Hickey said she receives hundreds of emails a week from veterans and tries to answer all of them, although sometimes this means emailing in the middle of the night.


"Many have stories that would make you cringe — I hear them all the time. I am glad they make me uncomfortable, break my heart, keep me awake at night and even, at times, bring me to tears. It has spurred me to action on their behalf," Hickey told cadets during her speech.


When Hickey was a student at the academy, she fought to get female cadets the same uniforms as the men: front-zippered slacks, shirts that could be tucked in gig lines, and precise gig lines. "So the women could feel included, look sharp, like the men, and hold their heads high in the long blue line," she said.


She ended up winning — and not just at the academy. The Air Force brass liked her idea and made the change across the service.


"It felt awesome — for a minute or two — and then uncomfortable for a year or two," she said. The male cadets were openly hostile to her class, which was known as the "Legendary '80s Ladies."


Hickey was raised in a military family and born on a military base in France. She integrated when "diversity was a few Jewish guys and an African American," said retired Lt. Col. Ed Herlick, a classmate of Hickey's who described the atmosphere as "brutal."


The Class of 1979, the last all-male class, labeled itself the "Last Class With Balls."


That same male-dominated military culture is often replicated inside VA, female veteran advocates say. But Hickey said that small changes can be powerful "symbols of inclusion," for instance, revising the look of her new eBenefits Web site to make sure it depicts women veterans. She has also tapped claims officers to work with a Facebook group for female veterans to assist with their claims.


She has made larger changes as well, specifically getting disability benefits for female veterans who had been denied them for post-traumatic stress disorder related to sexual assault in the military. She told veterans who said they had been victims of such assaults to resubmit their claims for a fresh look. Some had been pending for decades.


From 2008 to 2010, the approval rate for PTSD claims related to military sexual trauma was only about one-third. VA had long been dismissive of these claims and resisted calls to revamp the criteria used in awarding benefits. Today, roughly 55 percent of those claims are granted, the agency said.


She is proud of that win. As she told the cadets in her speech: "Push through the uncomfortable feelings and do the right thing anyway . . . even if it gets the 'you know what' beat out of you."



No comments:

Post a Comment