In 2011, the Service to the Armed Forces unit of the American Red Cross, which provides military family emergency communications, called AMCROSS messages, was fatally nationalized into a nonemergency business call center with $24 million per year in Defense Department funding. For more than a century the work of recording, verifying and then delivering an emergency message to military commands was never shackled by unrealistic time constraints.
Before the reorganization, SAF operated like the quasi-military unit it was meant to be. The demand of an individualized and expedited service was known as the “2-Hour Rule,” and a good reason was needed if a message wasn’t completed in the time allowed. That was to maintain quality because caseworkers were expected to meet the challenges and to avoid unnecessary delays.
Worldwide more than 1,000 caseworkers were let go, and the primary handling of emergency messages was consolidated into four regional locations — San Diego; Fort Sill, Okla.; Louisville, Ky.; and Springfield, Mass., with roughly 40 staff each. Since the Red Cross wouldn’t relocate employees, a massive hiring spree was required, so half of the caseworkers were new.
Management insisted that because phones and computers were used the work could be corralled into a metrics-based system, which, of course, came at the expense of the “emergency” part of the operation. It was a catastrophic mistake because anyone who had ever worked a case knew the plan was dead on arrival, and that the nature of an emergency service doesn’t change by wishful thinking.
We were told “everyone now owned the work,” so no one did. We were also told “SAF will be brought up to call center industry standards,” which lacked the awareness that SAF set its own standard as the congressionally mandated third-party emergency verification service of the U.S. armed forces.
When briefed by the p.m. staff the first day of being a call center, all I heard was “it’s a total disaster.” More than 100 butchered cases were scattered in the queues. It was instant chaos because caseworkers no longer controlled the flow of their work. In being responsible for the oncoming shift, we made a plan that finished dozens of cases every night.
The metrics required that 80 percent of the calls be answered within 20 seconds, yet no thought was given to staff working on other emergencies. Intakes were to be completed in eight minutes although a good intake usually took 15 minutes or longer because the client is often distraught and there are nearly 40 questions being asked. In a case with several people involved, or multiple members need notification, those intakes will certainly run longer.
In the past, sometimes a nurse needed a caseworker to stay on hold for a few minutes while getting the chart, but the new orders limited staff to a one-minute hold-time. So instead of caseworkers waiting, nurses were requested to call back when they found the time, if they didn’t forget.
At the end of the second week our plan was killed. My manager said he’d thought about firing me because the metrics showed I had never logged on. It didn’t matter that I was training staff and making outgoing calls.
Gimmicks were implemented, such as dividing the work among the four sites by the member’s last name. Incomplete intakes were common because staff was pressured to meet the new goals. I encountered nurses who were angry at the previous caseworker for refusing to accept “unknown” as an appropriate answer for both prognosis and life expectancy, which is Casework 101, especially with serious accidents and life-threatening illnesses.
No. 55535 — Doctor called because member’s baby will die within an hour of being born. The message had been delayed several hours because the database (Redbook) containing the command phone numbers had crashed. Anticipating this, the late night shift created a hard copy phone book, but its general distribution was rejected. Since I kept a copy the message was passed in a few minutes. It was telling that no one went online to get the unit number at Fort Pickett, Va., because it would’ve taken less than 10 minutes.
Some staff abandoned cases at the first obstacle because completing them was never a priority. The worst case I found had 17 failed verification attempts. If a patient was hospitalized and the unit nurse wouldn’t cooperate, there was no escalation to the charge nurse or to the nursing supervisor to obtain the medical statement. The burden was on the family if it wanted the message done in a timely manner.
After several very long months of seeing countless delays because of some three dozen reasons, I went back to taking ownership. Management didn’t want to hear about the ongoing problems.
No. 95032 — Sister called because grandfather had died. The caseworker noted speaking to the nurse and then to mother. “Call to hospital, spoke to nurse who stated they are still doing tests to determine if there is brain activity. Member’s mother was advised of the delay.” After finding the case, it was quickly passed. This was a guns-blazing life threat, yet it was acceptable to delay a message pending whether or not the patient was alive.
A week before being fired in May 2012, my shift started with me being given another case that required urgent attention.
No. 118392 — It was more than a month old. The command requested a verification for member who was stationed at Camp Pendleton, Calif. Mother was hospitalized in London with a life-threatening condition. It took three shifts, some 30 calls, and several emails to finally get the information for the command.
It got worse when the handling of disaster response calls was returned, which saw that work transferred to another unit during the reorganization. Disaster response calls trump military calls, so caseworkers put everything on hold until the responder is contacted.
Another gimmick had Louisville working exclusively on the cases it started, which caused more problems because when their clients reached the other sites they had to be redirected. Then the financing started to tighten at some of the sites, so several shifts were closed to reduce staff.
The following cases demonstrate the poor service continued long after SAF claimed the problems had been corrected:
No. 298803 — another case out of Camp Pendleton that took more than a month. It was the death of mother. The message was passed, but there was no callback to confirm it was received. The chaplain called a month later to advise that member was at Naval Air Station Jacksonville, Fla.
No. 305604 — 2 weeks and counting, wife ill and a breakdown in child care.
No. 344472 — 1 week and counting, father-in-law life-threat.
No. 348408 — 1 week and counting, grandfather life-threat.
SAF needs the metrics to look good. So cases are suspended (dropped) or dispatched to the local chapter queue (to wait), to make it appear the work is getting done. To pad the books, leave extensions get a new case number. If a new case would be delayed for a few days, it was closed out and restarted later.
Over the years I have contacted numerous congressional offices, committees, agencies and military-based organizations, and none of them has cared enough to address this issue. Until ownership of the casework is reinstated, it will continue to get worse.
Robert Billburg was a caseworker with the Service to the Armed Forces unit of the American Red Cross in San Diego for 10 years.