The Exceptional Family Member Program: The Long Road to Parity

January 6, 2017

The Exceptional Family Member Program (EFMP) will take center stage at a Pentagon meeting of the Military Family Readiness Council (MFRC) Jan. 26. The MFRC is a federal advisory committee composed of senior leaders, nongovernmental organizations, and military family members who create recommendations for the Secretary of Defense. This meeting will discuss programs and services for DoD family members with special needs such as health care and the EFMP.

Why is this important?

EFMP is a mandatory enrollment program for active duty servicemembers who have a dependent with special medical and/or educational needs. The enrollment guarantees that the dependent's special needs are considered part of the assignment process.

However, dependents who qualify as an exceptional family member need many additional supports - not just consideration in the assignment process. This is where it gets mucky. While special medical needs prompt enrollment into the EFMP, the program does not oversee or manage anything related to health care access or coverage.

Each military service runs its own EFMP, which includes unique and different enrollment processes, travel screenings, and family services.

For instance, each service has required completely different forms for enrollment, some of which have been streamlined. Family support services differ across the branches of the military as well. For example, all of the services offer respite care, but the Army disallows it if a family receives respite care via health insurance. (The other services allow it.)

To address the disparities, the FY 2010 National Defense Authorization Act created an Office of Special Needs (OSN) inside DoD to oversee all of the EFMPs, identifying gaps and addressing them in services, outreach, information, training, and education.

However, the OSN does not have legal or monetary authority to change the programs run by each of the services. Reports and studies have been conducted to identify the most glaring problems, and the OSN has worked with the services to streamline some of these process - in particular, the enrollment and travel screening processes. Some disparities remain a challenge.

Poor information sharing can result in diminished access to necessary health care programs. For example, if the Army is assigning a servicemember to a Navy installation but has minimal knowledge of the availability of specialized health care local to the Navy installation, that Army family may relocate and not have access to the right doctors. The Army and the Navy, in this example, must both be able to adequately assess the needs of the family and the robustness of the local resources to make the assignment process work.

Further, when families can't access the health care they need, where they need it, their recourse requires negotiation with TRICARE contractors, not the EFMP. The OSN and the service EFMPs do not have authority or control over health care support. Health care provided at the installation clinic or hospital is run by the service, and outside the installation is maintained via TRICARE contracts managed by the Defense Health Agency.

Inevitably, having many parties responsible for different areas of a complex issue results in disparity of service. The fact that the MFRC is revisiting this again indicates resolution has not yet been achieved.

MOAA will be at the Jan. 26 MFRC meeting to engage with leaders about how we can progress in addressing the needs of our exceptional families. You can also submit comments or attend this public meeting. See details here.



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