House Armed Services Panel Holds Hearing on Military Family Health Care

On February 5, the House Armed Services Subcommittee on Military Personnel held a hearing on the Exceptional Family Member Program (EFMP), to determine what progress has been made on recommendations in a 2018 Government Accountability Office (GAO) report on the program.  The short version:  almost none.

EFMP is a mandatory enrollment program for service members who have a family member with special needs requiring specialized medical care, treatment programs, or educational services.  The purpose is to ensure that service members receive duty assignments to locations where the special needs can be met, by documenting the needs, identifying local resources, and connecting families with those resources.  Respite care may also be available, although the coverage varies widely among the military branches, which each administer their own EFMP.  Families enrolled in EFMP may be eligible to enroll in the TRICARE Extended Care Health Option (ECHO) program, which pays for additional health care services and supplies, along the lines of Medicaid home and community-based waiver programs.

In 2018, the GAO found that, while the Department of Defense (DOD) Office of Special Needs (OSN) had developed a uniform policy for family service plans and family support staffing levels, there was no oversight of what the military services were actually implementing.  GAO recommended that DOD develop common performance metrics for duty assignment coordination and family support, evaluate the services’ activities, and report to Congress.  GAO testified last week that very limited progress has been made.

A first witness panel included NACBH colleagues in the TRICARE for Kids Coalition – the National Military Families Association, Military Officers Association of America, Military Child Education Coalition, and military family members.  They provided examples of challenges faced by special needs families as a result of EFMP shortcomings as well as administrative processes that would seem to be easily changeable.  On the health care side, recommendations included things like ensuring that medical specialists are actually accepting new patients versus just being listed on a directory, and allowing families to begin lining up appointments (or getting on waiting lists) before they arrive at their new duty location.  On the education side, family members reported that denials and delays in individualized education plans are routine; that public schools simply “wait out” a military family, knowing they’ll be moving on in a couple of years.  Local educational agencies receive defense funding, called impact aid, based on the number of military-connected students with disabilities in their schools but there is no accountability for how the funds are spent.

A second panel included witnesses from the Army, Air Force, Navy, and Marine Corps, as well as the Defense Health Agency and the DOD Office of Military Family Readiness Policy.  Other than the Marine Corps, whose EFMP was held up as a model that the other services should implement, they received a blistering rebuke from Subcommittee Chair Jackie Speier (D-CA).  Her displeasure was clear from the moment their opening statements concluded:  “It’s not good enough to come here and make happy talk about how you want to be helpful and how grateful you are for the courage of these parents to come forward and speak about their experiences . . . For your homework, I would like for each of you to read their statements because within them are numerous vignettes about other service member families and what they have dealt with . . . I’m telling you that we’re going to be hawks on this.  And we’re going to have all of you come back every three months to give us a briefing on whether or not you have met the specific requirements the GAO has asked you to do until you get it done.”  She also said that the subcommittee would host town halls on nights and weekends so that the overflow room full of EFMP family members who had come for the hearing would have a chance to tell their experiences, and she would ask all of the second panel witnesses to attend them.