Testimony Focus: Support for Special Needs Military Families

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As an Association, one of our top priorities is ensuring that military families with special needs family members have access to essential services and support. We highlighted this priority in our recent testimony before Congress. While we appreciate that in recent years the Department of Defense (DoD) has made strides in addressing the needs of special needs families, gaps in services still remain, due in part to differences among the Services’ Exceptional Family Member Programs (EFMP). In addition, TRICARE needs to increase support for special needs families in several important respects. We highlighted these issues in our testimony and asked Congress to take steps to remedy them.

The EFMP is intended to perform three interrelated functions: identify and enroll eligible family members; coordinate the assignment process to ensure special needs families are not sent to locations that lack adequate resources; and provide families with information about and referral to local resources. Each Service has its own EFMP and there are significant differences in how each Service operates the program. Some Services take a centralized approach to the EFMP, while others divide the three components of EFMP into separate functions. This lack of standardization can lead to problems, particularly in this era of joint basing, when families from one Service live and work on installations operated by a different Service.

A 2012 report by the Government Accountability Office (GAO), Better Oversight Needed to Improve Services for Children with Special Needs, (GAO-12-680, September 10, 2012) noted that there are no Department-wide benchmarks to set standards for the Services’ EFM programs. As a result, the Department is unable to assess the effectiveness of the branches' EFM programs and ensure that improvements are made when needed. In our testimony, we asked Congress to address this situation by directing DoD to establish benchmarks and performance goals for the EFM program. We also asked  the Office of Community Support for Military Families with Special Needs (OSN) develop and implement a process for ensuring the branches' compliance with EFM program requirements.

Our testimony also highlighted ways in which TRICARE could better serve special-needs military families. More than most families, special needs families require centralized case management and a seamless transition when they move between and within TRICARE. However, each TRICARE Managed Care Support Contractor (MCSC) has created different case management processes.

We raised concerns about whether families in the National Guard and Reserve, as well as retiree families, are adequately served under the current system. Active duty families may enroll in the Extended Care Health Option (ECHO) program to access benefits such as training, rehabilitation, special education, and assistive technology devices for their special needs family member. National Guard and Reserve families only have access to this program when they are in an activated status, and we are concerned about the lack of continuity of care as these families cycle in and out of the program. We asked Congress to examine ECHO benefits during the activation and deactivation cycle, and the impact on National Guard and Reserve families and their special needs family members.

Upon retiring from the military, families immediately lose their eligibility for the ECHO benefit. This can present enormous difficulties for families transitioning out of the military, as they must seek services from local community sources, where they often face lengthy waiting lists. We asked Congress to extend ECHO eligibility for one year after retirement for enrolled family members to provide more time for families to transition to state and local services.

Finally, we noted that Congress directed TRICARE to establish a pilot program to make Applied Behavioral Analysis (ABA) therapy available to all beneficiaries diagnosed with an autism-spectrum disorder. We are still waiting for the details of the pilot program to be released. We asked Congress to direct TRICARE and DoD to implement the pilot program in a timely manner to ensure that military children can receive the therapy they need. We also asked Congress to consider expanding eligibility for ABA therapy to beneficiaries with other diagnoses. ABA therapy has been shown to benefit patients with a wide range of diagnoses, and we are concerned with the inequity of one group of patients receiving a benefit that is denied to others.

For the latest information on our support of special needs families, please visit our policy issues section.

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