Summary

The Department of Defense's (DOD) Exceptional Family Member Program (EFMP) is a mandatory enrollment program for active duty servicemembers who have family members with special medical needs. When military servicemembers are considered for assignment to an installation within the United States, EFMP enrollment is used to determine whether needed services, such as specialized pediatric care, are available through the military health system at the proposed location. Due to this consideration, each military service assigns servicemembers with exceptional family members who have significant needs to certain locations because of the resources available through DOD's health care system in these communities. Further, DOD policy allows (but does not require) the military services to provide family support services specifically for exceptional family members. State and local medical, family support, and educational services in these communities may also serve the military's exceptional family members as part of providing services to local residents. The Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 directed us to evaluate the effect of EFMP on health, support, and education services in selected civilian communities with a high concentration of EFMP enrollees. As discussed with the committees of jurisdiction, this report describes (1) the services provided by the military health and family support systems that are available to meet the needs of exceptional family members within the United States, and (2) state and local services--including medical, family support, and educational services--available for the exceptional family members in select communities.

Through TRICARE and its supplementary coverage program, DOD provides exceptional family members located at installations within the United States with basic medical services--including inpatient and outpatient care, drugs, and durable medical equipment--and, when needed, additional medical services such as health care provided in the home and respite care. However, DOD officials with whom we spoke in all four communities said that certain medical services requested by exceptional family members may be difficult to obtain because of a limited number of specialists available in DOD's health care system in these communities. Due to a lack of data on exceptional family members and their medical conditions, we were unable to determine the extent to which medical services are utilized by exceptional family members. Family support services are also available to exceptional family members through military service family centers, which provide information about specialized services--including day care, after-school care, and recreational programs. However, some family support services may not be available to accommodate exceptional family members with certain medical conditions. State and local medical, family support, and educational services are available to exceptional family members. Some of the services available include mental health counseling, respite care, therapies for children with developmental delays, and therapy for autism. However, state and local agency officials in the four communities we visited were unable to provide data that could be used to determine the specific service needs of exceptional family members or their utilization of services. Even though data on EFMP were not collected, local officials said that it may be difficult to obtain some services because of the limited number of specialist providers practicing in the community. The availability of services also may depend on the laws and policies of the state where the exceptional family member resides. In addition, under federal law, exceptional family members attending a U.S. public school may be eligible for special education and related services from age 3 through 21. However, we could not identify the type or amount of special education services used by exceptional family members in the communities that we visited due to the absence of specific data on exceptional family members.