Special Needs Military Families Report Mixed Feelings About Program to Help with Medical Care, Services

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An Exceptional Family Member Program athlete, participates in an exercise using listening skills and balance during a Special Olympics equestrian camp at the Joint Base San Antonio-Fort Sam Houston Equestrian Center.
An Exceptional Family Member Program athlete participates in an exercise using listening skills and balance during a Special Olympics equestrian camp on Aug. 13, 2013, at the Joint Base San Antonio-Fort Sam Houston Equestrian Center. (Senior Airman Alexandria Slade/U.S. Air Force photo)

A new Pentagon survey of military families with special needs members found that less than half were satisfied and 57% were dissatisfied or had no opinion about the Exceptional Family Member Program, or EFMP, though reactions varied by military branch.

The Defense Department surveyed 100,000 active-duty troops enrolled in EFMP from November 2022 through March 2023 to gauge satisfaction with programs for special needs families provided by the military services.

EFMP is designed to help families access specialty medical care and services, including educational support, for those with a member who is disabled or has complex medical requirements.

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The survey found that most of those enrolled reported satisfaction with or had no opinion of the program. But just half said they had received support from their commands for EFMP needs in the previous year, and more than one-third reported dissatisfaction with a key purpose of the program -- to help families during permanent change of station moves.

According to the results released last week, 43% said they were satisfied with the program, while 33% said they were dissatisfied; the remainder had no opinion. Roughly 59% of Navy respondents expressed satisfaction -- the highest rate for any service -- while just 39% of Army respondents reported high levels of contentment. Fifty-eight percent of Marines and 35% of Air Force respondents said they were happy with their programs.

In terms of leadership, 50% of respondents said their chain of command had provided support with EFMP within the previous year; one-quarter said they never received help. Thirty-five percent of Army respondents said they never got any help, while 57% of Navy personnel said they "always or often" got help with the program from their chains of command.

EFMP is a mandatory program managed by the individual services for families with special needs. Last June, in response to military family advocates and Congress on the disparities in programs across the services, the Defense Department issued guidance to standardize the service-run programs, which not only varied from branch to branch but also across installations.

The new DoD guidelines aim to enhance the programs across-the-board, from improving the enrollment process to ensuring that families get a handoff from one EFMP support office to another during a move -- guidance designed to reduce wait time for medical care and services during the switch.

The policies also are meant to improve the assignment coordination process, ensure that EFMP support providers reach out to participants at least once a year, and standardize respite care -- assistance provided to families to give them a break.

The survey, which was conducted before the DoD released the standardization memo, was meant to provide information and data on military families' experience with the programs, according to Tomeshia Barnes, associate director of the DoD's Office of Special Needs.

The survey helped identify gaps in EFMP services that are vital parts of the program, including disparities in the understanding of respite care services and issues with permanent change of station moves. One-third to 40% of respondents reported not getting any help during a PCS move.

Barnes said that response will guide additional requirements for the services to ensure families receive support from one installation to another.

"Enhancing and improving the Exceptional Family Member Program is a priority for the department," Barnes said last week during an interview with Military.com. "It's important to us that we hear from military families."

The survey was provided to active-duty service members via email and had a 13% response rate, roughly the same as the last Status of Forces Survey by the Pentagon in 2022, which provides a snapshot of overall experiences of active-duty troops.

EFMP survey respondents were an average age of 37 and had roughly 14 years of military service. Roughly 70% said they had a child enrolled in EFMP while 46% said their spouse was enrolled and 1% had an enrolled parent. The biggest reasons for enrolling were for medical services -- 74% were for medical needs and 27% for medical and education services -- while 12% needed educational accommodations only.

Of the 12,620 respondents, 43% were Army, 30% were Air Force, 20% were Navy, and 7% were Marine Corps.

While EFMP requires mandatory enrollment, military personnel have been known to avoid participating because they think it will hinder their careers by restricting assignments only to locations where services are available for their family member. Barnes said the survey showed that 78% of respondents indicated they had never had to relocate without their families for their careers, and the program really had no impact -- positive or negative -- on a member's decision to stay in the military.

"It doesn't have that negative impact. ... We think that's something very important to highlight that we paid attention to, and it's also something we will continue to pay attention to," Barnes said.

Another bright spot in the results was families' opinions of their EFMP program offices, with the overwhelming majority saying that, when they needed support from their caseworkers, the experience was professional, with employees familiar with local resources and able to tailor programs to their unique needs.

"Those are the things that we truly want to hear, and I know that family support providers want to hear, [and] that the military services want to hear," Barnes said.

She said the Pentagon will use the data to identify areas of concern and improve the program, including new guidance on oversight and monitoring. The information will help identify trends of success and weakness.

Barnes added that the DoD-wide guidance was issued after assessing the best practices of the branch programs and the Pentagon will continue to tweak the programs to improve services.

Earlier this year, the Army announced the creation of a central office for its EFMP program to coordinate health care, military moves, education and additional services for enrollees.

The service recognized it needed to improve its program based on feedback from enrollees, according to Agnes Schaefer, assistant secretary of the Army for manpower and reserve affairs, who added that improving the quality of life of soldiers and their families is the service's top priority.

"We are listening and working to take necessary steps that continue to improve the Army EFMP to best serve our Army community," Schaefer said in a statement in March. "There is more work to be done, but we are excited to share this important step with the force."

Related: DoD's Failure to Standardize Exceptional Family Member Program Leaves Gaps in Services, Watchdog Finds

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