DOD reveals strengths, problems in special needs family member program

Less than half of service members with a special needs family member reported that they were satisfied with the military program that is supposed to be supporting them, according to a new Defense Department analysis.

A third of those surveyed indicated they were dissatisfied with the Exceptional Family Member Program, or EFMP.

At the same time, Navy and Marine Corps members reported more positive EFMP experiences than their Army brethren, according to the Pentagon.

EFMP is a mandatory enrollment program for service members who have a family member with any physical, emotional, developmental or intellectual disorder that requires special treatment, therapy, education, training or counseling. The EFMP works with both military and civilian agencies to provide a variety of support in housing, health care, educational or other personnel services.

This first-ever survey of service members enrolled in the program took place between November 2022 and March 2023, before the Pentagon made changes to beef up and standardize the program across the services, and before the Army made changes to improve their version of the program.

For years, military families with special needs have detailed their problems with the availability and quality of medical care and special education. Following a February 2020 congressional hearing, lawmakers mandated EFMP standardization and improvements in the fiscal 2021 National Defense Authorization Act.

But while DOD officials tout aspects of the survey results as indicative that the program is helping those who need it, some program families have questioned the validity of the survey results.

The survey analysis points to program areas that need improvement, as well as successes, according to Tomeshia Barnes, associate director of the Office of Special Needs in DOD’s Office of Military Family Readiness Policy.

One big area to tackle is the support families get when moving from one installation to another, and connecting them to critical services at the new location, Barnes told Military Times.

“Enhancing and improving the program is a priority for the department,” Barnes said, adding that “the voice of the families really matters” and the survey is one tool that helps DOD get data from families “and hear their voice and their lived experience with each component of the program.”

Defense officials sent surveys to all of the 100,000 service members enrolled in EFMP, and 13%, or 12,620, responded across the force.

The results appear to debunk a common misconception that enrolling in the EFMP would have a negative impact on the service member’s career, Barnes said, and it indicates that the majority of responding service members are satisfied with the support they’re getting at the local level from EFMP staff.

Families questioning the results

Some military families and others have questioned the results of this survey for a variety of reasons, including concerns about the way it was conducted — surveying service members, but not the spouses who generally shoulder most of the responsibility of coordinating services for the special needs family member.

“Who’s more knowledgeable, the service member of the spouse? We know it’s the spouse,” said Michelle Norman, executive director of Partners in Promise, a nonprofit advocacy organization whose mission is to protect the rights of military children in special education and disability communities. “It would have been smarter to send it to spouses of service members.”

“I feel they’ve missed a big opportunity to collect key data to improve the EFMP program,” she said.

Norman added that assessing the full report is difficult, as the publicly released 66-page analysis didn’t provide full data on the 79 questions asked of service members.

EFMP families experience the stresses of military life at a much higher level, Norman said.

“We were hopeful this would spotlight how all these quality of life issues impact our lives,” she said. “The goal for EFMP enrollment is to be a value add, not a burden. I don’t think we’re there yet. This survey kind of proves that point.”

About 46% of the service members who responded have a spouse enrolled in EFMP, but those spouses weren’t surveyed about their satisfaction with the program and its services. About 70% of respondents said their child is enrolled in EFMP.

There is an overlap, with some service members having both a child and spouse in EFMP, but defense officials haven’t delved into how many families have multiple dependents in EFMP.

That’s one of the things officials are looking at, Barnes said, as they progress in their oversight and data collection – assessing those with multiple dependents with an educational or medical need, “knowing that there could be heightened stress with that as well.”

Norman noted that there is satisfaction in some areas, such as in respite care, where 74% of those who used it were satisfied. However, only 8% of the service members who responded had used respite care services from their military family support program within the previous two years. Meanwhile, 35% of the service members responded that they were aware of the program, but didn’t use it.

Norman said when the survey was first launched, her organization heard that military families weren’t confident about the survey design and the way the questions were being asked.

“This is not surprising since DOD didn’t engage with family stakeholders back then to ask for their inputs,” she said. “We see that trend changing for the better.”

The vast majority of service members who responded — 83% — said their family members’ needs were met at least to some extent in the previous 12 months.

But there’s work to be done to provide better support when families are making the permanent change of station move from one installation to the next, DOD’s Barnes said. More than half of the service members who responded said the EFMP support hadn’t made their PCS move any smoother at all, a key element of the program.

Moves can be stressful enough for military families, but they can be more so for special needs families who are trying to make sure they’ll have the needed services and programs at their new location.

Among other things, EFMP staff can work to improve the “warm handoff” to the EFMP staff at the new location, to help families make a smoother transition, Barnes said. That requirement is part of the 2023 DOD instructions.

Of the service members who PCS’d since being enrolled in EFMP, 54% indicated the staff at their military treatment facility, or MTF, hadn’t helped them at all with coordinating medical services at their new location.

A higher percentage of soldiers — 63% —said their MTF staff hadn’t helped them at all. While military medical isn’t under the purview of EFMP, those officials do work with and coordinate with them and other military and civilian agencies.

These special needs are considered when deciding a service member’s next duty station, to ensure the family’s needs can be met there. The goal is to keep families together, and according to the survey results, more than three-fourths of service members said they had never made a PCS move without their family because of EFMP needs; 20% said they had done so one or two times.

Career perceptions

There has long been a perception among some service members that being enrolled in EFMP will have a negative impact on their career.

Officials were struck by survey results showing a larger percentage of respondents said EFMP has neither a negative nor a positive impact on their career, Barnes said.

There has been a perception that the program would restrict troops’ ability to move to certain duty stations, limiting career progression.

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“EFMP enrollment … is not something that will absolutely have a negative impact on the career, and that is something that we think is very important,” she said.

Of those who responded, 47% said EFMP enrollment had neither a positive nor negative impact on their job/career options in the military; 22% said it had a positive effect, and 31%, a negative effect.

And 59% said the enrollment had neither a positive nor negative impact on their military career so far, with 20% saying the effect was positive, and another 20%, negative.

Soldiers’ experiences less positive

The survey was conducted before the Defense Department issued new rules in 2023 to provide more consistency to the program, which is administered by each of the services.

And the survey results brought into focus the need for that standardization, showing the differences in satisfaction between the service branches. The analysis showed soldiers’ experiences with EFMP were less positive than the other services.

For example:

– Of soldiers who had to relocate because of a PCS move since being enrolled in EFMP, 60% said EFMP support hadn’t made their move smoother at all; compared to 51% of participants overall.

– While 83% of service members said their family member’s needs had been met to some extent in the previous 12 months, 17% said their needs weren’t met at all. For soldiers, 21% stated their needs hadn’t been met at all.

– A quarter of service members overall said EFMP enrollment will have a positive impact on their decision to stay on active duty; 26% reported a negative impact, and 49% said it won’t have an impact. A higher percentage of sailors (35%) and Marines (32%) reported a positive impact, while more soldiers (29%) and airmen (30%) reported a negative impact.

– Thirty-seven percent said that based on the EFMP services they received, their families favor staying on active duty, while 25% favor leaving. A higher percentage of sailors (44%) and Marines (42%) favor staying. A higher percentage of soldiers, 28%, favor leaving.

– While half of service members responded that their leadership had always or often provided support to help with EFMP needs in the previous 12 months, 26% percent said they never had gotten support. For soldiers, the percentage of those who never had gotten support was highest, at 35%.

Earlier this year, the Army announced they are creating a central office to oversee implementation of the EFMP, coordinating health care services, PCS order processing and family support services, as well as special education services.

In 2022, the Army launched a new digital platform called the Enterprise Exceptional Family Member Program system, to automate the enrollment process and make it easier for families to access support services and resources, according to Army spokeswoman Heather J. Hagan.

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The Army has also expanded their program of EFMP family support system navigators on their installations, providing military and community resources, EFMP respite care services and other support.

In putting together the new DOD rules for standardization, DOD’s Barnes said, officials looked at best practices that were being used to support military families. Going forward, officials have mechanisms in place to get feedback “so we can actually compare the results and see how we’re progressing,” she said.

While they intend to do the surveys on a regular basis, the timeline isn’t available, she said.

Meanwhile, officials are collecting data on the program, as a result of the new DOD rules, and will receive their first data report on the performance in the fall, to help them identify whether the standardization efforts are being met, Barnes said.