EFMP or the Exceptional Family Member Program. It’s supposed to be a program to help military dependents access care, find advocates and only PCS to locations that can really, truly serve their needs.
Except it doesn’t always work that way.
Military spouses hear from commands and MTFs that EFMP will totally help them! It’ll be so much easier to ensure access to the right health care providers, additional support services and education programs (for kids) at wherever they’re stationed.
They hear that it’s “mandatory” to be enrolled.
And then they hear the horror stories from other families, detailing all the things that have gone wrong, promises left unfulfilled and careers derailed.
So what’s the truth about military spouses and EFMP? We went straight to the source – military spouses with EFMP experience that run the gamut.
Digging into Real EFMP Stories from MilSpouses Who’ve Been There
Enrolling in EFMP is supposed to be simple, just some paperwork. Paperwork that you should be able to grab right at your on-base PCM. And your PCM should be helping to determine if you or your children are eligible to begin with.
That’s not always the case, as some military spouses have discovered. Air Force Spouse, Susan R., was given some faulty information
“I should have been enrolled years before, but was told some inaccurate information about EFMP and the population the program serves,” she said. “I was informed by my PCM in 2008, that EFMP was a pediatric program and that adult specialty medical care could always be found. Sadly, that’s not entirely accurate.”
Adults are, in fact, eligible for enrollment in EFMP. But this might not always be clear to your PCM, military or civilian.
Other spouses, like USMC spouse Melissa, were surprised with their EFMP status.
“I had a temporary condition that I did not know qualified me for EFMP, and I was enrolled in EFMP without anyone contacting me or contacting my active-duty spouse,” she explained. “I believe I was enrolled for about two years. When it came time to PCS, we suddenly found out that I was in EFMP, since it came up on the checklists. That was a surprise!”
Unlike Melissa, Susan found enrollment challenging, contrary to the “easy process” touted by the military powers that be.
“Enrolling in EFMP seems to be an easy process, too,” Susan shared. “Fill out a form, get the PCM to fill it out, sign it and that’s it. Sadly, that’s not it. Depending on the diagnosis there could be many physicians and specialists involved needing to fill out and sign paperwork. That process can be long and drawn out.”
Once in “the system,” many military spouses felt let down by the support and services they experienced.
Melissa felt completely ignored by the whole process. Not only was she not informed of her enrollment, she was barely involved in the process to get out.
“I saw a distinct lack of communication from the EFMP service at the base where we were, Melissa said. “I could not believe I’d been signed up and no one from the office contacted me. (It) took him three tries to get to someone who knew what forms we needed to get me out of the program. Then, the final in-person interview we needed to attend was only scheduled through my spouse, not me. He called and asked if I could attend the meeting time. No one from EFMP reached out to me then, either.”
Even though getting into EFMP, and apparently getting out as well, might be a challenge, there are some positives to this program.
“The base we were at had good programs for EFMP members, in terms of regular gatherings and events for both kids and adults,” Melissa said. “I think it was a good program for those who knew they were in it.”
Susan, an Army kid turned Air Force spouse, remembers the days pre-EFMP. In her eyes, the positives come close to balancing out the negatives.
“The positives of EFMP means that families with medical needs are being considered when the service member is up for an assignment,” she said. “I was an Army kid and I remember life as EFMP was being rolled out by the Army. We had families getting stationed in places where their medical, educational and family support needs were never considered. The stress on families was overwhelming. In some cases, rare cases, family members would get very sick and not have the medical care they needed.”
Good & Bad of EFMP
USMC Spouse Jen C. has seen both sides of EFMP. Both Jen and her children are enrolled in EFMP.
“I have been enrolled as EFMP member since 2003. I also am a disabled vet and have physical limitations,” Jen explained. “I had my oldest May 2005. I was given respite. I used respite with the CDC on base. I was given I believe 16 or 20 hours of respite a month. It actually helped our family since my husband was an e-5 and I only had a 10% service connected disability rating at the time.”
Respite care, available to EFMP-enrolled adults to care for their children as well as for EFMP-enrolled children, provides a qualified sitter or care providers. Families then apply for reimbursement at a set rate and for a particular number of hours.
However, after 2009, Jen saw EFMP change – and not for the better in her estimation.
“After 2009 things changed drastically because of the sequestration,” she said. “EFMP respite was than non-existent for EFMP adults.”
Will It Impact the Military Career?
Career issues top the list of why military families try to stay off of EFMP rosters. But if you’re talking to military powers that be, negative career effects are basically non-existent. But what’s the truth?
Actually, it seems like it’s both.
EFMP basically ensures that military families are not moved to locations without the correct services and supports. At least, it’s supposed to prevent that.
In reality, EFMP status can limit duty station options and lead to unaccompanied tours.
Army spouse Megan H. has experienced two unaccompanied tours and denial of tours, all due to EFMP-enrolled dependents. There are multiple EFMP-qualifying individuals in her household.
“(W)e were not just denied accompanied overseas assignments, but CONUS assignments as well,” Megan shared in her personal story. “(The) doctors, without understanding the process, not only ended up putting a wish list of services on each of my daughters’ forms (for now my three oldest all qualified to be enrolled) but they also enrolled me for about six or seven different diagnoses, some of which I didn’t really have, as well as listing approximately seven or eight providers that I needed to see either weekly or monthly for those diagnoses.”
Susan also saw impacts to her spouse’s career. While the personal impact is negative, she can also see the rationale behind the policy.
“(W)e were unable to move to a location that would have helped his career progression. The lack of medical care meant that my family was denied travel to that location. We ended up staying at a location for close to 8 years,” she explained. “I also believe that EFMP is supposed to impact the service member’s career. I’m sure this seems strange, but this is what I believe. If DoD didn’t have EFMP, then families who have children with autism, are diagnosed with cancer, have illnesses that require specialty medical care would move to duty stations and never be able to access the care and services needed.”
A new USMC study appears to show that there is little to no longterm impact on Marine’s careers.
“Not only did we find that career advancement was not distinguishably impacted by EFMP enrollment, we also learned that, on average, EFMP enrollees serve slightly longer than their non-EFMP active duty counterparts, achieve a slightly higher grade, and the majority achieve that high grade in the same or shorter amount of time than the average of their non-enrolled peers,” said Jennifer Stewart, the EFMP Section Head for Marine and Family Programs.
What Happens If I Don’t Enroll?
If your EFMP-qualifying issue is mild or well-controlled, then this should be listed on your medical paperwork. Opting to avoid enrolling is a 100% personal decision that needs to be based on multiple factors.
However, before choosing to skip EFMP, it’s important to understand the implications.
- Moving to a duty station where limited or no services are provided via MTFs or in-network civilian medical providers
- Being located in a place with limited or no support services, like ABA therapy
- Moving to a location where routine, infrequent maintenance screenings or check-ups are unavailable
Basically, you could be in a place where the things you or your child needs to cope with your diagnosis are just not available. While some diagnoses or individuals might be able to manage, others may not. And you just won’t know what’s there until you get there.
Susan appreciates the fact that her family’s duty station options are more limited.
“My husband and I are good with not being able to move to a location that doesn’t have the medical care to support our family,” she shared. “Our family is the most important thing which means having access to medical care that we need.”
However, Jen found that the system failed her family,
“We had serious waitlist issues in FL,” she explained. “I even called USMC EFMP HQ in Quantico because I asked why they sent me somewhere where there are no services.”
I was the ACS EFM Program manager for Army in Hawaii from 2001 to 2005. One important distinction that wasn’t addressed in this article is the fact that there are two related, but separate, EFMP programs, at least for the Army – the medical side and the social services side. In Hawaii the medical portion, which includes the mandatory reporting for a soldier who has a family member with a physical or emotional need for special care, is managed at Tripler Army Medical Center (TAMC). The social services are provided for these families by Army Community Services.
TAMC employees , who includes physicians, OT and PT specialists, Social Workers, and other medical experts, ensure the enrollment and screening requirements of the EFM Program are followed. Additiinally, they provide the medical assistance to these dependants, as their qualifications suggest.
ACS EFM Program specialists/managers assist the service member and his or her enrolled family in finding adequate services throughout the local military and civilian communities. This includes acting as a liaison at local schools for families with children with an IEP; informing them of local specialists (eg., dentists, caregivers, recreation, etc.); counseling families who may be having issues with their transition to or from Hawaii, and many other supportive aids.
It has been several years since I held that position. I am now retired. I’m certain there have been many changes to the EFM Program since my tenure. However, I am certain that the medical and social services provided by the Army in Hawaii are still fundamentally the same.
Additionally, I found that the other military services in Hawaii (i.e, Air Force, Marines, Navy and Coast Guard), which have a similar EFMProgram, are as committed to the service members and their families. And, although it’s possible that other installations may not have as strong a support system as the EFMP in Hawaii with medical and social services, through my experience, I am certain that assistance will be available to all families who have special needs, regardless of their need, at installations throughout the world.
It is imperative that a family NOT be relocated to an installation that cannot provide for their needs. However, it is the RESPONSIBILITY of the service member to be stationed where he or she is needed. If that means an unaccompanied tour, then, families, be thankful that your needs are being considered and addressed; that it’s “better to be safe than sorry”; and that your spouse/mom/dad/etc. are fulfilling their obligation to the Army/Navy/Air Force/Marines/Coast Guard, AND ensuring their family is safe, secure, and has the services they need.