Updated December 17, 2018
Defense Primer: Exceptional Family Member Program (EFMP)
Congress appropriates funds for military benefits and
Eligibility and Enrollment
services to improve the quality of life for service members
Active duty service members are required to enroll in
and their families. Military families face frequent moves
EFMP if they have a family member with a qualifying
around the globe, often causing disruptions to spousal
special need. Members of the Reserve Component are not
employment, school or child care arrangements, and other
required to enroll in the EFMP, unless they are in an active
challenges associated with establishing a household in a
duty status. DOD civil service employees selected for
new location.
overseas assignments are also eligible for EFMP services
Military members who have a dependent (spouse, child, or
on a space-available basis.
dependent parent) with special needs may experience
Service members may receive guidance on eligibility and
significant stress during these moves due to the need to find
completing enrollment in the program at their installation
specialized health care providers, school systems with
EFMP office. EFMP registration must be transferred when
dedicated support services, and community support
moving to a new duty station. While there are no costs to
assistance. The military established the Exceptional Family
enroll in the program, certain costs may be associated with
Member Program (EFMP) to ease these additional burdens
medical documentation required for enrollment. These costs
of a move for such families.
may be reimbursed by their respective Service or through
Background
an insurance-like program known as TRICARE.
The U.S. Army started EFMP in 1979, with the other
Criteria for EFMP Enrollment
Services following its lead. Enrollment was voluntary and
(one or more of the following)
the program initially provided medical support to families
with special needs in the U.S. and overseas locations.
Life-Threatening or Chronic Condition Requiring Special
Care (e.g., follow-up from a primary care manager)
As child advocacy groups raised concerns over the unique
Current and Chronic Mental Health Condition
pressures of military service on families, Congress enacted
the Military Family Act of 1985 as part of the Department
Asthma or Other Respiratory-Related Diagnosis
of Defense Authorization Act, 1986 (P.L. 99-145 §§801-
Attention Deficit Disorder/Attention Deficit
813). This act directed the Department of Defense (DOD)
Hyperactivity Disorder
to create an Office of Family Policy to “coordinate
Chronic Condition Requiring Adaptive Equipment,
programs and activities of the military departments as they
Assistive Technologies, or Environmental/Architectural
relate to military families.”
Considerations
After 20 years of high operational tempo and congressional
Special Educational Needs
hearings on strength, vitality, and sustainability of military
family support programs, Congress created the Office of
EFMP Services and Support
Community Support for Military Families with Special
EFMP offices also assist with military assignment
Needs in Section 563 of the National Defense Authorization
coordination and direct family support services. Dependents
Act (NDAA) for FY2010 (P.L. 111-84). Later renamed the
are eligible for support services once the service member
Office of Special Needs (OSN), its statutory mission is to
has enrolled in the program.
develop DOD-level oversight of EFMP and “enhance and
EFMP offices validate educational and medical resource
improve DOD support around the world for military
availability at the service member’s projected duty location,
families with special needs (whether medical or educational
in partnership with the Services’ personnel organization.
needs).”
Assignments may be canceled or modified if specific
OSN establishes overarching policy to support military
services or resources are not available at the prospective
families with special needs, while each Service (Army,
location.
Navy, Marine Corps, and Air Force) is responsible for
EFMP’s family support services identify local programs
administering its own EFMP. While the degree of legal,
and resources to support individual needs. This includes
educational, and training assistance provided varies by
connecting dependents with community support groups,
Service, OSN coordinates with each Service, the Defense
Individuals with Disabilities Education Act (P.L. 101-476)
Health Agency, and the DOD Education Activity in an
early intervention, and special education services.
effort to ensure EFMP adequately supports military
families. OSN holds quarterly advisory panels with military
Military families supported by EFMP may also receive
families to assess program satisfaction and provides an
respite care. Eligibility, availability, and amount of monthly
annual report to Congress (10 U.S.C. §1781c(g)).
allotted hours varies by Service.
https://crsreports.congress.gov
Defense Primer: Exceptional Family Member Program (EFMP)
Variance in Services and Support to Dependents
EFMP Services and Support
In addition to the aforementioned variances in respite care,
Information and Referral for
differences in legal services, development of service plans,
Education and Outreach to
Military and Community
training opportunities, relocation services, staffing levels of
EFMP Families
Services
offices and frequency of contact with EFMP offices have
been reported. The complexity of this situation may grow
Refer Families with Serious
Provide Local School and
for military families at a joint base, where a Service
Complicated Medical Issues
Early Intervention Services
different from the family leads the local organization.
to the Military Health System
Information
EFMP Support to the Reserve Component
Collaboration with Military,
Provide Assistance Before,
According to DOD policy, family support services for
Federal, State, and Local
During, and After a
Reserve Component families depend on each Service,
Agencies on Special Program
Relocation
which has established different criteria for enrollment in
Development
EFMP. For example, the Air Force states Reserve
Develop and Maintain
Non-Clinical Case
Components family members may apply for services upon
Individual Service Plans
Management
serving 30 days on active duty. In contrast, Army Reserve
Component families may voluntarily enroll in EFMP before
Active duty members and their families enrolled in EFMP
entering active duty status.
may also be eligible to enroll in the TRICARE Extended
Congressional Oversight
Health Care Option program, which pays for additional
DOD concurred with each GAO recommendation and must
services and supplies for those with special needs.
brief Congress on their status by March 1, 2019 (H.Rept.
As of October 2018, approximately 8% (137,000) of
115-676). The brief must include a plan to develop
military family members received support from EFMP.
performance metrics for assignment coordination and
U.S. Army dependents were the largest share (40%) of
family support, a method to monitor activities of the
those receiving EFMP support.
Services, and a review to determine the feasibility of
creating interstate compacts for schools supporting EFMP
Figure 1. Total Military Family Members Receiving
students. Additionally, the brief may include an update on
EFMP Support (as of October 2018)
the pilot to measure satisfaction with support services and
progress on the standardization of enrollment forms.
80,000
60,000
Relevant Statutes, Regulations, and Policies
Section 1781c of Title 10, U.S. Code – Office of Special Needs
40,000
DoD Instruction 1315.19 – The Exceptional Family Member
20,000
Program (EFMP)
0
CRS Products
2012
2014
2016
2018
CRS Report R41833, The Individuals with Disabilities Education
Army
Air Force
Marine Corps
Navy
Act (IDEA), Part B: Key Statutory and Regulatory Provisions, by
Kyrie E. Dragoo
Source: Communication from DOD Officials, 2018.
CRS In Focus IF11002, Defense Health Primer: TRICARE
Current Challenges
Extended Care Health Option (ECHO), by Bryce H. P. Mendez
Congress may consider legislation to address selected
CRS In Focus IF10530, Defense Primer: Military Health System,
issues identified by the Government Accountability Office
by Bryce H. P. Mendez
(GAO), DOD, and advocates of families with special needs.
Absence of Program Standardization
Other Resources
GAO’s studies in 2012 and 2018 found that EFMP
MilitaryOneSource, Office of Community Support for Military
implementation “var[ies] widely for each branch of Military
Families with Special Needs,
Service,” and that the overall program lacks
http://www.militaryonesource.com
standardization. GAO recommended that 1) DOD assess
Government Accountability Office, GAO Report 18-348,
and report to Congress how each Service provides support
Military Personnel: DoD Should Improve Its Oversight of the
to its members; 2) develop a common set of performance
Exceptional Family Member Program, May 8, 2018
metrics; and 3) evaluate the monitoring activities of each
Government Accountability Office, GAO Report 12-680,
Service.
Better Oversight Needed to Improve Services for Children with
An October 2018 RAND study on Enhancing Family
Special Needs, September 10, 2012
Stability During a Permanent Change of Station (PCS)
RAND, RR2304, Enhancing Family Stability During a Permanent
identified similar findings. RAND found that “needs related
Change of Station, October 2018
to having a family member [in] EFMP [was] the most
frequently mentioned negative aspect of PCS moves…” and
that “the specific provisions vary across service branches.”
Justin D. Ellsworth, Air Force Legislative Fellow
Bryce H. P. Mendez, Analyst in Defense Health Care
Policy
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Defense Primer: Exceptional Family Member Program (EFMP)
IF11049
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