Updated November 19, 2021
Defense Primer: Exceptional Family Member Program (EFMP)
Congress authorizes programs and appropriated funds for
with a qualifying special need. Members of the Reserve
servicemember and family benefits, including services to
Component are not required to enroll in EFMP, unless they
improve quality of life or attenuate military-specific
are in an active duty status (for more than 30 consecutive
challenges. Military families face frequent moves around
days). DOD civil service employees selected for overseas
the globe, often causing disruptions to spousal employment,
assignments are eligible for EFMP services on a space-
school or child care arrangements, and other challenges
available basis.
associated with establishing a household in a new location.
These challenges are often compounded for families with
Criteria for EMFP Enrollment
special needs.
(one or more of the fol owing)
Military members who have a dependent (spouse, child, or
Life-threatening or chronic condition requiring special
dependent parent) with special needs may experience
care (e.g., fol ow-up from a primary care manager)
significant stress during these moves due to the need to find
Current and chronic mental health condition
specialized health care providers, school systems with
Asthma or other respiratory-related diagnosis
dedicated support services, and community support
assistance. The military established the Exceptional Family
Attention deficit disorder/Attention deficit hyperactivity
Member Program (EFMP) to ease these additional burdens
disorder
of a move for such families.
Chronic condition requiring adaptive equipment, assistive
Background
technologies, or environmental/architectural
considerations
The U.S. Army started EFMP in 1979, with the other
services following. Enrollment was voluntary and the
Special educational needs
program initially provided medical support to families with
Servicemembers may receive guidance on eligibility and
special needs in the United States and overseas locations.
completing enrollment in the program at their installation
As child advocacy groups raised concerns over the unique
EFMP office. EFMP enrollment is not portable and
pressures of military service on families, Congress enacted
servicemembers must register for the program when
the Military Family Act of 1985 as part of the Department
transferring to a new duty station. There are no costs to
of Defense Authorization Act, 1986 (P.L. 99-145 §§801-
enroll in the program. However, there may be costs
813). This act directed the Department of Defense (DOD)
associated with obtaining civilian medical documentation
to create an Office of Family Policy to “coordinate
required for enrollment that may be reimbursed by the
programs and activities of the military departments as they
member’s service or through DOD’s health benefits
relate to military families.”
program, TRICARE.
Congress later created the Office of Community Support for
EFMP Services and Support
Military Families with Special Needs in Section 563 of the
EFMP offices also assist with the coordination of military
National Defense Authorization Act (NDAA) for FY2010
assignments and family support services. Dependents are
(P.L. 111-84). Renamed the Office of Special Needs (OSN)
eligible for support services once the servicemember has
in 2016, its statutory mission is to develop DOD-level
enrolled in the program.
oversight of EFMP and “standardize, enhance, and improve
DOD support around the world for military families with
EFMP Services and Support
special needs (whether medical or educational needs).”
Information and referral for
OSN establishes DOD policy to support military families
military and community
Education and outreach to
with special needs, while each military service is
Services
EFMP families
responsible for administering its own EFMP. The degree of
legal, educational, and training assistance provided varies
Refer families with serious
Provide local school and early
by service. OSN coordinates with the services, Defense
complicated medical issues to
intervention services
Health Agency (DHA), and DOD Education Activity in an
the Military Health System
information
effort to ensure EFMP adequately supports military
Col aboration with military,
families. OSN holds quarterly advisory panels with military
Provide assistance before,
federal, state, and local
families to assess program satisfaction and is required to
during, and after a relocation
agencies on special program
provide an annual report to Congress (10 U.S.C.
development
§1781c(g)).
Eligibility and Enrollment
Develop and maintain
Non-clinical case
individual service plans
management
DOD Instruction 1315.19 requires active duty
servicemembers to enroll in EFMP if they have a dependent
https://crsreports.congress.gov
link to page 2 
Defense Primer: Exceptional Family Member Program (EFMP)
Figure 1. EFMP-enrolled Dependents, 2014-2020
Source: Email communication with DOD and USCG officials, February 2021.
Notes: The Department of the Air Force was unable to provide data for 2015. Air Force data for 2020 includes Space Force enrol ees.
EFMP offices validate educational and medical resource
Medical Coordination for EMFP Enrollees
availability at the servicemember’s projected duty location,
The FY2017 NDAA (P.L. 114-328 §702) directed
in partnership with the services’ personnel organizations. If
numerous Military Health System (MHS) reforms,
specific services or resources are not available at the
including the transfer of administration of all military
servicemember’s prospective duty location, their military
hospitals and clinics from the Services to the DHA. Each
orders may be canceled or modified.
service is to continue administering its own EFMP and
EFMP’s family support services identify local programs
retain some medical responsibilities, such as screening and
developing support plans. In general, DHA is responsible
and resources to support individual needs. This includes
for providing required medical support for EMFP enrollees,
connecting dependents with community support groups,
instead of the Services (as was previously done). While
Individuals with Disabilities Education Act (P.L. 101-476)
Congress directed MHS reforms designed to streamline the
early intervention programs, and special education s ervices.
delivery of health care, the reformed MHS organizational
EFMP enrollees may also receive respite care. Eligibility,
structure could impede or delay EMFP enrollee access to,
availability, and amount of monthly-allotted respite care
or coordination of, complex medical services.
hours varies by service. EFMP enrollees may also be
eligible to enroll in the TRICARE Extended Care Health
Relevant Statutes, Regulations, and Policies
Option (ECHO) program, which pays for additional
10 U.S.C. §1781c – Office of Special Needs
services and supplies for those with special needs. In 2020,
9% (146,824) of military dependents received support from
32 C.F.R. Part 75 – Exceptional Family Member Program
EFMP (see Figure 1).
DOD Instruction 1315.19 – The Exceptional Family Member
Current Challenges
Program (EFMP)
Congress may consider legislation to address selected
CRS Products
issues identified by the Government Accountability Office
CRS In Focus IF11002, Defense Health Primer: TRICARE
(GAO), DOD, and advocates of families with special needs.
Extended Care Health Option (ECHO), by Bryce H. P. Mendez
Absence of Program Standardization and
CRS Report R43631, The Individuals with Disabilities Education
Inconsistency of Services to Dependents
Act (IDEA), Part C: Early Intervention for Infants and Toddlers with
In 2012 and 2018, GAO found that EFMP implementation
Disabilities, by Kyrie E. Dragoo
“var[ies] widely for each branch of Military Service” and
Other Resources
that the overall program lacks standardization. GAO
GAO Report 18-348, Military Personnel: DoD Should Improve Its
recommended that DOD; 1) assess and report to Congress
Oversight of the Exceptional Family Member Program, May 8,
how each service provides support to its members; 2)
2018
develop a common set of performance metrics; and 3)
evaluate the monitoring activities of each service. As of
GAO Report 12-680, Better Oversight Needed to Improve
November 1, 2021, GAO’s recommendations remain open
Services for Children with Special Needs, September 10, 2012
for DOD action. A 2021 RAND study identified similar
RAND, RR-A742-1, The Exceptional Family Member Program,
findings and recommended policy updates to improve
2021
“consistency across services where possible” and to
“standardize the experience that military families have with
Bryce H. P. Mendez, Analyst in Defense Health Care
the EFMP.”
Policy
IF11049
https://crsreports.congress.gov
Defense Primer: Exceptional Family Member Program (EFMP)
Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan shared staff to
congressional committees and Members of Congress. It operates solely at the behest of and under the direction of Congress.
Information in a CRS Report should not be relied upon for purposes other than public understanding of information that has
been provided by CRS to Members of Congress in connection with CRS’s institutional role. CRS Reports, as a work of the
United States Government, are not subject to copyright protection in the United States. Any CRS Report may be
reproduced and distributed in its entirety without permission from CRS. However, as a CRS Report may include
copyrighted images or material from a third party, you may need to obtain the permissio n of the copyright holder if you
wish to copy or otherwise use copyrighted material.
https://crsreports.congress.gov | IF11049 · VERSION 8 · UPDATED