Updated November 14, 2022
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 following)
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., follow-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
technologies, or environmental/architectural
Background 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. When transferring to a new duty station,
pressures of military service on families, Congress enacted EFMP enrollment is portable; though additional paperwork
the Military Family Act of 1985 as part of the Department may be required in order to coordinate and continue certain
of Defense Authorization Act, 1986 (P.L. 99-145 §§801- services and support. There are no costs to enroll in the
813). This act directed the Department of Defense (DOD) program. However, there may be costs associated with
to create an Office of Family Policy to “coordinate obtaining civilian medical documentation required for
programs and activities of the military departments as they enrollment that may be reimbursed by the member’s service
relate to military families.” or through DOD’s health benefits 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 Education and outreach to
military and community
with special needs, while each military service is EFMP families
Services
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
Collaboration 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)).
Develop and maintain Non-clinical case
Eligibility and Enrollment
individual service plans management
DOD Instruction 1315.19 requires active duty
servicemembers to enroll in EFMP if they have a dependent
[Link]
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 enrollees.
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
retain some medical responsibilities, such as screening and
EFMP’s family support services identify local programs 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 services. 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
Program (EFMP)
Current Challenges
Congress may consider legislation to address selected CRS Products
issues identified by the Government Accountability Office CRS In Focus IF11002, Defense Health Primer: TRICARE Extended
(GAO), DOD, and advocates of families with special needs. Care Health Option (ECHO), by Bryce H. P. Mendez
Absence of Program Standardization and CRS Report R43631, The Individuals with Disabilities Education Act
Inconsistency of Services to Dependents (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 20-400T, Military Personnel: DoD Has Made Limited
recommended that DOD (1) assess and report to Congress Progress toward Improving Oversight of the Exceptional Family
how each service provides support to its members; (2) Member Program, February 5, 2020
develop a common set of performance metrics; and (3)
evaluate the monitoring activities of each service. As of GAO Report 18-348, Military Personnel: DoD Should Improve Its
November 1, 2021, GAO’s recommendations remain open Oversight of the Exceptional Family Member Program, May 8, 2018
for DOD action. A 2021 RAND study identified similar GAO Report 12-680, Better Oversight Needed to Improve Services
findings and recommended policy updates to improve for Children with Special Needs, September 10, 2012
“consistency across services where possible” and to RAND, RR-A742-1, The Exceptional Family Member Program, 2021
“standardize the experience that military families have with
the EFMP.”
Bryce H. P. Mendez, Analyst in Defense Health Care
Policy
[Link]
Defense Primer: Exceptional Family Member Program (EFMP)
IF11049
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 permission of the copyright holder if you
wish to copy or otherwise use copyrighted material.
[Link] | IF11049 · VERSION 11 · UPDATED
