Chapter 21 The Exceptional Family Member Program: Helping Special Needs Children in Military Families

Historical Background  Americans With Disabilities Act.  Decrease in infant mortality rates.  Increase in autism spectrum disorders.  Active duty service members increasingly are parents of children with developmental disabilities.  Increased military focus on addressing needs of families.  The Army was the first to implement the EFMP in 1979, and since that time, the Navy, Air Force, and Marine Corps have incorporated EFMP into their assignment process.  Americans With Disabilities Act.  Decrease in infant mortality rates.  Increase in autism spectrum disorders.  Active duty service members increasingly are parents of children with developmental disabilities.  Increased military focus on addressing needs of families.  The Army was the first to implement the EFMP in 1979, and since that time, the Navy, Air Force, and Marine Corps have incorporated EFMP into their assignment process.

Military and Disability Culture: Two Worlds

The Exceptional Family Member Program (EFMP)  Four Components  Identification and enrollment  Services  Personnel assignment  Family support services  Four Components  Identification and enrollment  Services  Personnel assignment  Family support services

EFMP Identification and Enrollment  Eligibility requirements  Active duty status, Reserve or National Guard  A dependent family member with special needs  Member’s spouse, child, or other person (e.g., elderly parents of the service member) actually residing in the member’s household who is dependent on the member for over half of his or her financial support  Mandatory enrollment if eligible  The Special Needs (or EFMP) Coordinator at a base is responsible for:  Ensuring the quality of the Special Needs Identification process.  Reviewing facility determination packages from gaining bases (the prospective base for relocation) when medical or educational services are not available to support active duty assignment.  Maintaining cooperative working relationships with staff responsible for DoD educational activities.  Command points of contact and EFMP coordinators can assist service and family members with the enrollment process.  Eligibility requirements  Active duty status, Reserve or National Guard  A dependent family member with special needs  Member’s spouse, child, or other person (e.g., elderly parents of the service member) actually residing in the member’s household who is dependent on the member for over half of his or her financial support  Mandatory enrollment if eligible  The Special Needs (or EFMP) Coordinator at a base is responsible for:  Ensuring the quality of the Special Needs Identification process.  Reviewing facility determination packages from gaining bases (the prospective base for relocation) when medical or educational services are not available to support active duty assignment.  Maintaining cooperative working relationships with staff responsible for DoD educational activities.  Command points of contact and EFMP coordinators can assist service and family members with the enrollment process.

EFMP Personnel and Services  Family relocation clearance  General medical services  Special educational services  Specially designed instruction to meet the unique educational needs of a child with a disability, including:  education provided in school, at home, in a hospital or in an institution, physical education programs, and vocational education programs  school health services  social work services  parent counseling and training  Early intervention or related services  Transportation, developmental, corrective, and other supportive services as required to assist a child, from birth to 21 years of age with a disability to benefit from special education under the child’s Individualized Family Service Plan (IFSP) or Individualized Education Plan (IEP)  Can include speech-language pathology and audiology; psychological services and counseling; physical, occupational and recreational therapies; early identification and assessment of disabilities in children; rehabilitation counseling; orientation and mobility services (for the visually impaired); and medical services for diagnostic or evaluative purposes  These services mirror civilian special education laws (including structural accessibility)  Family relocation clearance  General medical services  Special educational services  Specially designed instruction to meet the unique educational needs of a child with a disability, including:  education provided in school, at home, in a hospital or in an institution, physical education programs, and vocational education programs  school health services  social work services  parent counseling and training  Early intervention or related services  Transportation, developmental, corrective, and other supportive services as required to assist a child, from birth to 21 years of age with a disability to benefit from special education under the child’s Individualized Family Service Plan (IFSP) or Individualized Education Plan (IEP)  Can include speech-language pathology and audiology; psychological services and counseling; physical, occupational and recreational therapies; early identification and assessment of disabilities in children; rehabilitation counseling; orientation and mobility services (for the visually impaired); and medical services for diagnostic or evaluative purposes  These services mirror civilian special education laws (including structural accessibility)

Housing Needs of EFMP Families  Need to be close to civilian services (such as occupational, speech, or behavioral therapy) for their child which may not meet the military alert requirements to be within a 15-minute travel time of the base.  May need to live in separate residences—base and civilian community. For children who use wheelchairs and other mobility devices, home searches may need to focus on single-level dwellings, which may limit the family’s choices of neighborhood and proximate amenities.  Simple home modifications to eliminate architectural barriers (such as building a ramp) are frequently not costly. However, permission from the landlord would be needed and the cost of this modification (up to a certain amount) would be covered by the base housing office.  For families who have only one car, the service member must have first priority for duty demands. This can isolate the spouse if public transportation is poor and if their housing is far from the base.  Need to be close to civilian services (such as occupational, speech, or behavioral therapy) for their child which may not meet the military alert requirements to be within a 15-minute travel time of the base.  May need to live in separate residences—base and civilian community. For children who use wheelchairs and other mobility devices, home searches may need to focus on single-level dwellings, which may limit the family’s choices of neighborhood and proximate amenities.  Simple home modifications to eliminate architectural barriers (such as building a ramp) are frequently not costly. However, permission from the landlord would be needed and the cost of this modification (up to a certain amount) would be covered by the base housing office.  For families who have only one car, the service member must have first priority for duty demands. This can isolate the spouse if public transportation is poor and if their housing is far from the base.

Child Care Needs of EFMP Families  Child care within a military installation is available to families on a sliding scale based on service member rank.  However, the capacity of generic types of military services to accommodate a child with a disability can be a barrier for EFMP families. As with civilian child care services, providers may not have the necessary training or experience in working with infants and children with developmental disabilities and/or special health care needs.  Child care providers may have concerns in areas of concern:  The most common concern is that the infant/child with a disability will take a disproportionate amount of the child care provider’s time, taking away from the needs of the other children being served. Other concerns:  that children with behavior problems may increase their liability because of potentially heightened risk of injury to self or injury to others.  potential resistance from the families of other children being served.  Military protective orders issued to potential service member offenders.  Child care within a military installation is available to families on a sliding scale based on service member rank.  However, the capacity of generic types of military services to accommodate a child with a disability can be a barrier for EFMP families. As with civilian child care services, providers may not have the necessary training or experience in working with infants and children with developmental disabilities and/or special health care needs.  Child care providers may have concerns in areas of concern:  The most common concern is that the infant/child with a disability will take a disproportionate amount of the child care provider’s time, taking away from the needs of the other children being served. Other concerns:  that children with behavior problems may increase their liability because of potentially heightened risk of injury to self or injury to others.  potential resistance from the families of other children being served.  Military protective orders issued to potential service member offenders.

Other EMFP Services  Special Needs Accommodation Process (SNAP) and other branches use the Special Needs Evaluation and Review Team (SNERT).  SNAP and SNERT both utilize a multidisciplinary team established to ensure that children with special needs have access to the most appropriate placement and accommodations at any military installation childc are facility.  After-school recreational and other services  Medical services—TRICARE  Special Needs Accommodation Process (SNAP) and other branches use the Special Needs Evaluation and Review Team (SNERT).  SNAP and SNERT both utilize a multidisciplinary team established to ensure that children with special needs have access to the most appropriate placement and accommodations at any military installation childc are facility.  After-school recreational and other services  Medical services—TRICARE

Civilian Services for EFMP Families  Family-Centered Care Planning. Professionals:  intentionally partner with families in the delivery of services  seek family input  view the family as the primary expert on the child  respond to family concerns using a strengths-based individualized approach  Least Restrictive Environment and Inclusion  Accommodations and Modifications  Formal Dispute Resolution Procedures—Due Process  Legal Foundations to Protect the Rights of People With Disabilities  State Developmental Disabilities (DD) Services  DD Training, Planning, and Advocacy Organizations  Family-Centered Care Planning. Professionals:  intentionally partner with families in the delivery of services  seek family input  view the family as the primary expert on the child  respond to family concerns using a strengths-based individualized approach  Least Restrictive Environment and Inclusion  Accommodations and Modifications  Formal Dispute Resolution Procedures—Due Process  Legal Foundations to Protect the Rights of People With Disabilities  State Developmental Disabilities (DD) Services  DD Training, Planning, and Advocacy Organizations

Family Support Services for EFMP Families—Military and Civilian  Military Home Front  program information, policy and guidance website  seek family input  view the family as the primary expert on the child  respond to family concerns using a strengths-based individualized approach  Specialized Training of Military Parents (STOMP)  workshops and presentations  direct one-on-one consultation with families  provision of a 3½-day training and technical assistance for Parent Professional Teams  four locations across the country  Service Member Support—Utilizing Military Command Structure  Training for Military and Civilian Service Providers  Case Management  Parent-to-Parent Support  Advocacy Services  Military Home Front  program information, policy and guidance website  seek family input  view the family as the primary expert on the child  respond to family concerns using a strengths-based individualized approach  Specialized Training of Military Parents (STOMP)  workshops and presentations  direct one-on-one consultation with families  provision of a 3½-day training and technical assistance for Parent Professional Teams  four locations across the country  Service Member Support—Utilizing Military Command Structure  Training for Military and Civilian Service Providers  Case Management  Parent-to-Parent Support  Advocacy Services