In May of 2013, I wrote this piece in Time: The Pentagon’s Letting Down Our Kids. Some of the feedback I received at the time was that I wasn’t patient enough. Three and a half years later, after submitting my own letter to the Pentagon last week (A Letter to DoD on Behalf of Military Kids with Disabilities) and after reading the following letter from the TRICARE for Kids Coalition, I don’t think my patience is the problem.
If you are a military family and you care about your child’s health, read this letter.
“To Members of the DoD Military Family Readiness Council (MFRC):
The TRICARE for Kids Coalition is a stakeholder group of children’s health care advocacy and professional organizations, disability advocacy groups, military and veterans’ service organizations and military families committed to ensuring that the Department of Defense meets the unique needs of children of military families.
The Coalition greatly appreciates the MFRC’s interest in the healthcare and supports provided to the 2.4 million pediatric beneficiaries in the Military Health System. That interest was obvious in the Council’s request that the Defense Health Agency (DHA) brief the MFRC on TRICARE for Kids at its June 2016 meeting.
“TRICARE for Kids” is the popular name for legislation passed as Sec 735 of the 2013 National Defense Authorization Act (NDAA), which ordered the Secretary of Defense to study the health care and related services for children of members of the Armed Forces, and is used as a colloquialism for the efforts surrounding that legislation and implementation. Then Undersecretary of Defense for Personnel and Readiness, the Honorable Jessica L.Wright, submitted the Section 735 Pediatric (Tricare for Kids) Report to the Congressional Defense Committees in July of 2014.
The DoD report included 31 significant findings related to the nine Congressionally-directed elements in Section 735. The TRICARE for Kids Coalition responded to this report in September of 2014. While agreeing with the 31 findings, the coalition was also troubled by numerous discrepancies and omissions in the report. Two examples include its failure “to set forth a plan to improve and continually monitor pediatric care” and to make “recommendations for legislation that the Secretary considers necessary to maintain the highest quality of health care for dependent children,” both requirements of Sec 735 of the 2013 NDAA. Addressing these findings and responding fully to Congressional direction are absolutely necessary to ensuring that the Department is meeting the needs of military children and their families.
Unfortunately, the June 2016 MFRC briefing provided by DHA officials failed to address DoD’s 31 findings or stakeholders’ previously submitted questions to DHA regarding status of those findings in June 2015 (both attached). The MFRC brief by DHA provided little more than a general update. While some of the information was interesting, the brief wasn’t specific to the DoD report and left MFRC members with more questions than answers, and advocates with significant concerns.
Besides the failure to address the 31 specific DoD findings, we had significant concerns because of factually incorrect statements with respect to interaction with the Military Compensation and Retirement Modernization Commission (MCRMC) findings regarding the Extended Care Health Option (ECHO) program, the purpose of ECHO, and a key element of the ECHO program, in the DHA briefing [to read the letter from the Military Special Needs Network on this topic, go here].
Because they were stated as fact versus opinion, and because the misstatements will lead to further delay and potentially inappropriate implementation of the Tricare for Kids findings, we would hope that the Council will continue its engagement and leadership on Tricare for Kids, look to DoD to correct the record, and consider receiving relevant testimony from stakeholders and experts. We would specifically recommend the professional staff from the MCRMC, charged with the Commission’s research, analysis and recommendations regarding the critical needs of families with exceptional members (EFMPs) who rely on ECHO services.
Similarly, egregious enough to warrant comment and concern by stakeholders was the point made in the briefing about DHA management of the respite care benefit, referencing concerns that it would be used as a babysitting service, a statement which suggests both an unacceptable level of ignorance of families’ needs and undue suspicion of motives directed at our most vulnerable military families. These kinds of comments and misconceptions are the type that advocates work tirelessly to correct among the general public, but it is especially concerning when such remarks are provided by the agency charged with reforming these programs and serving these families.
Our concerns with lack of progress addressing the specific findings and the delays in improving pediatric care are mirrored in both the House and Senate Armed Services Committees (HASC and SASC) since the Report was filed in 2014. Last year, regarding DoD’s report to Congress, the SASC stated,
“The report deeply concerns the committee because data gaps and deficiencies in this area fail to substantiate the conclusion that the military health system meets the health care needs of children, especially those children with special needs.”
Additional statutory language can be found throughout this year’s NDAA indicating continuing dissatisfaction with DoD’s follow-up regarding this topic.
Every day that DoD is not moving forward on correcting and improving the issues highlighted in DoD’s report, as well as our TRICARE for Kids Coalition response to that report, is a day that military families are not accessing needed supports and services.
The MFRC’s continued engagement and leadership in requesting updates and monitoring progress is crucial to ensuring accountability with Congressional directives and DHA’s own stated goals of meeting the unique needs of children. To that end, the TRICARE for Kids Coalition requests the Military Family Readiness Council include as one of its 2016 recommendations to Secretary of Defense Carter a statement that acknowledges the importance of pediatric care for military children and the necessity of updating the Council and stakeholders on actions taken to date and planned to specifically address the 31 findings of the TFK/ Section 735 report and related questions.
The TFK Coalition appreciates and applauds the diligence of the MFRC regarding TRICARE for Kids matters as DoD works toward filling the gaps, addressing areas for improvement, and improving health care supports and services for military children and their families, especially those with special needs.
Kara Tollett Oakley
Chair, TRICARE for Kids Coalition
About the Author: Jeremy Hilton is a Navy veteran, Air Force spouse, author, and advocate. He helped repeal the COLA cuts in the 2013 BCA as a #KeepYourPromise cofounder and is currently working to reform military pediatric healthcare as a “TRICARE for Kids” Champion. Jeremy has written for Time, Huffington Post, Military Spouse magazine, USAA, and Exceptional Parent magazine.