What to Look For |
What to Do |
What to Avoid
What to Expect |
When a Marine who has a special needs family member is not enrolled in the Exceptional Family Member Program, no consideration is given during the assignment coordination process. Often Marines arrive at the receiving Commands and quickly realize that their family members needs cannot be met and this has a negative impact on the Marine, personal and family readiness, the special needs family member, and their quality of life. If the Marine was enrolled, the assignment monitor would have coordinated with the EFMP Manager to ensure the Marine was stationed at a location that would meet the needs of the family member with special needs and an enormous amount of stress and hardship for the family, plus administrative burden for the accepting command, could have been avoided.
It is crucial that leaders identify these Marines early on, counsel the Marine on enrolling in the EFMP, follow-up to ensure he/she has enrolled, ensures that a Family Care Plan is completed,
and that the Marine is seeking assistance when needed from the EFMP Coordinator.
Leaders should respond quickly when Marines who are not enrolled accept assignments knowing fully that specialty medical or mental health services do not exist or who realize later on, after they arrive at a new duty station, that services do not exist and take no corrective action and as a result severely neglect the medical needs of their family member. Occasionally, it may have been a matter of the Marine not knowing where to turn for help, but if the Marine knows about the EFMP and still refuses to enroll and as a result receives an unsuitable assignment,
then official counseling is suggested. The financial
cost and impact on the Marine Corps is significant when a Marine receives an overseas-accompanied assignment after providing incomplete medical information during the Suitability Screening process, and and a family and all their household goods have to be returned back to CONUS because services are not available. It is the responsibility of the sending Commanding Officer to ensure that the Marine and his family member(s) have been appropriately screened and approved for an overseas assignment. Strict adherence to overseas screening
requirements cannot be overemphasized.
While many EFMP families are capable and can effectively handle the daily burden of care and stress associated with caring for a family member with special needs there are some who, for many reasons, need additional support or assistance. Marine Corps leaders should confirm whether or not a Marine who has identified themselves as having a family member with special needs is enrolled in the Exceptional Family Member Program. Indicators that a Marine may have a special needs family member that should be enrolled in the EFMP include:
- Frequent and ongoing liberty requests: When a Marine has frequent absences to take care of personal or family needs on an ongoing basis; this is a red flag that some outside assistance may be needed.
- Severe or prolonged stress: A Marine with an EFM may face many stressors including, worrying about the well-being or prognosis of a family member with a disability, not getting enough sleep for a prolonged period of time, coordinating and juggling a lot of appointments, dealing with unresponsive State service systems, medical bills, and handling severe behavioral problems, as well as juggling their career and the family. These issues might be even more compounded when there is a lack of respite
care and will eventually take its toll on the entire family and the Marine's ability to perform his duties.
- Financial problems: Medical
bills and supplies (such as special clothes, food, and equipment), plus expenses from traveling back and forth to doctor appointments can affect a family's financial stability.
- Marital problems: In every family there is the risk of a divorce, even without the stress of a family member with special needs. In a family where one member is seriously ill or impaired, that risk might become higher due to extra stress or their needs or behavior, financial problems, lack of sleep, guilt, depression, and having no one to talk to who can relate to or understand your problems. These are just some of the reasons why a Marine with a special needs family member may have marital problems. Marine & Family
Services have marriage and family counselors that can help couples identify and work through their relationship problems and deal with family stresses.
- Sleep deprivation: When a family member is medically fragile and homebound, the Marine or his spouse often becomes the sole 24-hour caregivers unless they are receiving support from a home-health
agency. Very little training is provided to families and, more often than not, respite care is non-existent. Eight hours of sleep for these families is a luxury.
- Depression: Many parents of children with special needs experience feelings of stress, anger, denial, depression, and ambiguity concerning their roles and their child's future. They sometimes experience a sense of powerlessness, helplessness or hopelessness. Also, because of the lack of respite care, combined with the feelings that people in the community may not understand their family member's condition or behavior(s) and may stare or make rude comments, depression and social withdrawal are also common among primary caregivers. It's important for the parents to talk to a professional and find a support group where they can share their emotions, understand that they are not alone, and learn how to overcome depression before it becomes a chronic problem.
Here is how to help a Marine
who you think may need to enroll in EFMP:
- Investigate and understand the impact the
condition has on the entire family.
- Emphasize the benefits of enrolling in
the EFMP.Talk to the Marine about ways in which the EFMP Coordinator can help, in particular, resources they may not know exist.
- Get the Marine an appointment with the installation EFMP coordinator to discuss whether they would qualify for the program and help them apply.
- Support EFMP Coordinator recommendations.
- Ensure a safety and support response
plan is in place for the family member's special needs if applicable,
i.e. power loss, evacuations and inclement
- Maintain open communication with the Marine. Periodically ask how the family member is doing and if the medical and community support needs are being met. Emphasize that their health is important too and they should take a break and get some needed respite care occasionally.
- Allow reasonable time for medical appointments or other related obligations. Marines whose family members have disabilities have a responsibility to make sure they are aware and prepared to handle the special needs of that family member when the primary caregiver is not able.
Here are some other general suggestions that can help prevent Marines from receiving assignments that will not meet the needs of their special needs family members:
- Ensure your NCOs, SNCOs and Officers are aware of the Exceptional Family Member Program and are making necessary referrals to the unit Family Readiness Officer and the EFMP Coordinator.
- Ask the installation EFMP Coordinator to provide an EFMP briefing to your Marines. If no Coordinator is available contact the EFMP manager and ask to receive EFMP literature.
- Ensure all Marines with special needs family members complete or are maintaining their Family Care Plans.
- Ensure proper assignment coordination. As the sending Commanding Officer/Leader it is important that you talk to the Marine about whether or not adequate medical or mental health services exist in the area to support the family member. If the Marine and his family member are having to travel over 50 miles several times a month to seek specialty care then you should question whether there may be another location, near a major medical facility, that might better serve the family member's needs. When PCS orders or a Humanitarian Transfer are unavailable, the Marine always has the option of accepting an assignment while the family is supported in another location.
- Ensure situational awareness, within
the limits of confidentiality and privacy,
pertaining to the Marine's family's needs, at all levels of the Chain of Command.
By not opening the door to communication with your Marines who have special needs you create an environment where Marines can't come to you to talk to you about their current problems and the need for additional support. Empathy and trust are important to Marine Corps families with special needs. They know you haven't necessarily walked in their shoes but a certain level of compassion and understanding are necessary to build a healthy foundation for trust and open communication. Here are some things that may destroy trust in their Chain of Command, close the lines of communication, and deter other Marines with similar issues from approaching their leaders:
- Asking too many questions: Because of the
Privacy Act, a Marine is not required to disclose any of their family member's medical information or diagnosis. If the Marine volunteers information that's fine, but don't ask or direct the Marine to share his family member's medical information. If you have any questions as to the type of assistance that might be needed, or what the EFMP Coordinator can provide, then please stop by or call your assigned installation EFMP Coordinator.
- Inappropriate comments: Avoid comments such as “I've been in your shoes” or “I know what you're going through” or “I know someone who has a family member with a disability and he…” Most likely your personal experiences are not the same as the particular situation or needs of the Marine unless your own immediate family member has the exact same medical condition or daily needs.
- Breaking confidence: Telling personnel who do not have a need to know, making the Marine and the family's situation a source for unit gossip.
- Inaction: Ignoring the issues and hoping
they will go away.
- Delaying: Delaying a necessary referral
to the EFMP Coordinator
- Most Marines will enroll in EFMP when they understand how it will help the readiness of both themselves and their unit.
- Most program-eligible conditions are those that are lifelong conditions, so leaders should not expect the level of support needed to change significantly over time, but assistance should help alleviate some of the associated stress and improve the Marine's personal readiness. You should continue to keep lines of communication open and either check with the Marine directly or talk with leaders in his chain of command.
As leaders it is important to be proactive on behalf of the Marine instead of reactive. Spending time talking to your Marine, learning generally about their family, and in particular the needs of special needs family members (within the limits of the Privacy Act) sends a positive message of support. However, when a Marine doesn’t enroll, doesn’t listen to your recommendations regarding communicating with the EFMP Coordinator and significant problems still exist that are affecting the Marine’s personal readiness, then further action is needed:
- During initial counseling and follow-up sessions leaders should convey their concerns to the Marine about the family member's medical needs not being considered during assignments if the Marine does not enroll and subsequent hardship on the family member and the entire family if they cannot get the medical help and support they require at a gaining Command and the possible costs to the Marine Corps.
- Unfortunately there have been cases when Marines have neglected the special needs family member. As a leader, if you identify or are notified that a Marine is abusing or neglecting a exceptional family member then you are obligated by law to report the Marine to the appropriate authority i.e. military police, Social Work Services, Family Advocacy Program or Child Protective Services immediately upon identification.
- Follow-up regularly with the Marine and encourage open communication at all levels in the Chain of Command.
- If the Marine is still requesting excessive amounts of time off to take family member to appointments then ask if they have spoken to the EFMP Coordinator about assignments that may better meet the needs of his family member.
- Ask the EFMP Coordinator to provide EFMP presentations or materials to distribute at quarterly meetings.
- Communicate regularly with squad and platoon Commanders and emphasize the need for Marines to be enrolled in the EFMP who have special needs family members and have them complete Family
Care Plansthat will clearly address who will care for the family members in their absence (deployments, training exercises etc). Having Family Care Plans completed is especially critical for our single Marine parents who have custody of their special needs child. The person who will be caring for the child in their absence should be fully aware of what the child's medical plan of care is, have a list of their medications, dosages, physician's and therapist's contact information and know important details that will help them care for the child.