When Will Military Kids Matter Enough?

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Army photo

A soldier Dad embraces his daughter after returning from a year in Afghanistan.

Less than a week after the tragedy in Newtown, Conn., conferees from the House and Senate met to discuss this year’s defense bill. Sadly, at least some of those conferees seem to have missed one of the larger points related to that horror: the need for families, in this case military families, to have access to the needed behavioral health treatments to treat their children with disabilities.

Let me be emphatic to say I’m not linking Newtown to children with disabilities. But it has reminded us of the importance of mental-health care for all.

In the middle of a national debate on appropriate mental health (of which behavioral-health treatments for our military kids is a component), the conference committee considering the 2013 National Defense Authorization Act found a way to overlook the votes the House and Senate had previously taken to support our military children.

In the House version of the NDAA, Rep. John Larson, D-Conn., introduced an amendment authorizing behavioral-health treatments for those military children impacted by autism, most notably Applied Behavioral Therapy (ABA).

According to Dr. Vera Tait of the American Academy of Pediatrics:

ABA has proved effective in addressing the core symptoms of autism as well as developing skills and improving and enhancing functioning in numerous areasthat affect the health and well-being of people with ASD [autism spectrum disorders].

My family is one of thousands of military families who have seen how much of a difference ABA can make, and would benefit from an expansion of this therapy. One aspect of Rep. Larson’s amendment deserves special understanding because it expanded access to our retired military population. In my testimony in the Senate, I told the story of Lance Corporal Hardy Mills, USMC (retired). His child lost his ABA therapy when his father was medically retired after he was hit by an RPG in Iraq. You could hear the audible gasp in the hearing room when I read from a letter by Lance Corporal Mills.

The amendment passed the House unanimously. This was due in part to the powerfulness of our family’s’ stories, but also in large part because of the bipartisan efforts of Reps. Larson, Walter Jones, R-N.C., and Thomas Rooney, R-Fla.

Sens. Patty Murray, D-Wash., and Kirtsen Gillibrand, D-N.Y., took up the cause in the other house a couple of months later, with support from Sen. Jim Webb, D-Va., chairman of the armed services personnel panel. The Senate passed a similar amendment, expanding the coverage to include those children with developmental disabilities such as Down syndrome and cerebral palsy, another group that has long benefited from ABA. The amendment passed the Senate 66-29, again with significant bipartisan support, with an expected first-year cost of $45 million. The bills from each house went to a conference committee to iron out their differences before final passage.

On Wednesday night, military families and advocates learned that both House and Senate ABA amendments had somehow been transformed into a “one-year pilot program,” limited to children with autism, to be administered by the Pentagon.

For those who don’t know, anytime the Defense Department is told to conduct a “pilot program” or to “study” an issue, the results will most likely not be in the interest of anyone but the Pentagon. The conferees cited an ongoing class-action lawsuit, seemingly as one of their reasons for wanting to put the pilot program in place (see page 123 of the conference report).

Why even have the House and Senate vote? Why not just appoint a conference committee to begin with if they are going to ignore the large majority votes and significant bipartisan support this issue enjoyed.

Many may say, “Well, you just have to give the Defense Department a chance.”

I wish we had that luxury. As noted in the conference report, military families have taken the Defense Department to court in a class action lawsuit on this very issue and won at the district court level. (Berge vs. U.S.). But as noted by the plaintiff in the case, Dawn Berge, in this piece on SpouseBuzz, the military is doing everything in its power not to comply with the federal judge’s ruling. Sadly, it may take holding the Department of Defense in contempt of court in order for them to obey.

As documented in this piece in The Atlantic, TRICARE, DoD’s health care insurance program, seems to look for reasons to say no to our most vulnerable military families.

ProPublica documented how TRICARE fails to provide the comprehensive treatment needed by those with traumatic brain injuries. Somehow, there is a sad irony in the fact that former Rep. Gabby Giffords has emerged as one of the main proponents pushing a reluctant TRICARE to cover appropriate care for military personnel with TBIs.

Military families aren’t alone in their mistrust. Many of those who advocate for military families feel the same way. Says Joyce Raezer, the executive director of the independent National Military Family Association:

We are stunned by the language that was included in the conference report. While it states the “pilot” will include all TRICARE beneficiaries, it provides no guidance to DoD on the intent and extent of the pilot, which could be critical as the conference did not authorize any additional funding to support the pilot. Sadly, the conference report language continues to exclude beneficiaries with diagnoses other than autism spectrum disorder from access to ABA therapy and, I think, gives DoD the flexibility to continue its fight against the court order mandating coverage. Plus, because of the duration of the pilot and the timing of the report, itgives Congress an excuse not to make any changes in the benefit next year as well.

Rachel Kenyon is a military spouse, advocate, a constituent of Rep. Larson, and the person most responsible for pushing for this change. She too was dismayed by what came out of the conference:

Just days ago, we were assured it was fixed. Press releases from several legislators on both sides of the aisle praised members of Congress in passing this critical legislation. It was a victory for our military families who have waited so many years for the treatment they need. Then suddenly, without a whisper, without a press release and behind closed doors, members of the conference committee changed their minds. Such back-room politics not only detract from the ideal that this country supports its troops, they continue to be the very reason so many Americans have little, if any, faith in Congress.

Is it possible that the military will appropriately handle this pilot program on an issue in which they have been sued by an entire class of military families and lost? Well, anything is possible. We can hope that the Pentagon will do the right thing. Our concern is that a pilot program can be interpreted by the military any way its lawyers wish to. The Pentagon, with the lawsuit pending, has an obvious conflict of interest. Putting them in the cockpit for this pilot program doesn’t give us military families much faith in the eventual outcome.

Time’s a-wasting. With each passing year, as our children grow, such therapy becomes less effective. At a time when we are forced, by a horrific tragedy, to realize the possible impact of a broken mental-health system, surely our military families who have spent the last decade at war — or loving those fighting it — should receive the treatments shown to improve their lives.

The question is no longer whether our leaders in government understand our needs.

We feel confident they do.

The question is: when will we matter enough?

Jeremy Hilton is a Navy veteran, an Air Force spouse, and the 2012 Armed Forces Insurance Military Spouse of the Year.

MORE: The Challenges of Raising Military Kids

1 comments
janet721
janet721

Great article, but all children are deserving of these benefits. To date, 32 states have passed legislation requiring health insurance coverage for behavioral therapy...but this only covers those whose insurance is regulated at the state level. Military families, federal government employees and those who work for companies that self-insure are left out.

Treating these kids while they are young avoids the high costs of dependency once these kids become adults.