The Pentagon’s Letting Down Our Kids

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Military Spouse Magazine

Jeremy Hilton, with his wife, Air Force Lieutenant Colonel Renae Hilton, and their children, Kate and Jack.

Last Thursday, Prince Harry swept a number of military moms off their feet at a White House Mother’s Day tea hosted by First Lady Michelle Obama.

The President proclaimed the next day National Military Spouse Appreciation Day.

April was the Month of the Military Child, and May is Military Appreciation Month.

Recognition and appreciation are wonderful and teas, proclamations, and Prince Harry are lovely, but if politicians truly want to show appreciation for military families, they should take steps to ensure military families have appropriate healthcare — particularly for those military children impacted by disabilities.

In 2010, military families filed a class action lawsuit against the Department of Defense (DoD) and TRICARE (the military’s healthcare insurance program) for their failure to provide medically-appropriate behavioral health treatment for military children impacted by autism.

In July, a federal judge found in favor of those military families. But the DoD, who is represented by the Department of Justice, is expected to continue appealing the case, possibly all the way to the Supreme Court.

TRICARE, under the guise that the treatment is experimental, has refused to pay for cranial helmets common for the treatment of positional plagiocephaly (infants with significantly flat heads).  Most military families don’t have an extra $3,000 to pay for these helmets.  Instead, these families have had to rely on charity to ensure that their children receive what is obviously preventative care.

The supposedly fully insured children of military families should not have to rely on charity for appropriate medical care.

Perhaps the best example of TRICARE and DoD failing to see the forest for the trees involves Kaitlyn Samuels, the teenage daughter of a Naval aviator. Kaitlyn has significant disabilities, including life-threatening scoliosis, for which the only successful treatment has been physical therapy (PT) involving the use of a horse. The rhythmic movement of the horse, working in conjunction with a licensed PT, has made a significant difference in Kaitlyn’s life, where traditional physical therapy had not been effective.

Initially, TRICARE paid for the therapy until officials discovered that the PT was being conducted on a horse, instead of inside an office building. When TRICARE demanded repayment of the previous funds spent, the Samuels, at a cost of almost $5,000 and two years of their life, appealed the ruling to the highest level of the TRICARE appeals process.

TRICARE’s own administrative law judge found in the family’s favor but TRICARE disagreed with its own judge, telling the family they were free to take their case to their Congressman.

Because of a connection to the Semper Fi Fund, an amazing nonprofit that helps wounded warriors and military families, Akin Gump, one of the nation’s preeminent law firms, has taken the case on pro bono, spearheaded by a dynamo of a lawyer, Marcella Burke.

Congress, to its credit, continues to provide bipartisan legislation and oversight to DoD, particularly via the House and Senate armed services committees. Rep. (Dr.) Mike Burgess, R-Texas, the Samuels’s congressman, recently introduced HR-1705, or “Kaitlyn’s Law”, which clarifies that tools a treating physical therapist uses in physical therapy is up to the therapist, not the Pentagon.

In last year’s defense authorization bill, Congress passed an amendment that was originally introduced by Rep. Steve Stivers, R-Ohio, then-Rep. Bobby Schilling, R-Ill., and Rep. Susan Davis, D-Calif., as the “TRICARE for KIDS” bill (HR-4341).

The purpose of the bill, according to Stivers, was “to better shape the policies and practices of TRICARE military benefits to account for the needs of children.” A coalition of advocates for military children, including the Children’s Hospital Association, the American Academy of Pediatrics, the Military Officer’s Association of America, the National Military Family Association, the March of Dimes, and the Military Special Needs Network recently sent a letter to Defense Secretary Chuck Hagel stating that they are standing by to work with DoD and TRICARE to ensure that military kids have appropriate pediatric healthcare.

Last June, I had the privilege of testifying before the Senate Armed Services Subcommittee on Personnel on the problems and issues surrounding our military families impacted by disabilities. In a very hopeful move for the 113th Congress, Senator Kirstin Gillibrand, D-N.Y., a staunch advocate for military children, has taken over the chair of the subcommittee. Through her and other armed-services committee members, Congress has continued to inquire as to how to effectively help our families, even in the face of budget uncertainties.

But for all the support our families receive in Congress, the bureaucratic inertia of the Pentagon seems to grind even slower when dealing with issues affecting our military families.

A DoD office set up specifically to deal with issues related to military family members with disabilities still doesn’t have any underlying policy, though Congress mandated one in the 2010 National Defense Authorization Act.

In 2011, the National Council on Disability (NCD), “an independent federal agency charged with advising the President, Congress, and other federal agencies regarding policies, programs, practices, and procedures that affect people with disabilities,” issued a report that dealt with military family members with disabilities, commonly referred to as “exceptional family members”, or EFMs.

The council stated:

NCD has concluded that far-reaching systemic changes are needed in our nation’s health, education, and long-term service systems to address the significant barriers faced by EFMs. NCD thus seeks support from Congress, the military, and the Administration to build the critical federal partnerships necessary to effect systemic change and ensure that the men and women serving our country can do so knowing their Family Members with disabilities will have the supports and services they need.

To date, we don’t know what the Pentagon’s response to this study was, what they liked or didn’t, and what action the Defense Department would recommend others take in response to the study.

In January, Obama signed the 2013 defense authorization bill, which contained an amendment creating a one-year pilot program for the treatment of military children with autism, to be implemented in 90 days.

We are at 133 days and counting as of May 16 with no expectation for a program anytime soon.

In a recent conversation with a retired four-star general (speaking about processes in the Pentagon), he stated that “the bureaucrats in the Pentagon have a Ph.D. in log rolling…when they don’t want to do something, it doesn’t get done.”

Has it really come to that?

In a 2011 speech at George Washington University, President Obama said:

Some are middle-class families who have children with autism or Down’s syndrome.  Some are kids with disabilities so severe that they require 24-hour care.  These are the Americans we’d be telling to fend for themselves.

At the 2012 Democrat National Convention, former president Bill Clinton said:

And the President and the Democratic Party will fiercely oppose the harsh cuts in Medicaid that would inevitably lead to no or significantly less health care for millions of Americans with disabilities, workers with disabilities, and families raising children with autism, Down’s Syndrome, and other serious disabilities.

I doubt that politicians realizes how hypocritical their comments sound to middle-class military families who have “children with autism or Down’s syndrome, and other serious disabilities,” who are fighting the Pentagon to give their kids a chance.

Given what Mrs. Obama and Dr. Jill Biden have done through their Joining Forces campaign, military families like mine are really trying hard to give the President the benefit of the doubt, and trying to remain hopeful.

In the end, this is President Obama’s Administration.

He has the chance to make this right and should do so by providing appropriate direction to his defense secretary.  Our service members have done so much for this country.  Their families have taken up the burden while their service members have been gone the better part of the last decade.

The least we as a nation can do is ensure they have appropriate healthcare, particularly for their truly exceptional family members.

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