Sergeant Major of the Army questions military child care in wake of COVID


Defense officials should expand child care capacity to ensure that military families’ needs are met during crisis conditions such as the COVID-19 pandemic, according to a recommendation on its way to Secretary of Defense Mark Esper from the high-level DoD Military Family Readiness Council.

The council also voted Tuesday to recommend addressing shortages of specialty medical care, especially for special needs families; shortages of behavioral health care; and to further explore the implications of the services’ access to childhood health care records of potential recruits who are military children.

Citing the current challenges with child care during the COVID environment, Sergeant Major of the Army Michael A. Grinston said, “What if we had to do our wartime job and didn’t have child care available?” He said DoD needs to evaluate whether it has the right model for providing military child care “given the conditions we’re in right now.” He specifically suggested expanding child development center capacity. Grinston also suggested officials review the cost structure of child care to ensure it’s not an increased burden on military families in the COVID environment. The availability of affordable child care has been an issue for military families for decades.

Grinston is one of 18 members of the DoD Military Family Readiness Council, a congressionally-mandated group that meets at least three times a year. In this Tuesday meeting, members voted on their annual recommendations to improve family readiness.

The council also voted on their focus topics for next year’s work. One is the education of the 1.6 million military-connected school-age children, whether they attend DoD schools or schools in the civilian community, as the majority do. The council will look at COVID impacts on the education of military children, as well as broader issues related to their education and transitions to new schools.

The council will also examine the effects of COVID-19 on military family readiness on a broader scale, such as financial readiness programs and transition assistance, spouse employment and education — and how the services and DoD may be planning to incorporate some lessons learned to be better prepared for the next crisis such as COVID.

Contingent upon adding an additional meeting, the council also voted to focus on child care, to include challenges for families who aren’t near a military installation.

Military family readiness is directly related to the readiness of the warfighter, said William Bushman, acting deputy under secretary of defense for personnel and readiness. “What we consider and deliberate on is of great value to furthering the protection of this country.”

In the area of specialty health care, too many families — especially special needs families and those who are geographically remote — have to wait too long to get specialty care appointments after making a permanent change of station move, upsetting their needed routines for care and prescriptions, said council member Lt. Gen. Jason T. Evans, deputy chief of staff for G-9, overseeing installations.

Evans suggested Defense Health Agency develop a simple user dashboard to allow families to pinpoint available specialty care services at any location, with the ability for families to easily communicate with the medical providers before a PCS move. He also suggested DHA analyze options to increase the Tricare provider network, to include reimbursement rates and incentives to attract and retain providers in the Tricare network and the military treatment facilities, in order to meet the requirements of special needs families and geographically dispersed families in particular.

play_circle_filled The Navy removed recruits from training after finding disqualifying information in their dependent medical records, according to their parents. Here, a recruit division commander offers motivation at Recruit Training Command in Great Lakes, Ill. (GSEC Seth Schaeffer/Navy)

In an effort to address another issue affecting military families, the council voted to recommend that DoD further evaluate its policies allowing military children’s childhood medical records to be used in determining fitness for military service. Military Times has written about a number of cases where military children were removed from training because of notations in their dependent medical records that parents weren’t even aware of. DoD needs to assess the impact of these policies on military children and their ability to join the military, said Evans, who suggested the recommendation. He noted the services don’t have access to this information regarding recruits from civilian families.

Evans suggested DoD establish a working group of experts to review the implications of those policies, and incorporate current science to inform policy while addressing questions of whether they recognize unique strengths of military children, or overly scrutinize those military children who could thrive in military service. Evans suggested the working group should determine whether current policies using these medical records to determine fitness for military service are discouraging military parents from seeking help for their children; and whether historical medical records provide reliable information about prior diagnoses and accurately identify individuals who are not capable of effectively serving. The working group should assess whether the policies reflect realities associated with increasing diagnoses of mental health and developmental disorders in the general population; and whether the policies reflect an understanding of the course of childhood illnesses over time or their impact on young adult functioning, according to the suggested recommendation.

The council also voted to recommend asking for a report by the end of September, 2021 on the “Building Healthy Communities” pilot program, and consideration for expansion of the program, which has been ongoing for three years in seven states. The pilot aims to address gaps in availability of resources for service members and their families who aren’t located near an installation. Council member H.L. Larry, director of Air Force Services, suggested a report that summarizes the abilities of DoD, the U.S. government, and the private sector to work together on critical issues to increase family resilience and service member readiness.

Focusing on total fitness, to include mental, behavioral, social and spiritual, not just the medical side of fitness, “is really what we’re talking about in building healthy communities,” said council member Sergeant Major of the Marine Corps Troy Black.





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