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GAO-13-165R 1 (2013-01-16)

handle is hein.gao/gaobacguo0001 and id is 1 raw text is: J GAO Accountablty *Integrity * Reliability United States Government Accountability Office Washington, DC 20548 January 16, 2013 The Honorable Carl Levin Chairman The Honorable James M. Inhofe Ranking Member Committee on Armed Services United States Senate Subject: Department of Defense Policies on Accommodating Children with Special Needs in Child Care Programs The Department of Defense (DOD) subsidizes child care programs to assist military families, including many with children with special needs, in balancing the competing demands of family life, accomplishing the DOD mission, and improving their financial health. Although DOD has a number of child care programs on and off installations, most military families who use DOD-provided care use Child Development Centers (CDC) or other forms of on- installation care, such as family homes. DOD child care is not guaranteed to all who need it, and the availability of such care depends on demand and the services' budgetary resources. However, when space is available, DOD officials stated that the military services are required to offer accommodations to children with special needs unless those accommodations fundamentally alter the nature of the program. For example, a child with special needs requiring constant one-on-one care may be denied a slot in a CDC, which is a group setting, because that level of care would result in a fundamental change to the nature of the program. 1 Senate Report 111-201 directed DOD to report on a number of issues related to children with special needs in the areas of education and child care, including services and challenges for military dependent children with special needs and their families.2 The Senate Report also directed GAO to review DOD's report. We recently issued a report on DOD schools to fulfill part of this requirement,3 but because child care service delivery structures differ, we examined the child care portion separately. This product describes key DOD policies and procedures for: (1) accommodating children with special needs, (2) monitoring program compliance with accommodation policies, and (3) administering medication to children with special needs to relieve symptoms quickly in emergencies4 and related litigation, if any. To identify policies and procedures related to these topics, we reviewed DOD policy and guidance documentation and accreditation criteria that pertain to accommodating children 1DOD officials said that children who need occasional one-on-one care, such as for toileting, or who have a caregiver that the family has arranged for may be admitted to a CDC. 2S. Rep. No. 111-201, at 138 (2010). 3See GAO, Military Dependent Students: Better Oversight Needed to Improve Services for Children with Special Needs, GAO-12-680 (Washington, D.C.: Sept. 12, 2012) 4In this report we refer to medications needed in emergencies to relieve symptoms quickly as rescue medications. GAO-13-165R DOD Special Needs Child Care

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