As school systems still struggle with how they will reopen in the midst of a pandemic, some military parents are asking how to get their children’s school physicals, sports physicals and immunizations at military treatment facilities.

There are more than 800,000 military children enrolled in Tricare Prime who have their primary care provider at a military treatment facility, according to a DoD report.

In the Washington, D.C., metro area, a few parents have reported difficulty in getting appointments for their children’s physicals at their military medical treatment facility, said Eileen Huck, deputy director for health care for the National Military Family Association, but she’s not sure how widespread the issue is.

It’s not clear whether those families were offered virtual reviews for physicals, which is the current procedure during the pandemic.

Here’s what the Defense Health Agency says about procedures for physicals at MTFs, in response to questions from Military Times:

*Any child seen in a military treatment facility in the prior 15 months for at least one face-to-face visit — and who screens negative on specific questions — doesn’t require a face-to-face visit for the physical. School and sports physicals are based almost exclusively on a medical provider’s review of a child’s relevant medical history, and answers to screening questions. The American Academy of Family Physicians and the American Academy of Pediatrics now endorse 15 months between physical exams, DHA officials noted.

*Cardiac and respiratory exams are only required if the child screens positive on specific questions, such as if the child has shortness of breath when climbing stairs.

*The providers are emailing or faxing the completed physical results to the parent or guardian. College physicals, in a similar way, require only a provider review of past medical history.

*In some larger markets, MTFs are planning sports/school physical days to get as many done as possible in a short period of time by consolidating medical resources. These are usually held on Saturdays.

*For questions about the process at a particular MTF, parents should call their appointment center to ask for a telephone consult , or send a message to their child’s health care team.

*Officials “strongly discourage” self-referred visits to urgent care clinics, because medical history is so important, according to the Defense Health Agency statement. Instead, parents should call the global Nurse Advice Line at 800-TRICARE (800-874-2273), Option 1. The nurses will help parents determine if care is needed, and will schedule an appointment if needed, or direct the patient to a network urgent care clinic.

Immunizations

There’s no vaccine for COVID yet, but there are immunizations for a lot of other diseases that need to be kept up to date.

And there are concerns about whether some children have fallen behind or will fall behind in their scheduled immunizations during the pandemic, Huck said.

Immunization requirements for enrolling in day care and K-12 schools are determined by each state, following recommendations from the Centers for Disease Control and Prevention, according to DHA officials. Colleges and universities may require additional immunizations.

To provide the best protection, immunizations are designed to be given in a certain number of doses over a certain period of time. If a dose is missed, the person might not be fully protected.

At the Walter Reed National Military Medical Center in Bethesda, Maryland, officials set up a drive-up immunization clinic in May, and have been offering all immunizations that are typically given in the indoor clinic.

At other MTFs, the primary care clinics are reviewing records to see which patients’ immunizations are overdue, and developing plans to contact patients to schedule a time and location to provide immunizations safely, said Regina Julian, chief of the Defense Health Agency’s Healthcare Optimization Division, in a DHA press release.

“Ensuring our pediatric population is up-to-date on their needed immunizations is a major DHA priority,” Julian said. Beneficiaries should check their MTF’s web site or social media page for updates. Julian also encourages beneficiaries to contact their MTF directly by calling the appointment center or immunizations clinic, or sending a secure message to their health care team.

Patients who are overdue for an immunization can work with their health care provider to set up a catch-up schedule.

Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book "A Battle Plan for Supporting Military Families." She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.

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