A senator is pressing defense health officials for information about how they’re using a 2017 law that allows military medical facilities to treat civilians and veterans who are victims of terrorism.

Military treatment facilities are designed to offer medical care to troops, retirees and their families. While MTFs can also take civilians who are unaffiliated with the armed forces, those patients must first navigate an approval process to be seen by military doctors.

The 2017 law aimed to change that by allowing the defense secretary to waive those rules for civilians and vets who are severely wounded or injured in a terror attack, offering them an easier path to further medical treatment after the initial emergency response. The law applies to MTFs worldwide.

“I urge the Department to fully utilize this authority and ensure that victims of terror are aware of their options to receive care at MTFs,” Sen. Elizabeth Warren, D-Mass., wrote Thursday in a letter to Lester Martinez-Lopez, the assistant secretary of defense for health affairs.

“MTFs can provide life-changing treatment for victims of acts of terror,” Warren wrote.

Warren, who chairs the Senate Armed Services Committee’s personnel panel, introduced the legislation in 2017 — titled the “Jessica Kensky and Patrick Downes Act” for a young married couple who each lost legs in the 2013 Boston Marathon bombing. The couple credited the specialized team at Walter Reed National Military Medical Center for helping them achieve a fuller recovery than they may otherwise have had.

“In return, Jessica and Patrick wanted to ensure other victims of terror have access to appropriate care at military medical facilities,” Warren wrote in her letter.

The care Kensky and Downes received at Boston trauma centers was important to their survival and initial recovery, they told Warren. But when they sought extra medical expertise at Walter Reed, the outsiders instead ran up against the military bureaucracy that needed to approve their specialized care.

In emergencies, anyone can receive care in an MTF to prevent undue suffering or loss of life or limb. Treating civilian emergency patients helps military medical personnel keep their clinical skills current, and a number of MTFs have built relationships with local communities to bolster an area’s civilian trauma care capabilities. And over the years, DOD has gained extra authorities to expand the scope of its medical care, like the flexibility to treat terror victims.

More than 50 terror attacks, including mass shootings, took place in the United States each year since the Kensky-Downes law was enacted in 2017 through 2020, the latest year tracked by the Global Terrorism Database at the University of Maryland. Many did not lead to injuries or fatalities.

Warren seeks answers from DOD by June 6, including the number of civilians treated at MTFs over the past 10 years for trauma-related and non-trauma incidents; which cases involved mass shootings and acts of terror; where those civilians were treated; and what types of injuries people incurred and the incidents that caused them.

Warren has also requested:

  • A description of the process for requesting and providing care;
  • A description of DOD policies in place to use its authority granted by law;
  • The number of terror victims who requested the care, whether any were denied care, and how long it took for care to be approved;
  • Whether DOD and MTFs have notified local communities, hospitals and civilians of the authorities and options for care in military medical facilities;
  • and information about waiving costs of care for civilians in these cases.

Meanwhile, DOD is in the midst of an effort to bring more military beneficiaries back to the MTFs from civilian doctors, where the military has pushed patients to seek care over the last few years. That decline in patients, in turn, spurred the military services to seek private-sector training opportunities for medical staff to keep their clinical skills current. The Pentagon is now working to boost MTF staffing to address a current provider shortage and support the demand that may follow as patients return to MTFs.

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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