Families say the State Department continues to curb benefits mandated by law.
State Department diplomats who have children with disabilities and mental health issues say U.S. Secretary of State Mike Pompeo has been ignoring their pleas for help in a struggle they’ve been waging for more than a year now against the erosion of their medical and education benefits.
A group of foreign service officers representing some 1,400 families sent Pompeo a letter in May saying the State Department had slashed benefit options and funding for children with special needs.
In the letter, obtained recently by Foreign Policy, the officials warned that the State Department Bureau of Medical Services was taking “deleterious actions” to restrict funding access for benefits the department is required to offer under U.S. disability law.
Now, nearly three months later, the secretary of state has yet to respond to the letter.
The group said the cuts have prevented skilled diplomats from taking up important posts or forced them to hide their children’s medical problems.
“Increasingly, Foreign Service employees are choosing to conceal issues related to their children’s educational and health needs rather than suffer career and family repercussions,” the letter said.
The State Department said in response that it “convened a working group” last year to look into the matter. A spokeswoman said in a statement to FP that the department’s leadership “continues to work toward a solution.”
“Our diplomats would not be able to perform their jobs without the support of their families, which is why it is important that we address their needs,” the spokeswoman added.
As U.S. diplomats travel to assignments around the world, the State Department’s medical bureau ensures they and their family members are healthy enough to live in the assigned country. In the case of some 1,400 families with children with special needs, the bureau is also in charge of ensuring adequate care is available in the assigned country.
But an investigation by FP in April found that, starting in 2015, the medical office has been arbitrarily cutting funding for children with autism, attention deficit hyperactivity disorder (ADHD), or other special needs or mental health issues. It has also revoked the medical clearances for some children that are required for foreign posting, forcing some diplomats out of their jobs because of their children’s special needs.
The investigation was based on over two dozen interviews with foreign service officers and their family members, who each had their own stories about how the department separated families and derailed careers.
The families affected by the State Department’s Bureau of Medical Services have tried to fight back internally, forming an employee group called the Foreign Service Families With Disabilities Alliance to push back against the cuts.
In April, the State Department told FP it was working with the group in earnest to find solutions to the problems and insisted the department took the needs and rights of its employees and their families very seriously.
But several State Department officials active in the alliance said matters have only deteriorated in recent months and that the State Department has stonewalled any efforts to improve the situation.
In their letter to Pompeo in May, officials involved with the alliance asked for a reversal of the restrictions imposed on education and support benefits. They also urged him to fire a senior figure in the medical bureau they say is causing the controversy.
In one instance, described to FP by two State Department officials, the bureau—referred to as MED within the department—told a foreign service officer that providing support benefits for their child with special needs, approved years earlier, was a mistake. Now, the family would have to return tens of thousands of dollars for years of back benefits.
“They’re saying, ‘Oh, we’re sorry we gave you that money we shouldn’t have given you years ago. You owe us $40,000,’” said one official familiar with the matter.
Another official said some foreign service officers are being forced to take out loans to try to pay back the benefits and are contemplating quitting the State Department.
According to the letter obtained by FP, the medical bureau is still forcing foreign service officers to cut short their postings at embassies abroad because the bureau is withdrawing medical clearances for their family members with special needs—even when the countries have appropriate schooling and support services.
“The State Department is suffering as an institution due to these practices. Employees hired to advance U.S. interests are unnecessarily distracted trying to navigate a process that is often arbitrary, opaque, and oppositional,” the letter said.
“MED’s approach prevents employees from being able to serve in areas where they have regional, language, and subject matter expertise and would be most effective in advancing U.S. interests. Morale is suffering enormously, and thousands of hours are being wasted in trying to meet MED’s ever-changing demands.”
The State Department spokeswoman said officials were working with the families with disabilities alliance “to achieve a shared goal of ensuring children of officers serving abroad receive the quality support and care they need.”
“The letter covers a wide range of complex subject areas which take time to untangle and address. Efforts to do exactly that have been underway since we received the letter,” the spokeswoman said. She added that the medical department has communicated with the alliance of families but declined to provide additional details.
According to the letter sent from the alliance, the problems center around Kathy Gallardo, the deputy medical director in the directorate for mental health programs, who helps oversee special needs education funding and benefits for State Department officials and their families traveling to assignments overseas.
“The common denominator during the past four years of worsening conditions is management of these programs by Dr. Kathy Gallardo,” the letter said.
It said Gallardo “rejected, or ignored for months, memos we sent to MED suggesting reforms or posing questions” and asked for Pompeo to help the bureau replace Gallardo. Two officials say she was promoted and given an indefinite extension in her role, which is supposed to be a two-year term.
Gallardo did not respond directly to a request for comment. In April, during FP’s original investigation, she denied the group’s claims and said she works to ensure her office operates with integrity and within relevant laws and regulations. Charles Rosenfarb, the bureau’s medical director, also said at the time that Gallardo “has served with great distinction” and “has worked tirelessly since her appointment” to improve the office’s work.
The families are hoping the situation will change if and when the Senate approves a new undersecretary of state for management, a position that would oversee the medical bureau.
But an official involved with the Foreign Service Families With Disabilities Alliance said Gallardo was preventing progress on internal discussions between State Department management and the diplomats.
“As long as she remains in place, I’m not at all hopeful for positive change,” the official said.BY ROBBIE GRAMER