YOKOSUKA NAVAL BASE, Japan — About 30 times a month, a servicemember, family member or civilian at Yokosuka Naval Hospital requires a long-distance trip for medical needs.

It could be to Hawaii or Okinawa for emergency heart surgery or a routine checkup. The hospital will arrange transportation, admission to the medical facility and, if patients qualify, transportation and accommodation for a nonmedical attendant — a friend or family member — to help them.

But most medical evacuations don’t qualify for an attendant. And for those that do, patients are allowed one person over 18.

Families often are frustrated to learn just one parent can accompany a sick child or that an adult patient can’t bring children along, said Petty Officer 1st Class Pamela Maloney, the hospital’s medevac coordinator.

“We get that all the time,” she said. “They want the whole family to go. If it is not a life-or-death situation, the family is not going.”

The rules stem from both patient needs and fiscal limitations, she said. Patients can have an attendant only if they need help.

There are a few exceptions. In a life-or-death situation, the entire family will be authorized to travel. And mothers may bring nursing children.

People also may pay for someone to accompany them and the hospital will help make arrangements. But parents still must have child care while at their appointments, Maloney said.

The restrictions come from how treatment is funded. A patient’s command pays for his or her expenses and the hotel and per diem of approved attendants.

The Air Force pays for all patient transportation in the region and therefore must adhere to the rules. The Air Force, for instance, pays train fare to bring someone from Marine Corps Air Station Iwakuni to Yokosuka or for anyone to fly to the States.

Rules also dictate that patients be sent to the closest military treatment facility that can meet their needs — not necessarily one they prefer or that is convenient.

All of those restrictions can create difficulties for a single parent or one whose spouse is deployed.

That’s why Maloney recommends planning ahead.

Single active-duty or dual military parents arriving in Japan, are required to fill out a Dependent Care Certificate outlining who will care for children in an emergency or deployment. The form requires designation of both a local short-term care provider and a long-term provider.

“It’s a means to evacuate the kids or get care for them,” Maloney said.

But if a servicemember’s situation changes — if a nominated care provider moves or the servicemember becomes single or part of a dual military family — creating or revising the Dependent Care Certificate is up to that servicemember, Maloney said.

Couples with one non-military parent need not have a certificate but Maloney recommends they nominate a caregiver anyway and put aside money for children’s use in an emergency.

While anxious families often must be told they can’t bring loved ones along, Maloney said, the hospital tries to help by organizing flight details as quickly as possible to give people time to plan.

But she offers two essential tips to minimize the impact: Plan for emergencies, then have a backup plan.

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