QUICK ACCESS GUIDE A&FRC Operations Page 2 Application Processing Page 2 Assignment Selection & the Q Code Page 5 Base of Preference Page 6 Clearances, Appeals & Command Sponsorship Page 7 Deferments Page 13 Disenrollment Page 14 ECHO Page 14 Education Services Page 15 EFMP Camps Page 15 EFMP Documentation Page 15 EFMP-Family Support Coordinator Positions Page 16 EFMP Services for Adults Page 16 Eligibility for Reassignment/Deferment under EFMP Page 16 Enrollment Page 17 Guard & Reserve Page 17 Miscellaneous Page 18 Military Personnel Section/Commander Support Staff Training Page 20 Negative Travel Recommendations Page 20 Post-Retirement EFMP Services Page 21 Program Participation Page 22 References Page 23 Respite Care Page 23 STOMP Page 25 1
A&FRC OPERATIONS How can we ensure MPSs and/or EFMP-SNC s provide the EFMP-FS in the A&FRC get the Q-Code list to be able to contact members and market program support? EFMP-FS staff members should simply request a listing of Q-Coded members from the Military Personnel Section in order to reach out to members/families. The FS staff may also request a diagnosis listing from the Medical Treatment Facility to help with community services. APPLICATION PROCESSING Why do you have to wait to submit your package for assignment? Why can't you submit at the same time the notification happens? The AF procedures for conducting an EFMP clearance depend on the Airman having received their assignment notification prior to the clearance. This ensures the member can participate in a fair and equitable assignment distribution system, and receives each assignment based on qualifications, rather than being pre-eliminated from career progression opportunities based on their family member s EFMP status. This also ensures the documentation collected for the clearance is the most up-to-date summary of needs. Members can ensure their package is kept current by notifying the EFMP office when their family members conditions change. By doing so, the member can greatly reduce the time spent on completing referrals and collecting records during the official clearance. How can AFPC be the final decision on medical reassignments if medical providers and doctors recommend the family member be moved? Reassignments under the EFMP must meet the criteria for approval based on the circumstances presented. Reassignment based on the climatic conditions or geographical area adversely affecting a family member s health, and the problem is of a recurring nature (such as asthma, allergies, eczema, etc.) are not normally approved. However, exceptions to policy can be granted if the continued presence of the family member in such a climate/environment is medically determined to be clearly life threatening. Clinical data to include hospitalizations, intensive care unit admissions, emergency room visits, etc., must be provided in addition to the recommendation letters from the medical providers. What is the timeline for an expedited relocation package? Once a complete EFMP application has been received by the Total Force Service Center, the expedited process timeline depends on whether an initial set of 5 locations provided by assignment functional managers can provide the required services. Gaining EFMP-M offices are allowed 14 calendar days to review all specified needs and provide a travel recommendation based on service 2
availability to AFPC. Once the travel recommendations are returned to AFPC, the assignment is loaded for the location with the highest mission priority, if indicated by the assignment functional manager. The process can normally be complete within 3 weeks of receiving the completed package, barring any issues with service availability or manning restrictions for smaller career fields. If a Specialist is requesting a certain place for my child to be is that considered when getting assigned? And does it help to have these specialists write Letter of Recommendations to give more insight on the situation? Regarding an official clearance due to assignment notification, Airmen may request that information be included in the package for care coordination purposes. During an EFMP reassignment, specific locations can be expressed by specialists in a memorandum format on the physician s official letterhead. The request will be review by the AFPC Medical Review Board as part of the application process. Any additional clinical data available to support the recommendation is highly encouraged to be included. The official clearance document outlining medical needs is the DD Form 2792. Once the Reassignment process has started and we get an assignment...can we turn assignment orders down? If an Airman applies for an EFMP reassignment based on a new diagnosis for a family member and specialty care is unavailable in the Military Treatment Facility, TRICARE network, or a combination thereof, in order to turn assignment orders down it would require verification from the Special Needs Coordinator that care is available through the supporting network. Please refer to AFI 36-2110, Assignments, for declining retainability and/or 7-Day Option criteria for normal assignment selection. My EFMP-M office has told me once application is submitted to AFPC, they no longer have visibility of the relocation/deferment package. Why is this? Once your local Special Needs Coordinator has completed their portion of the relocation process, the application changes over to the personnel community for assignment execution. Any status inquiries will go through the Total Force Service Center and your chain of command (MSgt and above) can call on your behalf. We are currently working on an innovative change to status visibility on applications for Airmen within the vmpf. I'm waiting to hear back if my EFMP application is approved for reassignment from OCONUS but when I call TFSC to ask for updates they told me only commander or shirt can call, how long will I have to wait to hear if my family is approved? EFMP Reassignment applications are normally processed within 4-6 weeks. However, we prioritize requests from overseas locations where the required care is not available and expedite as much as 3
possible. Is the 4-6 week timeline for the process only for the EFMP-Assignments determination? Or does that timeline also include our individual AFSC Assignments Team? The 4-6 week timeline begins when the Total Force Service Center receives a complete package, and includes the AFPC Medical Review Board, coordination with your career field assignment functional manager for 5 locations where manning can be supported (if a specific base of preference was not deemed necessary by the AFPC Medical Review Board), coordination with the potential locations Special Needs Coordinators, and lastly, a quality assurance review and assignment load execution. If the initial 5 locations provided by the assignment functional manager cannot provide the required services, a secondary set of Facility Determination Inquiries will be processed. While this is not common, it can delay the overall processing times. Of the 241 EFMP applications denied in FY16, were they typically overseas assignments, such as short tours where you can take your family? The 241 denied EFMP applications listed on the statistics slide were for reassignments from a current location or deferment from a projected reassignment or TDY/deployment. EFMP-A does not receive notification of a sponsor receiving a negative travel recommendation this is done through the Airman s vmpf application for a change of assignment. EFMP-A does not normally consider overseas locations during the reassignment process, as we are focused on getting the family to a location where required care can be supported within the Military Treatment Facility, the TRICARE network, or a combination thereof. Is there a way that the AFPC/EFMP Office could include and correspond with the EFMP-M office more? That way they are in the loop on the actions that are being taken behind the scenes. EFMP-Assignments and EFMP-Medical are in daily contact to ensure smooth transitions for EFMP families. The process for selecting the appropriate end assignment for an Airman is determined by both manning requirements, as well as care availability and accessibility at the location. If there are any specific concerns of note, please ensure they are indicated on the DD Form 2792, Family Member Medical Summary, and the DD Form 2792-1, Special Education/Early Intervention Summary. Locations being considered for reassignment are not released to EFMP families, as to avoid providing a false sense of direction and cause additional delays in processing. How often are exceptions to policy approved for cancellation of assignments? Since exceptions to policy are based on a case to case basis depending on the circumstances presented at the time of application, the frequency varies. Keep in mind that when speaking 4
of cancellation of assignments that voluntary assignments may be cancelled if care is not available at the gaining location through normal EFMP assignment rules. What is the mileage range for needs to have been met in regards to clearance to move family to a new location? I have heard 50 miles... for example, the MTF may not have that service, but the local community x miles away does. When determining medical sufficiency for inbound EFMP families, the gaining EFMP-M staff will disclose to the losing EFMP-M staff any foreseeable medical requirements that will cause the EFMP family to travel greater than 50 miles from the Primary Care Manager's office. Depending on frequency of the required specialty, it is reasonable to require EFMP families to travel over 100 miles for care. When a patient is referred by their primary care manager (PCM) for medicallynecessary, non-emergent specialty care to a location more than 100 miles (one way) from the PCM's office, the patient is eligible to have reasonable travel expenses reimbursed. If the specialty care is less than 100 miles, there is no reimbursement for travel expenses. ASSIGNMENT SELECTION & THE Q CODE Why don't the assignments people pick up the phone and call the member to get some info on the nature of the EFMP condition before just dropping orders? It would save everyone some frustration. EFMP enrollment is an indicator that a family member has special needs. It alerts the Military Personnel Section and Commander Support Staff that the Airman has additional processing required for reassignment processing before orders may be published. With nearly 10% of the total active force enrolled in the EFMP, not only does manning preclude this level of coordination, but would also be discriminatory in nature. The EFMP process in place currently has challenges that we are looking to streamline, however, it ensures that all assignment selections are made on a fair and equitable distribution system. Has the assignments process ever considered a proactive look at the most extreme EFMP cases? Maybe by request? When special selection boards meet, they have NO access to information as to locations where such extreme cases could even go. Do the assignment people consider all of this before giving someone orders? I know that I have a Q code, but it feels as if this is new information to the assignment folks. To ensure assignment selections are not made based on the disabilities or restrictions of EFMP family members, the medical conditions of dependents cannot be considered prior to normal assignment selection. To do so would be discriminatory in nature, and a violation of every Airman s right to be selected for an assignment in his or her own right. Officers have the ability to work directly with their Assignment Officers in advance of any special selection boards to ensure 5
concerns over locations that may support the EFMP family member needs can be met. The listing of Expedited Family Member Relocation Clearance FMRC locations in the CONUS is available on mypers by using the search feature and entering FMRC. The listing can assist Airmen and their families in making proactive assignment decisions. BASE OF PREFERENCE Can you participate in the Base of Preference Program if you are enrolled in EFMP? We are trying to BOP in place (where a treatment plan is already in place) is this allowed? Won't it get approved easily? Enrollment in the EFMP does not affect eligibility for any voluntary assignment program. In-place Base of Preference Program applications are not affected by EFMP enrollment. Approval of a Base of Preference Program is based on normal assignment criteria, to include manning, overseas vulnerability, etc. What are my chances for a Base of Preference assignment in which I updated locations that are EFMP supportive on my dream sheet? Base of Preference applications are a formal application processed through the vmpf, and not processed simply as a result of updating your dream sheet. Once submitted, EFMP enrollment is not a factor considered during the approval or disapproval process, as EFMP s Assignment Limitation Code Q cannot be used as a disqualifier for any assignment location. If approved for a location on your formal application, the Q code simply identifies to the Military Personnel Section the need for further assignment processing to ensure your EFMP family member(s) needs can be met at the projected location. When applying for a Base of Preference, we recommend that you refer to the Expedited Family Member Clearance (EFMRC) locations in the CONUS that approval travel for EFMP families approximately 98% of the time. The current listing can be found by searching EFMP or EFMRC in mypers. For BOP, since we are EFMP - will they look at EFMP choices from your dream sheet? I assume CONUS based on the other information presented. EFMP is not considered during the assignment selection process, as it is simply an indicator for the Military Personnel Sections and Commander Support Staffs that additional relocation processing must occur in order for the Airman to proceed on assignment. Approval under the Base of Preference Program is based on normal assignment criteria, to include manning, overseas vulnerability, etc... Overseas locations are not considered under the Base of Preference Program, since these assignments are made in accordance with overseas Permanent Change of Station 6
selection priorities. More information on overseas assignment option can be found on mypers by searching Assignments or within AFI 36-2110, Assignments. CLEARANCES, APPEALS, & COMMAND SPONSORSHIP How long does it take for members to be notified if they have been cleared to PCS or not? On the slides, it said "14 days" for the process? Once the gaining location receives a complete package, the review portion typically takes less than 14 days. This number could be extended if the MAJCOM, sister service facilities, or host nation facilities need to be consulted. Once the gaining base replies, the losing base EFMP-M office notifies the family without unnecessary delay. What can be done to appeal a positive travel recommendation? For this situation, please consult with your local Special Needs Coordinator and Chief of Medical Services (SGH). It is important to provide your Special Needs Coordinator with the most up-to-date medical/educational summary in order to receive the most accurate travel recommendation. For OCONUS assignments, will family members receive standard medical services via the MTF even though they were not recommended to travel due to a lack of specialty care? Family members who are TRICARE Prime eligible are entitled to a certain level of care from the Military Healthcare System. This eligibility status does not have a provision for the family member to waive entitlements. When a family member receives Command Sponsorship at an OCONUS MTF, the AFI is letting the family know that we can meet their needs to the degree for which they are entitled. In order to receive Command Sponsorship at the OCONUS MTF, a clearance must take place within the EFMP-Medical office. And that clearance must result in a positive travel recommendation. Automatic empanelment into an OCONUS MTF requires Command Sponsorship. If a family member has not been given Command Sponsorship, regardless of whether or not they intend to request specialty care via the military, that family member will only be automatically eligible for Space-Available status within the OCONUS MTF. Space-Available status does not include referrals out to the network. How does Command Sponsorship work if only one family member (e.g. spouse or one of multiple children) is not recommended for travel? Would I have the option of getting the non-efmp members command sponsored? 7
Command Sponsorship only applies to OCONUS assignments and has several factors, including a medical clearance. When a sponsor has more than one dependent, Command Sponsorship is considered on an individual basis. All family members receiving a positive travel recommendation from the OCONUS location will be eligible for Command Sponsorship from a Medical perspective. All family members who receive a negative travel recommendation from the OCONUS location will not be eligible for Command Sponsorship from a Medical perspective. Is an EFMP family member medically covered via the Military Healthcare System if they choose not to follow a negative travel recommendation and continue to assignment? This answer has two parts: CONUS and OCONUS: CONUS: When it has been determined that medical care is not available within the MTF or TRICARE network, family members will be required to travel outside the local area to receive healthcare. When a patient is referred by their primary care manager (PCM) for medicallynecessary, non-emergent specialty care to a location more than 100 miles (one way) from the PCM's office, the patient is eligible to have reasonable travel expenses reimbursed. If the specialty care is less than 100 miles, there is no reimbursement for travel expenses. With care not available in the local area there is also the option of using non-tricare network providers at a potential cost to the family. Additionally, Sponsors who take family members not recommended for travel to a CONUS location may not be eligible for EFMP Reassignment at a later date. An EFMP Reassignment may be considered only if it has been medically determined the family member is suffering from a lifethreatening situation and medical services cannot provide the required care. OCONUS: Receiving an assignment to an overseas location is an exciting endeavor. However, it could prove to be quite challenging if one or more family members have not been recommended for travel to your overseas (OCONUS) assignment. Airmen who elect to take their non-command sponsored dependents OCONUS will be met with some significant challenges. Non-command sponsored family members will not be eligible for: --Government-funded transportation to/from the overseas location. --Official government no-fee passport and/or VISA. --SOFA protection may not be afforded to non-command sponsored family members. --TRICARE Prime and possibly required to seek care off-base depending on access and availability. 8
At most overseas locations, non-command sponsored family members will only be eligible for: --Space-available attendance at a DoDDS school. --TRICARE Standard (additional costs will be incurred). --May not be eligible for logistical support, e.g., BX, commissary, etc. The Air Force understands an Airman s desire to remain with his/her family members. However, the cost of doing so under non-command sponsorship is strongly discouraged. The risks involved are too great and could come at an insurmountable price to the Airman. Airman must be counseled by their Military Personnel Section, prior to the Airman s departure, regarding the consequences of relocating family members under non-command sponsorship. If the sponsor decides to take their non-command sponsored family members with them on the overseas assignment, the medical coordination and costs could prove overwhelming. Enrollment in to TRICARE Overseas Program (TOP) or TRICARE Overseas Prime Remote requires family members to be command sponsored. Family members that are Command Sponsored are eligible to enroll in TOP Prime or TOP Overseas Prime Remote. Unless a specific exception exists, enrollment in to either one of these is available only to those service members who are permanently assigned overseas, and to ADFMs who are command sponsored and accompanying their sponsor on the overseas tour. Non-command sponsored ADFMs are not eligible for TOP Prime or TOP Overseas Prime Remote enrollment in any overseas location. Military Treatment Facilities have a limited number of staff, specialty care services and capacity at the OCONUS locations. This coupled with their missioncritical requirement to provide medical coverage to ADSMs as their first priority, and to command sponsored ADFMs as their second priority. ADFMs that are not command sponsored will be automatically covered by TOP Standard. TOP Standard ADFMs can be seen in an MTF on a space available basis at no cost; however, not all OCONUS MTFs have the capacity to treat/see space available patients. TOP Standard is identical to TRICARE Standard in the United States with benefits, deductibles, and cost-shares. Non-command sponsored beneficiaries deciding to reside overseas may be required to pay up front for services obtained and file a claim for reimbursement. The TOP contractor is not required to develop host nation provider networks to support the TOP Standard beneficiary population. The contractor is also not required to provide health care services on a cashless, claimless basis for TOP Standard beneficiaries. Further, the contractor is not required to make 9
appointments with host nation providers for TOP Standard beneficiaries. However, upon beneficiary request, the contractor shall provide the name, telephone number, and address of host nation network or non-network providers of the appropriate clinical specialty located within the beneficiary s geographic area. Also, there is no patient travel benefit associated with TOP Standard. Should a TOP Standard patient need to travel outside their local area to receive medical care, the patient and/or their sponsor are responsible to cover all associated travel costs. Note that in some overseas locations, specialty care is limited and may not be available locally and the best available care could be located stateside. With no travel benefits availed to TOP Standard patients, the sponsor and/or the patient would be responsible for all travel expenses. Lastly, a brief mention concerning ADSMs acting as non-medical attendants (NMA) for noncommand sponsored patients. Patient travel funding is driven by the beneficiary that requires the medical care. As mentioned previously, non-command sponsored ADFMs do not receive patient travel benefits and if the AD sponsor acts in the capacity as an NMA, the AD member may not be eligible to receive TDY travel benefits. Regarding educational needs, a student who arrives as non-command sponsored to an OCONUS location is enrolled on a space-available basis. This means that as long as the student's needs do not exceed what is currently in the school, they can be enrolled. However, there is the possibility that a non-command sponsored child, who is attending on a space-available basis, may be disenrolled from school based on services not being available. I have seen the term "medical coordination" listed under the duties EFMP-Medical. What does that mean? How does that differ from medical case management? During the official clearance, the losing EFMP-M office will provide a comprehensive summary of needs to the gaining EFMP-M office to ensure an appropriate travel recommendation is provided based on available services. The clearance does not take the place of the Case Management warm hand-off should the family require services at that level. If a family doesn't receive the EFMP "warm hand-off" they're supposed to during a PCS, what is their recourse? Having a central POC at AFPC would be helpful in such instances, if nothing else than to point families to their respective POC. When members or dependents experience a situation which they believe does not follow outlined guidance on operating procedures within the EFMP-Medical realm of responsibilities, we encourage them to contact their Patient Advocate located within their MTF. In regards to the Family Support 10
warm hand-off, all EFMP-FS staff work hard to ensure members/families receive a warm hand-off to help minimize interruption to the family's continuum of services. Please ensure you're working closely with your EFMP-FS staff so they know you definitely want a warm hand-off. Some families do forego this service. If the service is not offered to you, simply inquire with the FS staff you've been working with. Geographic presence of medical facilities does not necessarily mean accessibility (e.g., acceptance of new patients). Is this important aspect addressed during the assignment evaluation process? Yes. During the clearance, the gaining EFMP-M office will research their area to determine if the can provide the required services at their required frequencies within acceptable access to care standards. By ensuring the official summary of medical needs (DD Form 2792) is current and accurate, families can assist with providing the gaining base with a detailed list of required services and their expected frequencies. Does TRICARE trump the base clearance process if the medical and educational facilities determine they can accept a family? TRICARE service availability is incorporated into the clearance. During the clearance, the gaining EFMP-M office will research their area (MTF and local network) to determine if the can provide the required services at their required frequencies within acceptable access to care standards. By ensuring the official summary of medical needs (DD Form 2792) is current and accurate, families can assist with providing the gaining base with a detailed list of required services and their expected frequencies. If the SGH disagrees with off-base doctor recommendations, what other options do the service members have? When members or dependents experience a situation which they believe does not follow outlined guidance on operating procedures, we encourage them to contact their Patient Advocate located within their MTF. Can a family appeal an SNC decision regarding a particular gaining base? If so, how does that work? The Chief of Medical Services is the signing authority regarding travel recommendations during a clearance. When travel is not recommended for one or more family members, the member can utilize the appeals process outlined in AFI 40-701. By doing so, the member has 21 calendar days following the notification of a negative travel recommendation to submit new or omitted information relevant to the cause for receiving a negative travel recommendation. 11
Can a member appeal a negative travel recommendation based on distance to care if the member says they are willing to travel? When the gaining Chief of Medical Services (SGH) provides a positive travel recommendation, they are confirming the family will be able to receive adequate services within acceptable access to care standards based on their automatic eligibility status for military healthcare benefits. To make the travel recommendation for family members whose care is outside of the local area, the gaining Chief of Medical Services (SGH) will balance the distance to care alongside the frequency of the need. For example, it may be appropriate to recommend in favor of travel when the required care is available 70 miles away if the frequency is only twice a year. But that same case might receive a negative travel recommendation if the frequency is every week. Will there be actions put into place to ensure that the needed care is not just "available", but readily available? We were sent to a base with services, but there were extensive wait lists and only one or two providers in the area. During the clearance, the gaining EFMP-M office will research their area to determine if the can provide the required services at their required frequencies within acceptable access to care standards. By ensuring the official summary of medical needs (DD Form 2792) is current and accurate, families can assist with providing the gaining base with a detailed list of required services and their expected frequencies. If a clearance package contains both medical and educational needs, does the gaining base look at both, or just medical? If the gaining assignment was in a CONUS locale, the clearance will be largely based on medical needs, as the States are federally mandated to provide services on an existing IEP. The gaining EFMP-Medical office should be working with the School Liaison Office (SLO) at their base to navigate resources for extreme IEP requirements outside of typical IEP services. If the gaining assignment was in the OCONUS locale, and there are educational needs present, the gaining office will coordinate with the DoDEA/NDSP office to determine available educational resources. How does the family member know that their electronic health record contains all of the medical information if they see multiple providers in the civilian community? When family members see providers in the civilian community, their medical records should be provided by the family member or sponsor to the Records Management Office within the Military Treatment Facility to ensure a complete summary of care is transferred into their electronic health record. 12
What is the process for reassignment if the EFMP family member is not able to receive adequate medical care at the new base? We encourage families to voice their concerns about unavailable resources with their PCM team or Patient Advocate at the MTF. When families experience a service outage in their current assignment locale, they can contact the Special Needs Coordinator at the MTF to ensure their EFMP enrollment status and medical summaries are up-to-date. If the sponsor proceeds to the vmpf and requests a reassignment based on service unavailability, they will need to be enrolled in EFMP, and have a complete and accurate medical package for that application. The member will need to include in their package a letter from the Special Needs Coordinator outlining all required care alongside the service availability of each. Can Airmen reach out to the gaining unit medical clearance personnel to speak with them or do we have to wait on the Family Member Relocation Clearance facilitator at our current location? To avoid confusion and delays, we recommend sponsors, families, and the leadership work with their local EFMP-M office during a clearance rather than the gaining Special Needs Coordinator. For medical care and assignment deferment is there a mileage limit on how close a military care center must be? The gaining Chief of Medical Services (SGH), and the MAJCOM SG office for OCONUS assignments, will weigh distance to care against required frequency to determine whether or not the gaining location can adequately manage each case. How does Command Sponsorship work if only one family member (e.g. spouse or one of multiple children) is not recommended for travel? I assume this is common, since most people only have one member in EFMP and others who don't have special needs. Would I have the option of getting the non-efmp members command sponsored? Command Sponsorship only applies to OCONUS assignments. If the sponsor has 3 dependents who were recommended for travel, and one dependent who was not recommended for travel Command Sponsorship will only be granted to the three dependents who received a positive travel recommendation. DEFERMENTS Is deferment an option available to sponsors that are being deployed as opposed to PCSing and have EFMP dependents without support in their local area? Deferment (remain in place) is an option for Airman with a projected TDY/deployment or reassignment who has a family member meeting the DoD eligibility criteria for enrollment in the EFMP. The EFMP provides an initial 12-month deferment for a newly diagnosed condition when the 13
member s presence is essential in establishing and/or participating in the treatment program. Deferment from reassignment may also be appropriate if a treatment program is at a critical juncture and the member s continued presence is absolutely essential to continuing the treatment program. Deferment from deployment will not be granted for Airman with EFMP family members who have failed to establish a viable Family Care Plan for execution in their absence. If an EFMP reassignment/deferment is "approved" does that mean the Airman is going to their requested location, other, or staying in place? An EFMP reassignment means the Airman and family will be reassigned to a new location which has been verified to be able to support the special needs of the family members. An EFMP deferment means the Airman and family will remain at their current location for the deferment period approved by the Air Force Personnel Center. DISENROLLMENT How do I get a dependent removed from EFMP when the condition no longer warrants being in the program? When the medical or educational condition of an enrolled family member changes, and the family believes enrollment is no longer warranted, an updated DD Form 2792 (medical) or DD Form 2792-1 (educational) must be provided to the EFMP-M office. The Special Needs Coordinator will review the information on that form and determine whether or not the family member continues to meet criteria for EFMP. Each installation has a Special Needs Coordinator assigned to the Military Treatment Facility and they are available to answer any questions or concerns. I would like to dis-enroll since my EFMP dependent is joining the military and will not be living with us anymore. How long does this process take? When the enrolled family member has aged out of eligibility for military healthcare, or has been removed from dependency status in DEERS, the Airman can provide a DEERS printout to the Special Needs Coordinator at the MTF to dis-enroll from EFMP. ECHO How does Tricare ECHO fit into the EFMP process? EFMP enrollment assists dependents with gaining access to ECHO services. Please contact your health benefits advisor at your local MTF to assist with answering ECHO questions. After retirement, are there any major differences as far as what Tricare will cover, especially after losing ECHO? The Health Benefits Advisor within the TOPA Flight in your local Military Treatment Facility will best be able to explain TRICARE benefits as a retiree. 14
EDUCATIONAL SERVICES Does EFMP screen for availability of special education services at the gaining installation? Per last bullet on EFMP-FS Roles & Responsibilities slide, does EFMP-FS staff advocate for specific families? That is, if a family encounters problems. Yes, medical and educational needs are included in the clearance package. Yes, EFMP-FS staff do advocate for families when additional assistance is required. They can assist in contacting agency POCs/base personnel, via email or phone, depending on what your situation requires and what level of support you need. However, staff are not permitted to advocate by accompanying members/families to school, court or service provider meetings. EFMP CAMPS Where are these EFMP Camps at? EFMP camp types vary and may be located on or off the base. Camps are not offered at every single installation. It depends on whether or not an installation requested camp funding for the fiscal year. EFMP DOCUMENTATION Is there standardization for the EFMP paperwork required in a clearance? Yes. The standardized operating procedures for EFMP-Medical are outlined in chapter three of AFI 40-701. This area covers required EFMP documentation for enrollment and clearances. Does the DD Form 2792 need to be updated annually? The AF EFMP does not require annual updates to the DD Form 2792. The only time an enrolled family member must provide an updated form is when conditions/service requirements change. Additionally, the DD Form 2792 is considered current for 12 months during a PCS provided service requirements do not change in that time. When is the DD Form 2792, Family Member Medical Summary, required for travel clearance for CONUS-CONUS moves? Per Air Force guidance outlined in AFI 40-701, the DD Form 2792 is required for all clearances when the family member in question has been identified as having a special medical need. Please check with your base s AFI 40-701 Wing Supplement to clarify local operating procedures. Who presents the DD Form 2792; family or physician? Either the family member or the provider can provide a DD Form 2792 to the Special Needs Coordinator. 15
EFMP-FS COORDINATOR POSITIONS How does a base know if they are one of the 44 bases to receive a EFMP-FS full time position? When can we expect these positions to be advertised and filled? The AF is still working out all details (funding, identifying bases, advertising and recruiting) for the 44 installations to receive the EFMP-FS positions. More details will be released as information becomes available within the next couple of months. Will there be an increase number of EFMP-FS positions OCONUS as well? Yes, some of our OCONUS installations will receive an EFMP-FS position, and some large installations throughout the AF will also receive a second position. EFMP SERVICES FOR ADULTS Why aren't there more resources for those families whose EFMP member is a spouse? A vast array of wonderful resources and events abound for those families with children in EFMP, but very little is available for those families whose spouse is the EFMP member. EFMP-FS staff work closely with on and off-base agencies to ensure there are resources/support services for both adults and children with special needs. Programs vary from installation to installation. Attendance levels are usually higher for child programs. The AF, along with DoD, is working to provide more support and assistance to adults. ELIGIBITY FOR REASSIGNMENT/DEFERMENT What if the current area is causing family members condition? Chronic conditions such as breathing problems, are very prevalent among Air Force family members. Reassignments based on the climatic conditions or geographical area adversely affecting a family member s health, and the problem is of a recurring nature (such as asthma, allergies, eczema, etc.) are not generally approved. However, exceptions are made when the continued presence of the family member in such a climate or environment is medically determined to be clearly life threatening. A history of hospitalizations, intensive care unit admissions, emergency room visits, etc., needs to be present in order to receive consideration for EFMP reassignment based on climatic conditions or a geographical area. I heard that an EFMP family member can be coded a special way that requires that family member to stay in the local area so that the Active Duty member is limited to assignments in that area. Does that code exist and can you tell me more about the criteria? EFMP does not allow for a permanent deferment from assignments or deployments. 16
ENROLLMENT I am mil-to-mil with an EFMP child. The child is under me. What happens when I retire, does my husband then get Q-coded because of my child? How does the Colonel's group handle EFMP for assignments? When mil-to-mil couples have an EFMP child residing in their home, both members will receive a Q- code. Should one of the members retire, the case will remain active under the other parent. Enrollment Procedures apply to the Colonel s Group as well and they will receive a clearance as needed. Colonels who have matched to a Group, Wing, or Vice Wing position will have the EFMP portion of their PCS managed by the EFMP-Medical office at the Air Force Medical Operations Agency. Can a child be enrolled for a 504 Plans under educational needs? The enrollment criteria for EFMP, based on educational needs is limited to children who have an Individualized Family Service Plan (IFSP) aged 0-3, and children who have an Individualized Education Program (IEP) aged 3-21. Enrollment criteria does not include 504 Plans. Why are families not given the option to join EFMP program rather than making it mandatory? Mandatory enrollment into EFMP is directed by DoDI 1315.19, Authorizing Special Needs Family Members Travel Overseas at Government Expense, and is overseen by the Office of Special Needs at the Department of Defense. Is the service member supposed to be coded when their family member meets the criteria or wait until an assignment notification? Enrollment is designed to happen during diagnosis, however there are safety nets in place during out-processing to ensure families can participate in a clearance if that did not occur at an earlier date. GUARD & RESERVE Are AF Reserve and Air National Guard members eligible for EFMP services under Title 10 orders? The AF EFMP-Medical community will provide enrollment letters and preform clearances for all active AF members on Title 10 orders including Regular AF members, AF Reserve members, and Air National Guard members. Are reserve children eligible for camps and childcare? If so, how do they go about identifying their children as EFMP? Yes, and reservists do not have to be officially enrolled in the EFM Program to participate in camps or receive EFMP information from the A&FRC. Some centers may have a first-come first-serve 17
basis policy for EFMP camps, and others may use a priority system depending on the number of camp slots available. FS staff can briefly speak with you to assess your status. After AF Reserve member completes Title 10 orders and he/she is no longer on orders, what other resources are available for respite care? Yes, but reservists must be on Title 10 orders and activated for at least 31 days. Please inquire with your local respite partner agency for any exceptions to policy. The member may no longer be eligible for the AF respite care program, unless they qualify for some sort of exception to policy, but please visit you A&FRC EFMP-FS to inquire about additional respite resources for your family Are AF Reserve A&FR required to do a family assessment? Is there a specific form for completing and conducting a family needs assessment? There is no requirement for AD or Reserve EFMP-FS staff to conduct a formal family needs assessment. However, a formal needs assessment form has been designed for staff to use when needed and is located in AFFIRST, A&FRC secured customer management system. Are AF Reserve members (serving one weekend a month) qualify for A&FRC workshops? This are AF reserve members that are not under Title 10 orders. Yes, "most" A&FRC programs/services, unless otherwise specified, are open all ID cardholders (i.e., DoD members, guard, reservists, DoD civilians and all family members). There are very few services reservists are not eligible to utilize. MISCELLANEOUS Is there any written Air for policy and/or guidance regarding active duty members (enrolled in EFMP) being allowed time off from work to be with their dependent child at a local hospital? The Leave AFI was changed last May and permissive TDY is no longer allowed for the local area and the JTR only refers to being an NMA for a dependent for a hospital stay that s outside the local area. If your dependent has to be hospitalized outside of the local area, you re covered by NMA orders but if the hospital is in the local area where a member is stationed, it seems that we re at a loss. This is not an area covered under the EFMP guidance for EFMP-Medical, EFMP-Family Support or EFMP-Assignments, so we defer to the owners of AFI 36-3003, Military Leave Program. While Commanders no longer have the option to locally approve Permissive TDY for hospitalization of dependents in the local area, there is a provision within the AFI to request a waiver. Commanders also have the ability to approve normal and special passes, if they deem the situation meets the criteria. Additionally, the A&FRC community may be aware of alternative options as the cover the 18
family support side of EFMP, and assist families and sponsors with navigating local, state, and federal services. A&FRC needs to do more training on resiliency and management of caring for our EFMs. I ve been in EFMP for 9 years and until this month have never seen training and support for this. I have seen too many bowling trips and horseback riding trips. The AF offers a very robust resilience program for members which can be applicable to any area of concern in your life to include caring for an EFM. All A&FRCs have staff available to work with families one-on-one to assess needs and ensure families are properly referred. That also includes assessing/referring spouses to receive the best support. The FS staff are also available to discuss individual recommendations from members which can be elevated if needed. How does the EFMP program in the Air Force support families of Autistic children? How does the process define comparable services? My concern is that you have your medical and educational team sit together at one installation and at another location they do not. EFMP-FS services/support groups vary from installation to installation depending on the availability of staff, resources and needs of the community. The basic EFMP-FS services offered throughout the AF are the same (i.e., information and referral to local, state and federal resources, non-medical case management, program education/awareness). The location of the EFMP-FS is generally in the A&FRC, but it could vary if that works best for the installation Are there any special travel arrangements that EFMP can assist with? Have seen no information on this. Like with a child that's connected to several medical devices and requires, essentially, 24-hour care. Is there a medical rotator anymore to move such family members? The health benefits advisor in the TOPA flight within the MTF will be able to provide guidance on benefits for special travel arrangements. What process does a military member have to go through or criteria to meet to request a Humanitarian PCS? EFMP and Humanitarian reassignments are two distinct programs. Information for Humanitarian reassignments can be found within AFI 36-2110, Assignments, Attachment 24, or by using the search feature within mypers. What about consideration of a tiered coding system? Instead of an all-encompassing Q code, EFMP families would be sub-coded based on the medical concern; those most likely to change in a year (e.g., dental conditions) would be slotted for annual review, whereas those least likely to change with time (e.g., blood disorders) would be slotted for less frequent review, such as every five years. 19
Screenings are conducted as point-in-time clearances in appreciation of the ever-changing needs of medical conditions, as well as rapid fluctuations in service availability. We are in contact with other branches that have instituted a tiered Q-coding system and are learning from their challenges, victories and suggestions. One of the major concerns we are researching is the fact that the Personnel system is not currently designed to designate Airman into a particular tier. The branches that have/are using the tiered Q-coding system have struggled with maintaining data integrity for the appropriate tiers to which family members belong. The manpower that would be required to maintain such a system could far outweigh the potential benefits for this system. The EFMP-Medical community does not support a change in policy that would preclude sponsors from taking part in a fair and equitable assignment process. MPS/CSS TRAINING Is the MPF advising the member on the steps they must take? What training is being provided to the MPF staff to ensure they are providing the correct information to our service members? EFMP-A provides frequent training for Military Personnel Sections and Commander Support Staffs on the EFMP process and how to best assist customers. The most recent training was held on 6 Dec 2016, and the presentations used during the training can be found by using the search feature in mypers and entering EFMP. NEGATIVE TRAVEL RECOMMENDATIONS If I volunteer for a special duty assignment and my family and I am not recommended to travel. What are the options to try and continue to take the assignment? Assignments will not be automatically cancelled or deferred based on a negative travel recommendation. For this to happen, the member must specifically request a change to their assignment via the vmpf. Sponsors who take family members not recommended for travel to a CONUS location may not be eligible for EFMP Reassignment at a later date. An EFMP Reassignment may be considered only if it has been medically determined the family member is suffering from a life-threatening situation and medical services cannot provide the required care. There are medical and TRICARE related barriers for both CONUS and OCONUS assignments for which the sponsor does not obtain positive travel recommendations your local Special Needs Coordinator can provide a comprehensive listing and answer any specific questions you may have. What happens if my spouse is mandatory moved and his report date happens before the spouse is approved or disapproved for some reason; can the spouse still go regardless? Clearances are designed to take place prior to sponsor travel. Sponsors are typically notified of a PCS action within an appropriate amount of time to complete an EFMP clearance. If your sponsor 20
was not provided the appropriate amount of time, please have your sponsor contact their First Sergeant to address the concern. Report no Later Than Dates may be adjusted to allow processing to be completed. Please keep in mind that unless the assignment is a short-notice fill, the normal lead time for assignments is 120 days. The Family Member Relocation Clearance process can be completed once an assignment is loaded, and up to 6 months prior to the report date. If travel is not recommended, does the assignment get cancelled based on the non-recommend? Assignments will not be automatically cancelled or deferred based on a negative travel recommendation. For this to happen, the Airman must specifically request a change to their assignment via the vmpf. If travel is not recommended at what point is it specifically explained what services are not available? Members are notified of the status by their servicing EFMP-M office immediately following receipt of a negative travel recommendation. In order to participate in the appeals process, the servicing EFMP office will provide the member/family member with the justification for the negative travel recommendation at the same time. I'd appreciate clarification of service member/ family member options if travel is not recommended. EFMP clearances do not have the authority to cancel an assignment. If a member has been notified of an assignment, and a clearance through EFMP results in a negative travel recommendation, the member s original assignment is still loaded in the system, and their report no later than date is still active. When travel is not recommended for one or more family members, the member can utilize the appeals process outlined in AFI 40-701. By doing so, the member has 21 calendar days following the notification of a negative travel recommendation to submit new or omitted information relevant to the cause for receiving a negative travel recommendation. If the final response to the clearance is a negative travel recommendation, the member has options. They can either proceed to the assignment or request a change via the vmpf. For both options, we encourage the member to seek advisement from the Assignments team at their local MPS. POST-RETIREMENT EFMP SERVICES Are there any resources for searching post-retirement services? Members/families are still eligible for most A&FRC EFMP-FS services after retirement. This helps with a seamless transition from active duty to retiree status. Medical service availability questions can be answered by the health benefits advisor in the TOPA Flight found within the local MTF. 21