80 FR 76881 - Exceptional Family Member Program (EFMP)

DEPARTMENT OF DEFENSE
Office of the Secretary

Federal Register Volume 80, Issue 238 (December 11, 2015)

Page Range76881-76889
FR Document2015-31227

This proposed rule establishes the Exceptional Family Member Program (EFMP) and provides guidance, assigns responsibilities, and prescribes procedures for identifying a family member with special needs, and coordinating travel at government expense for family members of active duty Service members who meet the Department of Defense (DoD) criteria for identifying a family member with special needs. This proposed rule also prescribes procedures for processing DoD civilian employees who have family members with special needs for an overseas assignment and providing family support services.

Federal Register, Volume 80 Issue 238 (Friday, December 11, 2015)
[Federal Register Volume 80, Number 238 (Friday, December 11, 2015)]
[Proposed Rules]
[Pages 76881-76889]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-31227]


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DEPARTMENT OF DEFENSE

Office of the Secretary

32 CFR Part 75

RIN 0790-AI82
[Docket ID: DOD-2011-OS-0127]


Exceptional Family Member Program (EFMP)

AGENCY: Office of the Under Secretary of Defense for Personnel and 
Readiness, DoD.

ACTION: Proposed rule.

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SUMMARY: This proposed rule establishes the Exceptional Family Member 
Program (EFMP) and provides guidance, assigns responsibilities, and 
prescribes procedures for identifying a family member with special 
needs, and coordinating travel at government expense for family members 
of active duty Service members who meet the

[[Page 76882]]

Department of Defense (DoD) criteria for identifying a family member 
with special needs. This proposed rule also prescribes procedures for 
processing DoD civilian employees who have family members with special 
needs for an overseas assignment and providing family support services.

DATES: Comments must be received by February 9, 2016.

ADDRESSES: You may submit comments, identified by docket number and/or 
Regulatory Information Number (RIN) number and title, by any of the 
following methods:
     Federal Rulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: Department of Defense, Office of the Deputy Chief 
Management Officer, Directorate of Oversight and Compliance, Regulatory 
and Audit Matters Office, 9010 Defense Pentagon, Washington, DC 20301-
9010.
    Instructions: All submissions received must include the agency name 
and docket number or RIN for this Federal Register document. The 
general policy for comments and other submissions from members of the 
public is to make these submissions available for public viewing on the 
Internet at http://www.regulations.gov as they are received without 
change, including any personal identifiers or contact information.

FOR FURTHER INFORMATION CONTACT: Rebecca Lombardi, 571-372-0862.

SUPPLEMENTARY INFORMATION: 

Executive Summary

    This proposed rule would implement 10 U.S.C. 1781c, which 
established the Office of Community Support for Military Families with 
Special Needs (OSN). Under this proposed rule, the OSN would be housed 
within the Office of the Under Secretary of Defense for Personnel and 
Readiness. The purpose of the Office is to enhance and improve 
Department of Defense support around the world for military families 
with special needs (whether medical or educational needs) through the 
development of appropriate policies, enhancement and dissemination of 
appropriate information throughout the Department of Defense, support 
for such families in obtaining referrals for services and in obtaining 
services and oversight of the activities of the military departments in 
support of families. The OSN would be responsible for developing an 
EFMP policy that addresses the development and implementation of a 
community support program across the Services, and expand coordination 
of assignments for military families with special needs within and 
outside the United States.
    The rule would provide guidance for identifying family members with 
special needs and requires the Military Services to establish a system 
to identify, document and consider a military family member's special 
medical and educational needs when approving travel at government 
expense. It would also provide guidance for the processing of overseas 
assignments for DoD civilian employees who have family members with 
special needs. The rule also would establish a system of monitoring and 
assigning oversight responsibilities for the EFMP as well as 
authorizing the development of implementing guidance and forms 
necessary for the operation of the EFMP.

III. Costs and Benefits

    The Department of Defense and the Military Departments, which are 
responsible for providing services to Military families with special 
needs, receive their funding from the Operations and Maintenance (O&M) 
defense-wide budget. The approximate cost for the Exceptional Family 
Member Program for FY2011 was $30,509,878.93.

Retrospective Review

    This proposed rule is part of DoD's retrospective plan, completed 
in August 2011, under Executive Order 13563, ``Improving Regulation and 
Regulatory Review.'' DoD's full plan and updates can be accessed at: 
http://www.regulations.gov/#!docketDetail;dct=FR+PR+N+O+SR;rpp=10;po=0;D=DOD-2011-OS-0036.

Executive Order 12866, ``Regulatory Planning and Review'' and Executive 
Order 13563, ``Improving Regulation and Regulatory Review''

    Executive Orders 13563 and 12866 direct agencies to assess all 
costs and benefits of available regulatory alternatives and, if 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, distribute impacts, and equity). Executive 
Order 13563 emphasizes the importance of quantifying both costs and 
benefits, of reducing costs, of harmonizing rules, and of promoting 
flexibility. This proposed rule has been designated a ``significant 
regulatory action,'' although not economically significant, under 
section 3(f) of Executive Order 12866. Accordingly, the rule has been 
reviewed by the Office of Management and Budget (OMB).

Sec. 202, Pub. L. 104-4, ``Unfunded Mandates Reform Act''

    Section 202 of the Unfunded Mandates Reform Act of 1995 (UMRA) 
(Pub. L. 104-4) requires agencies assess anticipated costs and benefits 
before issuing any rule whose mandates require spending in any 1 year 
of $100 million in 1995 dollars, updated annually for inflation. In 
2014, that threshold is approximately $141 million. This proposed rule 
will not mandate any requirements for State, local, or tribal 
governments, nor will it affect private sector costs.

Public Law 96-354, ``Regulatory Flexibility Act'' (5 U.S.C. 601)

    The Department of Defense certifies that this proposed rule is not 
subject to the Regulatory Flexibility Act (5 U.S.C. 601) because it 
would not, if promulgated, have a significant economic impact on a 
substantial number of small entities. Therefore, the Regulatory 
Flexibility Act, as amended, does not require us to prepare a 
regulatory flexibility analysis.

Public Law 96-511, ``Paperwork Reduction Act'' (44 U.S.C. Chapter 35)

    It has been certified that 32 CFR part 75 does impose reporting or 
recordkeeping requirements under the Paperwork Reduction Act of 1995. 
These reporting requirements have been approved by the Office of 
Management and Budget and assigned OMB Control Number 0704-0411, titled 
Exceptional Family Member Program.

Executive Order 13132, ``Federalism''

    Executive Order 13132 establishes certain requirements that an 
agency must meet when it promulgates a proposed rule (and subsequent 
final rule) that imposes substantial direct requirement costs on State 
and local governments, preempts State law, or otherwise has Federalism 
implications. This proposed rule will not have a substantial effect on 
State and local governments.

System of Record Notices (SORN) and Privacy Impact Assessments (PIA)

    The applicable SORN for the Exceptional Family Member program is: 
DHA 16 DoD. The system name is the Special Needs Program Management 
Information System (SNPMIS) Records (available at http://dpcld.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/570679/edha-16-dod.aspx).
    The Privacy Impact Assessment (PIA) for this program is available 
at http://health.mil/Reference-Center/Forms/2014/07/29/PIA-Summary-
Special-

[[Page 76883]]

Needs-Program-Management-Information-System-SNPMIS.
    The Special Needs Program Management Information System (SNPMIS) 
provides access to a comprehensive program of therapy, medical support, 
and social services for young Department of Defense (DoD) Military 
Health System (MHS) beneficiaries with special needs. SNPMIS is the 
Military Health System (MHS) automated information system designed to 
ensure the DoD meets the unique information requirements associated 
with implementation of the Individuals with Disabilities Education Act 
(IDEA). SNPMIS captures records referral, evaluation, eligibility, and 
service plan data for children with special needs who are eligible for 
MHS services under IDEA. This system is a distributed data collection 
application with database servers distributed at various Medical 
Treatment Facilities (MTFs) located within the Continental United 
States (CONUS) and Outside the Continental United States (OCONUS). 
SNPMIS is currently used in 45 EDIS clinics at Army, Navy, and Air 
Force installations worldwide.

List of Subjects in 32 CFR Part 75

    Children, Family health, Special needs.

    Accordingly 32 CFR part 75 is proposed to be added to read as 
follows:

PART 75--EXCEPTIONAL FAMILY MEMBER PROGRAM (EFMP)

Subpart A--General
Sec.
75.1 Purpose.
75.2 Applicability.
75.3 Definitions.
Subpart B--Policy
75.4 Policy.
75.5 Responsibilities.
Subpart C--Procedures
75.6 DoD criteria for identifying family members with special needs.
75.7 Coordinating assignments of active duty Service members who 
have a family member with special needs.
75.8 Civilian employees on overseas assignment.
75.9 Provision of family support services.
75.10 Office of Community Support for Military Families with Special 
Needs (OSN).


    Authority:  10 U.S.C. 1781c

Subpart A--General


Sec.  75.1  Purpose.

    This part:
    (a) Establishes the EFMP and establishes policy, provides guidance, 
assigns responsibilities and prescribes procedures for:
    (1) Identifying a family member with special needs who is eligible 
for services as defined in this part.
    (2) Coordinating travel at government expense for family members of 
active duty Service members who meet the DoD criteria for special 
medical or educational needs.
    (3) Processing DoD civilian employees who have family members with 
special needs for an overseas assignment.
    (4) Providing family support services to military families with 
special needs.
    (b) Establishes a system of monitoring and assigns oversight 
responsibilities for the EFMP.
    (c) Authorizes the development of implementing guidance and forms 
necessary for the operation of the EFMP in accordance with this part.
    (d) Does not create any rights or remedies in addition to those 
already otherwise existing in law or regulation, and may not be relied 
upon by any person, organization, or other entity to allege a denial of 
such rights or remedies.


Sec.  75.2  Applicability.

    This part applies to:
    (a) The Office of the Secretary of Defense, the Military 
Departments, the Office of the Chairman of the Joint Chiefs of Staff 
and the Joint Staff, the Combatant Commands, the Office of the 
Inspector General of the Department of Defense, the Defense Agencies, 
the DoD Field Activities, and all other organizational entities within 
the DoD (referred to collectively in this part as the ``DoD 
Components'').
    (b) Service members who have family members with special needs as 
described in this part.
    (c) All DoD civilian employees in overseas locations and selectees 
for overseas positions who have family members with special needs as 
described in this part.


Sec.  75.3  Definitions.

    Unless otherwise noted, these terms and their definitions are for 
the purpose of this part.
    Assistive technology device. Any item, piece of equipment, or 
product system, whether acquired commercially or off the shelf, 
modified, or customized, that is used to increase, maintain, or improve 
functional capabilities of individuals with disabilities. This term 
does not include a medical device that is surgically implanted or the 
replacement of that device.
    Assistive technology service. Any service that directly assists an 
individual with a disability in the selection, acquisition, or use of 
an assistive technology device.
    CONUS. The 48 contiguous states of the United States, excluding 
Alaska, Hawaii, and U.S. territories.
    Early Intervention Services (EIS). Developmental services for 
infants and toddlers with disabilities that are provided under the 
supervision of a Military Department, including evaluation, IFSP 
development and revision, and service coordination provided at no cost 
to the child's parents.
    Evaluations. Medical, psychological, and educational assessments 
required to define a medical or educational condition suspected after a 
screening procedure.
    Family member. A dependent (a spouse and certain children, in 
accordance with 5 U.S.C. 8901(5) of a Service member) who is eligible 
to receive a DoD identification card, medical care in a DoD medical 
treatment facility, and command sponsorship or DoD-sponsored travel. To 
the extent authorized by law and in accordance with Service 
implementing guidance, the term may also include other nondependent 
family members of a Service member.
    For the purposes of Sec.  75.8 of this part only, this definition 
also includes civilian employees on an overseas assignment, or being 
considered for an overseas assignment, and their dependents who are, or 
will be, eligible to receive a DoD identification card during that 
overseas assignment. To the extent authorized by law and in accordance 
with Service implementing guidance, the term may also include other 
nondependent family members of a civilian employee on an overseas 
assignment.
    Family member travel. Refers exclusively to permanent change of 
station actions. Same as a ``dependent'' as defined by 37 U.S.C. 401.
    Family support services. Encompasses the non-clinical case 
management delivery of information and referral for families with 
special needs, including the development and maintenance of an 
individualized SP.
    Individualized Education Program (IEP). A written document 
identifying the special education and related services for a child with 
a disability.
    Individualized Family Service Plan (IFSP). A written document 
identifying the specially designed services for an infant or toddler 
with a disability and the family of such infant or toddler.
    Medical case management. A collaborative process of assessment, 
planning, facilitation, and advocacy for options and services to meet 
an

[[Page 76884]]

individual's health needs through communication and available resources 
to promote quality cost-effective outcomes. See Department of Defense 
TRICARE Medical Management Guide, 2009, Version 3 (available at http://www.tricare.mil/tma/ocmo/download/MMG_v3_2009.pdf).
    Non-clinical case management. The provision of information and 
referral to families and individuals that assist them in making 
informed decisions and navigating resources to improve their quality of 
life such as medical, educational, social, community, housing, legal, 
and financial services. This does not involve coordination and follow-
up of medical treatments.
    Overseas. Defined in 20 U.S.C. 932(3) and (4).
    Pinpoint location. A specific geographic location recommended for 
an active duty Service member's assignment because it has:
    (1) A valid requirement for the active duty Service member's grade 
and military occupational specialty.
    (2) Availability of required medical services.
    (3) Availability of required educational staff necessary to provide 
EIS and special education to the active duty Service member's child 
with special educational needs.
    Related services. Transportation and such developmental, 
corrective, and other supportive services, as required, to assist a 
child, age 3 through 21 years, inclusive, with a disability to benefit 
from special education under the child's IEP. The term includes speech-
language pathology and audiology, psychological services, physical and 
occupational therapy, recreation including therapeutic recreation, 
early identification and assessment of disabilities in children, 
counseling services including rehabilitation counseling, orientation 
and mobility services, and medical services for diagnostic or 
evaluative purposes. That term also includes school health services, 
social work services in schools, and parent counseling and training. 
The sources for those services are school, community, and medical 
treatment facilities.
    Related services assigned to the military medical departments 
overseas. Services provided by Educational and Developmental 
Intervention Services to Department of Defense Dependent School 
students, under the development or implementation of an IEP, necessary 
for the student to benefit from special education. Those services may 
include medical services for diagnostic or evaluative purpose, social 
work, community health nursing, dietary, occupational therapy, physical 
therapy, audiology, ophthalmology, and psychological testing and 
therapy.
    Respite Care Services. The provision of temporary relief to 
military family members who are responsible for the regular care of 
dependent family members with special needs.
    Responsible military department. The Military Department 
responsible for providing EIS or related services in the geographic 
areas assigned under 32 CFR part 57.
    Services plan (SP). An individualized plan written in collaboration 
with the family or the family member with special needs that documents 
current needs and steps to achieve their desired outcome.
    Special education. Specially designed instruction, including 
physical education, which is provided at no cost to the parent or 
guardians to meet the unique needs of a child with a disability, 
including instruction conducted in the classroom, in the home, in 
hospitals and institutions, and in other settings.
    Special needs. Includes special medical and educational needs of 
family members who meet the DoD criteria as found in Sec.  75.6 of this 
part.
    Specialty care. Specialized health care provided by a physician 
whose training focused primarily in a specific field, such as 
neurology, cardiology, rheumatology, dermatology, oncology, 
orthopedics, or ophthalmology and is required for health maintenance.

Subpart B--Policy


Sec.  75.4  Policy.

    It is DoD policy that:
    (a) The EFMP identifies family members with special needs, enrolls 
sponsors in the program, and participates in the coordination of 
assignments for active duty Service members in order for the special 
needs of family members to be considered during the assignment process.
    (b) Active duty Service members whose families include a member 
with special needs must enroll in the EFMP to ensure their family 
members' special needs are considered during the assignment 
coordination.
    (c) The EFMP provides family support services, including non-
clinical case management, to military families with special needs 
regardless of the sponsor's Service affiliation or enrollment status in 
the EFMP, as described in Sec.  75.9 of this part. Family support 
service to the Reserve Component is dependent upon each Service's 
eligibility requirements.
    (d) Active duty Service members whose families include a member 
with special needs may be stabilized in Alaska, Hawaii, or a 
continental United States (CONUS) assignment location for a minimum of 
4 years when:
    (1) The arrangement is initiated by the Service member.
    (2) The family member has a documented need for stabilization, as 
determined by Service-specific guidance.
    (3) Stabilization does not have an adverse effect on the mission 
requirements of the Military Department.
    (4) The career development of the Service member has been 
considered and is not affected adversely.
    (e) The special needs of a civilian family member will not be 
considered in the selection of a civilian for an overseas position.


Sec.  75.5  Responsibilities.

    (a) The Under Secretary of Defense for Personnel and Readiness (USD 
(P&R)):
    (1) Provides for an OSN, pursuant to 10 U.S.C. 1781c.
    (2) Submits an annual report to Congress pursuant to 10 U.S.C. 
1781c on the activities of the OSN, including identification of gaps in 
services for military families with special needs and actions being 
taken or planned to address such gaps.
    (b) Under the authority, direction, and control of the USD(P&R), 
the Assistant Secretary of Defense for Manpower and Reserve Affairs 
(ASD(M&RA)):
    (1) Consults with the Secretaries of the Military Departments, as 
appropriate, to ensure the development, implementation, and monitoring 
of an effective EFMP across DoD, in accordance with this part.
    (2) Resolves disputes among the DoD Components regarding the 
implementation of procedures in Sec.  75.6 through Sec.  75.10 of this 
part.
    (3) Requires the Military Services and DoD Education Activity 
(DoDEA) to notify OSN of additions, deletions, or substitutions to the 
locations of EIS and special education in overseas military 
communities.
    (4) Convenes a meeting at least once a year to review the 
implementation of this part. Representatives from the ASD(M&RA); the 
Assistant Secretary of Defense for Health Affairs (ASD(HA)); the 
General Counsel of the Department of Defense; the Secretaries of the 
Military Departments; must attend. A representative of the Commandant 
of the Coast Guard shall be invited to attend. Participants will:
    (i) Represent functional areas including: military medical; 
military and civilian personnel; housing; dependents' education; legal; 
child and

[[Page 76885]]

youth services; morale, welfare, and recreation; and community support 
activities.
    (ii) Review Service and DoDEA reports on family support services, 
assignment coordination, the pinpoint locations of EIS and special 
education overseas, and data requirements of this part.
    (c) Under the authority, direction, and control of the USD(P&R), 
the ASD(HA):
    (1) Advises the USD(P&R) regarding the availability of specialized 
medical services to family members with special needs.
    (2) Collaborates with the OSN on medical issues related to this 
part.
    (3) Participates in the development and deployment of a data 
management system, including appropriate interfaces that support the 
EFMP mission.
    (4) Ensures that policies and procedures are in place within the 
Military Health System (MHS) to safeguard personally identifiable 
information (PII) and protected health information (PHI) gathered 
during the medical processes required by this part in accordance with 
32 CFR part 310, DoD Instruction 6025.18, ``Privacy of Individually 
Identifiable Health Information in DoD Health Care Programs'' 
(available at http://www.dtic.mil/whs/directives/corres/pdf/602518p.pdf) and DoD 8580.02-R, ``DoD Health Information Security 
Regulation'' (available at http://www.dtic.mil/whs/directives/corres/pdf/858002rp.pdf).
    (5) Ensures procedures are established to make purchased care 
providers aware of the mandatory enrollment requirements when a family 
member of an active duty Service member is identified within the 
purchased care system with a medical condition that meets the criteria 
in Sec.  75.6.
    (6) Ensures that there is a medical case management program to 
support military families with special medical needs following Defense 
Health Program eligibility guidelines. The case managers will 
collaborate with the EFMP non-clinical family support services 
personnel in assisting the eligible population consistent with 32 CFR 
part 310, DoD Instruction 6025.18, and DoD 8580.02-R.
    (d) Under the authority, direction, and control of the ASD(M&RA), 
the Director, DoDEA:
    (1) Designates and updates as necessary a point of contact in each 
DoDEA overseas area to review the DD Form 2792-1 (available at http://www.dtic.mil/whs/directives/infomgt/forms/forminfo/forminfopage2581.html), ``Special Education/Early Intervention 
Summary,'' for all school-aged children (ages 3-21) with disabilities.
    (2) Makes recommendations to the Military Services and Defense 
Agencies on the availability of special education services.
    (3) Ensures that policies and procedures are in place to inform 
families of the requirement to enroll in the EFMP when their child is 
enrolled in a DoDEA school and is covered by an IEP.
    (4) Requests reimbursement from the sending Military Department 
when there is a failure to coordinate an overseas assignment with DoDEA 
that results in the assignment of the Service member to an overseas 
location when one or more of the following conditions are met:
    (i) DoDEA personnel are not available to provide special education 
pursuant to the child's IEP.
    (ii) There is no DoD school, but DoDEA has the responsibility to 
provide special education pursuant to the child's IEP.
    (iii) The DoDEA incurs expenses (e.g., hiring additional staff) 
beyond normal operations to provide special education pursuant to the 
child's IEP.
    (5) Submit an annual memorandum to the ASD(M&RA), reflecting the 
prior school year's data (e.g., August of one calendar year through 
June of the following calendar year) not later than October 15, 
including the number of:
    (i) Assignments coordinated by the DoDEA to include locations, 
travel recommendations and the associated military department.
    (ii) Problematic assignments, including the reasons (e.g., the 
assignment was not coordinated with DoDEA or the information that was 
supplied was incorrect or incomplete by Military Department or Defense 
Agencies and location) and the estimated cost to provide the required 
special services.
    (iii) Problematic assignments for which reimbursement was 
considered.
    (e) The Secretaries of the Military Departments:
    (1) Establish guidance consistent with this part and ensure 
leadership oversight at all levels of military command for 
implementation, monitoring, and evaluation of this part.
    (2) Program, budget, and allocate sufficient funds and other 
resources, including staffing, to meet the policy objectives of this 
part.
    (3) Establish an EFMP within their Department that includes 
identification and enrollment, assignment coordination, and family 
support services components; and promote collaboration between the 
three components.
    (4) Ensure that when a family member of an active duty Service 
member is identified within a military treatment facility with a 
medical condition that meets the criteria in Sec.  75.6, that the 
Service member is referred to the Service-specific EFMP point of 
contact. Confirm that the EFMP point of contact will enroll the Service 
member and follow-up to complete the DD Form 2792, ``Family Member 
Medical Summary.''
    (5) Require military treatment facility personnel to be trained on 
the policies and procedures in this part.
    (6) Participate in the development and deployment of a data 
management system, including appropriate interfaces that support the 
EFMP mission.
    (7) Publish the guidelines that define the EFMP on the appropriate 
Headquarters Service Web site and ensure that all installation Web 
sites link to this official information.
    (8) Ensure the establishment of generic email addresses for 
installation EFMP family support services personnel as well as the 
medical offices supporting the EFMP so that Service members and their 
family members have easy access to support capabilities.
    (9) Establish policies and procedures to safeguard PII and PHI.
    (10) Ensure the establishment of screening and evaluation 
procedures for the purpose of identifying family members of active duty 
Service members with special needs. The guidelines should be 
commensurate with established TRICARE access to care standards, and 
include those family members whose primary provider is in the TRICARE 
network.
    (11) Ensure annual education and training to key personnel is 
conducted on the policies and procedures in this part and on topics 
appropriate to providing family support services. These topics may 
include EIS, special education, Medicaid, supplemental security income, 
and TRICARE benefits, including the extended health care option and any 
other programs that benefit military families with special needs.
    (12) Require that information on this part be provided to all 
active duty Service members and their families, regardless of location, 
and to civilian employees or selectees who have applied for government 
employment in overseas locations.
    (13) Ensure military personnel activities coordinate all 
assignments with the responsible Military Department or other DoD 
Component when the sponsor requests accompanied

[[Page 76886]]

family member travel overseas. Refer to the Joint Travel Regulations 
``Uniformed Service Members and Civilian Employees'' (available at 
https://www.defensetravel.dod.mil/Docs/perdiem/JTR.pdf) for PCS travel 
and transportation allowances for eligible Service members and family 
members.
    (14) Ensure military personnel activities coordinate all CONUS 
assignments of Service members enrolled in the EFMP with the 
responsible Military Department or other DoD Component. Refer to the 
Joint Travel Regulations for PCS travel and transportation allowances 
for eligible Service members and family members.
    (15) Establish procedures to reimburse DoDEA when there is a 
failure to coordinate such assignments that result in the conditions 
described in paragraph (d)(3) of this section.
    (16) Require the military personnel activities to coordinate with 
the appropriate Military Department when considering Service member 
assignment(s) to an overseas area where the provision of EIS and 
related services is the responsibility of another Military Department, 
in accordance with Sec.  75.8 of this part.
    (17) Require human resources representatives to advise civilian 
employees or selectees for an overseas position of the availability of 
services to meet the family member's special needs in the specific 
assignment location.
    (18) Submit an annual report (not later than January 15) to the 
ASD(M&RA) identifying:
    (i) EFMP enrollment and assignment function:
    (A) Total number of Service members enrolled in the EFMP.
    (B) Total number of family members enrolled in EFMP.
    (C) Total number of assignments of Service members enrolled in the 
EFMP that were coordinated in the last year.
    (D) Assignment problems, including early return of family members 
or reassignment of the Service member resulting from failure to enroll 
in the EFMP or inaccuracies in the enrollment information.
    (E) Total number of requested stabilizations, those approved and 
the location.
    (ii) EFMP family support services program, by installation:
    (A) Type and number of EFMP family support services personnel.
    (B) Number of families supported through the EFMP, including number 
of individualized SPs.
    (C) Identified obstacles to the effective delivery of EFMP family 
support services, including military and non-military service 
providers.

Subpart C--Procedures


Sec.  75.6  DoD criteria for identifying family members with special 
needs.

    (a) Special Medical Needs. Individuals who meet one or more of the 
criteria in this section will be identified as a family member with 
special medical needs:
    (1) Potentially life-threatening conditions or chronic (duration of 
6 months or longer) medical or physical conditions requiring follow-up 
care from a primary care manager (to include pediatricians) more than 
once a year or specialty care.
    (2) Current and chronic (duration of 6 months or longer) mental 
health condition (such as bi-polar, conduct, major affective, or 
thought or personality disorders); inpatient or intensive (greater than 
one visit monthly for more than 6 months) outpatient mental health 
service within the last 5 years; or intensive mental health services 
required at the present time. This includes medical care from any 
provider, including a primary care manager.
    (3) A diagnosis of asthma or other respiratory-related diagnosis 
with chronic recurring symptoms that involves one or more of the 
following:
    (i) Scheduled use of inhaled or oral anti-inflammatory agents or 
bronchodilators.
    (ii) History of emergency room use or clinic visits for acute 
asthma exacerbations or other respiratory-related diagnosis within the 
last year.
    (iii) History of one or more hospitalizations for asthma, or other 
respiratory-related diagnosis within the past 5 years.
    (4) A diagnosis of attention deficit disorder or attention deficit 
hyperactivity disorder that involves one or more of the following:
    (i) Includes a co-morbid psychological diagnosis.
    (ii) Requires multiple medications, psycho-pharmaceuticals (other 
than stimulants) or does not respond to normal doses of medication.
    (iii) Requires management and treatment by mental health provider 
(e.g., psychiatrist, psychologist, or social worker).
    (iv) Requires the involvement of a specialty consultant, other than 
a primary care manager, more than twice a year on a chronic basis.
    (v) Requires modifications of the educational curriculum or the use 
of behavioral management staff.
    (5) A chronic condition that requires:
    (i) Adaptive equipment (such as an apnea home monitor, home 
nebulizer, wheelchair, custom-fit splints/braces/orthotics (not over-
the-counter), hearing aids, home oxygen therapy, home ventilator, 
etc.).
    (ii) Assistive technology devices (such as communication devices) 
or services.
    (iii) Environmental or architectural considerations (such as 
medically required limited numbers of steps, wheelchair accessibility, 
or housing modifications and air conditioning).
    (b) Special Educational Needs. Family members of active duty 
Service members (regardless of location) and civilian employees 
appointed to an overseas location eligible for enrollment in a DoDEA 
school on a space-required basis will be identified as having special 
educational needs if they have or are found eligible for, either an 
IFSP or an IEP under 32 CFR part 57.


Sec.  75.7  Coordinating assignments of active duty Service members who 
have a family member with special needs

    (a) Standards for authorizing overseas travel for family members 
with special needs of active duty Service members.
    (1) Family member travel at government expense overseas may be 
denied when an active duty Service member has a family member with 
special medical needs and the services to meet those needs are 
unavailable in a duty location, as determined by the MHS based on 
acceptable U.S. healthcare standards. The Military Department will 
follow the procedures in this part regardless of the sponsor's location 
when processing a Service member with a family member with special 
needs.
    (2) Active duty Service members may not be denied consideration for 
an essential (as defined by the military personnel assignment system) 
duty assignment overseas solely because they have children who are or 
may be eligible for EIS or special education services in accordance 
with 32 CFR part 57. They will receive the same consideration for 
travel at government expense to any duty location as families without 
such members.
    (3) The failure to assign an active duty Service member to a 
pinpoint location overseas, as defined in Sec.  75.3, is never a basis 
to deny EIS or special education to the active duty Service member's 
eligible infant, toddler, or child pursuant to 32 CFR part 57.
    (4) The responsible Military Department may request reimbursement 
from the sending Military Department if failure to coordinate an 
assignment with the responsible Military Department results in one of 
the following situations:
    (i) The assignment of the Service member to an overseas location 
where

[[Page 76887]]

responsible Military Department personnel are not available to provide 
EIS pursuant to the child's IFSP or related services pursuant to the 
child's IEP.
    (ii) The assignment causing the responsible Military Department to 
incur extraordinary expenses (e.g., hiring additional staffing) to 
provide EIS pursuant to the child's IFSP or related services pursuant 
to the IEP.
    (5) The receiving Military Department may also require the sending 
Military Department to provide those services that are pursuant to the 
child's IFSP or IEP when there is failure to coordinate an assignment.
    (b) Military Service Procedures. Each Military Service will 
establish procedures to:
    (1) Identify active duty Service members who have family members 
with special medical needs through completion of DD Form 2792, and with 
educational needs through DD Form 2792-1. The procedures require use of 
the information when considering family member travel.
    (2) Update the status of family member(s) with special needs when 
conditions occur, change, or no longer exist, and when Service-specific 
policy requires.
    (3) Coordinate the availability of medical and educational 
services.
    (4) Maintain records on the effectiveness of the assignment process 
involving sponsors who have family members with special needs and on-
assignment problems resulting from the inadequacy of the Military 
Services' procedures or failure to follow their procedures.
    (c) Military Personnel Activities. Military personnel activities 
will coordinate with appropriate sources to verify that required 
special medical and educational services are available.
    (1) Assignments Overseas.
    (i) Coordinate with medical activities to verify that required 
medical services are available, if the member has a dependent eligible 
for such services, before authorizing family member travel at 
government expense.
    (ii) Coordinate with DoDEA and the medical activity responsible for 
supporting DoDEA to ensure that assignments are made to locations where 
EIS or special education services are available. DoDEA will determine 
whether the needs can be met in any location or whether an established 
pinpoint location is required.
    (iii) Remove active duty Service members who have family members 
with special medical and educational needs from overseas orders if no 
suitable overseas assignment location can be found and there is no 
adverse impact on the military mission or on the active duty Service 
member's career.
    (2) Assignments within the United States and its Territories.
    (i) Coordinate and verify the availability of medical services 
essential to meet the needs of family members with special medical 
needs.
    (ii) Coordinate with the MHS, school districts or EIS providers, 
EFMP family support services personnel, the school liaison officer and 
others, as appropriate, to determine the availability of EIS and 
special education services essential to meet the family member's 
special education needs.
    (d) Military Medical Activities. Military medical activities will 
respond to requests from personnel activities to determine the 
availability of required medical services. Medical treatment facilities 
will identify or confirm family members who meet the criteria for 
special needs, as specified in Sec.  75.6 of this part, following 
Service-specific guidance.
    (e) Active Duty Service Members.
    (1) When the active duty Service member becomes aware that a family 
member may meet the criteria for special needs, as specified in Sec.  
75.6 of this part, the active duty Service member must:
    (i) Notify the cognizant military medical authority using Service-
specific guidance.
    (ii) Have the DD Form 2792 completed by the appropriate medical 
provider.
    (iii) Have the DD Form 2792-1 completed by the current EIS provider 
or current school providing special education to determine whether the 
family member (birth through 21 years of age, inclusive) is eligible 
for, or receiving, EIS or special education and related services.
    (2) The active duty Service member must provide the cognizant 
military authority the completed DD Form 2792 and DD Form 2792-1, when 
appropriate.
    (3) The active duty Service member must provide the information 
required to complete the DD Form 2792 and, when appropriate, the DD 
Form 2792-1. An active duty Service member who fails or refuses to 
provide the required information for a family member for whom the 
Service member is a personal representative for health information in 
accordance with Public Law 104-191, ``Health Insurance Portability and 
Accountability Act of 1996 (HIPPA)'', or who knowingly provides false 
information about any dependent, may be subject to disciplinary actions 
for such offense.
    (i) Such disciplinary actions would be in accordance with Article 
92 (failure to obey a lawful order or regulation or dereliction of 
duty) or Article 107 (false official statement), in violation of 10 
U.S.C. chapter 47 (also known and referred to in this part as ``The 
Uniform Code of Military Justice (UCMJ)'').
    (ii) In addition to UCMJ disciplinary action, the active duty 
Service member may also be subject to administrative sanctions, 
including denial of command sponsorship.


Sec.  75.8  Civilian employees on overseas assignment.

    (a) Vocabulary. Section 75.3 provides definitions of ``family 
member'' that apply only to this section.
    (b) Employee rights. (1) The DoD Components must select civilian 
employees for specific positions based on job requirement and merit 
factors in accordance with 5 U.S.C. 2302, and 29 U.S.C. 791 through 
794d. The selection for an overseas position must not be influenced by 
the special needs of a civilian employee's family member(s), or any 
other prohibited factor.
    (2) The civilian employee or selectee will be given comprehensive 
medical, dental, and educational information about the overseas 
community where the position is located to help the employee make an 
informed choice about accepting the position.
    (3) Refer to the Joint Travel Regulations (available at https://www.defensetravel.dod.mil/Docs/perdiem/JTR.pdf) for PCS travel and 
transportation allowances for eligible civilian employees and their 
family members.
    (4) Civilian employees or selectees assigned to positions overseas 
are generally responsible for obtaining medical and dental services and 
paying for such services, except services provided pursuant to 32 CFR 
part 57. Their family members may have access to the MHS on a space-
available, reimbursable basis only, except for services pursuant to 32 
CFR part 57.
    (i) The DoDEA and the Military Medical Department responsible for 
the provision of related services to support DoDEA at the duty station 
are required to evaluate school-aged children (ages 3 through 21 years, 
inclusive) eligible for enrollment in a DoDEA school on a space 
required basis and provide them with the special education and related 
services stipulated in their IEPs expeditiously and regardless of cost.
    (ii) The Military Departments are required to provide infants and 
toddlers (from birth up to 3 years of age, inclusive) eligible for 
enrollment in a DoDEA school on a space required basis

[[Page 76888]]

with the EIS stipulated in the IFSPs expeditiously and regardless of 
cost.
    (c) Processing a Civilian Employee for an Overseas Position. (1) 
When recruiting for an overseas position, DoD human resources 
representatives will:
    (i) Provide information on the requirements of this part related to 
civilian employees or applicants for employment, including employee 
rights provided in Sec.  75.8(a) of this part.
    (ii) Provide information on the availability of medical and 
educational services, including a point of contact for the applicant to 
ask about specific special needs. This information must be contained in 
any document used for recruitment for overseas positions.
    (iii) Include the following statements in recruitment information:
    (A) If an employee brings a child to an overseas location and that 
child is entitled to attend a DoD school on a space-required basis in 
accordance with DoDEA Regulation 1342.13 (available at http://www.dodea.edu/aboutDoDEA/upload/1342_13.pdf), the DoDEA and the 
Military Department responsible for providing related services will 
ensure that the child, if eligible for special education, receives a 
free appropriate public education, including related services pursuant 
to 32 CFR part 57.
    (B) If an employee brings an infant or toddler (up to 3 years of 
age) to an overseas location, and that infant or toddler, but for the 
child's age, is entitled to attend the DoDEA on a space-required basis 
in accordance with DoDEA Regulation 1342.13, then the Military 
Department responsible for EIS will provide the infant or toddler with 
the required EIS in accordance with the eligibility criteria consistent 
with 32 CFR part 57.
    (C) If an employee brings a family member to an overseas location 
who requires medical or dental care, then the employee will be 
responsible for obtaining and paying for such care. Access for civilian 
employees and their families to military medical and dental treatment 
facilities is on a space-available and reimbursable basis only.
    (2) When the gaining human resources representatives process a 
civilian for an overseas position where family member travel is 
authorized at government expense, then they must ask the selectee to 
determine whether a family member has special needs, using the criteria 
provided in Sec.  75.6 of this part. All selectees must be asked only 
after they have been notified of their selection in accordance with 29 
U.S.C. 791 through 794d, and 29 CFR 1630.14. If the selectee indicates 
that a family member has special needs:
    (i) The DoD civilian human resources representatives may not coerce 
or pressure the selectee to decline the job offer in light of that 
information.
    (ii) The selectee may voluntarily forward to the civilian human 
resources representative completed DD Forms 2792 or 2792-1 for each 
family member with special needs to provide information on the 
availability of medical and educational services. DD Form 2792-1 must 
be submitted if the selectee intends to enroll his or her child in a 
school funded by the DoD or a school in which DoD is responsible for 
paying the tuition for a space-required family member.
    (3) The gaining human resources activity will coordinate with the 
appropriate military medical and educational personnel on availability 
of services and inform the selectee in writing of the availability of 
medical, educational, and early intervention resources and services to 
allow the civilian employee to make an informed choice whether to 
accept the position. The notice will include:
    (i) Comprehensive medical, dental, and educational information on 
the overseas community where the position is located.
    (ii) A description of the local DoDEA facility and programs, 
specifying the programs for children with special education needs.
    (iii) A description of the local EIS available for infants and 
toddlers with disabilities.
    (iv) A statement indicating that the lack of EIS or special 
education resources (including related services assigned to the 
military medical departments) cannot serve as a basis for the denial of 
family travel at government expense and required services will be 
provided even if a local program is not currently established in 
accordance with 32 CFR part 57.
    (d) Use of EFMP Family Support Services.
    (1) Civilian employees may utilize EFMP family support services on 
a space available basis.


Sec.  75.9  Provision of family support services.

    (a) EFMP Family Support. EFMP family support services and their 
personnel:
    (1) Provide information and referral to military families with 
special needs.
    (2) Provide assistance, including non-clinical case management to 
families of active duty Service members (such as the development and 
maintenance of an individualized SP). The SP will include:
    (i) Identification of the family's current needs, the services they 
receive, and the support they require.
    (ii) Documentation of the support provided to the family and 
follow-on contacts, including case notes.
    (3) Refer families who have serious or complicated medical issues 
to the MHS to request medical case management.
    (4) Conduct ongoing outreach with military units, individuals and 
their families, other service providers, and military and community 
organizations to promote an understanding of the EFMP and to encourage 
families with special needs to seek support services when needed.
    (5) Serve as the point of contact with leadership in identifying 
and addressing the community support requirements of military families 
with special needs.
    (6) Collaborate with military, federal, State, and local agencies 
to share and exchange information in developing a comprehensive 
program.
    (7) Provide assistance before, during and after relocation, 
including coordination of services with the gaining installation's EFMP 
family support services program.
    (8) Educate and provide assistance to Service members and their 
families about EFMP family support services, the enrollment and 
assignment coordination process, resources, and other topics as 
appropriate.
    (b) Respite care. Family support services may include respite care 
services for family members regardless of the age of the family member


Sec.  75.10  Office of Community Support for Military Families with 
Special Needs (OSN).

    The OSN:
    (a) Develops and implements policies on the:
    (1) Provision of support for military families with special needs.
    (2) Identification and documentation of family members' special 
medical or educational needs.
    (3) Coordination of military assignments when the Service member 
has a family member with special needs.
    (4) Provision of EIS and special education services to eligible DoD 
family members in accordance with 32 CFR part 57.
    (b) Develops implementing guidance and forms necessary for the 
operation of the EFMP in accordance with this part.
    (c) Provides oversight for the:
    (1) Implementation of this part.
    (2) Availability and accessibility of programs provided by the 
Military Services and federal, State and local non-governmental 
agencies and identifies any gaps in DoD services available to military 
family members with special needs.
    (3) Provision of EIS and special education services to eligible DoD

[[Page 76889]]

family members in accordance with 32 CFR part 57.
    (d) Collaborates with the Office of the ASD(HA) on medical services 
regarding family members with special medical needs.
    (e) Develops and implements a Web-based data management system to 
support the EFMP with the Military Departments.

    Dated: December 7, 2015.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2015-31227 Filed 12-10-15; 8:45 am]
 BILLING CODE 5001-06-P


Current View
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionProposed Rules
ActionProposed rule.
DatesComments must be received by February 9, 2016.
ContactRebecca Lombardi, 571-372-0862.
FR Citation80 FR 76881 
RIN Number0790-AI82
CFR AssociatedChildren; Family Health and Special Needs

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