[Federal Register Volume 80, Number 238 (Friday, December 11, 2015)]
[Proposed Rules]
[Pages 76881-76889]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[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