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Exceptional Family Member Program (EFMP) H&S Bn, HQMC, Henderson Hall

1555 Southgate Rd. Bldg 12, Arlington, VA 22214-5000

IMPORTANT EXCEPTIONAL FAMILY MEMBER PROGRAM INFORMATION ON

INITIAL ENROLLMENT, RE-ENROLLMENT, AND DISENROLLMENT

MANDATORY ENROLLMENT

Sponsors are required to identify and enroll all family members who have a medical (physical,

mental, and emotional) or educational condition at the time of identification or diagnosis of the

condition by a qualified medical provider or educational authority. Commandant of the Marine

Corps (CMC), Manpower and Reserve Affairs, will make final determination concerning EFMP

enrollment of Marine Corps sponsors (MCO 1754.4B, Chapter 2, 4.). The DD Form 2792, AUG2014 and/or DD Form 2792-1 (if applicable) must be completed and submitted to the

Installation EFMP office no more than 90 days after the qualified medical provider and/or

school official signs the forms. NOTE: EFMP enrollment does not affect career progression.

Additionally, the DD Form 2792-1, AUG 2014 must be submitted for:

All infants and toddlers (birth to age 3) receiving Early Intervention Services via an

Individualized Family Service Plan (IFSP) under the Individuals with Disabilities Education

Act (IDEA).

All school-age children (ages 3 through 21 inclusive) who are receiving special education

services via an Individualized Education Program (IEP) under IDEA.

Per reference (e) of the MCO 1754.4B, a Marine who fails or refuses to provide the required

information, or who knowingly provides false information, may be subject to disciplinary action.

Charges for offenses may fall under Article 92 (failure to obey a lawful order or regulation or

dereliction of duty) or Article 107 Military Justice (UCMJ). In addition to UCMJ disciplinary

action, the Marine may also be subject to administrative sanctions including denial of command

sponsorship.

MARINE’S RESPONSIBILITIES

Ensure that the application for enrollment in the EFMP is complete, correct, and current and

is submitted to the local EFMP installation office.

Retain a copy of the EFMP package for personal records and update enrollment through the

installation EFMP office at least every 3 years, or when the conditions of special need

change. Changes, which may affect enrollment, include a change in marital status,

dependency, or medical status of the Exceptional Family Member.

Communicate directly with Manpower Management Division at Headquarters, Marine Corps

when in receipt or in anticipation of orders.

Purpose. Per Marine Corps Order 1754.4B, the primary purpose of the Marine Corps Exceptional

Family Member Program (EFMP) is to ensure continuum of care for eligible Marine Corps family

members by identifying families with special needs, and maximizing confidentiality and the provision

of services to enhance the quality of life provided to the Marine Corps family in order to meet the

mission of the Marine Corps.

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Submit updated application requesting disenrollment from EFMP when a family member no

longer requires the special medical and/or special educational services. Changes which may

affect enrollment include a change in marital status or dependency.

Check in/out with the local EFMP office during PCS moves to ensure the EFMP case file is

maintained by the appropriate EFMP office.

RESPITE CARE

If the Sponsor’s EFMP enrollment is not current, the Sponsor is ineligible to receive respite care

reimbursement. When there are multiple EFMs, all EFMs must be current with their enrollment

for the Sponsor to be eligible to participate in the respite reimbursement program.

ORDERS

If orders are anticipated within the next 9 months, it is critical for the Sponsor to ensure accurate

and current information has been submitted. Outdated paperwork slows down the orders process,

and in some cases, may impact the Sponsor’s choice of assignments.

AS SPONSORS APPROACH THEIR EFMP ENROLLMENT EXPIRATION DATE

Ninety (90) days prior to expiration of enrollment, the Family Case Worker (FCW) is required to

notify the Sponsor by email to request that he or she complete and submit the DD Form 2792 and

DD Form 2792-1 (if applicable). Additionally, the FCW will send the email as “High

Importance” with “Read Receipt” and attach the DD Form 2792 and DD Form 2792-1 (if

applicable), as well as Enrollment Instructions. The FCW will document all communication with

the family in the Case Management System (CMS) database and post the applicable dates on the

enrollment update tracking tool.

Sixty (60) days prior to expiration of enrollment, the Family Case Worker (FCW) will notify the

Sponsor by telephone requesting that he or she complete and submit the required forms and this

contact will be documented in the CMS and on the tracking tool, along with the response from

the Sponsor. If there is no positive response from the Sponsor, the FCW will notate in the CMS

that the request to update has been elevated to the EFMP Program Manager.

NOTE: If Family Case Workers are unable to contact a Sponsor due to incorrect or outdated

phone numbers, they are to follow the guidance provided in “ASSISTANCE FROM HQMC

EFMP.”

Thirty (30) days prior to expiration of enrollment, the EFMP Program Manager will notify the

Sponsor by telephone to offer assistance or clarification if needed, and request that he or she

comply with the MCO 1754.4B. The PM will send the Sponsor a follow-up email as well. These

telephone calls and follow-up emails will be documented in the CMS as well as the FCW’s

tracking tool. If no update is received from the Sponsor, the EFMP Program Manager will

contact the Commander of the Sponsor to ask for assistance regarding the newly expired EFMP

enrollment within his or her unit. The FCW will continue to contact the Sponsor at least

quarterly to request compliance with MCO until the update is received.

ACCOUNTABILITY The Marine Corps Order allows the EFMP Program Manager to provide each unit commander with an EFMP Commander’s Report which lists the Marines under their command who are

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enrolled in the EFMP and the status of their enrollment. This list only includes the Sponsor’s

name, EFMP enrollment date, and enrollment expiration date. Adhering to privacy and

confidentiality, EFMP personnel will not provide any additional details or information to the

Commander. The primary purpose of this report is to ensure timely updates by the Sponsor

prior to the expiration date. The Commander’s Report is color coded as follows:

RED indicates that the Marine’s enrollment has expired.

YELLOW indicates that the Marine is within 90 days of his/her expiration date.

GREEN indicates that the Marine’s completed paperwork is in process at HQMC EFMP.

Per Henderson Hall EFMP Standard Operating Procedure (SOP), Commander’s Reports

are provided to each unit commander monthly.

NOTE: The EFMP Marine Corps Order 1754.4B and DD Forms 2792 and 2792-1 can be found

at: http://www.mccshh.com/EFMP.html.

I have read and understand the above information.

SIGNATURE OF SPONSOR and DATE SIGNATURE OF FCW and DATE

Exceptional Family Member Program (EFMP) H&S Bn, HQMC, Henderson Hall

1555 Southgate Rd. Bldg 12, Arlington, VA 22214-5000

Exceptional Family Member Program Clients Rights and Responsibilities Acknowledgement Form

You have certain rights guaranteed to you as a member of the Exceptional Family Member Program. We want you and your family members to know, understand, and exercise these rights, which are listed below. Please initial each and sign and below.

CONFIDENTIALITY & PRIVACY ___ I understand that per MCO 1754.4B, EFMP is a mandatory enrollment program. Sponsors are required to enroll all family members who have a medical (physical, mental, and/or educational) condition at the time of identification or diagnosis by a qualified medical provider or educational authority. ___ I understand that EFMP staff shall preserve the confidentiality of my Personally Identifiable Information (PII), and safeguard written and electronic correspondence and databases at all times. Only when indicated, and with a signed Authorization to Release and Consent to Exchange Information (NAVMC 11720) can my information be released to outside parties. ___ I understand that my DD Form 2792 and DD Form 2792-1 and any other medical documentation may be used by DoD personnel to evaluate service specific programs such as Overseas Suitability Screening (OSS) and to determine whether there are adequate medical, housing, and community resources at the sponsor’s proposed duty station.

PARTICIPATION IN FAMILY SUPPORT SERVICES ___ I understand that I will receive quarterly contacts via email or telephone call from my assigned Family Case Worker (FCW). ___ I understand that I have the right to decline Family Support Services by signing a declination of services waiver. However, I can still be contacted by the installation Program Manager when my case is about to expire, when PCS orders are received, and at the request of Headquarters Marine Corps EFMP. ___ I understand that I am eligible to receive direct family support services and assistance with enrollment, transition, and meetings for supported services when requested.

CLIENT RESPONSIBILITIES ___ I understand that that I am responsible for updating my paperwork every three years or when significant changes occur with my EFM’s medical, mental health, or educational care plan. ___ I understand that eligibility determination is made by HQMC EFMP. I also understand that I must submit documentation of changes to the EFM’s medical, educational, or dependency status in order to be considered for disenrollment from the program. ___ I understand that it is my responsibility to keep my Family Case Worker aware of any changes in my EFM’s dependency status, address changes, and/or any Early Return of Dependents (ERD)/Humanitarian Assignment (HUMS)/Tour Curtailments (TC) actions. ___ I understand that HQMC EFMP reviews orders to determine service availability. Neither the HQMC EFMP nor the Henderson Hall EFMP office at any time makes any assignment recommendations or suggestions about future locations. HQMC EFMP Assignment Coordinators only review and screen for service availability against current orders submitted to the Assignment System (WebMass) by my monitor. ___ I understand that all administrative actions such as ERD’s, HUMS, and TC must be submitted through my chain of command for review and action. EFMP does not make any administrative decisions. However, all medical administrative requests must have an accompanying EFMP enrollment.

___ EFMP FAMILIES HAVE THE RIGHT TO:

• be treated with respect, dignity, consideration, and compassion

• receive services free of discrimination on the basis of race, color, sex/gender, ethnicity, national

origin, religion, age, class, sexual orientation, and physical or mental ability

• participate in creating a plan for non-medical case management services if necessary for systems

navigation support

• be informed about available services and options

• reach an agreement with their EFMP Family Case Worker (FCW) on frequency of contact

• withdraw voluntary consent to participate in non-medical case management/systems navigation

• have records treated confidentially

• be informed of the limitations of privacy, including mandated reporting and duty to warn (refer to

Notification of Privacy Limitations form)

• file a grievance about services received or for services denied

• be free from physical, sexual, verbal and/or emotional abuse or threats

___ EFMP FAMILIES ACCEPT RESPONSIBILITY FOR THE FOLLOWING:

• treating other families and EFMP staff with respect and courtesy

• protecting the confidentiality of other families within the EFMP

• participating as much as possible in creating a plan for non-medical case management/systems

navigation

• advising the EFMP FCW on any concerns regarding their plan or changes in their needs

• making and keeping appointments to the best of their ability; cancelling or changing

appointments whenever necessary

• staying in communication with the EFMP FCW by maintaining updated contact information and

responding to the EFMP FCW's inquiries to the best of their ability

I understand the above information and I have received a copy for my records.

Client’s Name (Print) EFMP FCW’s Name (Print)

Client’s Signature Date EFMP FCW’s Signature Date

Exceptional Family Member Program (EFMP) H&S Bn, HQMC, Henderson Hall

1555 Southgate Rd. Bldg 12, Arlington, VA 22214-5000

EFMP Enrollment, Update, & Disenrollment Instructions To be enrolled in the EFMP program, your family member(s) must also be enrolled as a dependent in the Marine Corps Total Force System (MCTFS) and the Defense Eligibility Enrollment Reporting System (DEERS). EFMP enrollment information must be updated at least every three years, or sooner, as information or conditions change.

Service Members/Sponsors need to ensure that the application for enrollment in the EFMP is complete, correct, and submitted to the local EFMP installation office in a timely manner: no more than 90 days after the qualified medical provider signs the DD Form 2792 and the school official signs the DD Form 2792-1.

**Due to changes in DoD privacy policy, please use your DoD ID card # instead of your Social Security number on the enrollment forms (DD form 2792 and DD form 2792-1).**

Forms for enrollment, update, and disenrollment include:

• DD 2792—Medical Summaryo Pages 1 and 2 to be completed by sponsor or family member over the age of 18 (unless

power of attorney, conservatorship, guardianship, etc.).o Sponsor signs page 1 and page 3 (Blocks 11 – a, b, & c).o Pages 4 to 7 to be completed by medical provider, along with pages 8-11, if applicable.

• DD 2792-1—Special Education/Early Intervention Summary is required for allinfants/toddlers (birth to age 3) and school-age children (3 to 21) receiving services underthe Individuals with Disabilities Education Act.

o Page 2 to be completed by sponsor, parent, or guardian.o Page 3 to be completed by early intervention or special education professional.

If your child has an Individualized Family Services Plan (IFSP) or an Individualized Education Program (IEP), please attach a copy of the most recent one to the DD 2792-1.

The EFMP Marine Corps Order 1754.4B, DD Forms 2792 and 2792-1, and sample instructions can be found at the Henderson Hall Exceptional Family Member Program webpage: www.mccshh.com/efmp.html.

Submission of completed forms:

• Deliver to Henderson Hall, Bldg. 12 (EFMP office) or scan and email to efmphh@usmc-mccs.org (please encrypt your emails when sending PII)

For questions, please call Family Case Workers: 703-693-4172/6510 Thank You

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