R 241558Z AUG 11 ALCOAST 400/11 COMDTNOTE 1754 SUBJ: SPECIAL NEEDS PROGRAM POLICY UPDATES 1. THIS ALCOAST ESTABLISHES SPECIAL NEEDS PROGRAM POLICY THAT WILL BE INCORPORATED INTO THE REVISION OF REFERENCE (A). THE POLICY BECOMES EFFECTIVE ON 1 OCTOBER 2011, WITH FULL COMPLIANCE EXPECTED BY 1 JANUARY 2012. 2. THE SPECIAL NEEDS PROGRAM IS A MANDATORY ENROLLMENT PROGRAM FOR ALL ACTIVE DUTY (AD) AND SELECTED RESERVE MEMBERS ON ORDERS FOR 180 DAYS OR MORE (HEREINAFTER REFERRED TO AS AD MEMBERS) WHO HAVE DEPENDENT FAMILY MEMBERS DIAGNOSED WITH MEDICAL, PSYCHOLOGICAL, PHYSICAL, OR EDUCATIONAL SPECIAL NEEDS. THE OBJECTIVE OF THE PROGRAM IS TO IDENTIFY AND SUPPORT THE SPECIAL NEEDS OF A COAST GUARD FAMILY WHILE ALLOWING THE ACTIVE DUTY MEMBER TO MAINTAIN THE MAXIMUM ASSIGNMENT FLEXIBILITY POSSIBLE. 3. AD MEMBERS MUST ENROLL IN THE SPECIAL NEEDS PROGRAM IF THEY HAVE FAMILY MEMBERS WHO MEET ONE OR MORE OF THE FOLLOWING CONDITIONS: A. MEDICAL SPECIAL NEEDS: (1) MEDICAL CONDITIONS WHICH WOULD LIMIT THE WORLDWIDE ASSIGNMENT ABILITY OF AD MEMBERS (SUCH AS AUTISM, HIGH-RISK NEWBORNS, SICKLE CELL DISEASE, INSULIN-DEPENDENT DIABETES, HUMAN IMMUNODEFICIENCY VIRUS). (2) MEDICAL CONDITIONS THAT REQUIRE MONITORING ON A PERIODIC BASIS DUE TO THE POTENTIAL OF LIMITING MEMBERS WORLDWIDE ASSIGNMENT (SUCH AS REMISSION OF CANCER WITHIN THE LAST 5 YEARS). (3) POTENTIALLY LIFE-THREATENING MEDICAL CONDITIONS (SUCH AS HIGH RISK PREGNANCY, AIDS). (4) DIAGNOSIS OF ASTHMA OR OTHER RESPIRATORY-RELATED DIAGNOSIS WITH CHRONIC RECURRING WHEEZING WHICH MEETS ONE OF THE FOLLOWING CRITERIA: (A) SCHEDULED USE OF INHALED AND ANTI-INFLAMMATORY AGENTS AND/OR BRONCHODILATORS. (B) HISTORY OF EMERGENCY ROOM USE OR CLINIC VISITS FOR ACUTE ASTHMA EXACERBATIONS WITHIN THE LAST YEAR. (C) HISTORY OF ONE OR MORE HOSPITALIZATIONS FOR ASTHMA WITHIN THE PAST 5 YEARS. (D) HISTORY OF INTENSIVE CARE ADMISSIONS FOR ASTHMA WITHIN THE PAST 5 YEARS. B. PSYCHOLOGICAL SPECIAL NEEDS: (1) CURRENT AND CHRONIC (DURATION OF 6 MONTHS OR LONGER) MENTAL HEALTH CONDITION (SUCH AS BIPOLAR DISORDER, MAJOR DEPRESSIVE DISORDER, SUBSTANCE ADDICTION, AND/OR PERSONALITY DISORDERS). (2) INPATIENT, OR INTENSIVE OUTPATIENT MENTAL HEALTH SERVICES WITHIN THE LAST 5 YEARS (SUCH AS DAY TREATMENT PROGRAM, COUNSELING PROVIDED AT FREQUENCY GREATER THAN 1 TIME PER WEEK, ETC). (3) INTENSIVE (GREATER THAN ONE VISIT MONTHLY FOR MORE THAN 6 MONTHS) MENTAL HEALTH SERVICES REQUIRED AT THE PRESENT TIME (CONSISTING OF MEDICAL CARE FROM ANY PROVIDER, INCLUDING A PRIMARY HEALTH CARE PROVIDER). (4) DIAGNOSIS OF ATTENTION DEFICIT DISORDER AND/OR ATTENTION DEFICIT HYPERACTIVITY DISORDER THAT MEETS ONE OF THE FOLLOWING CRITERIA: (A) FAMILY MEMBER HAS ANY ADDITIONAL PSYCHOLOGICAL DIAGNOSIS. (B) FAMILY MEMBER REQUIRES MULTIPLE MEDICATIONS, PSYCHO-PHARMACEUTICALS (OTHER THAN STIMULANTS) OR DOES NOT RESPOND TO NORMAL DOSES OF MEDICATION. (C) FAMILY MEMBER REQUIRES MANAGEMENT AND TREATMENT BY MENTAL HEALTH PROVIDER (FOR EXAMPLE, PSYCHIATRIST, PSYCHOLOGIST, AND/OR SOCIAL WORKER). (D) FAMILY MEMBER REQUIRES A MENTAL HEALTH SPECIALTY CONSULTANT, OTHER THAN A FAMILY PRACTICE PHYSICIAN OR GENERAL MEDICAL OFFICER, MORE THAN TWICE A YEAR ON A CHRONIC BASIS. (E) FAMILY MEMBER REQUIRES MODIFICATION OF THE EDUCATIONAL CURRICULUM OR THE USE OF BEHAVIORAL MANAGEMENT STAFF. C. PHYSICAL SPECIAL NEEDS: (1) FAMILY MEMBER REQUIRES ADAPTIVE EQUIPMENT FOR 6 MONTHS OR LONGER (SUCH AS AN APNEA HOME MONITOR, HOME NEBULIZER, WHEELCHAIR, SPLINTS, ORTHOTICS, HEARING AIDS, HOME OXYGEN THERAPY, HOME VENTILATOR, ETC). (2) FAMILY MEMBER REQUIRES ENVIRONMENTAL AND/OR ARCHITECTURAL CONSIDERATIONS (SUCH AS LIMITED NUMBER OF STEPS, WHEELCHAIR ACCESSIBILITY AND/OR HOUSING MODIFICATIONS, AND AIR CONDITIONING). (3) FAMILY MEMBER REQUIRES ASSISTIVE TECHNOLOGY DEVICES (SUCH AS COMMUNICATION DEVICES) OR SERVICES. D. EDUCATIONAL SPECIAL NEEDS: (1) CHILD (BIRTH THROUGH 2 YEARS OF AGE) HAS OR REQUIRES AN INDIVIDUALIZED FAMILY SERVICE PLAN (IFSP). (2) CHILD (3 THROUGH 21 YEARS OF AGE) HAS OR REQUIRES AN INDIVIDUALIZED EDUCATION PLAN (IEP). 4. SPECIAL NEEDS PROGRAM ENROLLMENT UPDATES FOR EACH FAMILY MEMBER ENROLLED IN THE PROGRAM ARE DUE EVERY 3 YEARS, NORMALLY WHEN THE MEMBER SUBMITS HIS/HER E-RESUME. EXCEPTIONS TO THIS TIMELINE (I.E., INSTANCES REQUIRING AN UPDATE) ARE AS FOLLOWS: A. THERE IS A CHANGE IN MEDICAL OR MENTAL HEALTH RELATED DIAGNOSIS, OR A NEW DIAGNOSIS DEVELOPS. B. THERE IS A CHANGE IN EARLY INTERVENTION OR SPECIAL EDUCATION NEEDS. C. IF AN UPDATE IS DUE AT THE TIME OF A PROJECTED ROTATION DATE (PRD), IT MUST BE INITIATED AT LEAST 9 MONTHS PRIOR TO THE PRD. 5. DISENROLLMENT FROM THE SPECIAL NEEDS PROGRAM SHALL OCCUR WHEN ANY OF THE FOLLOWING SITUATIONS OCCUR: A. IF SPECIAL MEDICAL, PSYCHOLOGICAL, SPECIAL ACCOMMODATIONS, OR EDUCATIONAL SERVICES ARE NO LONGER REQUIRED FOR A FAMILY MEMBER, AS VALIDATED BY A HEALTHCARE PROVIDER OR SCHOOL OFFICIAL. MEDICAL AND MENTAL HEALTH CONDITIONS MUST BE IN REMISSION FOR A MINIMUM OF 3 YEARS WITH NO MORE THAN ROUTINE PRIMARY CARE NEEDED. B. IF THE DEPENDENT CHILD IS NO LONGER THE MEMBERS DEPENDENT, OR DOES NOT RESIDE WITH THE SERVICE MEMBER WHICH WOULD AFFECT HIS/HER AVAILABILITY FOR WORLDWIDE ASSIGNMENT, UNLESS ENROLLMENT IN SPECIAL NEEDS PROGRAM IS REQUIRED FOR A PROGRAM FOR WHICH THE DEPENDENT IS OTHERWISE QUALIFIED, SUCH AS TRICARE ECHO. C. IN THE EVENT OF DIVORCE, LOSS OF CUSTODY, OR DEATH OF THE FAMILY MEMBER WITH SPECIAL NEEDS. BAH/DEPENDENCY STATUS IN DIRECT ACCESS WILL BE VERIFIED BY THE SERVICING HEALTH, SAFETY, AND WORK LIFE (HSWL) FAMILY RESOURCE SPECIALIST (FRS) TO CONFIRM DEPENDENCY INFORMATION. IN CASES INVOLVING CHILD CUSTODY ISSUES, A MEMO FROM A MEMBER SHALL BE FORWARDED TO THE HSWL FRS REQUESTING DISENROLLMENT FROM THE SPECIAL NEEDS PROGRAM. THE MEMO SHOULD INCLUDE THE FOLLOWING INFORMATION: (1) FIRST AND LAST NAME OF THE FAMILY MEMBER WITH SPECIAL NEEDS AND HIS/HER RELATIONSHIP TO THE SPONSOR. (2) TYPE OF DOCUMENT CITED (DIVORCE DECREE OR CUSTODY ORDER SIGNED BY A JUDGE, OR OTHER OFFICIAL DOCUMENTATION THAT SHOWS CHANGE IN DEPENDENCY STATUS). (3) EFFECTIVE DATE OF THE CHANGE IN DEPENDENCY STATUS. (4) INFORMATION ON WHO HAS RESIDENTIAL CUSTODY OF THE CHILD WITH SPECIAL NEEDS. INFORMATION PROVIDED IN THE MEMO MAY BE VERIFIED BY THE HSWL FRS. D. MEMBERS WHO HAVE RESIDENTIAL CUSTODY OF THEIR CHILDREN FOR 30 PERCENT OF THE TIME OR LESS, ANNUALLY, ARE NOT REQUIRED TO ENROLL IN THE SPECIAL NEEDS PROGRAM, OR THEY MAY BE DISENROLLED BY PRODUCING APPROPRIATE DOCUMENTATION (AS DESCRIBED ABOVE IN 5.C.(1),(2),(3),AND (4)). E. SEPARATION FROM A SPOUSE WITH SPECIAL NEEDS IS NOT GROUNDS FOR DISENROLLMENT FROM THE SPECIAL NEEDS PROGRAM. DISENROLLMENT BECAUSE OF DIVORCE CAN ONLY BE COMPLETED UPON FINAL TERMINATION OF THE MARRIAGE. F. RETIREMENT, DISCHARGE, OR TRANSFER TO RESERVE STATUS OF AN AD MEMBER WILL PROMPT AUTOMATIC DISENROLLMENT FROM THE SPECIAL NEEDS PROGRAM. 6. FOR ALL NEW ENROLLMENTS AND ENROLLMENT UPDATES PROCESSED AFTER THE EFFECTIVE DAY OF THIS POLICY, DD FORM 2792 (FOR MEDICAL, PSYCHOLOGICAL, AND PHYSICAL CONDITIONS) AND DD FORM 2792-1 (FOR EDUCATIONAL SPECIAL NEEDS) SHALL BE COMPLETED BY THE FAMILY MEMBERS MEDICAL PROVIDER OR SCHOOL PERSONNEL (RESPECTIVELY) AND SUBMITTED BY THE MEMBER TO THE SERVICING HSWL FRS. NO ADDITIONAL MEDICAL DOCUMENTATION WILL BE REQUIRED. THE FRS WILL FORWARD THE DD FORM 2792 AND 2792-1 TO THE COGNIZANT CG SENIOR MEDICAL EXECUTIVE (SME) FOR VERIFICATION OF ELIGIBILITY FOR ENROLLMENT. AS WARRANTED, THE FRS WILL VERIFY EDUCATIONAL ELIGIBILITY FOR ENROLLMENT BY REVIEWING CHILDS IEP OR IFSP. A DETAILED STANDARD OPERATING PROCEDURE WILL BE PROVIDED TO THE SMES AND FRSS FOR ADDITIONAL GUIDANCE IN THE NEAR FUTURE. 7. COMMANDING OFFICERS AND OFFICERS-IN-CHARGE SHALL ENSURE THAT ALL AD MEMBERS ARE MADE AWARE OF THIS POLICY. THEY SHALL ALSO ENSURE THAT ALL AD MEMBERS WHO HAVE FAMILY MEMBERS WITH SPECIAL NEEDS MEETING THE CRITERIA LISTED ABOVE COMPLY WITH THE MANDATORY ENROLLMENT REQUIREMENT. 8. POC FOR THIS MATTER IS MS. MARTA DENCHFIELD, SPECIAL NEEDS PROGRAM MANAGER. SHE MAY BE REACHED AT 202-475-5156 OR BY EMAIL AT MARTA.E.DENCHFIELD(AT)USCG.MIL. 9. RELEASED BY RADM MARK TEDESCO, DIRECTOR OF HEALTH, SAFETY, AND WORK LIFE. 10. INTERNET RELEASE AUTHORIZED.