EFMP

A1. Approximately 85% of those enrolled in EFMP are approved for travel to Europe. The top reasons Families may be denied Family travel are moderate to severe asthma, diabetes or other life threatening conditions, mental health concerns, chronic or life threatening conditions that require specialized medical or educational services.

However, each case is reviewed as a unique case and a diagnosis that may be denied travel for one Family member may not be denied for another because of varying factors (symptom frequency, intensity, duration, medication needs, etc.).

Furthermore, there are other considerations beyond type of healthcare providers such as educational concerns, housing concerns, medical adaptive equipment (splints, wheelchair, orthotics, home oxygen therapy, and so forth).

A2. Every clinic in Europe has a unique set of resources and healthcare providers. Due to providers’ deployments, these resources change over time as well. Furthermore, due to USAREUR’s transformation and the drawdown of assets in Europe, the number and type are constantly evolving.

Europe has changed from having three hospitals to one—Landstuhl Regional Medical Center in Western Germany near Kaiserslautern--and increased reliance on the host nation economy for specialty care. The best way to understand the current resources by location is at the Army Medicine website. There is also a host nation guide to healthcare at this website.

A3. Europe is a great place to serve, and it has first-rate healthcare, but healthcare, like food and housing and entertainment, can be different here. Do not expect the host nation medical system to be like exactly like ours; it follows the host country cultural norms.

We follow the Department of Defense Instruction which states "Family member travel at government expense may be denied when an active duty Service member has a family member with special medical needs and the service to meet those need are unavailable in the overseas location, as determined by the military healthcare system, based on acceptable US health care standards.”

We will take host nation resources into account for care when we know that the service delivery system will meet the particular medical needs of the family. In certain subspecialties, Family travel may be denied due to host nation care not meeting US standards of care. European healthcare is geographically specific and although excellent, does differ from US Standard in most areas.

A4. Soldiers and Family members should contact their local military treatment facility EFMP Case Coordinator or the local Army Community Service EFMP Manager (where the Soldier is currently stationed – not the overseas locations). These case coordinators can track down the location of a particular action and help the Family member with the processing of medical paperwork.

IMCOM also has EFMP System Navigators who help Families with EFMs move through the many facets of the PCS Process and help them navigate through services available to them at their gaining assignment. There is more information at Armyonesource.com about EFMP Systems Navigators.

Enrollment allows assignment managers at military personnel agencies to consider the documented medical needs of exceptional Family members in the CONUS assignment process (educational needs are taken into consideration only in an OCONUS assignment). When possible, Soldiers are assigned to an area where the medical and special education needs of their exceptional Family member can be met. This will depend upon a valid personnel requirement for the Soldier's grade, specialty and eligibility for the tour. All Soldiers are still eligible for worldwide and unaccompanied assignments.

The following Army components with exceptional Family members must enroll in the program:

• Active Army
• Active Guard Reserve Program. Mobilized and deployed Soldiers are not eligible for enrollment in EFMP.
• Army National Guard AGR personnel serving under authority of Title 10, United States Code and Title 32, United States Code.

Soldiers that are members of the Army Married Couples Program will both enroll in the EFMP when they have a qualified Family member. Department of the Army civilians will identify dependent children with special education and medically related service needs as well as adult Family members with medical needs each time they process for an assignment to a location outside the United States where Family member travel is authorized at Government expense.

In general, an active duty Family member qualifies for EFMP if they:

• Require medical care above the level normally provided by a general medical officer (GMO) in an outpatient setting, to include those who require follow-up with a specialist.
• Have serious or chronic medical problems, physical disabilities, behavioral health concerns, or require intensive follow-up support or early intervention/special education services.

Common Diagnoses for Enrollment:

• ADD/ADHD/ODD (if the Family member is on more than one medication, has a co-morbid condition or receives any counseling)
• Allergies (if the Family member requires allergy shots or follow-up with an allergist more than once a year)
• Asthma/RAD (unless it is mild and does not necessitate controller meds)
  
• Autism/Pervasive Developmental Disorders (all require medical enrollment, may also require educational enrollment)
• Autoimmune/Neuromuscular Disorders (such as Muscular Dystrophy, Lupus, Multiple Sclerosis, Rheumatoid Arthritis)
• Behavioral Health Conditions (Anxiety Disorder, Bipolar Disorder, Depression, Eating Disorder, Obsessive Compulsive Disorder, PTSD, Schizophrenia, etc. All must be enrolled who have been treated with medication or received therapy within the last 5 years.)
• Cancer (unless the Family member has completed treatments, is in remission > 5 years, and requires no further follow-up)
• Cervical Dysplasia/Abnormal Pap smear (if the Family member requires pap smears 2x/year or greater or if the Family member requires colposcopy)
• Cerebral Palsy or Loss of Mobility
• Cleft Lip/Palate 
• Developmental Delay (including those receiving early intervention services or speech treatment, PT, or OT)
• Diabetes (all IDDM; any NIDDM requiring frequent or specialist follow-up.)
• Equipment (e.g., g-tube, O2, pacemaker, shunt, tracheostomy, wheelchair or other aide, insulin pump)
• Genetic Disorders/Congenital Anomalies
• Hearing Problems/Deafness
• Heart Conditions
• Inflammatory Bowel Disease
• Immunodeficiency 
• Premature or High Risk Infants
• Seizure Disorders/Epilepsy
• Sickle Cell Disease/Bleeding
• Special Education/Early Intervention Requirements
• Substance Abuse
• Thyroid Problems
• Vision Problems/Blindness

Any other medical, educational or behavioral health condition should be considered if follow-up with a specialist is required. These include but are not limited to: Allergy/Immunology, Neurosurgery, Audiology, Obstetrics/Gynecology, Cardiology, Oncology, Dermatology, Ophthalmology, Developmental Pediatrics, Orthopedic Surgery, Endocrinology, Otolaryngology (ENT), Gastroenterology, Psychology, Hematology, Psychiatry, Infectious Disease, Pulmonology, Internal Medicine, Rheumatology, Neonatology, Surgery, Nephrology, Urology, and/or Neurology.

To learn more about EFMP Enrollment or Overseas Screening, please visit the AMEDD EFMP Website here.

Resources:

• Congratulations on your assignment to Europe!
• Further information on medical treatment in Europe

"I will be forced into assignments that will hinder promotions and career opportunities"
Enrollment cannot prejudice advancement or career opportunities of sponsors.  The sponsor has the option of accepting an assignment while the Family is supported in another location.

"As an EFMP sponsor, I cannot be deployed"
The program has no impact on the deployment responsibilities of the sponsor.  Overseas unaccompanied, unit deployments, and standard deployments must be carried out without interruption. A Family Care Plan is the means to provide for a Family member with special needs when the Soldier is deployed, TDY, or otherwise not available because of military duty. To learn more about Family Care Plans, please consult your Commander or visit Military One Source.

"Enrollment in the program will allow me to select a duty station"
The program ensures that the sponsor will be assigned to a location where appropriate services exist.  Branch will begin the nominative process and Family enrollment information will be forwarded to the gaining installation medical treatment facility's EFMP point-of-contact, who will assess area resources based on enrolled conditions. If services are available, the assignment process will move forward.

"I will not be eligible for an overseas accompanied assignment as an EFMP sponsor"
Overseas screening is the same for all Families anticipating accompanied orders. If the special needs of the Family member can be met by the gaining installation, an accompanied assignment may be authorized.