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Health and Fitness

Caring For Exceptional Family Members

EFMP ensures all resources needed are readily available

Boy or girl, when news of a pregnancy arrives, most parents are only hoping for a healthy child. When Tristan was born, his parents could not have imagined the long road that lay ahead for their second son to get to good health.

"He was born and we never really knew anything was wrong," said Electronics Technician 1st Class Stephanie Harris, who was a recruiter in San Diego at the time and is now a recruiter in Fairfax, Va. "We realized he had a protrusion coming from his stomach one time when he was one year old and we took him in. They started doing a whole bunch of testing and found that he had been born with this really rare and severe malformation of his renal and urinary system and needed several surgeries. That was when we started the enrollment process for the [Exceptional Family Member Program (EMFP)]."

The EFMP is a quality of life program that is mandated for all Sailors who have family members with a chronic medical or educational condition which requires special care and services.

The program was established in 1987 to ensure that when a Sailor is in the process of a permanent change of station (PCS) to a new duty station, any special needs required for a family member can be met at that new location. The Navy currently has over 17,000 family members enrolled in the program, which is broken up into six categories depending on the needs of each family member.

"Enrollment into the EFMP means a medical or educational need has been identified. We want to ensure current and future assignments can support those needs for a successful tour for both the service member and their family," said Lt. Cmdr. Brent Dennis, the Navy Program Manager for the EFMP. "Category one is for monitoring purposes. Category two pinpoints various overseas and remote locations within the United States. Category three is no overseas assignments because the family member has a medical or educational need that exceeds the availability of care. Category four means we have to keep you close to a major medical area within the continental U.S. (CONUS). Category five is treated like the homestead program where the needs are specialized and complex. In an effort to maintain a continuity of care the Sailor and family are placed in a location that provides what the family needs, and the Navy tries to keep them there. To meet the Sailor's career progression needs unaccompanied tours are always an option no matter what category their family member is assigned to. Category six is a temporary category used for short term medical evaluation that requires enrollment for six to twelve months."

Getting Tristan enrolled in the program came with its own hardships. Significant paperwork was needed by his parents and his doctors. That paperwork then needed to be sent up the chain for review.

"It was a little bit challenging," said Harris. "It's a large stack of paperwork. As a result of what we went through with Tristan, I became the EFMP coordinator at my command because there are so many things I found out afterward. I didn't have an EFMP coordinator; I was really on my own when I enrolled him. There's a good amount of paperwork that you fill out and then you have to take it to your doctor or specialist. It's mostly done by them, which is actually the most challenging part because you have to follow up with them and sometimes before they can give any of the paperwork back, they have to get it to their legal department and have the legal department review it because all of these healthcare facilities and hospitals have different requirements."

Harris said once you're in a category like category three, it is just saying that you can't be stationed overseas.

She said because of Tristan's particular condition, the types of doctors that our child needs are not close to every military base, so that's taken into consideration whenever we move.

When a condition is identified by a member of the healthcare or educational team, the family is referred to the EFMP coordinators at the local medical treatment facility or fleet and family service centers, said Dennis.

"The EFMP coordinators will assist the sponsor and family members with the enrollment process. The forms are reviewed to ensure they are complete and then sent to a central screening committee (CSC) for a category recommendation. The Navy currently has three screening committees located at Naval Medical Center (NMC) Portsmouth, NMC San Diego and U.S. Naval Hospital Yokosuka. Once the (PERS-456) get the CSC's review, a final category is assigned and that information is made available for the Detailers," said Dennis. "The enrollment process is much faster now that we are using the Navy Family Accountability and Assessment System (NFAAS). There are also automated notifications to the sponsors and the units to inform about enrollment and any category assignment and changes. The system even sends notifications to Sailors who need to update their EFMP status."

"The challenges that we as detailers have, is finding a billet that meets the category for the member," said Aviation Boatswain's Mate Handling (ABH) 1st Class Ronnie Hubbard, an ABH detailer.

When it was time for the Harris' to move, one big concern was what the quality of the care was going to be for Tristan at their new duty station.

"We've been so lucky when it comes to healthcare," said Harris.

Harris said when he was in San Diego, the military hospital did not have the types of doctors and surgeons that Tristan needed, so the doctors referred him to Rady Children's Hospital.

"We were at a children's hospital, which was an amazing, beautiful facility and that's where his surgeries and recoveries were and he got really amazing care there," said Harris. "When we came here we found out that they actually have pediatric nephrologists at Bethesda at Walter Reed and I was very anxious about that. I did not think that we were going to get the same level of care through the military medical center but it is amazing. It is absolutely amazing. The team of doctors they have there are so great and so attentive."

"Enrollment is mandatory to support the detailing process," said Dennis. "The primary goal is focused on the family member to ensure their medical and educational needs are met."

The process does not end once a Sailor enrolls their family member in EFMP. Continued attention and follow-up is required.

Once enrolled, everyone is assigned a case manager who is there to assist the sponsors and families with information about services and programs in the area. All enrolled need to get reevaluated every three years or twelve months prior to the next PCS. The case managers or local EFMP coordinators can assist the family with the reevaluation process.

"It's intimidating when you look at the paperwork that you have to do to enroll in EFMP and I think a lot of Sailors are not enrolling their family members in EFMP, but it is worth it because if anything should happen and they try to put in for something like a home tour, it's harder to substantiate their family's needs if they haven't already done that groundwork," said Harris.

"First and foremost, sponsors and family members need to get in contact with their local EFMP coordinator when they have been recommended for enrollment," said Dennis. "We have EFMP coordinators and liaisons at the fleet and family service centers and all naval medical treatment facilities. These folks know the program and they are there to help the sponsor and family members complete the enrollment paperwork. All units should assign an EFMP point of contact that can direct the service member to their local EFMP coordinator. The EFMP point of contact is usually someone in medical or it could be a career counselor or the command master chief."

For the Harris family, they understand that with their EFMP category the dream orders overseas are unlikely, but they are getting closer to their wish for a healthy child.