Last updated 4 days ago. Our resources are updated regularly but please keep in mind that links, programs, policies, and contact information do change.
Military life presents distinct challenges for all families with its frequent relocations, deployments, and separations. For military families with a member who has special medical or educational needs, navigating these challenges while ensuring access to necessary care requires additional support. The Department of Defense (DoD) established the Exceptional Family Member Program (EFMP) to address these needs.
EFMP is a mandatory enrollment program for active-duty service members who have dependents requiring ongoing specialized medical or educational services. The program’s primary function is to ensure that the special needs of family members are considered during the military assignment process, helping families relocate to duty stations where necessary services are available.
While the U.S. Coast Guard is not part of the DoD EFMP, it maintains a comparable mandatory program called the Special Needs Program (SNP) for its members.
Historically, EFMP implementation varied across military branches, creating inconsistencies for families navigating the system, particularly during PCS moves. After feedback from military families and advocacy groups, Congress mandated standardization efforts. In response, the DoD issued updated policy guidance in June 2023 (DoD Instruction 1315.19) aimed at creating a more consistent EFMP experience across all services.
What is the EFMP?
The Exceptional Family Member Program is a mandatory DoD enrollment program for active-duty service members with family members who have special medical or educational needs. Its core purpose is to provide a coordinated approach to community support, housing, medical, educational, and personnel services for these families.
The most critical function is ensuring that family members’ documented special needs are considered during the assignment coordination process. This involves verifying the availability of necessary medical and educational services at potential duty stations before orders are finalized.
The Three Pillars of EFMP
The EFMP functions through three interconnected components:
Identification and Enrollment
This is the entry point into the program. It involves identifying family members who meet the DoD criteria for special medical or educational needs and formally enrolling the active-duty sponsor. Medical services typically coordinate the documentation and enrollment process.
Assignment Coordination
Once enrolled, the family member’s documented needs become a factor in the assignment process. EFMP assignment staff work with military personnel departments to match the service member’s assignment with locations that have the necessary resources to support the family member’s needs, while balancing military mission requirements.
Family Support
This component, often located at installation Military and Family Support Centers, provides ongoing assistance to enrolled families. Services include:
- Information and referral to military and community resources
- Non-clinical case management
- Help developing family service plans
- Educational resources
- Transition support during PCS moves
- Connections to support groups and respite care information
Key Governing Policies
The primary DoD-level policy governing the EFMP is DoD Instruction 1315.19, with the most recent version effective June 23, 2023. This instruction establishes overarching policy, assigns responsibilities, and prescribes procedures for implementing all aspects of the program.
Each military service implements the program through its own regulations:
- Army: Army Regulation (AR) 608-75
- Navy: OPNAV Instruction 1754.2 series
- Air Force/Space Force: Air Force Instruction (AFI) 40-701
- Marine Corps: Marine Corps Order (MCO) P1754.4A
- Coast Guard: Commandant Instruction (COMDTINST) 1754.7 series (for SNP)
Recent emphasis on standardization underscores that previous inconsistencies were a major source of frustration for families. Reports from the Government Accountability Office (GAO) and the DoD Inspector General confirmed these issues, noting a lack of standardized procedures and performance metrics. While consistency is the goal, families should be aware that implementation of standardized policies may occur gradually across different services and installations.
Are You Required to Enroll?
Understanding who needs to enroll in EFMP is the first step. Enrollment is not optional if the criteria are met.
Who is Eligible to Enroll?
The Sponsor
Enrollment is mandatory for active-duty service members in the Army, Navy, Air Force, Marine Corps, and Space Force who have a family member meeting specific medical or educational criteria. This includes Army Active Guard Reserve (AGR) personnel.
Eligibility for National Guard and Reserve members typically depends on being on extended active duty orders (e.g., >30 days for Army USAR, >31 days activation for Air Force/Guardian respite care, >180 days for Coast Guard SNP enrollment). Drilling Guard/Reserve members are generally not eligible for EFMP enrollment itself, as assignment coordination is tied to active duty status.
The Family Member
A qualifying family member is a dependent enrolled in the Defense Enrollment Eligibility Reporting System (DEERS) who requires specialized services. This typically includes:
- Spouses
- Children (biological, adopted, stepchildren) under age 21 (or 23 if a full-time student under certain circumstances)
- Incapacitated children age 21 or older who are unmarried, incapable of self-support due to a mental or physical condition existing before age 21 (or 23 if a student), and dependent on the sponsor for over 50% of their support
- Other legal dependents, such as dependent parents or court-appointed wards, may also qualify under specific dependency and support criteria
Defining Special Medical Needs
According to DoD Instruction 1315.19, a family member meets the criteria for special medical needs if they have one or more of the following:
- Potentially life-threatening conditions or chronic medical/physical conditions lasting 6 months or longer that require follow-up care from a primary care manager more than once a year, or require specialty care. Common examples include:
- Asthma
- Diabetes
- Cancer diagnosed within the last five years
- Epilepsy
- Multiple sclerosis
- Chronic heart conditions
- Sickle cell disease
- Conditions requiring follow-up for high-risk newborns
- Current and chronic mental health conditions (lasting 6 months or longer), such as:
- Bipolar disorder
- Conduct disorder
- Major affective disorders
- Thought disorders
- Personality disorders
- Asthma or other respiratory-related diagnoses with chronic recurring symptoms that meet specific thresholds, such as:
- Scheduled use of certain medications (inhaled/oral anti-inflammatory agents or bronchodilators)
- A history of emergency room use or clinic visits for acute exacerbations within the last year
- A history of hospitalization for asthma within the past 5 years
- Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) that involves one or more specific complicating factors:
- A co-existing psychological diagnosis
- Requirement for multiple medications, complex psychopharmaceuticals, or lack of response to standard medication doses
- Requires management by a mental health provider
- Requires involvement of a specialty consultant more than twice a year chronically
- Requires modifications to the educational curriculum or use of behavioral management staff
- A chronic condition requiring:
- Adaptive equipment: Examples include apnea monitors, home nebulizers, wheelchairs, custom-fit orthotics/braces, hearing aids, home oxygen, or home ventilators
- Assistive technology devices or services: Such as specialized communication devices
- Environmental or architectural considerations: Medically necessary requirements like limited steps, wheelchair accessibility, housing modifications, or required air conditioning
Defining Special Educational Needs
A family member meets the criteria for special educational needs if they are eligible for, or currently receive, either:
- Early Intervention Services (EIS): For infants and toddlers from birth through age 2, documented on an Individualized Family Service Plan (IFSP)
- Special Education Services: For children and youth ages 3 through 21, documented on an Individualized Education Program (IEP)
It is important to note that while a Section 504 Plan provides accommodations under the Rehabilitation Act, having only a 504 plan does not typically meet the criteria for mandatory EFMP enrollment based on educational needs alone. However, the underlying condition leading to the 504 plan might meet one of the medical criteria for enrollment.
The detailed nature of these criteria, particularly for conditions like ADHD requiring specific associated factors, highlights that eligibility determination requires careful assessment by qualified medical or educational professionals. This complexity can sometimes lead to confusion for families or inconsistent identification if providers are not fully familiar with the specific DoD standards. Clear communication between families, providers, and EFMP staff is essential.
A significant point of friction exists between the program’s mandatory nature and family perceptions. While official policy states enrollment does not negatively impact careers, some families believe enrollment can limit assignment opportunities or lead to unfavorable outcomes like unaccompanied tours. This perception sometimes leads families to hesitate or avoid enrollment, despite the potential for disciplinary action and the program’s intent to provide support. This underscores the need for ongoing efforts by the DoD and service branches to build trust and clearly communicate how assignment decisions are made and what safeguards exist for EFMP families.
Navigating Enrollment: A Step-by-Step Guide
Once a potential need is identified, the process of enrolling in EFMP begins. While specific steps might vary slightly by service branch, the overall process follows a standardized DoD framework.
Starting the Process: Identification and Initiation
Enrollment can be triggered in several ways:
- Self-Referral: The most common way is for the service member or their spouse to recognize a qualifying need and proactively contact their local EFMP office to begin the process. This usually involves reaching out to the EFMP Coordinator at the nearest Military Treatment Facility (MTF).
- Provider Referral: A healthcare provider within the Military Health System (MHS), a representative from the Department of Defense Education Activity (DoDEA), or an Early Intervention Services (EIS) provider may identify a potential need during routine care or screenings and formally refer the family to the EFMP.
- Screening Trigger: Enrollment is often identified during mandatory screenings, such as developmental screenings for young children or the required Family Member Travel Screening (FMTS) process that all dependents must undergo before an OCONUS PCS.
Essential Forms: DD Form 2792 and DD Form 2792-1
Two key standardized forms are used across the DoD for EFMP enrollment:
DD Form 2792, Family Member Medical Summary
This form documents special medical needs, encompassing physical, developmental, and mental/emotional health conditions.
- Who Completes It: The service member, spouse, or adult family member completes the initial demographic sections and signs the authorization for release of medical information. The family member’s physician or other qualified medical professionals complete the sections detailing the diagnosis, treatment history and plan, severity, frequency of care, required specialists, and any necessary accommodations.
- Important Notes: Adult family members must sign their own HIPAA release; a sponsor cannot sign for an adult dependent unless they are the court-appointed guardian. The form requires the family member’s DoD Benefits Number (DBN), found on the back of the dependent ID card.
DD Form 2792-1, Early Intervention/Special Education Summary
This form documents special educational needs for children from birth through age 21 who are receiving or eligible for services under an Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP).
- Who Completes It: The sponsor, parent, or legal guardian completes the initial demographic information and signs the authorization to release educational information. School officials (for IEPs) or Early Intervention Services (EIS) representatives (for IFSPs) complete the sections detailing the child’s eligibility category, the specific services being provided, frequency, and any related services.
- Important Notes: This form must be submitted with a copy of the child’s current, signed IEP or IFSP. Only page 3 (the school/EIS portion) should typically be provided to the educational professionals; page 2 contains sponsor/family information.
Obtaining Forms: Families can usually get these forms from their installation’s MTF EFMP office or the EFMP Family Support office at their Military and Family Support Center. They are also available for download directly from the official Military OneSource website. Ensure you are using the most current version of the forms.
Key Players: Roles of Families, Providers, and Coordinators
Successfully navigating EFMP enrollment involves collaboration between several key parties:
Service Member and Family
You are responsible for:
- Initiating the process
- Providing complete and accurate information
- Ensuring medical and educational providers fill out their sections correctly
- Obtaining supporting documents (like IEPs/IFSPs)
- Signing necessary release authorizations
- Submitting the package
- Keeping the information updated over time
Medical and Educational Providers
These professionals (doctors, specialists, school psychologists, special education teachers, EIS coordinators) are responsible for:
- Accurately assessing the family member’s needs
- Completing the relevant technical sections of the DD Forms 2792 and 2792-1
- Providing diagnoses and details about required services
- Signing the forms
In the Army’s E-EFMP system, multiple medical providers can contribute to completing the DD Form 2792 if needed.
MTF EFMP Coordinator (Medical Component)
Located at the Military Treatment Facility, this coordinator is typically the central point for processing enrollment paperwork. Their responsibilities include:
- Overseeing the identification and enrollment process
- Providing forms
- Reviewing submitted packages for completeness and accuracy
- Assisting families in preparing the forms
- Forwarding the package to the appropriate service-level review committee for validation and coding
- Processing updates and disenrollments
- Conducting the medical aspects of the Family Member Travel Screening (FMTS)
EFMP Family Support Provider (Family Support Component)
Located at the installation’s Military and Family Support Center (e.g., Army Community Service, Fleet and Family Support Center, Airman & Family Readiness Center, Marine Corps Community Services), these providers offer non-clinical support. They help families:
- Understand and navigate the entire EFMP process
- Access military and community resources
- Receive non-clinical case management
- Develop Family Service Plans
- Access educational resources and workshops
- Transition smoothly during PCS moves through “warm handoffs” to the gaining installation’s EFMP office
Submission, Review, and Decision
After the necessary forms are completed by the family and providers:
Submission
The completed package (DD Form 2792 and/or 2792-1, plus supporting documents like IEP/IFSP) is submitted to the servicing MTF EFMP Coordinator. Some services utilize online portals for submission:
- Army: Enterprise EFMP (E-EFMP) system (https://efmp.army.mil/EnterpriseEfmp/) allows Soldiers (and spouses with DS Logon) to initiate and upload documents.
- Navy: Uses the Navy Family Accountability and Assessment System (NFAAS) to maintain electronic records and allow case management and status tracking. Enrollment initiated online by MTF coordinators.
- Air Force/Space Force: Uses the myVector platform for the Initial Travel Screening Questionnaire (ITSQ) and the automated Family Member Travel Screening (FMTS) application, which incorporates EFMP documentation submission.
Review and Validation
The MTF EFMP Coordinator reviews the package for administrative completeness. It is then forwarded to a higher-level, service-specific authority for clinical review, eligibility determination, and coding. Examples include:
- Army’s Regional Health Command (RHC) EFMP Team
- Navy’s Central Screening Committee (CSC)
- Air Force Personnel Center (AFPC) EFMP Central Cell
Enrollment Decision & Notification
If the family member meets the criteria, the enrollment is validated, the necessary codes are entered into the personnel and medical systems, and the family is notified of the enrollment decision. For Air Force/Space Force members, this often results in a “Q-code” being added to their personnel record.
Timeline
Be patient, as the entire process from submission to final enrollment and system updates can take several weeks. The Army estimates up to four weeks for data transfer between systems after RMC review, while the Air Force notes the FMTS process (which includes EFMP screening) can take 4-6 weeks.
The multi-step nature of enrollment—requiring coordination between the family, multiple medical or educational providers, the local MTF EFMP office, and a central service-level review body—coupled with the use of different forms and branch-specific electronic systems, can make the process feel complex and administratively burdensome, especially for families already managing significant care needs. This highlights the vital role of EFMP Coordinators and Family Support staff in providing guidance and assistance throughout the process, as well as the potential value of tools like Military OneSource’s EFMP & Me, designed to help families navigate these steps.
Keeping Your Information Current: Updates and Revalidation
Enrollment in EFMP is not a one-time event. Maintaining accurate and up-to-date information is crucial for the program to function effectively, particularly when it comes to assignment coordination.
Responsibility
The service member is ultimately responsible for ensuring their EFMP enrollment information remains current.
Standard Update Cycle
DoD policy requires EFMP enrollment documentation (primarily the DD Form 2792 for medical needs) to be updated at least every three years, or sooner if there is a significant change in the family member’s condition or required services.
Educational Updates
Information related to special education needs (DD Form 2792-1 and the supporting IEP/IFSP) generally requires annual updates, aligning with the typical school year review cycle for these plans.
PCS Trigger
Preparing for a PCS move, especially an OCONUS move requiring FMTS, is a critical time to ensure EFMP information is current. The Navy specifically requires updates to be initiated 12 months prior to an anticipated PCS date. Initiating updates well in advance of the PCS process is highly recommended.
Consequences of Non-Update
Allowing EFMP enrollment to expire or become outdated can have significant negative consequences. It can lead to:
- Delays in receiving PCS orders
- Potential cancellation of assignments
- Suspension of favorable personnel actions (like promotions or re-enlistment in the Army)
- Assignment to an unaccompanied tour if family travel cannot be approved due to outdated information
The consistent emphasis across official sources on the need for regular updates highlights the importance of proactive engagement from families. Waiting until PCS orders are imminent to update information can create significant stress and potentially jeopardize a desired assignment due to processing times and the need for accurate service availability checks. Treating the update cycle as a routine requirement, rather than a PCS-driven task, is a best practice for navigating the program smoothly.
Leaving the Program: The Disenrollment Process
While enrollment is mandatory for those who qualify, it is not necessarily lifelong. There are specific circumstances under which a service member can request disenrollment from EFMP.
Permanence
Generally, enrollment is considered permanent as long as the qualifying condition persists and the individual remains an eligible dependent of the active-duty service member.
Grounds for Disenrollment
Disenrollment is permissible only under specific conditions outlined in DoD policy:
- Condition Resolved: The medical or educational condition that originally qualified the family member for enrollment no longer exists or no longer requires specialized services beyond routine care. This must be documented by a new assessment from the relevant medical provider or school official. The Coast Guard requires medical/mental health conditions to be in remission for at least three years with only routine primary care needed.
- Loss of Dependency: The family member is no longer a legal dependent according to DEERS (e.g., due to divorce finalization where the member does not retain custody, child reaching age of majority and being capable of self-support, death of the dependent).
Our articles make government information more accessible. Please consult a qualified professional for financial, legal, or health advice specific to your circumstances.