Marine and Family Programs Exceptional Family Member Program MCAS Miramar

OBJECTIVES: MCO B – MARADMIN ELIGIBILITY (WHO IS ELIGIBLE FOR RESPITE?) PROVIDERS (WHO MAY PROVIDE CARE?) COMPLETING REQUEST APPLICATION RESPITE CARE POLICY HOLD HARMLESS AGREEMENT EFT AUTHORIZATION FORM COMPLETING THE REIMBURSEMENT FORM RECEIVING REIMBURSEMENT PAYMENTS

MCO B MARADMIN THE MARINE CORPS ORDER B WAS SIGNED ON SEPTEMBER 20 TH CHAPTER 2, 19, A-G IS THE SPECIFIC PROTOCOL FOR EFMP RESPITE CARE PROGRAM. MARADMIN HAS BEEN ACTIVE SINCE JUNE AND THE PROCEDURAL CHANGES ARE REFLECTED IN THE MCO B. All policies and procedures going forward are to coincide with MCO B

Who is eligible for Respite Care? ALL sponsors enrolled in EFMP with UPDATED DD2792 are eligible to request Respite Care. However Respite Care is not required by all EFMP enrolled families.

WHO MAY PROVIDE CARE? FAMILY MEMBERS MAY PROVIDE CARE* NIEGHBORS DAYCARE CENTER/CHILD DEVELOPMENT CENTER SKILLED NURSE** VOCATIONAL NURSE** *MUST BE 14 YEARS OR OLDER LEVEL 3 AND 4 MUST BE 18 OR OLDER AND HAVE DOCUMENTATION OF QUALIFICATIONS. **MUST HAVE DOCUMENTATION OF QUALIFICATIONS.

COMPLETING REQUEST APPLICATION COMPLETE EVERY BOX SAMPLE PROVIDED QUESTIONS?

RESPITE CARE POLICY RESPITE CARE POLICY UPDATED WITH THE MCO B. RESPITE LEVELS OF NEED LEVEL 1 – TYPICAL CARE LEVEL 2 – SPECIAL ATTENTION LEVEL 3 – SKILLED CARE LEVEL 4 – NURSING CARE ELIGIBLE PROVIDER WOULD DEPEND ON THE LEVEL OF NEED (SEE SAMPLE ENCLOSED FOR DETAILS ON LEVEL OF NEEDS AND WHO CAN PROVIDE CARE). LEVEL OF NEED IS ASSIGNED BY HQ AND REIMBURSEMENT RATE IS DETERMINED AND APPROVED BY THE EFMP PROGRAM MANAGER 1 COPY STAYS WITH FAMILY AND THE OTHER WILL BE ON FILE ****If you do not have a copy of your signed RESPITE CARE POLICY please stop by the Admin office.

HOLD HARMLESS AGREEMENT Hold Harmless Agreement simply releases Marine Corps Installation Miramar of any claims, liability and damage while EFM’s and siblings are under the care of your provider. List all children and/or adult EFM and their DOB. If you have one or more providers complete a Hold Harmless Agreement for each provider. They are kept on file for two years. Unless you are the adult EFM sign EMP Designee, Witness signature will be an EFMP staff member.

EFT AUTHORIZATION FORM SOCIAL SECURITY NUMBER IS THE SPONSOR/SPOUSE WHOSE NAMES ARE ON THE ACCOUNT THAT YOU WOULD LIKE YOUR REIMBURSEMENT TO BE DEPOSITED INTO. ENTER FINANCIAL INSTITUTIONS ADDRESS, IT WILL BE SENT BACK IF THERE IS NO ADDRESS.

THE REIMBURSEMENT FORM 1.Sponsors name and date 2.Name/s of EFM 3.Care provider name 4.Care Provider address 5.Care provider phone number 6.Care provider completes 7.List child(ren) and ages that care provider provided respite services for. List EFM and typical children rate of reimbursement, not your provider’s rate a) Date services were given b) Hour services began c) Hour services ended d) Total hours (not to exceed 6 consecutive hours) e) Number of EFM care was provided too f) Number of siblings care was provided too g) Total Cost per day 17.Total hours for the month (not to exceed 40hrs in a month), total dollar amount for one month 18.SPONSOR SIGNATURE CARE PROVIDER SIGNATURE Care provider MUST sign, reimbursement will not go through without a providers signature!

REIMBURSEMENT PAYMENTS REIMBURSEMENT FORMS ARE TURNED INTO THE EFMP OFFICE ON OR BEFORE THE 3 RD OF EACH MONTH. ADMIN PROCESSES THE 5 TH AND THERE SHOULD BE A DEPOSIT TO YOUR ACCOUNT IN 5-10 BUSINESS DAYS AFTER THE 5 TH. EXPECT DELAYS IN DEPOSITS WHEN THE 3 RD OR 5 TH FALLS ON A HOLIDAY OR A WEEKEND For your convenience we have a drop box to the left of the front door of our building. Fax your reimbursement forms to # , or them to You may also come by MON-FRI 0800 – 1600 Building

QUESTIONS????? EFMP CONTACT INFORMATION: Please contact EFMP staff with any questions or concerns, we are happy to help and understand that some months things happen, the dates are not set in stone for reimbursement they are a guideline to help us reimburse you and your family in a timely manner. OFFICE: FAX: