Amendment 0002 - Attachment 0006 - Sample Respite Care Packet W9124J26RRESP 26JUNE2026.pdf
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- Solicitation number
- W9124J26RRESP
About this file
This document is an Installation EFM (Exceptional Family Member Program) Document Checklist and supporting materials for managing respite care services for military families with exceptional family members.
The checklist requires four documents to be submitted: a dated and signed Respite Care Approval Letter, a Respite Care Discontinuation Letter, an Authorization for Transferring EFMP Respite Care Files, and documentation of the total number of approved respite care hours. The approval letter template indicates monthly respite care hours allocated to EFMP-enrolled dependents and notes that respite files must be updated during re-enrollment anniversaries or when condition changes occur. The discontinuation letter is issued when an exceptional family member no longer meets eligibility criteria for respite care services and will be removed from the active recipient list. The Authorization for Transferring EFMP Respite Care Files form facilitates file transfers to the government contractor providing respite care services and includes a Privacy Act Statement citing relevant authorities (10 U.S.C. 3013, 29 U.S.C. 794, DoDD 1342.17, AR 608-75, and AR 608-10). The form requires completion of sponsor information, contact details, and signatures from both the sponsor/spouse and ACS EFMP staff. Disclosure of information is voluntary but required to receive EFMP respite care services continuation.
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Installation EFM Document Checklist
Documents Required in Submitted File:
Respite Care Approval Letter
Signature Date
(Must be dated and signed)
Respite Care Discontinuation Letter
Authorization For Transferring EFMP Respite Care Files (Accompanies all documents transferred to Current Contractor)
_________________ Number of Total Approved Hours
DEPARTMENT OF THE ARMY
US ARMY INSTALLATION MANAGEMENT COMMAND
2405 GUN SHED ROAD
JOINT BASE SAN ANTONIO FORT SAM HOUSTON, TX 78234-1223
Dear Family, We are pleased to inform you that your family member will receive hours of Exceptional Family Member Program (EFMP) respite care each month for your EFMP enrolled dependent. Please note your EFMP respite file must be updated during your re-enrollment anniversary or at any time condition changes.
We hope that this respite care will provide the temporary break and support for your family. Should you have any questions, please feel free to contact your Installation EFMP Manager, , at ,or via email at .
SHARON G. SWISHER
EFMP Manager HQ Installation Management Command
DEPARTMENT OF THE ARMY
US ARMY INSTALLATION MANAGEMENT COMMAND
2405 GUN SHED ROAD
JOINT BASE SAN ANTONIO FORT SAM HOUSTON, TX 78234-1223
Dear Family, This is to advise you that your Exceptional Family Member (EFM) no longer meets eligibility criteria for Respite Care services and will be removed from active list of EFMP Respite Care recipients.
The reason for discontinuation is
Eligibility for Respite Care is determined at the time of enrollment or re-enrollment.
If you have not updated your enrollment information in E-EFMP, go to https://efmp.army.mil to update your enrollment. Your updated information will be reviewed and your installation EFMP Manager will provide the results of your reconsideration review.
Should you need additional services, the EFMP Family Support team is available and ready to assist. Please do not hesitate to reach out, and we would be happy to assist with your family’s needs.
, If you have any questions, please contact , and .
SHARON G. SWISHER
EFMP Manager HQ Installation
Management Command
Army Community Service (ACS) Exceptional Family Member Program (EFMP)
Authorization for Transferring EFMP Respite Care Files
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 3013, Secretary of the Army; 29 U.S.C. 794, Nondiscrimination Under Federal Grants and Programs; DoDD 1342.17 Family Policy; AR 608-75, Exceptional Family Member Program; AR 608-10, Child Development Services.
PRINCIPAL PURPOSE: Information will be used by EFMP personnel to transfer client records to the Government Contractor for all Families using respite care services. The transfer of files is necessary to receive continuation of respite care services.
ROUTINE USES: The DoD 11Bianket Routine Uses" that appear at the beginning of the Army's compilation of systems of records apply to this system.
DISCLOSURE: Disclosure of requested information is voluntary; however, if information is not provided individuals may not be able to receive EFMP respite care services.
1/We hereby authorize--------------------------- (Name of Installation and Name of EFMP Staff member) to release respite care files for -------------...J' Date of Birth------- (Name of EFM) to the Government Contractor providing Respite Care Services.
Sponsor ___________ _,. Rank. __ __,, Unit _____________ _
Duty Phone. ________ Spouse's Name-------------------
Home Phone. _________ Cell Phone. __________________ _
Address. _______________________________________ __
Sponsor/Spouse Signature. ___________________ Date:. ________ _
ACS EFMP Staff Signature. _________________ Date:. ______ _
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