SAMM E-Change 652 - Updates to Chapter 10.

1. Delete verbiage in Section C10.8.5.1.6. per below:

   C10.8.5.1.6. Before processing an IMS for any course in any country, the SCO should verify the IMS home country has not imposed restrictions that could prevent or delay a timely and safe return after training is complete (e.g., because of COVID-19 re/entry or quarantine period restrictions). If the home country has imposed restrictions that could delay or prevent a return home, the SCO must seek appropriate MILDEP or CCMD concurrence prior to issuing an ITO.

2. Delete Section C10.8.5.2.6. in its entirety.

   C10.8.5.2.6. Screening for Severe Acute Respiratory Syndrome /Coronavirus 2 and other United States Government-Designated Significant Health Threats. The rapid global spread in 2020 of COVID-19 highlighted the need for an organized, rapid, and flexible U.S. response to similar events. The guidance in this section pertains specifically to COVID-19, but screening requirements and procedures should hereafter be essentially the same for all similar epidemic or pandemic events. Specific guidance pertaining to each unique health threat will be promulgated by the USG as appropriate at that time. This section will be updated as needed to reflect changes in U.S. and DoD policy.

   C10.8.5.2.6.1. Until further notice, pre-travel medical screening will include COVID-19 testing for all IMSs. If symptoms of COVID-19 are present, travel to the United States will be delayed in accordance with guidance from the CDC and specific DoD directives. Generally, any person who tests positive for or is symptomatic of the disease will not be authorized to enter the United States.

   C10.8.5.2.6.2. The SCO will ensure the IMS home country MoD is aware of and understands current U.S. COVID-19 related travel restrictions and will work with the MoD, in coordination with the CCMD and IAs, to minimize the impact on the country's SC training plans.

   C10.8.5.2.6.3. The SCO will request that IMS vaccination information (i.e., manufacturer, lot number, and date given) be given to the SCO as soon as possible after any version or number of doses of a vaccine is administered. Vaccination information will be included on a DD Form 2808.

   C10.8.5.2.6.4. The SCO will maintain close contact with the Embassy team and CCMD medical personnel to ensure the SCO has the most current State and DoD guidance pertaining to COVID-19 related travel.

   C10.8.5.2.6.5. Regardless of IMS medical screening results, prior to issuing an ITO, the SCO will ensure the IMS is not restricted from entering the United States in accordance with the CDC's list of Travelers Prohibited from Entry to the United States.

   C10.8.5.2.6.6. Regardless of IMS medical screening results, prior to issuing an ITO, the SCO will review CDC Travel Health Notices and State Travel Advisories to ensure the IMS satisfies all U.S. entry requirements.

   C10.8.5.2.6.7. Medical Fast Track (see Section C10.8.5.5.) does not apply to examinations for or vaccinations against COVID-19.

   C10.8.5.2.6.8. Guidance pertaining to required actions, specific testing, and reporting for COVID-19 will be promulgated through appropriate DoD and State channels.

   C10.8.5.2.6.9. For information about an IMS who exhibits or reports any significant SARS/COVID-19 symptoms or has a positive COVID-19 test result while in training, see Section C10.20.11.

3. Renumber Section C10.8.5.2.7. to C10.8.5.2.6. and C10.8.5.2.8. to C10.8.5.2.7.

   C10.8.5.2.6. Pregnancy Test. All female IMSs must submit results of a pregnancy test taken between two and four weeks prior to issuance of an ITO, and the test results will be listed in DD Form 2808, block 73. If the IMS is pregnant, the SCO must submit a health policy waiver request. See Section C10.8.5.6. for health policy waiver procedures. See Section C10.9.7. for information about Pregnancy-Related Healthcare Insurance Policy Coverage. Participants in DoD Regional Center (RC) programs are not required to have a pregnancy test as a condition of attendance.

   C10.8.5.2.7. Dental Examination. All IMSs must have a complete dental examination prior to issuance of an ITO, and a partner nation MoD dentist or licensed practicing medical authority identified on the U.S. embassy-maintained list of qualified practitioners must complete and sign DD Form 2808, block 82, certifying the IMS does not require care for cavities, infection, or oral disease. The SCO must review the IMS's dental report to ensure it supports immediate entry into training. Participants in RC programs are not required to have a dental examination or certification as a condition of attendance.

4. Delete Section C10.8.5.4.8. in its entirety.

   C10.8.5.4.8. Screening for Severe Acute Respiratory Syndrome /Coronavirus 2 and other United States Government-Designated Significant Health Threats.

   C10.8.5.4.8.1. Until further notice, COVID-19 medical screening for AFMs is the same as for IMSs. See Section C10.8.5.2.6.1. for details.

   C10.8.5.4.8.2. For information about an AFM who exhibits or reports any significant COVID-19 symptoms or has a positive COVID-19 test result while in the United States, see Section C10.20.11.

5. Renumber Section C10.8.5.4.9. to C10.8.5.4.8.

   C10.8.5.4.8. Pregnancy Test. All female AFMs over the age of 18 must submit results of a pregnancy test taken between two and four weeks prior to issuance of an ITO. If an AFM is pregnant, the SCO must submit a request for a health policy waiver. See Section C10.8.5.7. for health policy waiver procedures. See Section C10.9.7. for information about Pregnancy-Related Healthcare Insurance Policy Coverage.

6. Revise verbiage in Section C10.8.5.8.4.4. per below.

   Current Wording:

   C10.8.5.8.4.4. While preparing IMS and AFM return travel, immediately notify the MILDEP about anything that could delay or prevent the timely and safe return to the home country, including pandemic-related (e.g., COVID-19) travel restrictions or catastrophic natural events (e.g., hurricanes, volcanos, or earthquakes).

   Revised wording:

   C10.8.5.8.4.4. While preparing IMS and AFM return travel, immediately notify the MILDEP about anything that could delay or prevent the timely and safe return to the home country, including public health travel restrictions, political travel restrictions, or catastrophic natural events (e.g., hurricanes, volcanos, or earthquakes.)

7. Delete Section C10.20.11. in its entirety.

   C10.20.11. Severe Acute Respiratory Syndrome/Coronavirus 2. The rapid global spread of COVID-19 in 2020 required significant changes to policies related to medical care and support for IMSs and their accompanying family members (AFMs) prior to, during, and following training, or in the event either is diagnosed with the disease. Applicable pre-training medical screening requirements are delineated in Section C10.8.5.2.6. This section pertains only to IMSs and AFMs who are already at a training location. Specific guidance pertaining to similar future health hazards will be promulgated by the United States Government (USG) as appropriate and may be included in or based on this guidance.

   C10.20.11.1. International Military Student or Accompanying Family Member diagnosed with Coronavirus Disease 2.

   C10.20.11.1.1. If an IMS or AFM exhibits or reports any significant COVID-19 symptoms or has a positive COVID-19 test result, DoD Component or installation representatives will obtain appropriate medical attention for the infected person in coordination with local DoD medical and public health personnel. A DoD Component representative (e.g., the training installation commander or Military Department (MILDEP) training program manager) will be immediately informed by the person responsible for the IMS (e.g., IMSO, local medical team, or SCO) in accordance with applicable privacy policies, so that appropriate contact tracing and public health safety measures may be initiated. Appropriate public health authorities will be notified by the Component representative in accordance with DoD guidance and U.S. state and local laws.

   C10.20.11.1.2. Where an IMS or AFM obtains healthcare services will depend on that individual's eligibility for services provided by DoD medical personnel or a civilian medical provider. This guidance does not establish IMS eligibility to receive healthcare services from a DoD healthcare facility. For information about healthcare coverage eligibility see Section C10.9. "Healthcare Coverage."

   C10.20.11.1.3. The IMS, AFMs, and anyone living with them will be isolated per current U.S. Centers for Disease Control and Prevention (CDC), DoD, State, and local guidelines or directives. Funding associated with required isolation will be managed in accordance with the following:

   C10.20.11.1.3.1. If an FMS-funded IMS is required to observe restricted movement protocols (RMP) (e.g., because of COVID-19) while en route to or from, or enrolled in U.S. sponsored training, any consequent additional living costs are the responsibility of the partner nation, and may be paid by the partner nation directly, by the IMS directly and reimbursed by the partner nation, or if approved by DSCA, by the applicable FMS case.

   C10.20.11.1.3.2. If a Foreign Military Financing (FMF) or International Military Education and Training (IMET)-funded IMS is required to observe RMP while en route to or from, or enrolled in U.S. sponsored training, the USG may pay any consequent additional living costs for the IMS only, in accordance with applicable program guidelines.

   C10.20.11.1.3.3. If the home country requires the IMS and AFMs to undergo a quarantine period in the United States prior to departure as a condition of return, any additional living costs should be funded from the same source used to fund TLA during training.

   C10.20.11.1.4. If an IMS or AFM who tests positive for COVID-19 is eligible for DoD-provided medical care, DoD medical personnel are authorized to provide care based on an assessment of the severity of the disease, and will comply with all applicable laws, DoD guidance, and any written agreements between DoD and the IMS home country, including protection of personal or private health information. For information about healthcare insurance coverage, see Section C10.9. "Healthcare Coverage."

   C10.20.11.2. Post-training Travel Affected by Coronavirus Disease 2-19.

   C10.20.11.2.1. When feasible, DoD personnel will help an IMS schedule post-training return travel with the best available routing to ensure a safe return home, keeping in mind pass-through country travel restrictions and testing requirements, which may require booking a more direct route in favor of the most economical fare.

   C10.20.11.2.2. If an IMS is unable to return to the home country because of disease related travel restrictions, the local installation will extend the duration of the ITO until safe travel is possible. IMSOs and DoD Components will coordinate with the SCO to amend ITOs while the IMS and authorized dependents wait for transportation. ITOs may not be extended beyond the time safe travel is available. Note that this guidance pertains only to ITO duration, not funding availability or authorization, which will need to be resolved in coordination with the home country.

   C10.20.11.2.3. IMSOs and DoD Components are responsible for monitoring IMSs and authorized dependents who remain in the U.S. after completion of training. The IMSO may determine the best method for maintaining accountability of the IMS and dependents' location and welfare while they wait for home-bound transportation. IMSOs will ensure the IMS and authorized dependents do not depart the local training facility area until a complete flight home itinerary has been confirmed or other official arrangements have been made.

   C10.20.11.2.4. IMSOs will report to the DoD Component any IMS or authorized dependent who does not comply with MILDEP monitoring requirements or instructions about where the IMS and authorized dependent are to wait for transportation.

   C10.20.11.2.5. If the IMS and dependents decline local installation support while waiting for transportation, they must request support from the home country embassy or consulate before they depart the installation. In all cases, the IMS must inform the IMSO before leaving the training installation or risk being reported as an unauthorized absence.

   C10.20.11.2.6. Some IMSs and authorized dependents may not be able to travel to follow-on training if MILDEP or local restrictions preclude such travel. If an IMS is unable to continue to follow-on training, the SCO will coordinate with the IMSO, MILDEP, or designated IA to return the IMS and authorized dependents to the home country as soon as safely possible.