MDHHS. BCAL 3305 (formerly OCAL 3305/BRS-3305) Page 2 of 2 Rev. July 2015
MDHHS reserves the right to update this benchmark based on overall participant performance, regular metric specification maintenance or other applicable events. In the event that the benchmark must be updated, MDHHS will provide sixty (60) days written notice to participants.
MDHHS. The Michigan Department of Health and Human Services was formerly two departments: the Michigan Department of Community Health and the Michigan Department of Human Services.
MDHHS. APPEALS shall provide copies of its action to the respondent, the appellant, recipient if different than appellant, the recipient's legal guardian, if any, the board of a CMHSP, the governing body of the LPH/U and the local office of recipient rights holding the record. If the appeal involves the findings of a MDHHSORR rights advisor, the MDHHS-XXX director shall also be provided copies of the action. If MDHHS-APPEALS upholds the findings of the office, notice shall be provided to the appellant of his/her legal right to seek redress through the circuit court.
MDHHS must involve the Contractor, to the extent allowed by law, in matters relating to any legal or court activities concerning the youth while in the Contractor's care.
MDHHS. APPEALS shall review the record generated by the local appeal. [t shall not consider additional evidence or information that was not available during the local appeal. Within 30 calendar days after receiving the appeal, MDHHS-APPEALS shall review the appeal and do one of the following: Uphold the findings of the office. Affirm the decision of the Appeals Committee. Return the matter to the director of the department's Office of Recipient Rights, the executive director of the CMHSP or the director of the LPH/U with instruction for additional investigation or consideration.
MDHHS may consider reenrollment of beneficiaries disenrolled in these situations on a case-by-case basis.
MDHHS may use the results of performance assessments as part of the formula for bonus awards and/or automatic enrollment assignments. MDHHS will continually monitor the Contractor’s performance on the performance monitoring standards and make changes as appropriate. The performance monitoring standards are attached to the Contract (Appendix I); the performance bonus template is attached to the Contract (Appendix J).
MDHHS. BCAL 3305 (formerly OCAL 3305/BRS-3305) Rev. July 2015 I, , give permission to Little Treasures Early Childhood Center to charge my card for the following services. My payment details will be stored in my profile and will be used for the services provided. My payment will also be used for auto pay when payment is due based on the information below. There will be a 3% fee for credit/debit cards or a $1.00 fee for ACH bank accounts that is charged by the billing company for each transaction. You may choose to have your card and bank account on file or just a card on file. It is required to have a card on file. If payment is declined, the payment will be reprocessed. MasterCard Discover VISA American Express Other ACH Information Bank Name: Routing Number: Billing Address: Name On Account: Account Number: Card Will Be Charged Every: Week Month Charges Will Be Made On: For The Amount Of: I have thoroughly read through the tuition contract and agreement provided and understand the terms of agreement. Customer Signature: Date: Primary Phone Number* Family Name* Address* Apartment/Unit # City* State* Zip Code* Date Received*: Referral Source* Agency Parent Guardian Other Initial Contact Method Email Phone Walk In Other: How did you learn about us? Authorization to Share (please read this statement in full)*: Part of Oakland Schools is to support your family, which means we may refer you to another program or organization. Do you give permission to Oakland Schools to share the information you’ve given me today with affiliate/community organizations in order to best support your family? Information may also include the results of the Ages and Stages Questionnaire. This will remain in effect until the youngest child in the family turns five or your family requests, either verbally or in writing, that information sharing be stopped. Parent/Guardian Signature* For which year are you hoping to have your child enrolled or be considered for services? 2023-2024 2024-2025 Desired Program Schedule Part Day School Day - 4 days per week School Day - 5 days per week Child’s Legal First Name Middle Name Child’s Legal Last Name Suffix Date of Birth (Month, date, year) Gender Is Hispanic or Latino Yes No Race/Ethnicity * Select the one that you most identify with. American Indian/Alaskan Native Asian Black/African American Native Hawaiian/Other Pacific Islander White Do you need transportation? (transportation is not available in all areas) Yes No The questions contained in this ...
MDHHS. APPEALS shall review the record generated by the local appeal. [t shall not consider additional evidence or information that was not available during the local appeal.
