FEDERAL IV-E GUARDIANSHIP ASSISTANCE PROGRAM (GAP) - AGREEMENTGuardianship Assistance Agreement • November 22nd, 2022
This agreement for the guardianship assistance program, which is signed prior to the issuance of an order establishing guardianship, is entered into by and between the North Dakota Department of Health and Human Services and the prospective guardian(s) for the purpose of establishing the terms of the guardianship subsidy to be provided on behalf of the above-named child. The prospective guardian(s) agree that he/she/they intend to become the legal guardian for the child, are committed to a permanent relationship with the child and agree to the terms and provisions contained in this document.
OVERVIEWGuardianship Assistance Agreement • April 5th, 2022
Pursuant to state and federal law, the Michigan Department of Health and Human Services (MDHHS) may enter into a guardianship agreement with the successor guardian(s) for:
GUARDIANSHIP ASSISTANCE AGREEMENT BETWEEN THE DEPARTMENT OF CHILDREN AND FAMILIES AND GUARDIANS REGARDING PAYMENTS AND SERVICESGuardianship Assistance Agreement • July 24th, 2019
We (I), the guardian(s) of , a child who is presumptively eligible for guardianship assistance in the State of Florida, agree and understand that:
INTRODUCTIONGuardianship Assistance Agreement • April 15th, 2015
After eligibility is determined, the agreement is signed by the guard- ian and the DHS designee, and the court has appointed the guard- ian, the DHS subsidy office will determine allowable expenses claimed by the guardian or a third party (that incurred expenses on behalf of the guardian). The maximum allowable reimbursement is
Guardianship Assistance AgreementGuardianship Assistance Agreement • July 13th, 2004
This agreement is between the Children, Adults and Families Office of the Oregon Department of Human Services, hereinafter referred to as THE DEPARTMENT , and
GUARDIAN GUARDIANSHIP ASSISTANCE AGREEMENT LEGAL CUSTODIAN RELATIVEGuardianship Assistance Agreement • December 21st, 2016
A child who meets the eligibility criteria for receiving guardianship assistance under the Guardianship Assistance Act [MCL 722.871 et seq.].
GUARDIANSHIP ASSISTANCE AGREEMENT BETWEEN THE DEPARTMENT OF CHILDREN AND FAMILIES AND GUARDIANS REGARDING PAYMENTS AND SERVICESGuardianship Assistance Agreement • December 28th, 2020
Guardianship: IV-E $ $ Guardianship: TANF $ $ Guardianship: State Funded/General Revenue $ $ YES NO LEGAL COST $ TRAVEL COST $ OTHER $ Total Projected Cost: $0.00
Sample Guardianship Assistance AgreementGuardianship Assistance Agreement • October 18th, 2012
The following agreement has been entered into by and between the (child welfare agency), hereinafter called “the Department,” and (Name of Guardian(s)) hereinafter called the “guardian(s)” for the purpose of providing assistance to facilitate the transfer of guardianship of (Child’s Name) , hereinafter called “the child”, who was born on .
GUARDIANSHIP ASSISTANCE AGREEMENTGuardianship Assistance Agreement • July 26th, 2006
Date(month, day, year) In the matter of: Name of child Name of guardian Name of guardian As the above-named child has met the eligibility criteria for the Assisted Guardianship Program, and as the above-named legal guardian(s) has been determined eligible to receive monthly assistance payments under the Assisted Guardianship Program for the care of the child, the legal guardian(s) and the local Department of Child Services (DCS) office agree to the following: LEGAL GUARDIAN LOCAL DCS OFFICE (1) Apply for appropriate medical insurance coverage, either from a private company or through Medicaid, before or immediately following the creation of the legal guardianship. (2) Assign any rights to receive child support to the Department of Child Services. (3) Use all monthly payments made under this program for the care of the child. (4) Provide any financial and other information requested by the local DCS office for the purposes of an eligibility redetermination that is to occur at least on
AGREEMENT PROVISIONSGuardianship Assistance Agreement • April 15th, 2015
State and federal law require that the Department of Human Ser- vices (DHS) enter into Guardianship Assistance Agreements (DHS- 3313) and state-funded Juvenile Guardianship Medical Subsidy Agreements (DHS-3013GA) with the guardian as a condition of eli- gibility for:
GUARDIANSHIP ASSISTANCE ACT (EXCERPT)Guardianship Assistance Agreement • December 2nd, 2021
Sec. 5c. (1) Subject to provisions of this act, the department may pay guardianship assistance to an eligible successor guardian on behalf of an eligible child.
NORTH CAROLINA GUARDIANSHIP ASSISTANCE AGREEMENTGuardianship Assistance Agreement • December 22nd, 2016
GUARDIANSHIP ASSISTANCE AGREEMENT BETWEEN THE DEPARTMENT OF CHILDREN AND FAMILIES AND GUARDIANS REGARDING PAYMENTS AND SERVICESGuardianship Assistance Agreement • February 12th, 2022
Do the guardian(s) and child elect to opt into the Extension of Guardianship Assistance Program? Yes No N/A *Only applicable to a child who is age 16 or 17 when the initial agreement is signed.
OVERVIEWGuardianship Assistance Agreement • April 5th, 2022
State and federal law require that the Michigan Department of Health and Human Services (MDHHS) enter into the DHS-3313, Guardianship Assistance Agreements, and state-funded DHS- 3013GA, Juvenile Guardianship Medical Subsidy Agreements, with the guardian(s) as a condition of eligibility for:
