Participant Forms - Michigan

File Downloads / Links

  • Budget worksheet Word
  • Budget worksheet PDF
  • Disenrollment Form Word
  • Right to Hire form 1 Word
  • Right to Hire form 1 PDF
  • Right to Hire form 2 Word
  • Right to Hire form 2 PDF
  • Job Description form Word
  • Job Description form PDF
  • Backup Worker form Word
  • Backup Worker Form PDF
  • Disenrollment Form PDF

Article Publication Date: 
10/9/2007
Summary: 
Self Determination in Long Term Care (SDLTC) is a MI Choice waiver program option. The following forms are used for this program: Budget worksheet, Disenrollment form, Right to Hire form, Right to Hire with Driving Record, Job description form for a PCA/HHA, and Backup Worker form.
Topics: 
Consumer/Participant Direction; Medicaid Waivers
Types/Tools: 
Marketing materials; Template / Form
Populations: 
Personal Assistant; Caregivers
Sources: 
NRCPDS
Michigan
Programs/Initiatives: 
Cash and Counseling
States: 
All States/Territories; Michigan
Keywords: 
Long-Term Care
Self Determination in Long Term Care; SDLTC; MI Choice waiver program option; Budget worksheet; Disenrollment form; Right to Hire form; Right to Hire with Driving Record; Job description form for a PCA/HHA; Backup Worker form

Contact

Elizabeth Maguire
National Resource Center for Participant-Directed Services
elizabeth.maguire.1@bc.edu
Phone: 
617-552-0562

Short URL: http://www.advancingstates.org/node/52254