Statewide Guidance determining Priority for Services ...

?Michigan Migratory Education Program (MiMEP)Office of Educational Supports, Special Populations Unit Priority for Services: Eligibility Determination Worksheet Under ESSAThe Priority for Services (PFS): Eligibility Determination Worksheet will assist the local MEP in determining which migratory children and youth meet the Priority for Services criteria and should receive MEP services first. This information is used to update the Migrant Education Data System (MIS2000) and kept on file, along with supporting documentation, in a central location designated by the local MEP director. Achievement data used in making the PFS determination must be less than one year old.Student’s Name FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Today’s Date FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Date of Birth FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????COE # FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????QAD (enrollment) FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????District or MEP FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????QAD/LQM (re-enrollment) FORMTEXT ????? FORMTEXT ?????School FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Grade Enrolled FORMTEXT ????? FORMTEXT ????? Priority for Services Status (PFS or NPFS): FORMTEXT ????? SY FORMTEXT ????? Summer Receiving local MEP funded services FORMTEXT ????? yes FORMTEXT ????? noTitle I, Part C ServicesIf yes, please note the type of MEP service received: Use SY for school year and Sum for summer on all that apply FORMTEXT ????? Any Instructional Services FORMTEXT ????? Math Instructional Services FORMTEXT ????? Reading Instructional Services FORMTEXT ????? Credit Accrual Services FORMTEXT ????? Counseling Services FORMTEXT ????? Support Services: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? Support Services: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? Referred Services: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? Referred Services: FORMTEXT ????? FORMTEXT ?????Additional Information: Use SY for school year and Sum for summer on all that apply FORMTEXT ????? Bi-National Enrollment FORMTEXT ????? Non-Migrant, District Counseling Services FORMTEXT ????? Former Migrant (FM) receiving continuation of services COS FORMTEXT ????? FLEP (exit date, assessment, and score: FORMTEXT ????? FORMTEXT ?????) _______________________________________ FORMTEXT ????? Title I, Part A FORMTEXT ????? Section 31a FORMTEXT ????? Title III, EL FORMTEXT ????? Title III, Immigrant FORMTEXT ????? Title I, Part D FORMTEXT ????? Homeless FORMTEXT ????? Section 41To qualify as Priority for Services, a migratory child or youth must have made a qualifying move within the previous 1-year period and have met one of the risk factors listed in Table B. Table A. Qualifying MoveQualifying Move (Change of Residency, Across School Boundaries, due to Economic Necessity)Date of Qualifying MoveExample: Move from and Move to (city, state)Example: 10/05/2024 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Table B can be found on page 2.For additional guidance, see Michigan MEP PFS Eligibility Determination Guidance Document. Table B. Risk Factors for failing to meet State Standards CriteriaCheck all that applyRisk FactorsAt least one item must be checked to qualify.Assessments must be less than 12 months old.Description and/or Scores FORMCHECKBOX Scored partially proficient or basic on the Michigan’s State Reading Assessment FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Scored partially proficient or basic on the Michigan’s State Mathematics Assessment FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Scored partially proficient or basic on Michigan’s State Writing Assessment FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Scored partially proficient or basic on Michigan’s State Science Assessment FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Scored partially proficient or basic on Michigan’s State Social Studies Assessment FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Scored below proficient on State Assessments received from other states FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Scored below the 50th percentile on norm-referenced test (reading and/or math) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Scored below grade level on locally administered assessments in reading or math (DRA2, Delta Math or other) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Is classified as an English Learner and has not met the requirements from the Michigan’s Entrance and Exit Protocol to be exited from EL services.EL Assessment & Assessment Date: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Qualifies for Special Education ServicesDate of IEP: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Is behind in accruing credits toward graduation requirements FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Has grades indicating below average performance in math and/or language arts at the elementary level FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Has grades indicating below average performance in math, language arts, sciences, or social studies at the middle or high school levels FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Repeated a grade level or course FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Enrolled in a structured, early childhood program for at-risk children (PS only)Note program and enrollment period: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Pursuing a GED course of studyNote program and enrollment period: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMCHECKBOX Has dropped out of schoolNote the drop out date: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Child’s Name FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Today’s Date FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? ................
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