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DHS Pub 114 Relative Caregiving

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MICHIGAN RELATIVE CAREGIVER LEGAL DOCUMENTS PACKAGE

©2016 - U.S. Legal Forms, Inc.

MICHIGAN RELATIVE CAREGIVER
LEGAL DOCUMENTS PACKAGE

Control Number: MI-ADOP2-PKG

USLEGAL

USLEGALFORMS.COM

U.S. Legal Forms™ thanks you for your purchase of a Relative Caretaker Legal Documents Package. This package contains summaries of state laws and valuable information to assist with placing a child with a relative.

TABLE OF CONTENTS

  1. Form List with descriptions
  2. Descriptions of Forms
  3. Legal Document Storage information
  4. Tips on Completing the Forms
  5. Disclaimer

I. FORM LIST

With your Relative Caretaker Legal Documents Package, you will find valuable information for a relative to take care and custody of a child.

Included in your package are the following forms:

  1. Placement of Children With Relatives
  2. The Rights of Presumed (Putative) Fathers
  3. Disclosure of Confidential Child Abuse and Neglect Records
  4. Grounds for Involuntary Termination of Parental Rights
  5. Power of Attorney for the Care and Custody of Child

II. DESCRIPTIONS OF FORMS

Brief descriptions of the forms contained in your Relative Caregiver Legal Documents Package are found below.

Placement of Children With Relatives - This publication summarizes state laws and statutes regarding placement of children with relatives when they are removed from their home and enter foster care. In order for states to receive federal payments for foster care and adoption assistance, federal law requires that they "consider giving preference to an adult relative over a nonrelated caregiver when determining placement for a child, provided that the relative caregiver meets all relevant state child protection standards." Most states give preference or priority to relative placements in their statutes. This publication discusses definitions of "relative," financial support for relative placement, and adoption by relatives.

The Rights of Presumed (Putative) Fathers – This informational guide discusses the rights of the alleged fathers of children born out-of-wedlock and whether states have registries for such fathers.

Disclosure of Confidential Child Abuse and Neglect Records – This guide contains summaries of statutes detailing the officials who may have access to confidential records and the circumstances under which information may be disclosed.

Grounds for Involuntary Termination of Parental Rights – This publication reviews state laws that detail the specific circumstances that must be present when a court terminates the legal parent-child relationship.

Power of Attorney for the Care and Custody of Child - This Power of Attorney is a form which provides for the appointment of an attorney-in-fact for the care of a child or children, including health care. This Power of Attorney form requires that the signature of the person giving another the power of attorney to be notarized.

If you need additional information, please visit www.uslegalforms.com and look up forms by subject matter. You may also wish to visit our legal definitions page at http://definitions.uslegal.com/

III. LEGAL DOCUMENT STORAGE

Once you prepare legal documents and forms in your U.S. Legal Forms™ Essential Legal Life Documents Package, it is highly recommended that you keep forms together. An optional USLegal Life Documents Organizer – small or large size is available for purchase from www.uslegalforms.com to help store you legal documents.

Legal documents should also be kept in a very secure place such as a bank safe deposit box or personal home safe. You may wish to tell your attorney or a family member about the location of your Legal Life Documents Package in the event you are unable to communicate it to them when needed.

IV. TIPS ON COMPLETING THE FORMS

The form(s) in this packet may contain “form fields” created using Microsoft Word or Adobe Acrobat (".pdf" format). “Form fields” facilitate completion of the forms using your computer. They do not limit your ability to print the form “in blank” and complete with a typewriter or by hand.

It is also helpful to be able to see the location of the form fields. Go to the View menu, click on Toolbars, and then select Forms. This will open the Forms toolbar. Look for the button on the Forms toolbar that resembles a shaded letter "a". Click this button and the form fields will be visible.

By clicking on the appropriate form field, you will be able to enter the needed information. In some instances, the form field and the line will disappear after information is entered. In other cases, it will not. The form was created to function in this manner.

V. DISCLAIMER

These materials were developed by U.S. Legal Forms, Inc. based upon statutes and forms for the subject state. All information and Forms are subject to this Disclaimer:

All forms in this package are provided without any warranty, express or implied, as to their legal effect and completeness. Please use at your own risk. If you have a serious legal problem, we suggest that you consult an attorney in your state. U.S. Legal Forms, Inc. does not provide legal advice. The products offered by U.S. Legal Forms (USLF) are not a substitute for the advice of an attorney.

THESE MATERIALS ARE PROVIDED "AS IS" WITHOUT ANY EXPRESS OR IMPLIED WARRANTY OF ANY KIND INCLUDING WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF INTELLECTUAL PROPERTY, OR FITNESS FOR ANY PARTICULAR PURPOSE. IN NO EVENT SHALL U.S. LEGAL FORMS, INC. OR ITS AGENTS OR OFFICERS BE LIABLE FOR ANY DAMAGES WHATSOEVER (INCLUDING WITHOUT LIMITATION DAMAGES FOR LOSS OR PROFITS, BUSINESS INTERRUPTION, LOSS OF INFORMATION) ARISING OUT OF THE USE OF OR INABILITY TO USE THE MATERIALS, EVEN IF U.S. LEGAL FORMS, INC. HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.

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What the DHS Pub 114 Relative Caregiving document is

The DHS Pub 114 Relative Caregiving is a Department of Human Services publication and form used to document and verify caregiving arrangements provided by relatives for benefit, eligibility, or case management purposes. It records names, relationships, caregiving schedules, and supporting evidence that state or local DHS offices use to evaluate eligibility for programs or to support case files. Agencies often use the form to determine temporary caregiving allowances, custodial responsibility, or case-level supports; accurate completion helps agencies process requests and maintain consistent records.

Why completing DHS Pub 114 Relative Caregiving matters

Completing the form accurately documents caregiving arrangements needed for eligibility decisions, service coordination, and program audits. It reduces follow-up requests, supports timely benefit determinations, and creates a consistent administrative record for family caregiving situations.

Why completing DHS Pub 114 Relative Caregiving matters

Who typically completes and relies on this form

State and local DHS staff, caseworkers, and family members use the form to document relative caregiving arrangements and to support benefit or placement decisions.

  • Relative caregivers and parents who provide day-to-day care and must document their role for agency review.
  • DHS caseworkers and eligibility staff who verify relationships, review supporting documents, and make benefit decisions.
  • Legal or social services advocates preparing files and evidence for hearings, case plans, or program enrollment.

Accurate completion benefits both household members seeking assistance and the agencies that must document caregiving relationships for eligibility, audit, and service planning purposes.

Primary signer profiles

Relative Caregiver

A family member providing care who signs to confirm relationship, availability, and responsibilities. The narrative should explain living arrangements, daily caregiving tasks, and any agreed financial or time commitments for agency review.

DHS Caseworker

An authorized agency employee who reviews submissions, verifies evidence, and signs off on eligibility determinations or case notes. Their signature binds the administrative record for the case and documents the agency action taken.

Core elements to include in a professional DHS Pub 114 Relative Caregiving

A complete form captures identification, relationship details, schedule specifics, documentation of legal authority when applicable, and dated signatures. Each element supports consistent eligibility decisions and reduces downstream requests for clarification.

Caregiver Identity

Full legal name and government ID reference for verification and matching to case records; consistent spelling avoids data mismatches during eligibility checks.

Care Recipient

Full legal name, date of birth, and case or client ID to ensure the caregiving relationship is tied precisely to the intended individual in agency systems.

Relationship

Specify biological, step, kinship, or other family relationship and describe how the caregiver is related to the care recipient to support eligibility rules.

Care Schedule

Clear recurring days, hours, and location of care. Include start date and any planned end date or review interval for case management purposes.

Supporting Evidence

Attach documents such as birth certificates, school records, or court orders that corroborate the relationship and living arrangement as required by the agency.

Signatures and Dates

Dated signatures from caregiver and caseworker with printed names and contact details to validate the attestation and create an audit trail.

Step-by-step: completing and submitting the form

Follow these steps to prepare a clear, verifiable submission to your local DHS office.

  • 01
    Gather IDs: Collect government IDs and birth records for all named parties.
  • 02
    Complete Fields: Fill each field fully using MM/DD/YYYY for dates.
  • 03
    Attach Evidence: Scan or copy supporting documents and label them clearly.
  • 04
    Submit and Track: Send to the agency via the approved channel and note any confirmation number.

How the DHS Pub 114 moves through agency processing

Typical processing follows a straightforward path from submission to verification and case update.

  • Submission: Form is received by the designated DHS intake unit.
  • Verification: Caseworker checks identity and supporting documents.
  • Decision: Eligibility or case notes updated based on verification.
  • Notification: Agency provides written acknowledgement or request for more information.

Setting up an online completion and review workflow

Configure a simple digital workflow so caregivers, caseworkers, and supervisors can complete, sign, and store the form electronically.

Field Configuration
Authentication Email or SMS code for signer verification
Attachments Allow PDF/PNG uploads for supporting documents
eSignature Place signature and date fields for each signer
Retention Set automatic archival per agency retention rules

Technical and platform considerations for eSubmission

Choose a platform that supports secure uploads, audit trails, and optional stronger signer authentication for sensitive records.

  • File types: PDF, DOCX, JPG supported
  • Integrations: Connect to case management or cloud storage
  • Authentication: Email, SMS code, or stronger options

Security and compliance items to confirm before eSigning

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest
Audit Trail: Timestamps, IP, and action logs retained
HIPAA: BAA required for PHI handling
ESIGN / UETA: Legal framework for electronic signatures
21 CFR Part 11: Available for FDA-regulated records
SOC 2 / ISO: Third-party security attestations available

Timing considerations and typical deadlines

Timelines vary by agency and program; plan for document collection, verification, and case updates during intake and review cycles.

Submission Timing:

Submit when caregiving begins or when requested by the agency

Evidence Collection:

Provide supporting documents promptly to avoid verification delays

Agency Review:

Review timing follows the agency's internal schedule and caseload

Follow-up Requests:

Respond quickly to additional information requests to prevent application holds

Case Update:

Retain confirmation of agency decision and update case notes

Key processing milestones for a DHS Pub 114 submission

Track these numbered stages to ensure the form progresses from intake to case action without unnecessary delays.

01

1. Form Completion

Caregiver completes the form and attaches evidence

02

2. Intake Verification

Agency intake unit validates identity and documents

03

3. Caseworker Review

Caseworker assesses eligibility and updates records

04

4. Decision Notification

Agency issues written acknowledgement or next steps

Common mistakes to avoid when preparing the form

  • Using nicknames or inconsistent spellings that prevent matching to agency records and trigger identity verification delays.
  • Failing to attach required proof of relationship or residency, leading to requests for additional documentation and slower processing.
  • Leaving dates blank or using nonstandard date formats, which can cause ambiguity about when caregiving responsibilities began.
  • Allowing unsigned or undated attestations; unsigned forms are frequently returned and cause administrative rework.

Administrative risks and potential penalties for incorrect submissions

Incorrect Tax Reporting: Backup withholding 24% if TIN missing
1099 Penalties: $60–$330 per form (IRC §6721)
I-9 Paperwork: $281–$2,789 per violation (8 CFR §274a.2)
Delays in Benefits: Incomplete records can postpone eligibility decisions
Audit Exposure: Insufficient documentation increases audit risk
Intentional Misstatement: Civil and criminal liability if falsified

Illustrative use cases for DHS Pub 114 Relative Caregiving

Real-world examples show how the form supports case management and benefit coordination in common scenarios.

State Child Welfare Office

A caseworker collects the completed form during intake to document kinship care placement.

  • The form establishes temporary caregiving responsibility.
  • The documented schedule and attached school records allowed the office to update the case plan, confirm eligibility for support payments, and avoid repeated follow-up for verification.

Family Caregiver Verification

A grandparent completes the form to receive respite supports for an enrolled child.

  • The form links caregiver identity to the child.
  • Attaching a birth certificate and a signed attestation expedited approval for short-term supports and provided a durable record for future reviews.

Comparing common eSignature vendors for this workflow

Vendor pricing and feature availability vary; signNow is listed first per table convention. Confirm each vendor plan for the exact feature set you require.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Yes Yes Yes Yes
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently asked questions about completing and submitting DHS Pub 114

Answers to common procedural and technical questions to reduce delays and clarify agency expectations.


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