mdhhs-6024-FAC, michigan juvenile justice
families advisory council (mjjfac) application information

Michigan Department of Health and Human Services

(New 9-23)

eligibility

Adults who have family members who are actively participating in or previously serviced by a Michigan Department of Health and Human Services (MDHHS) or juvenile court system. Additional experience may also include Children’s Protective Services (CPS) or foster care.

participation

The Juvenile Justice Families Advisory Council will assist the MDHHS and partner agencies by developing recommendations or suggestions for improving juvenile justice and child welfare responses to children and families and provide input on policy development. Council members will participate in quarterly meetings and work to achieve objectives through additional activities such as: • Developing and reviewing policies and procedures. • Participating in engagement opportunities such as workgroups, advisory boards, or steering committees that inform programs and policies. • Participating in legislative advocacy or testimony. • Participating in forums and presentations involving juvenile justice and child welfare stakeholders. • Otherwise engaging in positive advocacy on behalf of children and families impacted by the juvenile justice system.

term of appointment

Terms are a two-year appointment. Members must commit to participating in both council meetings and engagement opportunities.

REIMBURSEMENTS/INCENTIVES

• Reimbursement for approved travel at state rate. • Participation reimbursement will be provided as outlined in the MJJFAC Operating Guidelines.

membership application instructions

Send membership application along with two letters of support/recommendation via: Email: MDHHS-JJFAC@michigan.gov Mail: MDHHS-JJ Program Office, 5th Floor, Attn: MJJC, PO Box 30037, Lansing, MI 48909 Questions: If you have questions or need assistance in completing this form, email MDHHS-JJFAC@michigan.gov

disclaimer

Application does not ensure membership appointment. The applicant-provided email address noted in this application will be used for primary communication unless otherwise noted in special accommodations. Having no access to transportation or phone does not prohibit appointment.

mdhhs-6024-FAC, michigan juvenile justice
families advisory council (mjjfac) application

Michigan Department of Health and Human Services

(New 9-23)

section 1 – applicant information

Full Name (Last, First, MI)	Date

Street Address	City	State	Zip Code

Telephone Number	Email (Required – Primary form of communication)	Date of Birth

Do you have access to transportation? Yes No	Do you have access to a phone? Yes No

Have you ever worked for MDHHS or private agency? Yes No If yes, where

Are you able to attend required quarterly meetings? Yes No If no, explain

Are you willing to carpool members to events? (not required) Yes No Possibly

section 2 – program involvement (Provide dates of your family members applicable current or previous service involvement)

Juvenile Justice/Residential/Juvenile Court Yes No	To From

Children’s Protective Services Program Yes No	To From

Foster Care Yes No	To From

Other (explain)	To From

May we call your caseworker (optional) Yes No

Name of Caseworker	Telephone Number	County

section 3 – experience (Include any MDHHS/Private Agency committee or project participation)

Company	Job Title

Street Address	City	State	Zip Code

Supervisor Name

Company	Job Title

Street Address	City	State	Zip Code

section 4 - other

Desired Program Areas of Interest (Identify any program interests, for example: policy review, presenting, specific maltreatment topics)

Do you require special accommodations (i.e., dietary, travel, phone accessibility, other)?

section 5 – disclaimer and signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to appointment, I understand that false or misleading information in my application or interview may result in my release.

Signature	Date

Additional Include two letters of support and/or recommendation (required) You may also include any additional information, if desired, e.g., resume, cover letter (not required) Application can be sent either via email or mail. Email: MDHHS-JJFAC@michigan.gov Mail: MDHHS-JJ Program Office, 5th Floor, Attn: MJJC, PO Box 30037, Lansing, MI 48909

The Michigan Department of Health and Human Services will not exclude from participation in, deny benefits of, or discriminate against any individual or group because of race, sex, religion, age, national origin, color, height, weight, marital status, partisan considerations, or a disability or genetic information that is unrelated to the person’s eligibility.