Michigan Migrant Education Program (MEP)
Office of Field Services, Special Populations Unit
Priority for Services: Eligibility Determination Worksheet
2013-2014
The Priority for Services (PFS): Eligibility Determination Worksheet will assist the local MEP in
determining which migrant students meet the Priority for Services criteria and should receive migrant
services first. This information should be used to update the Michigan Educational Database System
(MEDS) 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 should be less than one
year old.
Student’s Name __________________________________
Date of Birth _________________
Current QAD/LQM _____________
Current Grade Enrolled__________
Priority for Services Status: ___ PFS ___ NPFS
Receiving local MEP funded services ___ yes ___ no
If yes, please note the type of MEP
service received: Check all that apply
Today’s Date _________________
School ______________________
District or MEP _______________
School Year __________________
COE # ______________________
Additional Information: Check all that apply
___ Bi-National Enrollment
___ Non-Migrant, District Counseling Services
___ Any Instructional Services
___ Formerly Migrant (FM) receiving continuation of services (COS)
___ Math Instructional Services
___ FLEP (exit date, assessment and score:
___ Reading Instructional Services
_______________________________________________
___ Credit Accrual Services
___ Title I, Part A
___ Section 31a
___ Counseling Services
___ Title III, Immigrant
___ Support Services: ______________ ___ Title III
___
Title
I,
Part
D
___ Homeless
___ Referred Services: _____________
To qualify as Priority for Services, a migrant student must have experienced one of the possible
educational interruptions in Table A, and met one of the risk factors listed in Table B.
One item must be checked to qualify.
Table A. Qualifying Interruptions
Check the most Qualifying Interruptions
recent cause
Date
Interruption
Occurred
1. QAD/LQM after 9/1/2012 (or the start of the regular school year)
**Note QAD/LQM must be during the regular school year**
2. Moved from one district to another due to migrant lifestyle, but
the move did not qualify as a new QAD/LQM
Describe event: _____________________________________
3. Absent for at least 5 consecutive days due to the migrant lifestyle
Describe event: _____________________________________
4. Officially withdrawn from school for at least five days and then
re-enrolled due to the migrant lifestyle
Describe event: _____________________________________
Table B can be found on page 2.
For additional guidance, see Michigan MEP PFS Guidance Document.
Page 1 of 2
09/2013
Table B. Risk Factors for failing to meet State Standards Criteria
Check all that
apply
Risk Factors
Assessments must be less than 12 months old
5. Scored partially proficient or basic on the Michigan
MEAP/MME Reading Assessment
Description
and/or Scores
6. Scored partially proficient or basic on the Michigan
MEAP/MME Mathematics Assessment
7. Scored partially proficient or basic on Michigan MEAP/MME
Writing Assessment
8. Scored partially proficient or basic on Michigan MEAP/MME
Science Assessment
One item must be checked to qualify.
9. Scored partially proficient or basic on Michigan MEAP/MME
Social Studies Assessment
10. Scored below proficient on State Assessments received from
other states
11. Scored below the 50th percentile on norm-referenced test
(reading and/or math)
12. Scored below grade level on locally administered assessment
in reading or math (DRA2, Delta Math or other)
13. Is classified as Limited English Proficient and has not met the
requirements from the Michigan’s Entrance and Exit Protocol
to be exited from EL services.
LEP Assessment Date _______
14. Qualifies for Special Education Services
Date Of IEP ______
15. Is behind in accruing credits toward graduation requirements
16. Has grades indicating below average performance in math
and/or language arts at the elementary level
17. Has grades indicating below average performance in math,
language arts, sciences, or social studies at the middle or high
school levels
18. Repeated a grade level or course
19. Pursuing a GED course of study (OSY only). Note program and
enrollment period.
20. Enrolled in a structured, early childhood program for at-risk
children (PS only). Note program and enrollment period.
Student’s Name_______________________________
Today’s Date __________________
Page 2 of 2