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BEM 117 5 of 6 DEPARTMENT WARDS, TITLE IV-E AND ADOPTION ASSISTANCE RECIPIENTS BPB 2018-007 4-1-2018

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

• The name, address and telephone number of the out-of- state agency who is a party to the adoption assistance agreement. • A copy of the adoption assistance agreement. • All copies of the DCH-0078.The EXHIBIT in this item shows a format for the memo. Send the memo via ID mail to:

Department of Health and Human Services

Adoption Subsidy Program

Division of Adoption Services

235 S Grand Avenue

PO Box 30037

Lansing, MI 48909 LEGAL BASE MA P.L. 99-272, Sections 9529 and 12305 42 CFR 435.115; .227; .403