Little Traverse Bay Bands of Odawa Indians

Waganakising Odawak

Little Traverse Bay Bands of Odawa Indians

Office of the Tribal Chairman

7500 Odawa Circle, Harbor Springs, Michigan 49740

Phone 231-242-1423 ● Fax 231-242-1430

LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS

DEPARTMENT OF KIKAAJIK

HOUSEKEEPING SERVICES POLICY

I.

Introduction. The purpose of this Policy is to set out specific guidelines and

requirements for the LTBB Department of Kikaajik to provide housekeeping

services to Elders who live alone with verifiable health and/or other limitations or

have a spouse or significant other with verifiable health and/or other limitations

prohibiting them from cleaning their own home. Hereinafter the Housekeeping

Services will be referred to as “HS.”

II.

Definitions.

A.

LTBB Tribal Elder: Refers to a Tribal Citizen of the Little Traverse Bay

Bands of Odawa Indians who is fifty-five (55) years of age or older by

December 31st of the current calendar year.

B.

HS: means the LTBB’s Department of Kikaajik Housekeeping Services

Program.

C.

Housekeeping Services: Services which include general cleaning of the

household common areas, sanitary cleaning of the bathroom, and general

cleaning of the kitchen and bedrooms. Care of beds, windows, and other

areas not referenced will be the responsibility of the Elder.

D.

Significant Other: means a life partner and/or cohabitating companion.

E.

Spouse: means wife/husband of an LTBB Tribal Elder.

F.

Verification of Limitations: means verification from a licensed physician

that the Elder has limitations that make them eligible for assistance.

III.

Management. This program is managed by the LTBB Department of Kikaajik.

IV.

Funding. This Policy is in effect for the HS Program run by the LTBB

Department of Kikaajik. The funding may be allocated from Tribal General Fund

and/or by a Title VI Grant from the Administration on Aging (AoA).

V.

Program Assistance. Subject to funding availability, HS will provide

housekeeping services to LTBB Tribal Elders who reside within the Respite

Service Area.

Department of Kikaajik Housekeeping Services Program Policy

Page 1 of 3

VI.

Eligibility Criteria.

A.

VII.

In order to receive housekeeping services, the following criteria must be

met:

1.

Applicant must be a LTBB Tribal Elder.

2.

Applicant must complete an application with the LTBB

Department of Kikaajik.

3.

Applicant must live alone with verifiable limitations. If the

Applicant has a spouse or significant other, they must also have

verifiable limitations preventing them from cleaning their own

house.

4.

Applicant must not have access to housekeeping services via a

Health Attendant or Resident Assistant.

5.

Applicant must reside within the Respite Service Area.

Processing Requests.

A.

Application. Applicants are responsible for submitting a completed

application to the LTBB Department of Kikaajik each calendar year. The

application may be obtained by mail by calling the LTBB Department of

Kikaajik to request an application or the application can be completed in

the LTBB Department of Kikaajik located at the LTBB Government

Building, 7500 Odawa Circle, Harbor Springs, MI 49740.

1.

At a minimum, the annual application will require:

a.

b.

c.

d.

e.

f.

g.

B.

Name,

contact information,

Enrollment number

Statement of need.

Initials and Acknowledgment of all policies and procedures

found on application

Verification of limitations.

A signature by the Tribal Elder as verification that all

information is true and correct to the best of their

knowledge.

Method of Payment. Once the LTBB Tribal Elder has applied for HS and

he/she has been determined to meet the eligibility requirements, a

purchase order will be submitted to the LTBB Accounting Office for

direct payment to the contracted vendor.

Department of Kikaajik Housekeeping Services Program Policy

Page 2 of 3

VIII. Services. The housekeeping services will be provided by a vendor contracted by

LTBB. The specific services for each eligible Tribal Elder will be done according

to approved needs.

A.

Certification:

1. Prior to contracting a vendor, the LTBB is responsible for

verifying that the vendor has passed a background check, has

provided proof of liability insurance, and has passed a System

Award Management (SAM) check to ensure that the vendor is

eligible.

IX.

Determination: The LTBB Department of Kikaajik Director is authorized to

exercise discretion, including making necessary determinations, to administer this

Policy. An Applicant who is dissatisfied with a determination has thirty days

from the date of the determination to submit a request for reconsideration to the

Unit Director for review. Upon receipt, the Unit Director has thirty days to review

and provide a response to the Applicant with a copy to the Department Director.

Any questions related to this Policy or the HS Program should be directed to the

LTBB Department of Kikaajik.

CERTIFICATION

As Chairperson, I certify that I approve of this Department of Kikaajik Housekeeping

Services Program Policy. This Housekeeping Services Program Policy will be posted for

public comment and may be amended pursuant to public or staff comments before

submission to Tribal Council.

11/21/2024

Date: _______________

_______________________________________

Tribal Chairperson

Department of Kikaajik Housekeeping Services Program Policy

Page 3 of 3

Little Traverse Bay Bands of Odawa Indians

Elders Department

Housekeeping Program

Name

Address

City

County

State

Enrollment #

Birthdate

MI

Zip

Phone

Other persons living in household

Name

I am in need of Housekeeping because: (please complete below)

1

2

3

4

5

Income: Documentation must be provided for all income for all persons living in home

Name

Income Source

x 12 = Annualized Income



I certify that I live alone or have a housemate/spouse with verifiable health limitations that prevents

us from cleaning our home.



I hereby certify that all information in this application is true, correct and complete to the best of my

knowledge.



I understand that giving false or incomplete information can result in referral to the prosecuting

attorney for fraud, and/or recovery of funds paid on my behalf.



I understand that failure to provide all necessary information and documentation can result in denial

of my application



I understand that I may request a hearing if I disagree with action taken on this application



Supporting Documentation from your health care provider is required



Household income documentation is required



Copy of Tribal ID is required

Applicant’s Signature

Date

Elders Department

Director’s Signature

Date

Documentation Checklist-Office use only do not write below this line

Completed application

Copy of tribal ID

Supporting Income Documentation

Written statement of need

Current Year: 2018

Little Traverse Bay Bands of Odawa Indians

Elders Department

7500 Odawa Circle, Harbor Springs, MI 49740

Ph: 231.242.1422 or 231.242.1423

Fax: 231.242.1430

Aanii LTBB Tribal Elder,

This letter is intended to provide you with information regarding the Housekeeping

Program. Elders may apply only once during a 12 month period for this program.



This assistance may be used to assist those tribal elders that are unable to clean

their homes due to health limitations on the individual.

Each elder is required to complete the enclosed application one time per year. In order for

the application to be processed in a timely manner, it is important that the directions for

this program be followed and completed properly.

Directions for program are as follows:

 Applicant must live within the county of Emmet.

 Application must be completely filled out, signed and dated by the applicant.

o Information may be taken over the phone and application will be mailed

for signature.

o Application can be completed in the Elders Department office.

 Supporting documentation must be submitted with application:

o Income documentation for all persons living in home.

o Supporting documentation from your health care provider.

 Assistance request must be for their primary residence.

 Total household income must adhere to the income guidelines.

Notice will be sent to the applicant once a decision has been made. If approved, a

requisition will be submitted to tribal accounting offices for direct payment to vendor. If

denied, a notice will be mailed to applicant, stating reason for denial.

If you have any questions about the application process, please contact the Elders

Department Assistant at (231) 242-1423 or the Elders Department Director at (231) 2421422

Miigwetch!

LTBB Elders Department

Current Year: 2018