WebThe assessment will address specific information regarding the applicant including recent medical history, care needs and preferences, current prescribed medications, medical diagnosis, significant known behaviors or symptoms, history of depression, anxiety, and mental illness if applicable, social, physical and emotional strengths and needs, … WebDisclosure of Services Form Word / PDF (DSHS 10-508) Instructions for Completing and Submitting Disclosure Forms. AFH Incident Log (DSHS 13-645) Notice of Transfer & Discharge (DSHS 15-458) Request for AFH Application Fee Waiver (DSHS 15-436) Request Licensed Bed Capacity Increase (DSHS 06-168) Word / PDF. Request …

Estimating Nursing Home Comparable Home and Community …

Web• Have a Washington State Medical Test Site Waived (MTSW) license, and • Perform the tests correctly by trained staff, and • Follow good testing practices The Washington state MTSW license meets both federal and state requirements. The federal program for waived test is called CLIA (Clinical Laboratory Improvement Amendments). WebElectronic DSHS Forms You may download some DSHS forms. These are provided only if a DSHS program requests forms to be available electronically for public use. DSHS forms are available for electronic completion in different software; however, all DSHS forms below are available as Adobe Acrobat PDF files. blink cv family office

Forms DSHS - Washington

WebAdult Family Home Assisted Living Facility (including ARC / EARC) If client is, or will be in an in-home setting, how many hours a day is a caregiver available (average): CLIENT’S PRIMARY HEALTHCARE PROVIDER’S NAME ... DSHS 13-906 (REV. 04/2024) Bed Transfer / Positioning Device Instructions and Work Flow . WebNearly one out of every four Washington citizens turns to the Department of Social and Health Services' Economic Services Administration for assistance with cash, food, child support, child care, disability determination, transition to employment, and other services. Core services focus on: Community Partnership Program; Community Services Office WebThe State of Washington (State) and the Adult Family Home Council (AFHC) have agreed to Article 7.11 of the 2024-2024 Collective Bargaining Agreement (CBA). ... At the next assessment, assess the AFH resident’s interest in and need for Meaningful Day Activities. ... [email protected]. Kelly Hampton, DDA AFH Program Manager (360) 407 ... blinkdates.com