This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.
The document is provided in Cambodian. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form 05-256?
A: Form 05-256 is the Notice of Action Exception to Rule for Adult Family Home (AFH) Daily Rates in Washington.
Q: What is an Adult Family Home (AFH)?
A: An Adult Family Home (AFH) is a residential home that provides care and support to elderly or disabled individuals.
Q: What is the purpose of Form 05-256?
A: The purpose of Form 05-256 is to notify individuals of any exceptions to the rules regarding AFH daily rates in Washington.
Q: Who needs to fill out Form 05-256?
A: AFH providers or individuals who are applying for or currently receiving services from an AFH need to fill out Form 05-256.
Q: What does an exception to the rule for AFH daily rates mean?
A: An exception to the rule for AFH daily rates means that there will be a deviation from the standard daily rate for care and support provided by an AFH.
Q: Are there any specific requirements for filling out Form 05-256?
A: Yes, there are specific requirements for filling out Form 05-256. These requirements are outlined in the form itself and may vary depending on the individual's circumstances.
Q: Can I appeal a decision made regarding an exception to AFH daily rates?
A: Yes, individuals have the right to appeal a decision made regarding an exception to AFH daily rates. The appeals process is outlined by the DSHS and can be initiated by following the appropriate procedures.
Q: Is the information provided on Form 05-256 confidential?
A: Yes, the information provided on Form 05-256 is confidential and subject to privacy laws and regulations.
Form Details:
Download a printable version of DSHS Form 05-256 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.