This version of the form is not currently in use and is provided for reference only. Download this version of DSHS Form 14-416 for the current year.
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 14-416?
A: DSHS Form 14-416 is a document used to review eligibility for long term services and supports in Washington.
Q: What is the purpose of the Eligibility Review for Long Term Services and Supports?
A: The purpose of the review is to determine if an individual is eligible for long term services and supports provided by DSHS.
Q: Who is eligible for long term services and supports in Washington?
A: Eligibility for long term services and supports in Washington is based on factors such as income, assets, age, disability, and need for care.
Q: What information is required for the eligibility review?
A: The eligibility review requires information on income, assets, medical history, and current living situation.
Q: How often does the eligibility review need to be completed?
A: The eligibility review needs to be completed every 12 months to ensure continued eligibility for long term services and supports.
Q: Are there any fees associated with the eligibility review?
A: There are no fees associated with the eligibility review for long term services and supports in Washington.
Q: What happens if the eligibility review determines I am not eligible?
A: If the eligibility review determines that you are not eligible, you may be provided with information on other available resources and services.
Form Details:
Download a printable version of DSHS Form 14-416 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.