Worker Responsibilities

Forms that must be reviewed with the household at the time of interview:

Rights and Responsibilities

Review form DSHS 14-113(X), Client Rights and Responsibilities with the household:

Face to Face Interviews

When conducting a face-to-face interview, explain the rights and responsibilities to the applicant and ask them to sign form DSHS 14-113 to acknowledge that they understand them. Send the document as file only to be scanned into the client’s Electronic Case Record (ECR).

2. Phone Interviews:

When conducting phone interviews, explain the rights and responsibilities to the applicant, send them a copy of form DSHS 14-113 , and request them to sign and return the document (do not hold up benefit issuance waiting for this form).

Your DSHS Cash or Food Assistance Benefits

For cash or food assistance benefits, review form DSHS 14-520, Your DSHS Cash or Food Assistance Benefits with the household:

1. Face to Face Interviews:

When conducting a face-to-face interview, explain the allowable use of benefits to the applicant and ask them to sign DSHS 14-520 to acknowledge that they understand the restrictions and penalties for illegal use. Send the document as file only to be scanned into the client’s Electronic Case Record (ECR).

2. Phone Interviews:

When conducting phone interviews, explain the allowable use of benefits to the applicant, send them a copy of form DSHS 14-520 , and request them to sign and return the document (do not hold up benefit issuance waiting for this form).