DSHS Form 14-521 MI "Your Rights" - Washington (Mien)

This "Dshs Form 14-521 Mi "your Rights" - Washington (Mien)" is a part of the paperwork released by the Washington State Department of Social and Health Services specifically for Washington residents.

The latest fillable version of the document was released on May 1, 2017 and can be downloaded through the link below or found through the department's forms library.

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Download DSHS Form 14-521 MI "Your Rights" - Washington (Mien)

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AGING AND LONG TERM SUPPORT ADMINISTRATION
PO BOX 45600
OLYMPIA WA 98504-5600
Meih nyei ze’buonc do-leiz
Meih maaih ze’buonc haih tov gunagc guangc ndutv gorngv taux sic dauh hoic gorngv meih mv longc hnyouv
goux, zoux hoic, dorh nyaanh mingh longc mv ei leiz aengx caux guangc huiang. Se gorngv meih maaih waa-
porv gaux longc bun sienx duqv gorngv meih gengh zoux maaih gorngv daai yiem gu’nguaaic deix sic dauh
nor meih se maaih ze’buonc leiz nyeic mingh:
1. Zoux sou fungx mingh bun taux ninh mbuo tengx gunv goux zuangx mienh aengx caux baengc zingh
(Department of Social and Health Services (DSHS)) gorn zangc aengx caux gunv leiz gorn zangc aengx
caux dorh waa-fienx mingh bun dorh meih sienx duqv gorngv haih tengx zaah dimv mangc cing duqv nyei
gorn zangc dorngx aengx caux paaiv heuc haaix dauh mienh dongh sienx gorngv maaih waa-fienx gaux
longc.
2. Tengx zunh zaanx mengh dauh nzaaux guangc liouh zoux sou box tong a’fai haih zoux maaih gorn gorngv
mv longc hnyouv goux, zoux hoic, dorh nyaanh mingh longc mv ei leiz aengx caux guangc huiang.
3. Oix zuqc zoux bun maaih mengh hoc aengx caux taaih doic longc waac horpc bun caeqv nzaanz sic.
4. Lorx dorngx dauh bun waaic fangx mienh yiem bueix dongh mingh haaix zanc mingh box tong fienx aengx
caux haaix zanc tengx zaah mangc aengx caux gunv goux mangc yietc nyeic gong wuov.
5. Zoux sou-tov heuc cuotv haapc maax waac mv bun haaix dauh mienh dongh zoux hoic meih ei yiem
gorngv daaih nyei sic dauh yiem njiec meih nyei biauv, buaangh taux meih a’fai bieqc zorqv nyaanh longc
a’fai longc siou-setv jaa-dorngx.
6. Zipv longc wa-fienx yiem caux ninh mbuo DSHS aengx caux fungx mingh bun yiem da’nyeic norm horpc
jaa dorngx dauh dongh haih njiaaux, zaah dimv mangc a’fai zoux nyei gong.
7. Box fienx mingh mbuox tong gorngv taux zaah dimv cuotv nyei sic dauh, yietc nyeic gong-bou, porv leiz
zaamc nyei gong-bou aengx caux ninh mbuo gorn zangc siou liouh sic dauh dongh zoux sic dauh bun
meih ndortv naanc wuov.
8. Tov heuc fungx mingh njiaaux a’fai gorn zangc tengx goux mangc gan do-leiz bun ku-yiem tengx mbenc
maaih baeng-orn dorngx, zaah dimv mangc aengx caux muangx bun-paaiv sic dauh.
9. Ngopv gox taux ninh mbuo DSHS gorngv taux zaah dimv mangc a’fai zoux yietc nyeic gong-bou aengx
caux oix zuqc heuc gaan dau fienx bun muangx sic siepv.
Dorh mingh zoux sou gorngv taux zoux cunv hoic, mv longc hnyouv gaux longx, guangc hiuang,
ga’ganh-zuqc guangc hiuang a’fai longc nyaanh zoux sic eix mv ei leiz a’fai tov lorx waa-fienx nor kork
waac mingh bun taux:
1-866-EndHarm (1-866-363-4276)
Muangx waa-qiez/TTY bieqc 1-800-737-7931
Ninh mbuo oix zuqc fungx meih mingh taux APS yiem njiec buon-deic dorngx nyei gong-gorn zangc tengx
zoux box tong fienx sou a’fai tov lorx longc waa-fienx.
Lorx buangh taux buon-deic waa-fienx:
YOUR RIGHTS
DSHS 14-521 MI (REV. 05/2017) Mien
AGING AND LONG TERM SUPPORT ADMINISTRATION
PO BOX 45600
OLYMPIA WA 98504-5600
Meih nyei ze’buonc do-leiz
Meih maaih ze’buonc haih tov gunagc guangc ndutv gorngv taux sic dauh hoic gorngv meih mv longc hnyouv
goux, zoux hoic, dorh nyaanh mingh longc mv ei leiz aengx caux guangc huiang. Se gorngv meih maaih waa-
porv gaux longc bun sienx duqv gorngv meih gengh zoux maaih gorngv daai yiem gu’nguaaic deix sic dauh
nor meih se maaih ze’buonc leiz nyeic mingh:
1. Zoux sou fungx mingh bun taux ninh mbuo tengx gunv goux zuangx mienh aengx caux baengc zingh
(Department of Social and Health Services (DSHS)) gorn zangc aengx caux gunv leiz gorn zangc aengx
caux dorh waa-fienx mingh bun dorh meih sienx duqv gorngv haih tengx zaah dimv mangc cing duqv nyei
gorn zangc dorngx aengx caux paaiv heuc haaix dauh mienh dongh sienx gorngv maaih waa-fienx gaux
longc.
2. Tengx zunh zaanx mengh dauh nzaaux guangc liouh zoux sou box tong a’fai haih zoux maaih gorn gorngv
mv longc hnyouv goux, zoux hoic, dorh nyaanh mingh longc mv ei leiz aengx caux guangc huiang.
3. Oix zuqc zoux bun maaih mengh hoc aengx caux taaih doic longc waac horpc bun caeqv nzaanz sic.
4. Lorx dorngx dauh bun waaic fangx mienh yiem bueix dongh mingh haaix zanc mingh box tong fienx aengx
caux haaix zanc tengx zaah mangc aengx caux gunv goux mangc yietc nyeic gong wuov.
5. Zoux sou-tov heuc cuotv haapc maax waac mv bun haaix dauh mienh dongh zoux hoic meih ei yiem
gorngv daaih nyei sic dauh yiem njiec meih nyei biauv, buaangh taux meih a’fai bieqc zorqv nyaanh longc
a’fai longc siou-setv jaa-dorngx.
6. Zipv longc wa-fienx yiem caux ninh mbuo DSHS aengx caux fungx mingh bun yiem da’nyeic norm horpc
jaa dorngx dauh dongh haih njiaaux, zaah dimv mangc a’fai zoux nyei gong.
7. Box fienx mingh mbuox tong gorngv taux zaah dimv cuotv nyei sic dauh, yietc nyeic gong-bou, porv leiz
zaamc nyei gong-bou aengx caux ninh mbuo gorn zangc siou liouh sic dauh dongh zoux sic dauh bun
meih ndortv naanc wuov.
8. Tov heuc fungx mingh njiaaux a’fai gorn zangc tengx goux mangc gan do-leiz bun ku-yiem tengx mbenc
maaih baeng-orn dorngx, zaah dimv mangc aengx caux muangx bun-paaiv sic dauh.
9. Ngopv gox taux ninh mbuo DSHS gorngv taux zaah dimv mangc a’fai zoux yietc nyeic gong-bou aengx
caux oix zuqc heuc gaan dau fienx bun muangx sic siepv.
Dorh mingh zoux sou gorngv taux zoux cunv hoic, mv longc hnyouv gaux longx, guangc hiuang,
ga’ganh-zuqc guangc hiuang a’fai longc nyaanh zoux sic eix mv ei leiz a’fai tov lorx waa-fienx nor kork
waac mingh bun taux:
1-866-EndHarm (1-866-363-4276)
Muangx waa-qiez/TTY bieqc 1-800-737-7931
Ninh mbuo oix zuqc fungx meih mingh taux APS yiem njiec buon-deic dorngx nyei gong-gorn zangc tengx
zoux box tong fienx sou a’fai tov lorx longc waa-fienx.
Lorx buangh taux buon-deic waa-fienx:
YOUR RIGHTS
DSHS 14-521 MI (REV. 05/2017) Mien