AGING AND DISABILITY SERVICES ADMINISTRATION

November 28, 2003

ADSA: AFH #2003-021
AFH ANNUAL FEE COLLECTION

Dear Adult Family Home Provider:

The purpose of this letter is to inform you of changes that will be occurring related to the collection of your annual renewal fee. Residential Care Services (RCS) is transitioning the collection of Adult Family Home annual fees to the Office of Financial Recovery (OFR), another division of the Department of Social and Health Services (DSHS). As of December 1, 2003, OFR will be responsible for sending you the notice and coupon for payment of your annual fee, and you will need to return your payment to OFR. RCS will continue to be responsible for licensing, annual inspection, and complaint investigation in your home.

You will receive the new payment coupon and statement during the month that your annual fee is due. Enclosed is a sample copy of the revised statement. With the receipt of the new annual renewal fee billing statement, you will notice some important changes:

• The format of the statement is different
• The bottom portion of the statement should be returned with your payment
• Your fee will be returned to a different address.

Also, instead of receiving a copy of the summary sheet with your billing statement, you will now only receive one document. Please make any corrections or changes to the information on the statement in the section of the invoice that instructs you to do so. It is very important to update the invoice with any needed corrections, so that we have accurate information about your home.

Contact your RCS Field Manager with any questions about this change.

Sincerely,

Patricia K. Lashway, Director
Residential Care Services

Enclosure