WorkFirst HandBook

Engaging Parents in WorkFirst

1.3 Up-front Referrals

The Up-front Referrals section includes:

1.3.1 What up-front referrals are required?

Some issues may need to be considered when developing an Individual Responsibility Plan (IRP). Up-front referrals or additional evaluations include the:

The remainder of this section describes Equal Access (formerly known as NSA) and family planning. Other assessments and evaluations are described in the Resolving Issues and Pregnancy to Employment sections. You can find links to these other sections, and more information listed in the resource section below.
1.3.2 What do Equal Access (EA) services mean?

CSO staff screen all heads of household to determine if the individual requires a reasonable accommodation resulting from a disability or learning or literacy issue to access and maintain DSHS services.

EA screening is needed to complete the:

When identified or requested, reasonable and necessary accommodations are given to ensure these individuals can access and maintain WorkFirst services and benefits. See NSA WAC .

EA plans support the IRP and allow the individual to access and maintain services for which the individual is eligible.

Staff may refer the individual to the WFSW when the WFSWs expertise in completing the EA Screen or Plan is required.

Limited English-Proficiency Program (LEP):

Equal Access services DO NOT include referrals for Limited English Program (LEP). The focus of EA services is on accommodation of disabilities and learning and literacy issues (not to be confused with services for persons having limited-English proficiency.

Screening of Heads-of- Household:

EA screening is completed on each head of household at the time of:

Screening of Others (Non-Heads-of- Household):

All other household members age 16 and older, who are required to participate in WorkFirst activities, are screened upon initial contact. Reasonable and necessary accommodations are provided under NSA WAC prior to the required participation,

Equal Access Screens and Documents:

Client Handout (link to be added)

The EA Screening tool is used to determine:

The EA Plan is electronically developed depending upon the responses given during the EA Screening.

Staff may refer to the WFSW when the l a referral is necessary to best serve the individual.

In some cases it may be necessary to refer the individual to the WorkFirst Social Worker (WFSW) for completion of the EA Screening and Plan (if needed).

1.3.3 Equal Access - Step-by-Step Guide

Using the Aces On-Line EA Screen, if not already completed, the WFPS screens individuals applying for WorkFirst cash assistance or State-Funded Assistancerequire necessary supplemental accommodations. The WFPS refers the individual to a WFSW if the WFSW's expertise is needed.

  1. The EA Plan is automatically developed based upon the response received during the EA Screening.
  2. Other Non-Heads-of-Household members age 16 an older whom are required to participate in WorkFirst activities are required to be screened at first contact.
  3. EA Services may differ from services to address barriers to participation.
  4. See E A-Z Manual Equal Access (Necessary Supplementary Accommodation) for more details.)
1.3.4 What is Family Planning?

Family planning services are educational, medical and social services that help male and female individuals make decisions regarding additional pregnancies while on WorkFirst cash assistance/SFA. We offer on-site family planning services including information on various birth control methods. Advantages for offering these services include, but are not limited to:

1.3.5 How to screen for Family Planning?

It is mandatory to:

  1. Provide written information about a variety of family planning resources to each individual. This information must include:
  2. Offer all individuals family planning information or a referral to the family planning worker or nurse at least once a year. The referral and/or family planning information should be completed at the following times:

The information and referrals help us meet the goal of the WorkFirst Family Planning program: zero additional pregnancies while on WorkFirst cash assistance/SFA. Once referred, every individual will:

1.3.6 What are the responsibilities of DSHS staff and family planning nurse or worker?

DSHS is responsible to provide adults and emancipated minors with family planning information, services, and referral to family planning nurses or local agencies. The purpose of providing information and referrals is to make individuals aware of the family planning services available to them so they are able to make an informed decision as to how unplanned pregnancy will affect their hopes and dreams for the future. The family planning nurse/worker or DSHS staff does not document the actual birth control method or specific pregnancy related choices (e.g. termination) in eJAS.

Family planning outcomes or updates that can be documented in eJAS for WorkFirst individuals are:

  1. The nurse attempted to contact the individual and the individual never responded,
  2. The nurse had contact with the individual and individual declined services, or
  3. The nurse had a face-to-face meeting with the individual.

DSHS staff and family planning nurses will collaborate to educate and provide information for individuals to make an informed decision about future pregnancies. The family planning nurses do not have to disclose any details of their conversations nor what birth control method the individual chooses.

Use the following script when individuals call a Call Center or Customer Service Center about family planning services:

"If you have a Medical ID Card (exception is Medically Indigent card), you can get family planning services at the Community Services Office (CSO), family planning clinic, doctor and/or pharmacy. If you do not currently have a Medical Id card, you may apply for one or be able to get family planning services from a medical program called TAKE CHARGE. To find a provider near you, call the Family Planning Hotline at 1-800-770-4334."

1.3.7 Examples of various types of family planning screening and referrals
Young Adult:

Melanie has just been approved for WorkFirst. June, her WFPS/WFSW asks if she has received the "Let's Talk" information on Family Planning. Melanie is 24 years old with a 14 month-old son. June asks her what her ideal family size would be. She has always wanted three children but has not been able to get above a minimum wage job. June explains the cost to raise a child and that an unplanned pregnancy can make it harder to support a family and provide all that her children will need. WorkFirst will work on increasing her ability to earn more money. Family nurse providers have information and supplies that can help plan when you want more children. Has she seen the nurse yet? Melanie answers "no" and is referred to the family planning nurse. The nurse discusses current information on family planning options, how to use her medical ID card to pay for services and what is covered. Melanie talks about her dream to have more children later. The nurse gives her some emergency contraception products and sets her up with an appointment for family planning services and a telephone number for any questions. After Melanie's appointment, the nurse contacts her to discuss any questions or need to review other available methods. The nurse sends June a communication to let her know that she was able to contact Melanie and enters documentation in the eJAS Family Planning note type “Showed to her family planning appointment today.”

Male:

Todd is a 27 year-old single father of two young children. At the eligibility interview the WFPS gives Todd the "Let's Talk" wallet card and the "Let's Talk" brochure asking him if he has thought about how an additional child would affect his dreams for the future. The WFPS asks Todd if he has seen the family planning worker. Todd indicates that he hadn't seen her, but wasn't sure he needs to because he isn't married. The WFPS explains how some pregnancies are unplanned and that the family planning worker can assist him so this would not happen to him. She can also give him free condoms and explain how he can get various birth control methods using his Medical ID card in case he should want to obtain any other method some time in the future.

Middle-Age, non-childbearing female:

Barbara is a 41 year-old mother of two children, 17 year old Kristi and 15 year old Josh. She has come in for cash assistance. Through the course of your intake interview, Barbara revealed that she just ended a short relationship and made the comment that over the last year, she has "gone through three losers" and that she can hopefully snag someone worth keeping soon. Upon her up-front family planning screening, Barbara states she had a hysterectomy about four years ago.

There are several issues to consider in this example. Even though birth control is not the first issue for Barbara, she is in multiple relationships that put her at an increased risk of contracting a sexually transmitted disease (STD). In this situation, the DSHS staff or the family planning worker/nurse can make a referral to the local family planning agency or to the person's primary care physician for STD counseling, education and care. A second issue is that even though her daughter, Kristi, will be screened, her son Josh is at an age where he may become sexually active. Discuss the benefits of giving information to him and acknowledge that talking with our children may be difficult, but the family planning worker is available and would welcome helping Barbara speak to her son, or speaking to him for her. By assuming that because Barbara cannot have children, she doesn't need to see a family planning worker, we are also making decisions for her that she and her family can't benefit from family planning services.

1.3.8 eJAS/ACES codes

When a WorkFirst individual is referred for family planning, use the eJAS code:

1.3.9 Family Planning - Step-by-Step Guide

When a WorkFirst individual is screened for family planning, the WFPS will:

  1. Enter the eJAS comprehensive evaluation, click on "Family Planning," and then select either "full evaluation" or "partial evaluation."
  2. If the individual needs a Family Planning referral, click on the Family Planning Referral button and:
    1. The eMessage DSHS Referral Form will appear.
      1. Complete the referral form,
      2. After the form is completed, you have two referral options (buttons) to choose from located in the upper right hand corner of the screen. To make a referral, you may:
        • Locally print – click the “Print this Referral” button, or
        • Send by eMessage – click the “eMsg this Referral” button.
          • eJAS will ask you to enter the Userid for the recipient of the referral. Fill in the box or, if you do not know the recipient Userid, you can find it by click on the “Userid help”.
          • After the Userid information is entered, click on the “Send eMsg” button. You will see a screen that says, "E-msg Referral sent or printed Close Window". Click on it to close the window.
    2. The Family Planning screening/referral screen will appear. Document relevant referral information in the comment section at the bottom of the screen.
    3. Click "Save this Page" button to continue the screening process.
  3. If the individual declines or refuses a family planning referral on the Family Planning screening/evaluation screen, click on the Family Planning Information button and:
    1. Give the individual, at a minimum, DSHS form 22-400 "Let's Talk" wallet card, and "Let's Talk" brochure DSHS form 22-985(x).
    2. Document what was given to the individual in the comment section at the bottom of the screen.
    3. Click on the "Save this Page" button.

    Note: Staff must screen and offer family planning information/services at least once per year and document this in eJAS under the Family Planning note type. (For this purpose, a year has been defined as 350 days.)

  4. The family planning worker or nurse will:
    1. Follow up on the eMessage or paper referrals,
    2. Make contact with the individual based on local office procedures.
    3. Have access to view non-confidential notes and Client Demographic screen in eJAS.
    4. Document their outcomes or updates in the Family Planning Note category in eJAS.
    5. Report back to the WFPS/WFSW based upon the instructions completed on the e-message or paper referral form.

      6. Note: The family planning nurse or worker will be able to document actions, view eJAS and receive eMessages or paper referrals via eJAS for WorkFirst individuals only.

Resources

Related WorkFirst Handbook Sections
Forms & Other Resources

For more information about the WorkFirst HandBook, contact Kim Shidell, WorkFirst Program Manager.