6.3 Participation While Resolving Issues
The Participation While Resolving Issues section includes:
- 6.3.1 What is supporting participation?
- 6.3.2 Stacking activities and issue resolution
- 6.3.3 How do we code participation?
- 6.3.4 What are the types of participation while resolving issues?
- 6.3.5 How do we treat parents with medical issues who do not have Medicaid?
- 6.3.6 Parents with medical issues who do not have Medicaid - Step-by-step Guide
- 6.3.7 What are the documentation of physical impairments and mental conditions guidelines?
- 6.3.8 What kinds of documentation/evidence should I request?
- 6.3.9 Supporting participation - Step-by-Step Guide
6.3.1 What is supporting participation?
The purpose of WorkFirst is to help WorkFirst families become self-sufficient through employment as quickly as possible. Many families need support to participate in WorkFirst activities. Supporting a parent's participation in job search or employment is fundamental to his/her success.
The main purposes of the comprehensive evaluation, stacking activities and the Social Service Specialist assessment are to:
- Identify how best to support the person's self-sufficiency through employment.
- Provide needed supports that meet the person's identified needs.
- Create a long-term plan for persons who are exempt and unable to participate.
- Help people who cannot participate to stabilize their situation as soon as possible when people cannot participate in countable activities so they can progress.
- Address issues, increase participation and transition to work or work-like activities as soon as possible when the person is resolving issues like mental health, chemical dependency, family violence, learning disabilities or working with DVR.
People are usually able to participate in other activities while also addressing issues that interfere with full-time employment. See the Stacking Activities Chart for a list of core and non-core activities that can be added to a person's IRP and help them progress while meeting WorkFirst participation requirements. Consider whether to add the following core activities:
- Independent life skills training (code these hours under the LS eJAS component code). For more information on independent Life Skills training, please refer to section 7.3.6 - What is Independent Life Skills Training?
- Community Work, Community WEX or Community Jobs.
Full deferment from Career Scope activities should only be considered when it is not possible for the person to accept employment or at least participate in 20 hours of Career Scope activities. In those cases, the person may need to resolve an issue prior to participating in Career Scope activities.
For example, a person may need Residential (In-Patient) treatment for alcohol or substance abuse/chemical dependency.
It will be necessary to defer job search or other activities while the person is in residential treatment for a short time (usually 28 days but may require up to 90 days). Depending upon the individual circumstances and treatment plan, the person can often resume participating in job search or other activities while also completing the Outpatient Treatment Plan. If the person is waiting for an opening to enter treatment, determine if there are other activities in which the person is able to participate.
See section 6.6, Disabilities, if the person claims to have a disability or medical issue that limits their ability to work, look for work or prepare for work.
For other deferrals, allow 30 days to gather documentation. The person must show "good-cause" if more than 30 days is needed to gather documentation. For example, the person must show that the information has been requested but not received within the 30-day time period. If the parent has not provided the needed documentation within the 30-day time period, send an appointment letter to determine if "good-cause" exists.
6.3.2 Stacking and Issue Resolution Activities
Parents who are resolving countable "X" code issues, such as mental health (XG) or Family Violence (XF), can stack other activities to increase their hours of participation. Stacking activities is combining other needed WorkFirst activities, such as job search, life skills, unpaid work, parenting, and seeking stable housing with the countable "X" code,. See section 3.3.2, section 6.6, Disabilities, and the Stacking Activities Chart for more information
Continued communication and monitoring between the WFPS or WFSSS and others who are working with the person are necessary to ensure:
- Multiple services/referrals are kept reasonable for the person;
- Appropriate information is shared;
- The IRP is amended as appropriate;
- Participation requirements are enforced; and
- The person receives appropriate support services and child care.
The WorkFirst partner agencies and most contractors normally can tell how many hours a parent will be expected to participate in their program activities. The WFPS or WFSSS develop IRPs accordingly. See section 126.96.36.199 and 188.8.131.52 for more information about how to meet program/participation goals and build an IRP.
There may be rare occasions when the service provider has not established a standard amount of hours each parent will be required to participate. When this occurs, the WFPS or WFSSS will have to estimate the expected hours of participation on the IRP.
Use the Individual Responsibility Plan (IRP) to clearly state the required participation and the supports we will provide.
Deferrals ("X" codes) taking longer than 90 days require verification and approval by:
- A multi-disciplinary case-staffing;
- Supervisor or higher level authority approval; or
- Documentation provided by a health-care or other professional.
Develop an IRP that specifies the activities the person is to be taking to resolve the issues and the expected time to resolve the issue. For example, "Follow recommended treatment plan," or "attend all physical therapy sessions as prescribed by physician."
Review the case every 30 days to ensure the individual is making satisfactory progress in resolving the issue unless the person is not engaged in activities each month. For example, a person may be consigned to 90 days bed rest by his or her physician. In these cases, review periods can exceed 30 days but require approval by:
- A multi-disciplinary case-staffing;
- Supervisor or higher level authority approval; or
- Documentation provided by a health-care or other professional.
For information on how to treat excused and unexcused absences, please refer to section 184.108.40.206 - How do we treat excused and unexcused absences?
6.3.3 How do we code participation?
Use the appropriate "X" or referral codes in eJAS to identify the person's issues, authorize support services, and/or make referrals to other resources.
Example: Following 90 days of Intensive In-Patient treatment, the person must attend 2 AA meetings and 1 group therapy session per week. Transportation to and from meetings or appointments do not count as actual hours of participation.
- The AA meetings last 2 hours each (4 hours total).
- The group therapy session is hours (2 hours total).
The actual number of hours spent in treatment-related activities is 6 hours.
Hours spent in independent life skills activities are coded in eJAS under the component code "LS". The scheduled hours of participation should be as close to 32 to 40 hours per week as possible.
The WFPS/WFSSS develops an IRP that brings the person up to full-time participation in countable activities as soon as the person is able. We also want to make stabilization and issue resolution activities short-term if we can, so the parent can transition into work-focused activities that lead to employment and self-sufficiency.
6.3.4 What are the types of participation while resolving issues?
Described below are various types of stabilization and issue resolution and specific eJAS codes used. More information can be found on each type in other sections of the WorkFirst Handbook.
Types of activities to resolve issues
Pursuing SSI/L&I/VA or other benefits (not countable)
See 6.8 Exemptions section
No child care available or caring for a disabled adult who is in school full time (not countable)
In a DVR plan (a countable core activity)
Alcohol/substance abuse/chemical dependency Treatment (a countable core activity)
Family Violence Resolution (a countable core activity)
Mental health treatment or Counseling (a countable core activity)
Resolution of Homelessness (not countable)
Learning Disabilities Services (a countable core activity)
Temporary incapacity undergoing medical treatment (not countable)
Caring for a child with special needs who is in school full time (not countable)
Parenting skills, nutrition classes, choosing child care and family planning (normally used if pregnant or have child under 12 months of age, but also used for other parents in need of these services)
6.3.5 How do we treat parents with medical issues who do not have Medicaid?
Parents who do not have Medicaid due to citizenship verification requirements and who have an activity requirement that is dependent on Medicaid coverage are not required to participate in these activities until Medicaid eligibility is established. Until Medicaid coverage is established, these parents will be coded with the component code 'CV'. This is an indicator code only and has no IRP or monitoring requirements.
However, parents will be required to participate in other WorkFirst activities identified as appropriate through the Comprehensive Evaluation and other assessments that are not dependent on Medicaid coverage.
Once citizenship verification requirements are met and Medicaid is approved, the component code 'CV' will be removed and participation requirements will be changed to include appropriate medical services.
For parents with chemical dependency issues, please refer to section 6.7.4- Who is financially eligible for substance abuse treatment?
6.3.6 Parents with medical issues who do not have Medicaid - Step-by-Step
Parents who are unable to participate in any other activities due to a medical issue
If a parent has a severe enough medical issue to prevent participation in any other activities:
- Document in the appropriate eJAS note section the reason the parent is unable to participate
- Update the eJAS component screen with the indicator component code 'CV'
Parents who are able to participate in other stacked activities
If a parent has a medical issue, but is also able to participate in other activities:
- Update the eJAS component screen with the indicator 'CV' (in lieu of using component code 'XM' or 'XG' if the parent had Medicaid coverage and was able to seek treatment services)
- Update the eJAS component screen with the appropriate stackable activities in which the parent is able to participate
- Develop the IRP for the required activities
- Document in the appropriate eJAS notes the number of hours per week the parent would normally be expected to participate in medical issue resolution if he/she had Medicaid coverage
- Document the parent's other required activities in the appropriate eJAS notes
6.3.7 What are the documentation of physical impairments and mental conditions guidelines?
Obtain professional documentation that supports the need for resolving a physical impairment or mental condition using the guidelines set forth in WAC 388-448-0020 for the General Assistance - Unemployable (GA-U) program. See section 6.6 Disabilities, for further instructions.
WAC 388-448-0020 Which health professionals can I go to for medical evidence?
We accept medical evidence from these sources:
- For a physical impairment, a health professional licensed in Washington state or where the examination was performed:
- A physician, which for GA program purposes, includes:
- Medical doctor (M.D.);
- Doctor of osteopathy (D.O.);
- Doctor of optometry (O.D.) to evaluate visual acuity impairments;
- Doctor of podiatry (D.P.) for foot disorders; and
- Doctor of dental surgery (D.D.S.) or doctor of medical dentistry (D.M.D.) for tooth abscesses or temporomandibular joint (TMJ) disorders.
- An advanced registered nurse practitioner (ARNP) for physical impairments that are within the ARNP's area of certification to treat;
- The chief of medical administration of the Veterans' Administration, or their designee, as authorized in federal law; or
- A physician assistant when the report is cosigned by the supervising physician.
- For a mental impairment, professionals licensed in Washington state or where the examination was performed:
- A psychiatrist;
- A psychologist;
- An advanced registered nurse practitioner certified in psychiatric nursing; or
- At our discretion:
- A person identified as a mental health professional within the regional support network mental health treatment system provided the person's training and qualifications at a minimum include having a Master's degree and two years of mental health treatment experience; or
- The physician who is currently treating you for a mental impairment.
- "Supplemental medical evidence" means information from a health professional not listed in subsection (1) or (2) of this section and who can provide supporting medical evidence for impairments identified by any of the professionals listed in subsections (1) or (2) of this section. We include as supplemental medical evidence sources:
- A health professional who has conducted tests on or provides on-going treatment to you, such as a physical therapist, chiropractor, nurse, physician assistant;
- Workers at state institutions and agencies who are not health professionals and are providing or have provided medical or health-related services to you; or
- Chemical dependency professionals (CDP) when requesting information on the effects of alcohol or drug abuse.
6.3.8 What kinds of documentation/evidence should I request?
See section 6.6, Disabilities , for documentation required for parents with an emotional, mental or physical disorder.
Documentation for a parent caring for a child with special needs (see 6.4 Children: Special Needs) may include health-care professionals as described above in WAC 388-448-0020 or other documentation provided by:
- Public Health Nurse (PHN)
- The child's school district
- Division of Developmental Disabilities Case Manager
- Licensed Child Care provider
- Certified Mental Health Professional (CMHP)
- Certified Mental Retardation Professional (CMRP)
6.3.9 Supporting Participation - Step-by-step guide
- The WFPS follows the instructions in Section 6.6, Disabilities, for emotional, mental or physical disorders
- For all other deferrals, the WFPS consults with the individual and the following persons, as appropriate, to determine the need for issue resolution participation.
- The WFSSS;
- SSI facilitator;
- Treatment provider; and/or
- Community service provider
- The WFPS then:
- Enters the appropriate code in eJAS.
- Enters the specific activities, scheduled hours and the expected end date for the activities on the IRP, describing in detail the activities and/or treatment the person is required to complete, with the exception of drug related issues or other protected information .
- Stacks activities to increase hours of participation to the extent the person is able, and adds the information to the IRP.
- Authorizes support services and child care needed to complete her or his IRP requirements.
- Documents the actions in eJAS.
- Monitors participation monthly following the procedures in Section 3.9.2, Documenting and Reporting Participation.
- Gets supervisor or higher approval for issue resolution IRPs that will take longer than 90 days.