First Steps
DSHS Home Page
 
Search     for:


First Steps


Revised October 3, 2013



Purpose: This category describes the First Steps Program which is designed to promote healthy birth outcomes, increase access to early prenatal care, and reduce infant morbidity and mortality.

GUIDELINES

The 1989 Maternity Care Access Act, implemented as First Steps, seeks to reduce poor birth outcomes, maternal and infant illness and death as well as increase access to maternity and infant care for low-income families. The First Steps program is administered by the Health Care Authority (HCA).

 

First Steps includes:

Medical Services:

·         Prenatal care,

·         Delivery,

·         Post pregnancy follow-up, including family planning

 

Enhanced Services:    

·         Maternity Support Services (MSS)

·         Infant Case Management (ICM)

·         Childbirth Education (CBE)

 

Expedited Alcohol and Drug Assessment and Treatment Services.

Ancillary Services:

·         Expedited eligibility determination,

·         Case finding,

·         Outreach,

·         Transportation and

·         Interpreter services

 

Family Planning

An additional 10 months of Family Planning only is available after pregnancy health care coverage ends.

MATERNITY SUPPORT SERVICES (MSS) and INFANT CASE MANAGEMENT (ICM)

  • Participation in MSS and/or ICM is voluntary.  Clients choosing to participate in MSS or ICM are free to choose which First Steps provider to see. 
  • Transportation to and from all MSS and ICM appointments is available and interpreter services are also available. 
  • Appointments may take place in the client’s home, an office or other safe place. 

Maternity Support Services (MSS)

MSS is available to eligible women on Washington Apple Health from the time they are pregnant and continues through the end of the month in which the 60th day post pregnancy occurs.  The MSS provider facilitates access to health care for pregnant women, including prenatal care, as early in pregnancy as possible, and infants into pediatric care. 

MSS is provided to eligible women by an interdisciplinary team of nurses, dietitians, behavior health specialists and community health workers. Members of the interdisciplinary team provide screening, professional assessments, health education, care coordination, case management and interventions related to targeted risk factors known to influence poor birth outcomes.  The team coordinates care with health care providers and staff from other agencies and organizations who is or could be working with the client and/or her infant to meet their needs.

MSS care coordination may include, but is not limited to:

  • Prenatal health care
  • WIC
  • Dental and vision care
  • Pediatric care
  • Family Planning
  • Childbirth Education
  • Lactation Consultation
  • Family Health website information operated by WithinReach (formerly Healthy Mothers Healthy Babies)
  • Local community resources specific to individual needs, e.g. Domestic Violence hotline, educational resources, Crisis Clinic, mental health resources, car seats, food bank, CPR training resources,  transportation, interpreter services, disability services, and the Tobacco quit line.
  • Referral for chemical dependency services.

Infant Case Management (ICM)

The purpose of ICM is to improve the welfare of infants by providing their parent(s) with information and assistance in order to access needed health care, social, educational, and other services.  Clients who meet certain risk criteria and need help in accessing resources to meet their needs are eligible for ICM.

To be eligible for ICM, the infant must:

  1. Receive Washington Apple Health,
  2. Reside with a parent(s), and
  3. Be within the ICM eligibility period which is the day after MSS ends through the end of the month of the infant's first birthday.

Infants meeting the above eligibiltiy criteria are screened by an Infant Case Manager for a variety of risk factors that may impact the infant's welfare, health, and/or safety.

An Infant Case Manager must be a qualified person who is employed by an agency or entity approved as an MSS/ICM provider by MPA.


NOTE:

As part of the ongoing First Steps provider network, the CSO works with the group to establish the referral process in the local community.


WORKER RESPONSIBILITIES

The Community Services Office (CSO) plays a critical role in assisting clients to access First Steps services. Eligibility for Washington Apple Health coverage is determined By the Health Benefit Exchange and serves as an entry point for First Steps services. All pregnant women on Washington Apple health must be offered a referral to a local provider for First Steps services.

 

A Bar Code report, generated at least weekly, of all newly eligible pregnant women in the CSO can be used to refer the clients to local First Steps providers.


1.    Minimum service level: Offer all pregnant women with Washington Apple Health care coveragea referral to First Steps services.  

2.   Best Practice service level: Conduct an assessment to determine the woman's needs for First Steps services. Arrange for First Steps services and other services if needed, i.e., shelter, food and clothing. Obtain any needed release from the client and share the assessment with the partners providing services (i.e.: MSS, ICM). Follow-up to ensure the client has connected with the needed services.


NOTE:

Maternity Support Services and Infant Case Management providers have already signed Confidentiality Agreements with DSHS and are held to the highest standards for client protection during regular program monitoring by First Steps State Staff.


RESOURCES

For additional information about the First Steps program and available services visit:


CHILDREN’S ADMINISTRATION (CA) - Prenatal Substance Abuse "Screen Out" Intakes

GUIDELINES

On all Child Protective Service (CPS) "screen-out" intakes involving pregnant women allegedly abusing substances, CA will determine Washington Apple Health status. CA will send the intake to Community Services Division (CSD) headquarters OR directly to the First Steps provider depending upon the Washington Apple Health status. If there are multiple First Steps providers serving one area, CA will email the intake to the CSD First Steps Service Delivery program manager..

For additional information about the CA Prenatal Substance Abuse policy visit: http://www.dshs.wa.gov/ca/pubs/mnl_pnpg/chapter2_2500.asp#2551

WORKER RESPONSIBILITIES

Children's Administration:

  1. On all "Screen Out" intakes involving a pregnant woman allegedly abusing substances, intake staff will identify whether she is receiving Washington Apple Health.
    1. If the woman is not on Washington Apple Health, intake staff will email a copy of the intake to ESA at CSDFirstSteps@dshs.wa.gov.
    2. If the woman is on Washington Apple Health, intake staff will send a copy of the intake by email, mail or fax to the First Steps provider whenever possible. If there are multiple First Steps providers serving one community, intake staff will send to ESA HQ at CSDFirstSteps@dshs.wa.gov.
  2. When the referrer is ESA or a First Steps provider, intake staff will not need to send an intake.

Community Services Division:

  1. For current recipients of Washington Apple Health, where there are multiple First Steps providers, the CSD First Steps Service Delivery program manager will receive the Children's Administration (CA) intake at CSDFirstSteps@dshs.wa.gov email address.
    1. After receiving the First Steps referral the CSD First Steps Service Delivery program manager identifies the client's catchment office and default First Steps worker.
    2. The First Steps Service Delivery program manager will create a First Steps tickler assignment in Barcode.
      1. The First Steps Service Delivery manager note type as First Steps Provider Referral Needed, copies client information into the subject box and sends the tickle to the default First Steps worker in Barcode.
    3. The First Steps worker receives an assignment via DMS tickles.
    4. When the First Steps worker completes the referral to the First Steps provider they will mark the tickle complete.


  2. For women not receiving Washington Apple Health, the CSD First Steps Service Delivery program manager receives the CA intake referral at CSDFirstSteps@dshs.wa.gov email address.
    1. After receiving the First Steps referral the CSD First Steps Service Delivery manager identifies the client's catchment office and default First Steps Worker.
    2. The First Steps Service Delivery program manager creates a First Steps tickler in Barcode.
      1. The First Steps worker notes type as First Steps Application request, copies client information into the subject box and sends the tickle to the default First Steps worker in Barcode.
    3. The First Steps worker receives an assignment via DMS tickles.
    4. The First Steps worker sends a Health Benefit Exchange application to the client at the address listed.
Modification Date: October 3, 2013