5.1 Pregnancy to Employment

Created on: 
Apr 09 2018

Revised December 1, 2021

(Infant Exemption)

Legal References:

The Pregnancy to Employment section includes:

  • 5.1.1 What is Pregnancy to Employment?
  • 5.1.2 Who must participate in Pregnancy to Employment?
  • 5.1.3 What is a Pregnancy to Employment full comprehensive assessment?
  • 5.1.4 What is a partial Pregnancy to Employment assessment?
  • 5.1.5 When to conduct a full vs. a partial Pregnancy to Employment assessment?
  • 5.1.6 What additional assessments are required?
  • 5.1.7 How is the participant identified in eJAS once they enter Pregnancy to Employment?
  • 5.1.8 What are the participation requirements during the first and second trimester?
  • 5.1.9 What are the participation requirements during the third trimester?
  • 5.1.10 What are the participation requirements after the child is born?
  • 5.1.11 What is the "infant exemption" and "toddler exemption" (previously known as infant exemption extension)?
  • 5.1.12 How is the participant identified in eJAS once they choose to claim the infant or toddler exemption?
  • 5.1.13 What is the "12-week postpartum exemption period"?
  • 5.1.14 How is the participant identified in eJAS once s/he chooses to claim the "12-week postpartum exemption period"?
  • 5.1.15 What are the Pregnancy to Employment participation options and requirements?
  • 5.1.16 What are Home Visiting and Parent Support services and when is a referral offered?
  • 5.1.17 What is WorkFirst Family Literacy?
  • 5.1.18 What is First Steps?
  • 5.1.19 Can a participant in Pregnancy to Employment be sanctioned?
  • 5.1.20 eJAS Codes
  • 5.1.21 Pregnancy to Employment - Step-by-step guide
  • 5.1.22 Home Visiting and Parent Support-Referral Step-by-Step

5.1.1 What is Pregnancy to Employment?

Pregnancy to Employment (P to E) provides a way for participants to:

  • Build a healthy family relationship,
  • Prepare them for engagement in WorkFirst activities while assuring the family's medical and other needs are addressed, and
  • Become self-sufficient.

The goal of P to E is to provide services that allow participants to learn how to work, look for work or prepare for work while still meeting the family's needs. Each participant in P to E must participate in an assessment with the WorkFirst Social Service Specialist (WFSSS) to decide which activities best meet the participant's needs. The activities required depend on:

  • The results of the assessment,
  • Where the participant is in their pregnancy or the age of the child, and
  • Services available in the community.

5.1.2 Who must participate in Pregnancy to Employment?

Every pregnant person or parent(s) receiving TANF/SFA with a child under the age of two years is a mandatory participant in P to E. In a two-parent household, both parents are participants and must receive an assessment by a WFSSS.

Note:  Schedule an assessment using an ACES General Appointment Letter (50-05), the eJAS appointment letter, or in the IRP.

5.1.3 What is a Pregnancy to Employment full comprehensive assessment?

The full comprehensive assessment helps to identify family needs and determine which WorkFirst services are appropriate, as available within the community. In order to complete a full assessment, the WFSSS must discuss and document all issue areas in the eJAS Pathway Development Tool (PDT). See WFHB 3.2.3.

Based on the results of the full assessment and any other available information (i.e. Department of Children, Youth, and Families (DCYF), Equal Access, medical reports, etc.) the WFSSS or WorkFirst Program Specialist (WFPS) works with the participant to develop an Individual Responsibility Plan (IRP) to participate in activities that:

  • Offer a combination of services that help to resolve the issues and at the same time prepares the participant for work, and
  • Provide a base from which the participant can start building and adding on activities that help lead to self-sufficiency.

NOTE: Use the DSHS 14-012 Consent to Exchange Information for Services Coordination when exchanging highly protected (special records) information with another service provider.

5.1.4 What is a partial P to E assessment?

A partial assessment includes a minimum requirement to identify if the family's circumstances have changed and the family's needs require the department to address any potential issues such as mental health, chemical dependency, etc. The eJAS PDT is also used to document a partial P to E assessment (See WFHB 3.2.3).

To fulfill partial assessment minimum requirements, the WFSSS must cover the following:

  • Who is in the household besides the mother and child under two?
  • What type of family support is available?
  • Assess for all of the following:
    • Family Violence.
    • Family Planning.
    • First Steps.
    • Chemical Dependency.
    • Mental Health.
    • Child and adult health needs.
    • Documentation of involvement with WIC, prenatal care provider or pediatrician.
    • Activities the parent can engage in.

5.1.5 When to conduct a full vs. partial P to E assessment?

WorkFirst staff must schedule all P to E assessments within 30 days of the referral.

A participant must complete a full comprehensive assessment when the department first becomes aware they are:

  • Pregnant or
  • Parenting a child under the age of two.

NOTE: Don't require the other parent in a 2-parent household to complete a full assessment or any assessment before the baby is born.

A partial P to E assessment requirement applies to:

  • Both parents when they report the birth of the child, or
  • The parent choosing the infant or toddler exemption, or 12-week postpartum exemption that doesn't have a full nor partial completed assessment since the birth of the child, or
  • The other parent if added to the grant after the birth of the child.

NOTE: The WFSSS may require a partial assessment at any time if information received indicates there are mental health and/or chemical dependency issues.

5.1.6 What additional assessments are required?

If mental health or chemical dependency is identified in the P to E assessment, the WFSSS refers the parent to a professional for an in-depth assessment to support the initial identification.

  • Persons with an identified need for mental health are referred to a professional for medical corroboratory evidence to determine whether the parent needs mental health services.
  • Persons with an identified need for chemical dependency are referred to a Licensed Chemical Dependency Professional (CDP) for a chemical dependency assessment to determine whether the parent needs chemical dependency treatment.

Persons with an identified need for mental health and chemical dependency are referred to the appropriate professional for more in-depth evaluations.

5.1.7 How is the participant identified in eJAS once they enter Pregnancy to Employment?

PI (Pregnancy/Child under two) is the indicator component code used to identify P to E participants on the Component Screen in eJAS.

The PI indicator code allows staff to track and monitor all of their P to E participants. The PI component is NOT an activity; it is an identifier. Another component, such as GE or XP, should always go with the PI component, unless the parent/caregiver is is not required to participate, or is choosing not to participate, because they are:

  • In their third trimester of pregnancy,
  • Choosing the Infant or Toddler Exemption or,
  • The non-participating parent in a two-parent household.

WF staff should enter the PI component with zero hours for a maximum of 21 months. You may want to use the length of the component as a tickler for the pathway milestones. 

Note: Staff need to create a new PI component to capture months more than 21.

For example, a participant reports a pregnancy with an estimated due date. The WFSSS/WFPS may then set the end date of the PI code to coincide with the date the participant enters the third trimester, the date the baby is due or every three months until the date the baby reaches two years of age.

If there is a future estimated due date on the eJAS Client Demographic screen and no active PI component on the Component/Contractor/IRP Update screen, the WFPS/WFSSS receives a pop-up message notifying a PI component is needed.

5.1.8 What are the participation requirements during the first and second trimester?

In the first and second trimester of pregnancy, participation is based upon the results of the assessment and may include work, looking for work or a combination of pregnancy to employment services. A pregnant person is required to participate full-time during the first two trimesters of pregnancy unless they have a good reason to participate fewer hours.

5.1.9 What are the participation requirements during the third trimester?

The third trimester of pregnancy starts 90 days before the estimated due date. For example, if the estimated due date is 7/14, the third trimester starts on 4/15. Please use the Defining 3rd Trimester Tip Sheet to determine the start date of the third trimester.

In the third trimester of pregnancy, participation for the pregnant participant is based upon the results of the full assessment and the participant may:

  • Be required to participate up to 20 hours per week if the comprehensive evaluation, or an assessment, indicates a need for mental health and/or alcohol or drug treatment (unless medical evidence indicates that the participant is not able to participate in any activity),or

  • Participate in the WorkFirst program on a voluntary basis, if there are no identified mental health and/or chemical dependency issues, or

  • Choose not to participate in WorkFirst activities until delivery date, if there are no identified mental health and/or chemical dependency issues.

Note: All pregnant minor participants must be actively participating in high school diploma or equivalency completion programs to remain eligible for benefits, therefore, they are not eligible to take the 3rd trimester exemption (see WAC 388-486-0010.)

If a mental health or chemical dependency professional indicates that a participant should do more than 20 hours per week of treatment, we should encourage them to participate in the number of hours recommended; however, we can only require 20 hours per week of participation. If they refuse to participate in required available treatment, follow the good cause process. Indicate the appropriate participation status on the "Component/IRP Information Screen" by selecting if the participant is:

•Required to participate in mental health and/or chemical dependency treatment;

•Volunteering to participate in mental health and/or chemical dependency treatment; or

•Exempt from participating.

Note:  See 3.5.2.4 before lifting a sanction in the third trimester.

5.1.10 What are the participation requirements after the child is born?

After the child is born, the participant(s) receiving TANF cash assistance:

  • Must, at minimum, complete a partial assessment with a WFSSS to assess the participant(s) needs for continued services when the child is born or prior to choosing the infant or toddler exemption, or postpartum exemption if no assessment has been completed since the child was born.
  • May choose to take the infant exemption, toddler exemption or postpartum exemption and not participate in WorkFirst activities until the child reaches the age of two years (only one parent living in the household can claim this exemption at any given time).
  • May volunteer to fully participate in WorkFirst activities (see WAC 388-310-0300).
  • May choose to take the 12-week postpartum exemption period if the participant used all of their 730 day lifetime infant or toddler exemption and chooses not to participate in WorkFirst activities until the child reaches 12 weeks of age.
  • Must participate up to 20 hours per week if the comprehensive evaluation or assessment indicates a need for mental health and/or alcohol or drug treatment (unless medical evidence indicates that participant isn't able to participate in any activity).
  • Must participate up to 20 hours per week if the comprehensive evaluation or assessment indicates a need for parental education or parent skills training in Parental Education Project pilot sites only.
  • Must complete a comprehensive evaluation or assessment once the participant reaches 365 days in the infant or toddler exemption. A partial assessment may be appropriate based on any information received that indicates there are mental health and/or chemical dependency issues.

Voluntary Participation while taking the Infant, Toddler, or Postpartum Exemption

If a participant qualifies for the infant exemption, toddler exemption, or postpartum exemption, has no identified mental health and/or chemical dependency issues per the comprehensive evaluation and chooses to participate in WorkFirst activities the department won't pursue sanction if we learn they are no longer participating as required in their IRP.

Take the following steps if the participant stops participating:

  • Send the Pregnancy to Employment Infant Exemption letter giving the parent 10-day notice that we plan to place them into Infant or Toddler Exemption status.
  • If the participant contacts their worker within the 10 days and wants to continue participating, update the IRP as needed and don't enter the IE or TE component.
  • If the participant doesn't contact you:
    • Close the activity(ies) at the end of the 10-day period, and
    • Enter the infant exemption (IE) for families with a child under one year old, until (whichever comes first):
      • The child's first birthday,
      • 365 days (including a combination of IE and TE), or
      • 730 days if the total number of days in IE or TE has exceeded 365.
    • Enter the toddler exemption (TE) for families with a one year old child, until (whichever comes first):
      • The child's second birthday,
      • 365 days (including a combination of IE and TE), or
      • 730 days if the total number of days in the IE or TE has exceeded 365.

Staff must also document in eJAS "Pregnancy/Parenting" notes the period of time the participant is taking the infant or toddler exemption and that they provided the letter.

Note: If a discrepancy in the number of infant exemption days used is identified, review the following information to determine if:   

  • TANF closed while the IE was being counted,
  • The participant was in an activity meeting minimum participation requirements,
  • There wasn't a child under one in the AU while the IE was being counted,
  • The IE component ‘Actual End Date’ field reflects the correct end date.

If the Actual End Date entered doesn’t reflect the date the IE should have been closed, contact Customer Support with the following information requiring an update:

  • The correct Actual End Date
  • The correct number of days used in the IE component

The IE counter located on the eJAS Component/Contractor/IRP Update screen tracks and identifies how many days of IE the participant has used.

Note: At this time, the TE counter displays but isn't functional. Please continue to calculate TE days manually. Additionally, even though WF staff can add TE components, IT Solutions Customer Support can't data fix or make adjustments to them.

Required Mental Health/Chemical Dependency Treatment

If the participant stops participating in required mental health and/or alcohol or drug treatment, start the good cause process whether or not the participant is using the IE or TE.  If the participant chose to use their IE or TE and enters sanction, they continue using their exemption. 

If a mental health or chemical dependency professional indicates that a participant should do more than 20 hours per week of treatment, encourage the participant to participate in the number of hours recommended; however, we can only require 20 hours per week of participation.

5.1.11 What is the "infant exemption" and "toddler exemption"?

Participants can choose to be excused from participating in WorkFirst activities during months that they're needed in the home to personally provide care for their child(ren) under two years of age. Participants have a personal responsibility to decide whether to choose the infant or toddler exemption. The exemptions aren't automatic; participants must choose to claim the exemption.

The infant and toddler exemption options serve as a safety net to allow participants to be in the home with their child for the early stages of development while still having WorkFirst opportunities available. Encouraging voluntary WorkFirst participation is important since the exemption doesn’t stop the 60-month TANF time limit clock.

When offering either exemption, staff must remind the participant of the benefits of participating in WorkFirst activities, such as:

  • Employment and training opportunities,
  • Enhancement of skills,
  • Support services and childcare.

All rules of the Infant Exemption (IE) apply to the Toddler Exemption (TE) except that the age requirement has expanded to one year old children and the lifetime limit has increased to 730 days.

  • Infant Exemption – Exemption from WorkFirst activities for participants with a child under the age of one.
  • Toddler Exemption – Exemption from WorkFirst activities for participants with a one year old child. 
  • Use of the Infant Exemption and/or Toddler Exemption can’t exceed 730 days in a participant’s lifetime on TANF.
  • The extension of the infant exemption to children under the age of two changes the way we code them in eJAS:
    • IE - Infant Exemption for a child under one year old
    • TE - Infant Exemption for a one year old child
  • Any combination of the IE and TE can be used for up to 730 days, but only one exemption can be used at any given time. If a household has multiple children under the age of two, use the infant or toddler exemption for the youngest child.

Note: If a discrepancy in the number of infant exemption days used is identified, review the following information to determine if:   

  • TANF closed while the IE was being counted,
  • The participant was in an activity meeting minimum participation requirements,
  • There wasn't a child under one in the AU while the IE was being counted,
  • The IE component ‘Actual End Date’ field reflects the correct end date.

If the Actual End Date entered doesn’t reflect the date the IE should have been closed, contact Customer Support with the following information requiring an update:

  • The correct Actual End Date
  • The correct number of days used in the IE component

Until additional system changes become available, Customer Support won't be able to make adjustments to the TE component. 

Only the custodial parent(s) can claim the infant or toddler exemption; needy relatives/caregivers aren’t eligible for this exemption unless they have legally been given parental rights.

Unmarried parenting minors can choose to take the IE for up to 12 weeks after the birth of the child.  After the 12 weeks, they're subject to the school attendance requirement for unmarried parenting minors. 

Only one participant living in the household with a child under two years old (even if there are two infants/toddlers in the household) can claim an infant or toddler exemption at any given time, for a maximum of 730 days in a lifetime, not to exceed 730 days. Participants choosing to use the infant or toddler exemption may:

  • Be required to participate up to 20 hours per week if the comprehensive evaluation or assessment indicates a need for mental health and/or alcohol or drug treatment, or
  • Participate in the WorkFirst program on a voluntary basis if there are no identified mental health and/or chemical dependency issues.
  • Choose not to participate in WorkFirst activities for a set period of time or until the child turns two years of age if there are no identified mental health and/or chemical dependency issues.

Remind the participant that they can only claim the infant or toddler exemption for 730 days in a lifetime.  Then tell the participant what their required participation is, if they DO claim the infant or toddler exemption, and if they DO NOT claim an exemption.  This gives the participant the information they need to decide whether to claim the exemption.  

Upon 365 days in either exemption (or combination of the two), WorkFirst staff must schedule an annual comprehensive evaluation update appointment for the participant to review their situation and determine if they need any additional services.  WFPS may require a new Pregnancy to Employment assessment at this time if deemed necessary. 

Example One: The assessment indicates a need for three hours a week of chemical dependency treatment.  You explain that the treatment is required and if the participant doesn’t want to claim the exemption they are required to do an additional 17 hours of another approved activity.  The participant decides to use the infant exemption. Code the required treatment hours and infant exemption, and track treatment participation.  
Example Two: The assessment indicates a need for two hours a week of mental health treatment. Based on medical evidence, the participant is unable to do anything but mental health treatment for at least the next six months.  You explain that participation requirements are the same, whether or not the participant uses the infant exemption.  The participant decides not to use the infant exemption.  You code the treatment and track participation, but don’t code an IE.   
Example Three: Based on the assessment, there are no mental health, chemical dependency or other barriers and the participant is working five hours per week. You explain that if the infant exemption isn't used, there are requirements to participate in other activities to bring participation up to 20 hours per week.  The participant uses the infant exemption and continues to keep working voluntarily.  Code the infant exemption and work hours. We can provide support services and childcare because employment increases their self-sufficiency.
Example Four: This is a two-parent household.  Based on the assessment and medical evidence, parent one is exempt due to a disability and parent two has no barriers.  You explain that only one parent can claim the exemption, parent one won’t be required to participate (whether or not they claim the infant exemption) and parent two needs to participate at least 35 hours per week if they don't claim the infant exemption. Parent two decides to use the infant exemption so they can care for parent one and newborn. You code parent one with an XB and parent two with an IE.
Example Five: A participant applies in September.  The participant opts for the toddler exemption for their 13 month old child (TE) and have only used three months of the exemption. The participant reapplies in June and now has a newborn child.  The participant wants to opt for the infant exemption for the newborn (IE) even though there are two qualifying children in the home. Once the newborn turns 9 months old, the participant exhausts 365 days between the Infant and Toddler Exemption.  The WFPS mails an engagement appointment. There are no mandatory requirements and the participant wants to continue providing care for the infant.  The participant continues taking the Infant Exemption for the newborn (IE) through the newborn's first birthday.  Once the newborn turns one, close the IE component and open the TE component.

 

It is essential to document in the eJAS “Pregnancy/Parenting” note type whether a participant chooses either exemption. If the participant chooses the infant or toddler exemption, document the period of time the participant is choosing to take it.

The department contacts a participant choosing either exemption who isn’t engaged in any other WorkFirst activities once every three months to:

  • Offer available services and/or referrals.
  • Remind them that they can choose to end the exemption and engage in WorkFirst activities at any time.

The three-month contact may be either by a letter or telephone. (WorkFirst staff must document the contact in eJAS and update the IRP, if necessary)

5.1.12 How is the participant identified in eJAS once they choose to claim the infant or toddler exemption?

Component code IE identifies participants who are choosing the infant exemption for a child under the age of one and the TE to identify participants who are choosing the infant exemption for a one year old child. The component codes are:

  • For DSHS staff use only
  • Not able to generate support services
  • ONLY for parents who choose to use their exemption
  • Time limited (not to exceed 730 days)

Don't use this code for any other reason. Using this code for any other reason makes a participant's exemption count inaccurate.

eJAS tracks and display the total number of days a participant uses their infant exemption in the "Number of days in IE" field on the Component/Contractor/IRP Update screen. Remember, TE days must be tracked manually at this time.

When opening the IE or TE component, the WFPS/WFSSS are required to indicate the appropriate participation status for participant's choosing to take the exemption on the "Pregnancy to Employment Participation Status" field by indicating if the participant is:

  • Required to participate in mental health and/or chemical dependency treatment;
  • Volunteering to participate in mental health and/or chemical dependency treatment; or
  • Exempt from participating (choosing not to participate in any activities).

WorkFirst staff:

  • Use the eJAS component IE to identify the infant exemption period for a child under one.
  • Use the eJAS component TE to identify the infant exemption period for a one year old child.
  • After entering the IE or TE code, select the participation status.
  • Document the period of time a participant wants to take the infant exemption in eJAS notes under the "Pregnancy to Employment" note type.
  • Enter the IE or TE start date as the date the participant notifies the department that they want to claim either exemption.
  • Enter the infant exemption (IE) end date for families with a child under one year old, until (whichever comes first):
    • The child’s first birthday,
    • 365 days (including a combination of IE and TE), or
    • 730 days if the total number of days in IE or TE has exceeded 365.
  • Enter the toddler exemption (TE) end date for families with a one year old child, until (whichever comes first):
    • The child’s second birthday,
    • 365 days (including a combination of IE and TE), or
    • 730 days if the total number of days in IE or TE has exceeded 365.
  • Use the Caseload Management Report (CLMR) and/or ad hoc report to monitor these cases.
  • Encourage participation in WorkFirst activities during this time-limited opportunity.

Note:

WorkFirst participants may choose to use their infant or toddler exemption when needed in the home to personally provide care for their child under two years of age whether they are receiving TANF for that child or not.

If the child under two years old isn't on the TANF assistance unit, add the child as a non-member in ACES 3G.  This lets eJAS know that the participant has a child under two years old in the home and eJAS allows you to code the IE or TE.

5.1.13 What is the 12-week postpartum exemption period?

Participants who have already claimed the infant or toddler exemption (or a combination of the two) for a maximum of 730 days can request an additional 12-week postpartum exemption period (84 days) if they have another child. This period allows participants to spend time with the newborn before they must participate in WorkFirst activities.

A participant can participate in the WorkFirst program on a voluntary basis during this period if there are no identified mental health and/or chemical dependency issues. If a participant qualifies for a postpartum exemption period, has no identified mental health and/or chemical dependency issues per the P to E assessment(s) and chooses to participate in WorkFirst activities the department doesn't pursue sanction if we learn that a participant is no longer participating as written in the IRP.

Take the following steps when the participant stops participating:

  • Send the Pregnancy to Employment Infant Exemption letter giving the parent 10-day notice that we plan to put them into the 12-week postpartum exemption period status.
  • If the participant contacts their worker within the 10 days and wants continue participating, update the IRP as needed and don't enter the IE or TE.
  • If the participant doesn't contact you:
    • Close the activity(ies) at the end of the 10-day period, and
    • Enter the postpartum exemption period (PD) until the child turns 12 weeks of age (not to exceed 84 days).

Staff must also document in eJAS "Pregnancy/Parenting" notes the period of time the participant is taking the PD and that the letter was provided.

If the comprehensive evaluation or other assessment(s) indicates a need for mental health and/or alcohol or drug treatment the participant must participate up to 20 hours per week.

A participant may choose to not participate in WorkFirst activities for a set period of time or until the child turns 12-weeks of age if there are no identified mental health and/or chemical dependency issues. Only one parent living in the household can claim this 12-week postpartum exemption, not to exceed 84 days, at any given time.

5.1.14 How is the participant identified in eJAS once s/he chooses to claim the 12-week postpartum exemption period?

Use component code PD to identify participants who choose to take the 12-week postpartum exemption period. This indicator component code is:

  • For DSHS staff use only.
  • Not able to generate support services.
  • ONLY to be used for participants who have exhausted their infant exemption and infant and toddler exemption and choose to use their 12-week postpartum exemption period.
  • Time limited (not to exceed 84 days).

When opening the PD component, the WFPS/WFSSS is required to indicate the appropriate participation status for participant's choosing to take the PD on the "Pregnancy to Employment Participation Status" field by indicating if the participant is:

  • Required to participate in mental health and/or chemical dependency treatment;
  • Volunteering to participate in mental health and/or chemical dependency treatment; or
  • Exempt from participating (choosing not to participate in any activities).

WorkFirst staff:

  • Use the eJAS component PD to identify the 12-week postpartum exemption period.
  • After entering the PD indicator code, select the participant's participation status.
  • Document the period of time a participant wants to take the 12-week postpartum exemption period in eJAS notes under the "Pregnancy to Employment" note type.
  • Enter the PD start date as the date the participant notifies the department that they wants to claim the 12-week postpartum exemption period and an end date of the elected 12-week postpartum exemption period, not to exceed 84 days.
  • Use the Caseload Management Report (CLMR) and/or ad hoc report to monitor these cases.

Encourage WorkFirst as the 12-week postpartum exemption period is limited to 84 days for each child after they have exhausted their infant or toddler exemption.

5.1.15 What are the Pregnancy to Employment participation options and requirements?

A parent's IRP and activities should reflect a steady progression towards work, looking for work, or preparing for work, as well as having a healthy and thriving child. P to E activities may include linking parents to:

  • Home Visiting and Parent Supports,
  • Parenting education or parenting skills training,
  • Safe and appropriate child care,
  • How to obtain good health care,
  • Life Skills classes with parenting components,
  • Mental health treatment,
  • Chemical dependency treatment,
  • Family violence services,
  • Education and training, or
  • Employment services.

Staff must continue to engage parents in WorkFirst activities that moves them most effectively toward economic stability.

The Pregnancy to Employment Participation and Coding Quick Guide, also located in the Forms & Other Resources section, details participation requirements while the person is pregnant and after the child is born.

5.1.16 What are Home Visiting and Parent Support services and when is a referral offered?

Home visiting programs are voluntary, family-focused services offered to expectant parents and families with new babies and young children to support the physical, social, and emotional health of the family. When families receive home-based support, children are more likely to be better prepared for school and support a stronger parent-child bond.

When families engage in home visiting programs they are voluntarily matched with trained professionals. These home visitors engage families in their homes or community settings to provide information and support related to children’s healthy development, support the parent-child relationship, and provide information on importance of early learning and connections to other information, services and supports in the community.

The Home Visiting & Parent Support referral pathway focuses on increasing access to home visiting and other local community parenting supports for WorkFirst families.

Its goals are to:

  • Increase voluntary enrollment of WorkFirst families in evidence-based home visiting services, offered through local county public health departments and community-based organizations,
  • Directly connect families to other parenting/two-generation supports within their community.

 

WorkFirst Staff offer a referral to Home Visiting/Parent Support services at various points while a family is in the P to E pathway:

  • At all P to E Assessments
  • At three month contact   
  • At initial PDT and Updates

 

If/when, a participant accepts a referral for these services; staff may either refer the family to a local known service provider, or to Within Reach. Within Reach partners with DSHS to assist in connecting families with home visiting and parent support options within their community.

Participants who continue to engage in these services, Post-PtoE Pathway:

The goal of connecting parents to home visiting and parent support services is to encourage and support family well-being and development of the child. These programs allow parents the agency to choose whether to engage in services. If at any time a participant, who is no longer in the PtoE Pathway, decides engaging in home visiting or parent support services is not right for their family, staff are to engage them in a discussion regarding their IRP and if need be, determine appropriate alternative activities.


 

5.1.17 What is WorkFirst Family Literacy?

Known in some locations as Families That Work, WorkFirst Literacy Skills Center, etc. (check your local college or CBO WorkFirst Delivery Agreement (WFDA) for Education and Training). Parents receive instruction in the basic skills they need to join the workforce, improve their child raising skills, and break family cycles of illiteracy. Parents served by WorkFirst Family Literacy are current WorkFirst recipients.

The goal for WorkFirst Family Literacy parents is an economically stable and literate family, with outcomes that include:

  • Basic literacy and job preparation skills;
  • Work activity for some parents or paid employment for others;
  • Wage and skill progression for working parents;
  • Family management and parenting skills; and
  • Learning success for all children in the family.

Parents participating in WorkFirst Family Literacy programs follow the same model for quantifying participation, as do our participants in other training programs. To calculate participation hours, use the actual hours the parent is in the education and training activities, to include classes, labs, and supervised study halls/tutoring sessions. The college or community based organization notifies the WorkFirst case manager of the appropriate eJAS component code to use.

NOTE: Life Skills training is a countable activity for participation and Parent Education is not, though it may be an appropriate activity for the parent depending on their situation.

Parents in the WorkFirst Family Literacy program will be doing a combination of the following types of allowable activities:

  • ABE/ESL taught in the context of work skills that lead to a job;
  • Family management/parenting skills (time management, fiscal management, communication among family members, the impact of work on family life/child behavior);
  • Age appropriate education for children while the parent is involved in work and education; and,
  • Parent and child activities that help children gain the literacy skills they need to succeed in school.
  • Involvement of the parent in their child's education.

Parents are involved in work activities at the level appropriate to their skills and their IRPs. These can include volunteer experiences, WorkFirst Work-Study, Community Jobs, etc.

  • In addition to Family Literacy funded by WorkFirst, the State Board for Community & Technical Colleges (SBCTC) through the Adult Basic Education Office funds Family Literacy at community colleges in 3 locations across the state. Each provider works with community partners like DSHS WFPS's and WFSSS's, Head Start and ECEAP directors, WorkSource Center staff, and First Steps case managers.

5.1.18 What is First Steps?

The First Steps Program is designed to provide additional health care, enhanced services and case management to Washington Apple Health eligible people and infants. This program seeks to reduce parent and infant illness and death, as well as increase access to maternity and infant care for low-income families.

First Steps services include, but aren't limited to:

  • Prenatal Health Care
  • WIC
  • Pediatric Care
  • Family Planning
  • Childbirth Education
  • Lactation Consultation
  • WithinReach website (formally 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, child care, transportation, interpreter services, disability services, and the Tobacco quit line
  • Referral for Division of Alcohol and Substance Abuse (DASA) services

The WFSSS should provide all pregnant person with information regarding the services available through the First Steps program as follows:

  • If a pregnant person reports that they are not active on Washington Apple Health (WAH) Medicaid, refer to www.wahealthplanfinder.org to apply for pregnancy medical. The Health Care Authority (HCA) generates a monthly list for First Steps providers capturing all newly identified pregnant people on Medicaid.
  • If a participant already has health insurance and reports pregnancy, share ways to access First Steps by contacting the Within Reach Family Hotline at 1-800-322-2588.

For additional information about the First Steps program visit the Social Services Manual by clicking here.

5.1.19 Can a participant in Pregnancy to Employment be sanctioned?

Participants in P to E may enter sanction for:

  • Refusing to participate in an assessment with the WFSSS to identify family needs and determine what WorkFirst services are appropriate, or
  • Not participating in mandatory WorkFirst activities (per assessment- Mental Health/Chemical Dependency treatment, if required per assessment. (See 3.5.1 Sanction)

At no time would sanction be pursued if a Pregnancy to Employment participant declines a home visiting/parent support referral or does not engage in home visiting/parent support services.

When a parent enters sanction for refusing to complete an assessment and they didn't choose the infant or toddler exemption, don't code the IE or TE with the sanction. 

When a participant enters sanction for refusing to complete an assessment, and then completes an assessment lift the sanction

Note:  When the parent is at the end of their exemption period and you schedule a next steps appointment, you can't sanction the parent for not attending the appointment during the parent’s exemption period. 

5.1.20 eJAS codes

The following eJAS codes are commonly used for WorkFirst individuals engaged in P to E:

  • RO is used to refer cases to the WFSSS and to require assessments
  • PI (pregnancy/child under two) is an indicator for all participating in P to E
  • PD (postpartum exemption period) is an indicator to identify participants using the 12-week postpartum exemption period
  • IE (infant exemption) is an indicator to identify participants using their infant exemption for a child under the age of one
  • TE (toddler exemption) is an indicator to identify participants using their toddler exemption for a one year old child
  • XP is used for actual hours each week engaged in home visiting or other parent support programs in the community, or in activities required as part of a child welfare related plan (e.g. reunification plan) - learning parenting skills, taking nutrition classes. It can also be used to indicate the participant is in the process of choosing childcare.
  • XC is used for actual hours spent seeking childcare each week when no appropriate child care is available – or no appropriate care for an incapacitated adult
  • RW is used to refer WorkFirst participants to Within Reach to assist in connecting families with home visiting and parent support options within their community.
  • HV is used as an indicator to identify participants working with home visiting or parent support providers in their community. 

In addition to the PI identifier code, indicate the WorkFirst participation by using the appropriate eJAS codes on the component code screen as needed, to the actual hours of time spent in activities (such as XF for family violence resolution or JS for job search). It is important for tracking program progress to show the different components the participant is in.

5.1.21 Pregnancy to Employment - Step-by-step guide

The WFPS:

  1. Refers all pregnant participants or parents with children under the age of two for an assessment using appropriate eJAS codes: 
    1. RO component for a P to E assessment referral when: 
      1. The department becomes aware a participant is pregnant or parenting a child under age two. 
      2. The participant chooses the Infant or Toddler Exemption and hasn't completed an assessment since the child's birth. 
    2. PI indicator component to identify the participant is in P to E.
Note: Enter eJAS notes in the Pregnancy/Parenting category prior to entering the PI code indicating the parent is a P to E participant.

Note: On the Customer Accountability Report (CAR), participants in stand-alone PI displays in Participation Not Required (State Only) section. However, participants coded PI with other components displays in the section of the report determined appropriate based on their level of participation. For example, a participant is coded PI and 20 hours per week in PT. The participant shows in section 6 - Participation Below Full Time at WorkFirst Standard.

The WFSSS:

  1. Completes a full or partial assessment, using the eJAS Pathway Development Tool (PDT) or the DSHS 14-433(X), Intensive Services Assessment. WFSSSs may also draw upon assessments from other agencies. However, if the PDT isn't used and the DSHS 14-433(X), or another assessment form is used, all the same PDT topics should be covered and documented using the PDT. The WFSSS should assess all areas relevant to the participant and review any other available information.
  2. Uses the assessment to identify the participant's strengths, barriers, issues and needs. The assessment needs to identify what activities a participant is able to do and the maximum number of participation hours including stacking activities so they participate to the fullest of their abilities. The WFSSS makes decisions about which cases have barriers or issues that could benefit from continuing case management by the WFSSS until those issues are resolved. Other cases may be referred back to the WFPS for case management.
  3. Makes appropriate referrals, based on the assessment.
  4. Documents offer of a referral to home visiting/parent support programs (see WFHB 5.1.21)
  5. Works with the WFPS, participant and other service providers (as appropriate) to build an IRP, as required, that addresses the participant's and child's needs as identified in the full or partial assessment or comprehensive evaluation.
  6. Enters (if not already entered) the PI code on the eJAS Component Screen with the accompanying component when required.

Either the WFSSS or WFPS - whomever is managing the case:

  1. Updates the IRP if participating in WorkFirst activities,
  2. Monitors/reviews on a monthly basis for attendance and progress if participating in WorkFirst activities,
  3. Doesn't pursue sanction if the participant is no longer participating as required in the IRP if they qualify for an IE, TE or PD (don't have identified mental health and/or chemical dependency issues) and chooses to participate in WorkFirst activities. The following steps are taken when the participant stops participating:
    1. Sends the Pregnancy to Employment Infant Exemption letter giving the participant 10-day notice that we plan to put them into Infant Exemption status.
    2. Updates the IRP as needed and don't enter the IE or TE if the participant contacts their worker within the 10 days and wants to continue participating.
    3. Closes the activity(ies) at the end of the 10-day period, and enter the infant exemption (IE for a child under one or TE for a one year old child) if the parent doesn't contact you, until:
      1. The child's first or second birthday,
      2. 365 days (including a combination of IE and TE), or
      3. 730 days if the total number of days in IE or TE has exceeded 365.
  4. After entering the IE or TE code, enters the appropriate participation status in the "Pregnancy to Employment Participation Status" field.
  5. If taking either exemption and not required to participate in mental health and/or chemical dependency treatment, makes follow-up contact (via office interview, phone, letter or home visit) with the participant at least every three months to re-evaluate the participant's/child's needs to ensure that they are receiving the services they need.
  6.  At each 3-month contact, the assigned worker offers services, resources, and remind the participant that s/he can choose to end the exemption and fully participate in the WorkFirst program. Additionally, staff must document an offer of a referral to home visiting/parent support programs (see WFHB 5.1.21)
    • If the participant chooses to end their exemption, update the IRP to reflect any changes in their activity.
  7. If taking the postpartum exemption period, enters the PD code for the time the participant is choosing to claim this exemption up to 12 weeks.
  8. After entering the PD code, enters the appropriate participation status in the "Pregnancy to Employment Participation Status Required" field.

5.1.22 Home Visiting and Parent Support- Referral Step-by-Step

  1. If a participant in the Pregnancy to Employment Pathway is not currently engaged in home visiting/parent support WFPS/WFSSS staff are required to document and offer a referral:
    1. Following the completion of a full or partial P to E assessment,
    2. At each 3 month contact while a participant is in the IE/TE,
    3. Initial PDT and updates.
  2. If the participant is interested in engaging in home visiting/parent support the WFPS/WFSSS:
  • Reviews the options of first referring to Within Reach to determine a provider for the participant or refer directly to a provider. If the WFPS/WFSSS does not utilize a referral to Within Reach skip to the Home Visiting/Parent Support Referral Contracted Providers or Home Visiting/Parent Support Referral Non-Contracted Providers section below.  

WFPS/WFSSS referral to Within Reach-

1.   Request “Consent” (DSHS 14-012) form completed and signed by the participant.

  1. Create a “Pregnancy/Parenting” referral type in eJAS by using the RW (WithinReach Referral) component with contractor code HAK . Include information such as date of birth, estimated due date, contact information, and preferred contact method.  
  2. Input RW component with 0 hours for 60 business days.
  3. Complete the referral in eJAS.
  4. Create an IRP for the customer to respond to WithinReach.
  5. Document in eJAS using “Parenting/Pregnancy” note type. 

 

Within Reach:

  1. Accepts the RW component.
  2. Attempts to contact customer with a minimum of two attempts in 10 business days.
  3. If contact is made and the participant is referred to a home visiting or parental support provider, WithinReach will:
  4. Documents in “First Contact” notes or general eJAS note, outlining referral and information provided to the customer.
  5. E-Messages WFPS/WFSSS to see eJAS notes. eJAS notes will include details of the programs referred to and name of the contracted home visiting/parent support program.
  6. If contact is made with the customer and WithinReach has provided all services, WithinReach can “refer back” the case using the “completed program” eJAS reason.
  7. E-Messages WFPS/WFSSS that no further follow up is needed and to refer to eJAS notes for provider details.
  8. If unable to connect with customer, Within Reach will refer customer back to WFPS/WFSSS in eJAS document contact attempts in eJAS notes.

 

Note: If Within Reach is unable to make contact WFPS/WFSSS will close the RW component and review case for next steps (such as contacting the participant to develop a new IRP).

Home Visiting/Parent Support Referral Contracted Providers -

  1. Refer the participant to the Contractor using the XP component code for one hour for 90 days, the appropriate contractor code, and IRP template.
  2. Enter the HV indicator component for zero hours and 90 days.
  3. Advise the participant to:
    • Contact the Contractor within ten days.
  4. Authorize support services for engagement with the XP program.

  Upon receipt of the XP referral, the Contractor:

  1. Attempts to contact the participant to enter the First Contact note.
  2. Accepts the referral and complete the First Contact note with the specific details of the contact, if First Contact is made within ten (10) days.
    • Reject the referral on the eleventh (11th) day if First Contact is not made within ten (10) days.

Once the participant is enrolled, the Contractor:

  1. Enters the date the participant enrolled in the home visiting/parent education program in the Actual Start Date column of the Contractor Caseload Screen.

For the duration of the home visiting/parent education program, the Contractor:

  1. Enters monthly summary notes in eJAS between the first (1st ) and tenth (10th) of the following month on the previous month’s activities.
  • The eJAS client note will include documentation of attendance, absences, and overall progress.
  • Sends an immediate notification in eJAS to the WFPS upon two (2) excused or two (2) unexcused absences in a calendar month.

Prior to the XP component end date the WFPS/WFSSS and the contractor conducts a Continuous Activity Planning meeting (CAP), see WFHB 3.2.1.5, to determine if the participant may continue utilizing home visiting/parent education:

  1. If the participant doesn’t continue the home visiting/parent education activity, close the XP and HV components by entering the actual end dates in the Actual End field in the Component/Contractor/IRP Update screen.
  2. Contact the participant for a WorkFirst engagement appointment to discuss the next appropriate activity.

Home Visiting/Parent Support Referral Non-Contracted Providers -

  1. The participant meets with the WFPS/WFSSS.
  2. If the participant is not currently engaged in home visiting/parent education services WFPS/WFSSS staff are required to offer a referral when the department first becomes aware the participant is:
    1. Following the completion of a full or partial P to E assessment,
    2. At each 3 month contact while a participant is in the IE/TE,
    3. Annual comprehensive evaluation updates.
  3. If the participant is interested in engaging in home visiting/parent education the WFPS/WFSSS:
    1. Enters an XP component code for one hour for 90 days.
    2. Enter the HV indicator component for zero hours for 90 days.
    3. Advises the participant to provide verification of enrollment with provider within 10 days.
    4. Reports monthly eJAS participation note using the WorkFirst participation verification form.

Resources

Related WorkFirst Handbook Sections

Forms & Other Resources