Revised on: September 20, 2021
The Resolving Issues Overview section includes:
Resolving issues begins with identifying barriers that can interfere with a person's ability to look for work or work or participate in other WorkFirst activities. When issues are identified, we can provide necessary supports to help the participant engage in activities that will lead to employment.
Many WorkFirst participants will need to resolve some issues to succeed in WorkFirst. People come to us without basic supports or perhaps, not much experience in being a working participant. And, although we may not even think of authorizing child care or making a family planning referral as "resolving issues" -- it is.
Many participants come to us with more serious concerns that will take longer to resolve, like disabilities or family violence. It is important to start working through these problems as quickly as possible - and add other activities as soon as participants are able - so they can start building on their strengths while eliminating some negatives.
Last, some participants face issues so severe, that it is unlikely they will be able to enter the job market. WorkFirst Social Service Specialists (WFSSSs) may need to work intensively with these participants, perhaps helping them apply for Supplemental Security Income (SSI).
We look for issues that may need to be resolved at:
If issues are identified when a participant starts working or participating in WorkFirst activities, you should work with the individual to resolve these issues.
As shown in the chart below, the level of intervention required to work with issues varies, depending on the type of problem the person faces.
| Issue | Likely intervention |
|---|---|
| Lacks basic supports |
Likely a shorter-term intervention by the WorkFirst Program Specialist (WFPS) or WorkFirst Social Service Specialist (WFSSS) to:
|
| Lacks expert advice | Likely a shorter-term intervention by the WFSSS (that can be combined with looking for work or work) to provide:
|
| Family & health concerns | Likely requires a longer-term WFSSS intervention. These situations may need to be stabilized before adding other activities.
|
There are some common themes you see whenever we talk about resolving issues.
Identify and begin to resolve issues as soon as possible to give the participant any additional supports they need to succeed.
The purpose of issue resolution is to help the participant find ways to participate in WorkFirst activities while also assuring the family's medical and other needs are addressed. Employment remains a major focus with economic mobility as the ultimate goal.
Temporary deferments may be necessary and appropriate in some situations. Most participants, however, want to work and may see work as very therapeutic in helping them cope with other concerns.
Finding creative ways for the participant to participate without a temporary deferment is usually the best option. It is often possible to accommodate a family's special needs while at the same time supporting the participant's employment efforts.
Resolving issues, while encouraging employment, can help us increase WorkFirst cash assistance exits, reduce WorkFirst returns, and keep caseloads down.
The WFPS is a central player in identifying issues and collaborates with the WFSSS and other service providers to:
The WFSSS plays a key role in providing screening, assessment, referral services, and has valuable expertise in intensive case management. The WFSSS coordinates services with WorkFirst partners and other service providers as needed. WFSSSs assist in helping participants (such as parenting minors, teen head of households, pregnant, hard to engage, sanctioned, and disabled/incapacitated participants) resolve issues, including:
Upon referral the WFSSS:
Revised on November 21, 2024
Legal References:
The Assessment section includes:
An assessment is an analysis used by a WorkFirst Social Service Specialist (WFSSS) to gather detailed information about a participant's life and issues that may impact their ability to support their family. Obtaining information from a participant during an assessment can be difficult. Use open ended question to assist in getting the information needed to establish supportive WorkFirst activities. Results of these assessments are used to establish WorkFirst activities for intensive services for participants. The Pathway Development Tool (PDT) is one way to complete assessments allowing for a full assessment or partial assessment to be completed (See WFHB 3.2.3).
Assessments include:
An assessment reveals a participant's issues and strengths, so we can connect the participant to appropriate resources, services, and activities to foster self-sufficiency.
Request an assessment:
As shown in the chart below, there are many issues that may interfere with a participant's ability to become self-sufficient, provide stability or care for a child in their home. Any indication of the issues listed below may require a WFSSS assessment so they can be addressed.
| Key Issues to resolve | |
|---|---|
| Education & employment | Problems in school or on the job may indicate hidden learning disabilities, critical skills gaps, or other factors that require further evaluation. |
| General health | Lack of dental care or physical disabilities may require a referral to a dentist, doctor, SSI or DVR. |
| Pregnancy or parent of child less than 24 months old | Help is available to provide prenatal care, child support, parent education, and to create a better support system. |
| Family planning | Family planning services are available to avoid unintended pregnancies that can make it harder to achieve independence. |
| Child health & nutrition | Help obtaining immunizations, regular well-child check-ups and health or nutrition advice. |
| Parent/child development | Parenting classes are available to deal with the issues faced by working parents. |
| Mental/Emotional health | Help is available to deal with depression, anxiety, anger, grief or the aftermath of physical, sexual or emotional abuse. |
| Domestic violence | Connect participants with domestic violence agencies for expert advice and assistance. |
| Substance abuse/Chemical dependency | Refer participants for substance abuse/chemical dependency assessment and treatment. |
| Housing/TLA eligibility | Help in finding stable and adequate housing, or supporting determination of appropriateness of living situation for pregnant/parenting teens in Teen Living Assessments (TLA.) |
| Child care | Help in finding safe, affordable, and reliable child care. |
| Transportation | Help in developing a reliable transportation plan (looking at mass transit, insurance, driver's license issues). |
| Legal Issues (Past or Present) | Help in dealing with various legal issues that can interfere with employment (like evictions, bankruptcy, or criminal history such as a current or past offense towards children or vulnerable adults). |
| Other agencies/Tribal | Connect the participant to other resources (like Head Start or tribal services) or coordinate with other agencies (like CPS). |
A participant may need additional assessments based on the results of a social service assessment. For example, it may indicate a need for a DASA referral, so the participant can be assessed further for drug and alcohol treatment.
When referring a participant to the WFSSS for an assessment, use the eJAS referral codes, such as:
When a pregnant woman applies for Pregnant Women Assistance (PWA) and isn't eligible for a 60 month TANF Time Limit Extension, the Case Manager (WFSSS) accepts the referral and assesses the PWA recipients' needs. All financial eligibility has been determined before the Case Manager (WFSSS) completes the First Steps Assessment (see CSD Procedure Handbook Pregnant Women Assistance (PWA) and WFHB 5.1.18 What is First Steps?).
During the assessment, the Case Manager (WFSSS):
See the PWA flow chart and CSD procedure, Pregnant Women Assistance (PWA) for additional information.
Revised On: March 25, 2024
Legal References:
The Participation While Resolving Issues section includes:
The purpose of WorkFirst is to help WorkFirst families become economically stable through employment as quickly as possible. Many families need support to participate in WorkFirst activities. Supporting participation in job search, employment, and/or issue resolution is fundamental to their success.
The main purposes of the comprehensive evaluation, stacking activities and the social service assessments are:
Participants 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 participant's IRP and help them progress while meeting WorkFirst participation requirements. Consider adding the following core activities:
Consideration for a full deferment from Career Scope activities should only occur when it isn’t possible for the participant to accept employment or participate in at least 20 hours of Career Scope activities. In these cases, the participant may need to participate in issue resolution activities prior to participating in Career Scope.
For example, a participant may need Residential (In-Patient) treatment for alcohol or substance abuse/chemical dependency.
It is necessary to defer job search or other activities while the participant 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 participant can resume participating in job search or other activities while also completing the Outpatient Treatment Plan. Determine if other activities are available if the participant is waiting to enter treatment.
See section 6.6, Disabilities if the participant claims to have a disability or medical issue that limits their ability to work, look for work or prepare for work.
For deferrals, allow 30 days to gather documentation. The Case Manager can support the participant to obtain needed evidence such as medical evidence, chart notes, or testing. Beyond 30 days, the participant must provide ‘good cause’. For example, the participant must show that the information has been requested but not received within the 30-day time period. If the evidence is not received within 30 days, the WFPS/WFSSS sends an appointment letter to determine if "good-cause" exists and invites the participant in the to discuss participation.
Participants 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, participating, 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 WorkFirst Staff or Case Manager and others who are working with the participant are necessary to ensure:
The WorkFirst partner agencies and most contractors normally can tell how many hours a particpant expects to participate in their program activities. The Case Manager develops the IRP accordingly. See section 3.3.2.3 and 3.3.2.4 for more information about how to meet program/participation goals and build an IRP.
Use the Individual Responsibility Plan (IRP) to clearly state the required participation and the supports available.
Deferrals ("X" codes) taking longer than 90 days require verification and approval by:
Develop an IRP that specifies the activities the participant 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 participant is making satisfactory progress in resolving the issue unless they're not engaged in activities each month. For example, a participant is ordered 90 days bed rest by their physician. In these cases, review periods can exceed 30 days but require approval by:
For information on how to treat excused and unexcused absences, please refer to section 3.7.1.5 - How do we treat excused and unexcused absences?
Use the appropriate "X" or referral codes in eJAS to identify the participant's issues, authorize support services, and/or make referrals to other resources.
Example: Following 90 days of Intensive In-Patient treatment, the participant 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 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 Case Manager develops an IRP that brings the participant up to full-time participation in countable activities as soon as they're able. We also want to make stabilization and issue resolution activities short-term if we can, so the participant can transition into work-focused activities that lead to employment and economic stability.
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 |
|
|---|---|
|
XB |
Pursuing SSI/L&I/VA or other benefits (not countable) See 6.8 Exemptions section |
|
XC |
No child care available or caring for a disabled adult who is in school full time (not countable) See 6.6 Disabilities section or WCCC manual |
|
XD |
In a DVR plan (a countable core activity) |
|
XE |
Alcohol/substance abuse/chemical dependency Treatment (a countable core activity) |
|
XF |
Family Violence Resolution (a countable core activity) |
|
XG |
Mental health treatment or Counseling (a countable core activity) |
|
XH |
Resolution of Homelessness (not countable) |
|
XJ |
Learning Disabilities Services (a countable core activity) |
|
XM |
Temporary incapacity undergoing medical treatment (not countable) |
|
XN |
Caring for a child with special needs who is in school full time (not countable) |
|
XP |
Parenting skills, nutrition classes, choosing child care, family planning, participating in home visiting or participant education services. Note: Normally used if pregnant or have child under 12 months of age, but also used for other participants in need of these services. |
Parents who do not have Washington Apple Health due to citizenship verification requirements and who have an activity requirement that is dependent on Washington Apple coverage are not required to participate in these activities until Washington Apple Health eligibility is established. Until Washington Apple Health coverage is established, these participants are coded with the component code 'CV'. This is an indicator code only and has no IRP or monitoring requirements.
However, participants are required to participate in other WorkFirst activities identified as appropriate through the comprehensive evaluation or assessments that are not dependent on Washington Apple Health coverage.
Once citizenship verification requirements are met and Washington Apple Health is approved, the component code 'CV' is removed and participation requirements changed to include appropriate health care services.
For participants with chemical dependency issues, please refer to section 6.7.4- Who is financially eligible for substance abuse treatment?
Participants who are unable to participate in any other activities due to a medical issue.
If a participant has a severe enough medical issue to prevent participation in any other activities:
Participants who are able to participate in other stacked activities
If a participant has a medical issue, but is also able to participate in other activities:
See section 6.6, Disabilities, for documentation required for participants with an emotional, mental or physical disorder.
Documentation for a participant caring for a child with special needs (see 6.4 Children: Special Needs) may include health-care professionals as described above in WACs 388-449-0010 or 388-447-0005 or other documentation provided by:
Foundational Community Support (FCS) is a voluntary supported employment and coordinated entry referral program to help individuals on Medicaid who have physical, mental health, and/or housing needs. Once referred WellPoint conducts a thorough assessment to determine eligibility based on criteria for supported employment and supportive housing services.
Who can receive FCS services?
Participants who are in an X component for:
What is FCS eligibility criteria?
Supported Employment participants must be:
Meet at least one health needs-based criteria:
Meet at least one risk factor:
Supportive Housing participants must be:
Meet at least one of the health needs-based criteria:
Meet at least one risk factor:
How does a participant enroll in FCS?
What services does FCS provide?
WorkFirst participants who are eligible and seeking supportive employment and/or housing and struggling with mental or physical incapacities may receive the following assistance:
WorkFirst Staff:
Coordinated Entry provides a streamlined access point for those experiencing homelessness through a crisis response system. The system is usually provided by the county, providing access to an assessment and referral process for each housing service and support available in their communities.
Who can contact Coordinated Entry?
Anyone seeking housing due to homelessness can contact Coordinated Entry to explore their options for assistance and services available to their specific needs. Services are available for the following unhoused populations;
How to contact Coordinated Entry?
Washington State Department of Commerce holds the funding sources and distributes funding to the housing programs and services statewide. Commerce has many resources to share with those experiencing homelessness, the Family and Adult Coordinated Entry Sites for people experiencing homelessness is a list of providers per county within the state with location phone numbers and websites. Each county in the state provides an intake assessment to evaluate the needs of the applicant. The details from his intake allows the Coordinated Entry partner to provide tailored information and referrals for the available resources that meet their specific needs.
What is discussed during the assessment?
Multiple questions are asked during the assessment with the housing case managers with Coordinated Entry, such as, is the person currently housed and in jeopardy of losing housing? Or, is the person living on the streets in a place inhabitable for humans? During the assessment, the case manager collects the information and if the agency has access to the Homeless Management Information Systems (HIMIS) they record the assessment/data to assist with determining housing needs/supports.
Referrals to housing services depend on the specific need of each individual or family. The role of WorkFirst staff is to provide the appropriate Coordinated Entry information to those in need of housing or at jeopardy of losing housing, to find supports available in their local area. WorkFirst staff can use the Family and Adult Coordinated Entry Sites for people experiencing homelessness resource and provide the local community contact information for those in need.
How can WorkFirst staff support unhoused participants?
If the participant is unhoused, seeking shelter, fleeing from a domestic violence abuser, or living in a situation that's unfit for human habitation, and need to connect with Coordinated Entry, WorkFirst staff can complete the following actions;
If the participant has already contacted Coordinated Entry and are working with housing providers WorkFirst staff can complete the following actions;
Revised on: March 20, 2023
Legal References:
The Children with Special Needs section includes:
A child with special needs has medical, developmental, or behavioral needs that require individualized care, treatment, or intervention. Families that include a child with special needs should have their special needs accommodated in the development of their Individual Responsibility Plan (IRP). Make every effort to meet the child's needs while allowing the participant to progress in employment.
Accommodations may include:
Whenever a participant indicates the inability to participate in WorkFirst activities because of a child with special needs or the need for special child care arrangements, the WorkFirst Program Specialist (WFPS) should accept the statement and make referrals to get more information and assistance.
The Public Health Department may initially evaluate the child's needs and document the impact on the participant's ability to participate in WorkFirst activities. Or, a DSHS social service specialist may be able to assess the situation based on existing information.
At the end of any deferral or exemption period, use other forms of documentation to determine whether the participant qualifies for continued deferral or exemption. If no other documentation is available, you may request a follow up evaluation from a public health nurse with supervisory approval.
Participants who care for a child with special needs may also qualify for an exemption if the participant is only able to participate for 0 to 10 hours per week. We code these cases with a ZC eJAS component code. For more information see section 6.8 Exemptions section.
Use creativity in developing the IRP for a participant who is parenting a child with special needs. Work with the participant(s) to develop activities that keep her and/or him engaged, support work, job search activities, or prepare him and/or her for future work. The following activities are examples of appropriate WorkFirst activities.
NOTE: An IRP is not required for an exemption, unless volunteering to participate.
Documentation for a participant caring for a child with special needs may include health-care professionals as described in WAC 388-449-0010 or WAC 388-447-0005 or other types of documentation provided by:
When a participant has a child with special needs, use the following eJAS codes:
When a participant indicates the inability to participate in WorkFirst activities because of a child with special needs, the WFPS or WFSSS:
Requests documentation of the child's special needs and the impact the child's special needs has on the participant's ability to participate in WorkFirst. If needed, the WFPS or WFSSS refers the family to the local Public Health Department, using an electronic referral* to the Public Health Nurse (PHN) in eJAS [or manually uses DSHS form 10-256], following the Step-by-Step guide below:
11. At the end of the initial deferral or exemption, obtains documentation to determine whether the participant qualifies for another exemption or deferral. Only use a follow up evaluation from a public health nurse if there's no other documentation available and with supervisory approval.
Revised September 28, 2023
Legal References:
The Family Violence section of the WorkFirst handbook includes:
Family violence is a general phrase that refers to a variety of abusive behaviors that can occur within a family structure.
Family violence includes any or all of the following;
The focus of this section is on what is traditionally known as domestic violence. Domestic violence is physical, sexual, psychological, and/or emotional abuse of an intimate partner in which one partner uses a variety of tactics to gain and maintain power and control over the other partner.
Family violence includes both current experience of these abusive behaviors and the continuing effects of abuse that happened in the past. Some of the common ways abusers control the person:
Family violence victims may need help because family violence may prevent a person from gaining or maintaining employment and becoming self-sufficient. In family violence situations, some factors affecting participation in activities are:
One of the missions of DSHS is to help individuals to live in a safe environment. Individuals subjected to, or at risk of, family violence need help to achieve a healthy and safe environment.
In order for individuals to achieve self-sufficiency, it is essential for the individual to have a safe environment for themselves and their children, and to be free from physical or emotional harm or stalking.
The Family Violence Option (FVO) recognizes the importance of not just screening individuals, but also actually doing something when a person indicates that they are a victim of domestic violence. This gives the state the flexibility to help these participants safely participate in activities leading to employment and self-sufficiency.
Washington State law maintains that DSHS must:
DSHS staff must give all victims of family violence an ongoing opportunity to disclose circumstances of family violence and to engage in activities that give them more control over their circumstances. If it appears that the person may have a cognitive disability or is unable to read and/or understand what is being asked, determine if Equal Access (EA) plan is needed and/or has been provided.
DSHS staff must actively take steps to refer and/or place participants into activities to help resolve or cope with the issues and to create a safe environment for the family. Every reasonable attempt to help the participant feel comfortable in talking about the situation must be made.
Referrals or activities for family violence may include:
If it is safe for the participant, screening for family violence is required:
Document all family violence screenings in eJAS under the Family Violence Note. If appropriate, offer to refer the participant for additional services described above.
When screening for family violence, safety is of paramount importance.
Never ask the participant about family violence when the other partner is present as this may endanger the participant. Some successful methods for separating couples to safely complete the screening include having an office protocol that recommends completion of all IRPs separately, or the scheduling of an appointment with a family planning worker to separate the couple during their visit to the office.
Review your policy regarding collaboration with local resources and partners. Local resources may be able to offer training or guidance, to refine protocols for screening couples.
Every adult, minor teen participant or emancipated teen must be given general information both verbally and in writing about:
Written information must include at a minimum the "Open the Door" brochure DSHS 22-265(x) available in English and Spanish. The WFPS/WFSSS must document in eJAS when this brochure has been given or mailed to the client.
Remind each person that they have an opportunity to disclose issues at any point in time.
| Distributing information about family violence | |
|---|---|
| Safety Plan Pocket Guide (DSHS 22-276) | Place these guides in areas where individuals can help themselves to the information (like restrooms, front counters or on your desk) |
| TANF Family Violence Information brochure "Open the Door" (DSHS 22-265(X)) | Ask each individual to read this brochure at the initial eligibility interview and at least yearly thereafter. Then, provide a verbal summary of the information in the flyer. |
| Family Violence Technical Assistance for all staff working with WorkFirst individuals | 360-586-1022 Ext 102 or 104 Monday-Friday 9:00am-5:00pm |
The following is the opening statement and the screening/evaluation questions in eJAS Pathway Development Tool (PDT) for family violence. Screening is required for adults and emancipated minors.
"This is a series of questions we ask everyone about family violence (also know as domestic violence). We know that violence in the home can be hard to talk about. We also know a lot of people experience this, which is why we ask. There is no 'right' answers and this does not affect your eligibility.
If the worker clicks 'Not safe to screen at this time', a Family Violence Screening note type will be generated and the text will read: 'Not safe to screen for family violence at this time.' This is a reminder that the family violence screening has yet to be completed.
If it is safe to continue with the screening, workers need to gather 'yes' or 'no' responses to the following six screening questions:
If 'yes' is the response to any of questions 2-6 above, let the participant know that there are specialists on staff who can help with safety issues as well as tailoring plans within WorkFirst to help avoid danger and promote success in the program. Please explain to the participant that the services are available to address family violence. Offer a referral to a Social Services Specialist, Family Violence Advocate or other local family violence resources. Select all the appropriate options that fit the next steps and document in the Pathway Development Tool:
If the participant answers 'no' to all questions, document that the person reports no issues at this time. When 'No, family violence concerns disclosed at this time' is checked and comments are entered, a note type is generated and the text reads, 'Client screened for family violence. Client has indicated no issues at this time.'
When WorkFirst partners at Employment Security, Community Trade and Economic Development, or the State Board of Community and Technical Colleges are informed by the participant that family violence is an issue, the worker involved must immediately:
Good Cause allows a participant to be excused from cooperating with Division of Child Support (DCS). The participant must claim to have good cause for not cooperating with DCS. A participant may have good cause when they verify that cooperating with DCS would result in serious physical or emotional harm to themselves or the child in their care. This stops DCS from taking any action to establish an order or to collect child support, which may jeopardize the participants' or family's safety.
The participant must claim and the department must approve or deny the good cause.
If a participant indicates that Family Violence is an issue, consider whether or not Good Cause for non-cooperation with DCS should be established.
For more information, refer to the Good Cause chapter in the Social Service Handbook and the Child Support chapter in the E-Z Manual.
The Address Confidentiality Program (ACP) protects the address of persons attempting to escape from actual or threatened domestic violence, sexual assault, trafficking, or stalking situations. Criminal Justice Affiliates, Election Officials, and Protected Health Care workers may also participate in the ACP. The program provides participants with a substitute address to use in place of their actual work, home, or school addresses. State and local government agencies can then respond to public records requests without disclosing the actual location of the participant. The Office of the Secretary of State administers the program. The ACP works best if the individual has relocated to a location that is not already in public record.
A trained advocate provides individuals with safety planning and assists with the ACP application process. For a current list of advocates trained in your community to sign people up for the ACP, go to https://www.sos.wa.gov/address-confidentiality-program-acp and click on the map for your location.
DSHS staff must accept the participant's substitute address and enter it into all records; never record the actual street address for work, school, or home of an ACP participant in any automated system. If someone is participating in the ACP, don't require them to disclose their actual home, work, or school address. For ACP participants, ACES letters don’t include the CSO address on them to protect their geographical location. When scheduling WF appointments for these participants, all ACES letters instruct the participant to call 1-877-501-2233 or visit https://www.washingtonconnection.org/home/ to find out the location of their appointment. Don’t add the CSO’s address or appointment locations.
By itself, the ACP won't keep a person safe. To be really valuable, using the ACP substitute address must be part of a more complete and long-term safety plan.
If the individual doesn't have their authorization card, government agencies may call the ACP office (360-753-2972) to verify that the individual is an active ACP participant.
IRPs are tailored to each participant. DSHS staff has the ability to create IRPs with activities designed to help a victim deal with the issues that result from family violence.
In any situation where the participant/caregiver participates in any family violence activities, it is necessary to reflect the information in the IRP. Correct coding of family violence is necessary because of federal reporting requirements regarding all participants on TANF especially for those receiving benefits for more than 60 months.
The following are common examples of family violence situations and the correct way to code and document in eJAS:
When participants disclose family violence, use the XF eJAS code to:
Note: XF isn't used for the perpetrator. WFPS/SSS should add other codes (activities) in addition to XF if appropriate based on the Family Violence Service Plan.
Special circumstance: XF as stand-alone activity. The WFPS/WFSSS, in collaboration with the domestic violence advocate, should determine the actual amount of hours per week that the person will be participating and code those hours in eJAS when participants/caregivers are unable to participate in any other WorkFirst activity except resolving family violence challenges. The participant doesn't have to add any other activities because XF activities are the only participation that the individual is able to do. In this case, the amount of hours doesn't have to reflect 32-40 hours per week. The case needs to reflect the actual amount of hours that the individual is participating.
As part of the Deficit Reduction Act, the XF countable core activities include:
Housing and legal issue resolution are not included as federally countable core activities within family violence services. Therefore, the hours for these activities must be reported separately from those mentioned above in order to report the correct federally countable participation. The WorkFirst Participation Verification form must indicate the hours spent working with a participant in family violence countable core activities, listing housing and/or legal services separately.
Since our State cannot report housing and legal issue resolution hours as part of XF countable core activities, the State is not going to get credit for those hours in a federal audit. Even though these activities are not federally countable, housing and legal issue resolution services are still state approved XF activities.
Example:
A participant's Individual Responsibility Plan (IRP) and component screens shows that the participant is scheduled for 30 hours of XF activities. When the WFPS or WFSSS receives the WorkFirst Participation Verification form, it indicates 5 hours of counseling, 10 hours of legal services, and 15 hours for securing stable housing. The only hours that can be entered and reported in eJAS actual hours are the 5 hours of counseling.
In collaboration with family violence advocacy providers, the WFPS/WFSSS gathers documentation that supports participant's individual needs for WorkFirst family violence services.
Contracted family violence providers must report participant's actual hours and progress for family violence activities using eJAS by the 10th day of the following month. See WorkFirst Handbook 3.7.2.5 for contracted service requirements.
Staff sends non-contracted family violence providers the WorkFirst Participation Verification form for each WorkFirst participant noted in eJAS as receiving family violence services. The non-contracted family violence provider completes, signs, and returns these forms or other documents that verify actual hours and progress to the referring WFPS/WFSSS by the 5th day of the following month. The WFPS/WFSSS enters the countable hours indicated on the form in eJAS actual hours by the 15th day of each month for the previous month's activity.
When a participant answers "yes" to any of the family violence screening questions in the screening/evaluation:
The WFPS/WFSSS must:
Good documentation is extremely important in these situations. It is important to document family violence information in the family violence note type in eJAS to protect the safety of participants.
Victims of Family Violence may not be able to participate in job search or work activities. As a result, it is necessary to make every effort to avoid unfairly penalizing participants by imposing sanctions. If family violence is a significant part of the reason a participant has been unable to follow through with the activities in their IRP, don't impose a sanction; rather renegotiate and modify the IRP to address the barrier so that it aligns with any current family violence service plan that moves the participant forward safely. Documentation in eJAS to support your decision is critical.
Note: Family violence may be a significant part of the reason a participant is unable to follow through with WorkFirst activities whether the family violence is current or occurred in the past.
A victim of family violence may be sanctioned. As described in WFHB 3.5.2.4, if a sanctioned person’s circumstances change, their grant, IRP and/or cure requirements may also change. Waive a family violence victim’s four-week (28 day) cure requirement if their family violence situation is directly or significantly contributing to their inability to participate – see examples of family violence situations below.
Examples: A participant is sanctioned for refusing to do job search and discloses the month following sanction that they are dealing with family violence issues. Follow section 6.5.19 Family Violence and Sanctions - Step-by-Step to discover if family violence is directly or significantly contributing to their not participating. Below are five different situations with the appropriate response for each.
#1: Good cause found – Current Family violence is preventing participation – Reverse sanction decision
This woman reports that her abuser is intercepting her mail and phone calls and won't allow her to use their shared vehicle and that this has been happening since before her good cause appointment. Because the family violence is (and was) preventing her participation in WorkFirst activities, we would reverse the good cause decision, lift the sanction, and remove the sanction penalty back to the date the penalty was first approved. Refer the participant to a worker or advocate trained in family violence to create a family violence service plan. Use this family violence service plan as a guide for developing a new IRP and explain that she must participate in the activities agreed upon in her revised IRP to avoid future sanction and retain her TANF grant. For example, the only activity she may be able to safely do is to contact her WFSSS or family violence advocate on a regular basis by phone. However, she may want to integrate other activities into her IRP as well, and this may be indicated on the family violence service plan. See WFHB 6.5.17.
#2: Good cause found – Past Family violence is preventing participation – Reverse sanction decision
This woman reports that she has been away from the abuser for two years, but when she tries to leave her home, she fears he may find out how to locate her. She wanted to participate in job search, but could not manage the courage to leave her home. She also reported that she was ashamed to call her case manager because it happened so long ago. Because the family violence is (and was) preventing her participation in WorkFirst activities, we would reverse the good cause decision, lift the sanction, and remove the sanction penalty back to the date of sanction. Refer the participant to a worker or advocate trained in family violence to create a family violence service plan. Use this family violence service plan as a guide for developing a new IRP and explain that she must participate in the activities agreed upon in her revised IRP to avoid future sanction. For example, the only activity she may be able to safely do is to contact her WFSSS or family violence advocate on a regular basis by phone. However, she may want to integrate other activities into her IRP as well, and this may be indicated on the family violence service plan. See WFHB 6.5.17.
#3: No good cause found – Past Family Violence isn’t preventing participation – Four-week (28 day) sanction cure requirement
This woman comes in to develop a new IRP to cure sanction. Previous family violence had been disclosed, and she reports that she continued attending weekly family violence support group meetings but stopped attending job search because she thought she found employment and the job fell through. Past family violence did not contribute to her non-participation. She will be required to complete a four-week (28 day) cure to lift sanction. We would encourage her to stay connected with a local advocate or family violence program to assist her in staying safe. See WFHB 6.5.17.
#4: No good cause found – Current Family violence is preventing participation – Waive sanction cure requirement
This man reports that he wants to cure his sanction, but his abuser returned last week and made physical threats. This is new and significant family violence that will keep him from meeting participation requirements but didn’t exist when he entered sanction. Regardless of the reason for the original sanction, after the Sanction Re-engagement is completed, we waive his four-week (28 day) cure requirement and remove the sanction penalty. We should explain that he must participate in the activities agreed upon in his revised IRP to avoid future sanction. Refer him to a worker or advocate trained in family violence to create a family violence service plan and use that plan as a guide for developing a new IRP. For example, the only activity he may be able to safely do is to contact his WFSSS or family violence advocate on a regular basis by phone. See WFHB 6.5.17.
#5: No good cause found – Past Family Violence isn’t preventing participation – Four-week (28 day) sanction cure requirement
This woman reports that she has been away from the abuser for two years, and thinks that she may need some help resolving issues that are a result of living with the abuser but acknowledges that she doesn’t fear that he will find her at this time. She had answered that she had been in a family violence situation during her Comprehensive Evaluation, but reported that she didn’t need help at that time. She also reported that she did not attend job search because she lost the paperwork and didn’t know where to go or who to call. Because family violence was not the reason she was not participating in her IRP, there is no good cause. Refer the participant to a worker or advocate trained in family violence to create a family violence service plan. Use this family violence service plan as a guide for developing a new IRP. Her family violence service plan indicates that with a family violence activity she should be able to participate full-time in another activity. This woman’s past family violence experience was affecting her current behavior but was not significantly related to her inability to participate. You discuss the Community Jobs program with her, and she agrees that would be a better fit than returning to job search. Because she is able to participate in activities other than those related to family violence, she will be required to complete a four-week cure to end sanction. See WFHB 6.5.17.
Note: If a situation occurs where WF staff make an initial determination on the participant’s family violence service plan because an advocate is not available and later the advocate comes to a different conclusion about what the client can safely do, the worker should discuss the family violence service plan with the advocate.
Screen or re-screen participants for family violence during the good cause appointment before sanctioning a participant and proceed with sanction if screening doesn't identify family violence. However, if screening identifies family violence follow the steps below:
Consult with a WFSSS or family violence advocate (Case Staffing) to determine if the violence is preventing the participant from participating in job search or work activities if screening identifies family violence.
Clearly document this in the family violence notes and continue the sanction process if family violence isn't currently impacting the participant's ability to do job search or work activities; or
Don't proceed with the sanction process.
Update the 'special record' IRP in eJAS with appropriate activities that will move the participant forward safely.
Clearly document your decision if the participant disclosed family violence, but you determining that whatever abuse is currently taking place, or historically occurred isn't the reason they aren't following through with their IRP.
Note: Documentation of the family violence issues must be indicated in the Family Violence Category in eJAS.
Good documentation is extremely important in these situations. It is important to document family violence information in the family violence note type in eJAS to protect the safety of participants.
Revised September 9, 2024
Legal References:
The Disabilities section includes:
This section includes information about medical conditions (physical, mental, emotional disorders or learning disabilities) that can interfere with a participant's ability to work, prepare for work or look for work. Substance abuse/chemical dependency, which can also interfere with participation, is covered in the following section of the handbook, Substance Abuse 6.7.
Approval of deferrals or exemptions can only occur with medical evidence that documents what the participant can and cannot do.
Our goal is to promote consistent decisions, increased participation and better outcomes for WorkFirst participants with physical, mental or emotional conditions.
Guiding principles to support participants with medical conditions:
As shown in the Medical Evidence Evaluation Basic Flow Chart, WorkFirst staff use a consistent process to respond when a participant shares they may have a physical disorder (XM), a mental or behavioral disorder (XG) or a learning disability (XJ). Throughout the process, the participant can receive accommodations to support activity engagement before moving to full-time participation.
WorkFirst staff start by obtaining medical evidence to determine what the participant can and cannot do. Obtaining the medical evidence is the first step even if the participant has applied for SSI on their own. Evidence is needed to determine whether the participant qualifies for a WorkFirst deferral or exemption, and to assist with participation planning, including whether they need a referral for SSI facilitation.
WorkFirst staff reviews the medical evidence to determine the next steps:
When the participant reports, or appears to have, a medical, mental or behavioral condition that interferes with their ability to participate, WorkFirst staff work with participants to obtain medical evidence to determine what they can and cannot do. Types of providers you may use are found in WAC 388-310-0350.
WorkFirst staff obtain the following information from the participant up front, in order to follow up as needed:
Note: If staff don’t have access to Barcode, they may use a hard copy of the DSHS 14-050, Statement of Health, Education and Employment form, in case the medical evidence shows the participant may be a viable SSI candidate.
WorkFirst staff completes the IRP using the OR eJAS component code requiring the participant to obtain medical evidence within 30 days and offers to help the participant obtain the evidence as needed. Supervisory approval must be obtained before the participant may be given more than 30 days to obtain medical evidence.
If needed, time can be extended in 30-day increments with supervisor approval, if the following is done:
The OR IRP template requires the participant to provide the DSHS 10-353 form or alternative medical evidence that provides the:
WorkFirst support services are available to pay for medical evidence when existing medical evidence is insufficient, and the participant would incur a cost to obtain the necessary examinations or testing.
WorkFirst staff may purchase exams or testing to:
Determine if a participant’s impairments are appropriate for an SSI referral; or
Support a SSI application when:
Recommended by the contracted physician, or
Following an SSI denial if it was overlooked and appears necessary to establish SSI eligibility.
Do not use WorkFirst support services to purchase medical evidence when:
Washington Apple Health should normally cover the cost of the medical exam and form completion. However, the medical professional may charge for copies of the participant's chart notes. It may be appropriate to pay for missed doctor appointments when our staff set up the appointment for the participant and the participant was not able to give the doctor a 24-hour cancellation notice.
See categories 34 (testing/diagnostic) and 37 (medical exams/services) in the WorkFirst Support Services Directory for the types of medical exams and services that can be purchased using support services.
WorkFirst staff reviews the DSHS 10-353, WorkFirst Documentation Request for Medical/Disability Condition and any chart notes. If the participant provides alternative medical evidence, contact the doctor as needed to obtain the key information below.
Depending upon the participant's situation, use these eJAS codes:
WorkFirst staff:
Based on the medical evidence and EA screening, determines:
If the participant is suspected of having a learning disability, refer the participant to their Care Manager who uses the eJAS Learning Needs Screening to:
Revised: May 31, 2024
Legal References:
The Substance Use Disorder (SU) section includes:
Substance use disorder is the use or overuse of a legal or illegal chemical or substance, including alcohol, in a way that is different from the way it is generally used medically or socially.
Substance use either creates disruption or problems for the user or complicates an existing problem in the individual's life. It does not matter whether the person is abusing the substance by choice, or abusing as part of an addictive pattern. Eventually, substance use may impact the person physically, behaviorally, socially, occupationally, or in other ways and could lead to chemical dependency.
Chemical dependency occurs when the person's use/abuse of alcohol, chemicals, or other substances progresses to physical and/or psychological dependence. Chemical dependency means the person is addicted to the substance. Addiction is the loss of control and compulsive use of a mood or mind altering chemical along with the inability to stop the use in spite of the fact that such use is causing problems in their life.
Substance use disorder assessments must be completed by a Licensed Chemical Dependency Professional (CDP) to determine:
Persons who are eligible for WorkFirst likely qualify for Washington Apple Health.
WorkFirst participants do not need to be referred by an ADATSA assessment agency to receive treatment. They can receive assessment and treatment services from any Division of Alcohol and Substance Abuse (DASA) treatment agency contracted to provide services to WorkFirst participants.
WorkFirst participants without Washington Apple Health due to citizenship verification requirements who need substance use disorder treatment may be able to access ADATSA (W02) services. Please refer to section 6.3.5 How do we treat participants with medial issues who do not have Washington Apple Health?
Require participants to apply for Washington Apple Health in their IRP if they don’t currently have coverage so they can access a substance use disorder assessment or treatment. Failure to apply for Washington Apple Health without good cause may result in sanction (See WAH Application IRP for suggested IRP language).
Note:
Priority populations are pregnant individuals, injecting drug users, WorkFirst families (parents with dependent children), and youth.
| Consider a referral for a substance use disorder assessment when there is; |
|---|
| Some conditions are so severe that a participant should be concentrating solely on getting medical treatment. |
| A history of unfinished substance use disorder treatment. |
Behavior consistent with being under the influence of excessive drug/alcohol use, such as:
|
Individuals self-reporting that drug or alcohol use caused:
|
Admission to modality of care is determined based on the American Society for Addiction Medicine patient placement criteria.
1. Detoxification Services
2. Intensive Inpatient/Residential Treatment
Provides up to 30 days of a concentrated short-term program of:
3. Recovery House/Residential Treatment
Provides up to 60 days of care and treatment with social, vocational, and recreational activities to aid in patient adjustment to abstinence and to aid in job training, employment, or other types of community activities. Treatment includes individual and group counseling by a CDP.
4. Long-term Inpatient/Residential Treatment
Provides up to 180 days of care and treatment to chronically impaired alcoholics/addicts who have personal-care capabilities. Treatment includes:
5. Outpatient Treatment
Programs of care include individual and group treatment services of varying duration and intensity according to a prescribe Treatment Plan and education directed at relapse prevention, HIV/AIDS, hepatitis B & C, and sexually transmitted diseases.
The Division of Alcohol and Substance Abuse (DASA) also administer Pregnant and Parenting Women's (PPW) programs, such as Safe Babies Safe Moms (SBSM), Parent Child Assistance Program (PCAP), and treatment for Opiate dependence.
PPW programs address specialized needs associated with substance use disorder/chemical dependency for pregnant and parenting women, including:
Safe Babies/Safe Moms Program:
Parent Child Assistance Program:
Opiate Dependency
Federal law prohibits the disclosure of personal information relating to alcohol and/or drug use, with criminal and civil penalties applied for unauthorized disclosure. This means:
Be particularly thorough in the completion of the form if you are requesting an exchange of information regarding a participant either:
The form must be very specific as to the purpose of the release and to whom the information is to be shared. If the forms are not completed thoroughly and correctly, the treatment agency cannot give any information and you may not share information.
Information stored in eJAS Special Records Chemical Dependency notes is highly restricted and protected. Enter all substance use disorder assessment and treatment information on the Chemical Dependency Special Records screen in eJAS notes. Do not document information about the substance use disorder assessment or treatment in less protected areas of eJAS.
When adding the requirement to follow through with a substance use disorder assessment and any treatment requirements on the individual's IRP, WorkFirst staff include the requirements to the Special Records IRP available in eJAS.
For tracking purposes, it is very important to always enter the following appropriate eJAS code when a participant is referred for a substance use disorder assessment and when an individual enters treatment.
Use the following appropriate eJAS code when an individual is referred for a substance use disorder assessment or when an individual enters treatment: SR - Referred for substance use disorder ASSESSMENT.
WorkFirst staff suspects there is a substance use disorder problem and:
The treatment agency completes the substance use disorder assessment, and
The Case Manager:
If the Case Manager finds out that a participant is already in substance use disorder treatment, they:
It is not uncommon for individuals to relapse during treatment, especially during the early stages of recovery. Relapses, within themselves, should not be considered as non-compliance. Therefore, individuals should not be sanctioned or have treatment services denied just because there was a relapse.
Without good cause, failure to have a substance use disorder assessment or attend treatment when the need has been identified may be considered non-compliance. Work closely with the CDP to ensure the treatment plan is being following. Case staffings involving the individual and the CDP are strongly recommended. Individuals are much more likely to be successful in their recovery if they have support of others including their Case Manager.
Revised September 9, 2024
Legal References:
The Exemptions section includes:
6.8.1 What are exemptions?
Exemptions support households where situational needs create hardships to engagement in WorkFirst activities. In most circumstances, exemptions waive mandatory participation requirements for individuals who aren't able to actively engage in work, look for or prepare for work.
When placing a participant into an exemption, their specific situation and needs are assessed, taking into consideration the entire household. Participants are granted an exemption if they:
An exemption from participation may not always be appropriate. Participants who have health or family issues that temporarily interfere with their ability to work (instead of exempt) from job search and other WorkFirst activities are deferred from participation. See WFHB 6.3, Deferrals, for more information.
Example #1: Lee is a single parent with two children ages 12 and 14. Lee is also caring for their elderly father who was recently diagnosed with dementia, lives in their home and needs round the clock care. Lee shares with the Case Manager that there is relief care available when Lee sleeps, but that during the day Lee needs to be home to support with daily activities for their father. Lee and the Case Manager agree their IRP should reflect that Lee is exempt from participation due to caring for an adult relative with a severe and chronic medical condition (ZB component).
Example #2: After many years of medication management, and behavioral and medical treatment, Micah has been denied at the final appeals level with SSA for SSI for his diagnosis of severe depressive disorder and severe pain disorder. Micah also has a back injury that keeps him from returning to heavy exertion types of employment. With the combination of his severe depressive disorder symptoms and his sedentary work needs, Micah is unable to return to the workforce at this time. His Case Manager has provided him resources for retraining with the Division of Vocational Rehabilitation - DVR (WFHB 1.2.9), but Micah stated his symptoms, severe pain, and insomnia create problems for him to focus and maintain employment. He has provided medical evidence from both his medical and behavioral health providers stating his condition is 12 months or longer in duration and treatment will not lessen his symptoms. Micah and his Case Manager agree his IRP should reflect that he is exempt from participation as an adult with severe and chronic disabilities (ZD component).
Example #3: Maggie provided documentation that she has bipolar depression, anxiety, a history of substance abuse and some permanent limited mobility due to a back injury which limits her ability to sit or stand for long periods of time. Her doctor said that due to Maggie’s mental and medical health issues, she would be unable to work for 12 months or longer. The doctor recommended that Maggie could benefit from mental health treatment and referred her to begin counseling and medication. Maggie and her Case Manager agree that applying for SSI would be a good option for long-term income. Based on the conversation with Maggie, and documentation from her doctor, her IRP should reflect that she is exempt from work activities as an adult with severe and chronic disabilities (ZD component). However, in addition to the ZD component, based on the direction of her doctor, her IRP would also require mental health treatment (XG component) and working with the SSIF to pursue SSI (XB component).
Example #4: Rene is a single mother of a child who is seven and has significant behavioral needs. Her child isn’t able to attend school due to the child’s emotional and medical needs. Rene is working with her child’s providers to evaluate and support the child’s needs. She has multiple appointments out of town to see specialists and is unable to engage in work or related work activities. She met with her Case Manager to see the public health nurse. Per the public health nurse’s assessment,
Rene will need to take her child to medical appointments, and care for their needs for the next 12 months. Rene and her Case Manager agree her IRP should reflect that she is exempt from participation, per the public health nurse’s assessment, so she can be available to care for her child with special needs for the next 12 months (ZC component).
See WFHB 6.4 – Children: Special Needs for details on how to support families who need referrals to the public health nurse or, if there isn’t a public health nurse in their area, support to find resources.
Documentation to support an exemption may come from a variety of sources based on the participant's situation. Medical documentation must be adequate to identify the severity and duration of the disability. Exemptions can't be approved without the appropriate documentation, see WFHB 6.6. If there are questions about the medical evidence, WorkFirst staff seek support from peer Case Managers or the SSIF to staff the case, reviewing evidence together to support the participant in their goals.
For the Infant Exemption see WFHB 5.1, Pregnancy to Employment and WAC 388-310-0300 and WAC 388-310-1450 (exemption from full-time participation for a maximum of 730 days in a lifetime if caring for a child less than two years of age).
For an older, needy caretaker relative, proof of age (55 or older) is all that is needed to approve an exemption. These exemptions do not require periodic reviews to determine if the relative continues to meet exemption criteria.
An exemption may be approved for an individual who is needed in the home to care for a child with a special medical, developmental, mental or behavioral condition when the child is determined to require specialized care or treatment that significantly interferes with the individual's ability to prepare for work, look for work or work.
Documentation may include statements by a public health nurse, physician, mental health provider, school professional, other medical professional, HCS, MHD and/or a RSN.
To determine whether the individual qualifies for an exemption, Case Managers:
The exemption must be reviewed at least every 12 months to determine if the person continues to meet the exemption criteria. Depending upon the individual's circumstances, the review period may be shorter. A case staffing may be leveraged to support review of the case. See the 3.4 Case Staffing section for more information.
See 6.4 Children: Special Needs section for more information about children with special needs. See also Examples of Caring for a Child with Special Needs.
Exemptions may be approved for individuals needed in the home to care for an adult relative with a verified disability who cannot be left alone for significant periods of time and the individual is the only one available to provide care. The individual is exempt from participation if they can only participate 10 hours or less per week due to providing this care.
Documentation includes evidence of disability from a medical/mental health professional or from DDA, DVR, MHD, RSN or HCS. The exemption approval process and review requirements are the same as those for Children with Special Needs.
We may approve exemptions or long-term deferrals for adults with chronic and severe disabilities. To make the exemption/deferral decision, Case Managers:
If the medical evidence shows the person has a chronic and severe physical, mental or behavioral disorder, Case Managers:
SSI referrals (XB), exemptions (ZD) and long-term deferrals (XG or XM) must be reviewed at least every 12 months to determine if the person continues to have a chronic and severe medical condition.
A participant with chronic and severe disabilities may be approved for SSI, resulting in long-term cash assistance and on-going health care coverage. However, it can take a year (or more) to get a final decision.
The Case Manager:
Uses the SSI Track Flow Chart to determine who may receive facilitated SSI applications (similar to the ABD process).
If the participant’s disability appears likely to meet SSA criteria, the Case Manager refers the case directly to the SSIF with all relevant medical records.
If it is unclear whether the participant’s disability will meet SSI criteria, the Case Manager refers the case to the contracted physician using the Barcode TANF Disability Assessment subsystem, (see TANF Contracted Physician Referral Desk Aid for instructions on process and completing DSHS 14-507 Disability Assessment).
Documents needed for the TANF contracted Physician Referral:
Recent medical records and all relevant medical records that help to establish duration of impairment or show treatment history.
Ongoing case management duties as follows:
The contracted physician:
Determines when a participant appears to meet SSI Disability criteria.
Provides a DSHS 14-507B, Disability Assessment: TANF Decision form with their review and reasons for approval or denial.
The SSIF:
WorkFirst staff may refer participants who want to work, but need assistance due to a physical, sensory, cognitive, or mental disability, (see Social Services Manual - DVR.) If accepted into the program, DVR can provide:
If the participant is exempt due to a severe and chronic disability, they may be required to participate in limited activities per WAC 388-310-0350 (4). This is limited to activities that support:
Exempt individuals may voluntarily participate. WorkFirst will provide services or refer voluntary participants to service providers for assistance and support.
What type of activities can exempt individuals voluntarily participate in?
For those who choose to voluntarily participate, eJAS exemption codes remain on the case to ensure that sanction will not be imposed for failure to participate.
The following eJAS codes are used when an individual is approved for an exemption or long-term deferral:
The codes below may be coupled alongside the ZD exemption component to indicate mandatory participation per WFHB 6.8.9 or may be used to support voluntary activity engagement per WFHB 6.8.10.
WorkFirst Staff work with participants as described below.