Chapter 6: Resolving Issues

6.1 Overview

Created on: 
Feb 16 2017

Revised on: September 20, 2021

The Resolving Issues Overview section includes:

  • 6.1.1 What is resolving issues?
  • 6.1.2 When do we resolve issues?
  • 6.1.3 What are the principles for resolving issues?
  • 6.1.4 What is the role of the WorkFirst Program Specialist?
  • 6.1.5 What is the role of the WorkFirst Social Service Specialist?

6.1.1 What is resolving issues?

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).

6.1.2 When do we resolve issues?

We look for issues that may need to be resolved at:

  • Application.
  • Comprehensive evaluation.
  • Eligibility reviews.
  • Assessment.
  • Anytime upon the participant's request.

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:

  • Refer for medical/dental care.
  • Provide child care (WFSSS may help find suitable child care).
  • Provide AREN to find or keep housing or refer for emergency housing.
  • Explore transportation options and provide support services to pay for it.
Lacks expert advice Likely a shorter-term intervention by the WFSSS (that can be combined with looking for work or work) to provide:
  • Prenatal care.
  • Family planning.
  • Parenting classes.
  • Child health/nutrition advice.
  • Legal advice.
Family & health concerns Likely requires a longer-term WFSSS intervention. These situations may need to be stabilized before adding other activities.
  • Caring for a child (or adult) with special needs.
  • Family violence.
  • Substantial physical/mental/learning disabilities.
  • Substance abuse/chemical dependency.

6.1.3 What are the principles for resolving issues?

There are some common themes you see whenever we talk about resolving issues.

Overall principles for 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.

6.1.4 What is the role of the WorkFirst Program Specialist?

The WFPS is a central player in identifying issues and collaborates with the WFSSS and other service providers to:

  • Determine needs
  • Obtain resources
  • Complete the foundation section of the comprehensive evaluation
  • Develop the IRP with the participant's input, using recommendations from Employment Security's employment plan, and consideration of other relevant information
  • Ensure the participant has adequate child care and transportation and coordinates other services as necessary

6.1.5 What is the role of the WorkFirst Social Service Specialist?

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:

  • Mental, physical, and learning disabilities
  • Caring for a child with special needs
  • Alcohol or substance abuse/chemical dependency
  • Family violence
  • Homelessness
  • Family planning.
  • Parental Education or support
  • Pregnancy to Employment
  • Child Protective Services

Upon referral the WFSSS:

  • Completes assessment using the Pathway Development Tool (PDT) - see WFHB 3.2.3
  • Provides intervention and support to help the participant address issues that may interfere with their ability to complete the comprehensive evaluation or impede movement toward economic economic mobility
  • Develops a plan for issues identified and make appropriate referrals to specialized services to help resolve these issues
  • Helps the participant resolve issues identified by WorkFirst partners and other service providers
  • Stacks services, if appropriate, to help participants engage in activities that leads to employment
  • Attends case staffings
  • Provides specific, intensive, and time-limited services to participants at risk of losing benefits or services
  • Provides follow-up services, as needed, to keep the person engaged

Resources

Related WorkFirst Handbook Sections

Forms & Other Resources

6.2 Assessment

Created on: 
Sep 28 2018

Revised on May 19, 2021

Legal References:

The Assessment section includes:

  • 6.2.1 What are assessments?
  • 6.2.2 Who needs it?
  • 6.2.3 Are there issues to be resolved?
  • 6.2.4 Are there any other considerations?
  • 6.2.5 eJAS Codes
  • 6.2.6 Pregnant Women's Assistance (PWA) referral and assessment process
  • 6.2.7 Assessment - Step-by-Step

6.2.1 What are assessments?

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:

  • Basic participant information, such as name, address, assistance unit, education/employment, family planning and other agency involvement.
  • Issues of the Pregnancy to Employment population such as pregnancy, child health and child care. (Only completed as needed.)
  • Other concerns, such as health issues or family violence. (Only completed as needed.)
  • A plan to help resolve the issue or issues.

6.2.2 Who needs it?

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:

  • For participants who are pregnant or have a child less than twenty-four months old,
  • For pregnant or parenting minors who require a determination of the appropriateness of their living arrangements,
  • For In Loco Parentis caregivers, voluntarily, as a part of a Character, Competency, and Suitability review, 
  • For a recipient of Pregnant Women Assistance (PWA),
  • When a participant has an issue that they can't easily resolve, such as mental health or substance abuse,
  • When a participant is engaged in WorkFirst activities, but may also need to spend some time working on issues that interfere with employment,
  • When an eJAS comprehensive evaluation or the eJAS note type indicates further assessment is needed to determine next steps, and
  • During the application process, if the participant has an immediate or urgent need.

6.2.3 Issues to be resolved

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).

6.2.4 Are there other considerations?

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.

6.2.5 eJAS codes

When referring a participant to the WFSSS for an assessment, use the eJAS referral codes, such as:

  • RO (Other), or
  • SR (referred for drug/alcohol assessment)

6.2.6 Pregnant Women's Assistance (PWA) referral and assessment process

When a pregnant woman applies for Pregnant Women Assistance (PWA) and isn't eligible for a 60 month TANF Time Limit Extension, the WFSSS follows the process outlined below to accept the referral and assess the PWA recipients' needs. All financial eligibility has been determined before the following steps are taken below by the WFSSS.

The WFSSS:

  • Receives a referral for PWA from the @WFQ or @SWA pool.
  • Reviews the Social Service Referral form (DSHS 14-084) in the Barcode ECR and marks it complete. If a DSHS 14-084 form is not received, contact the eligibility worker who made the referral and request the form to be generated, then proceed with the case.
  • Opens the incapacity screen listing pregnancy, in Barcode, and reviews the EDD for proper tracking.
  • Reviews the case in all systems; ACES, Barcode, eJAS, and in programs such as Equal Access Plans, and FamLink.
  • Generates and provides to the PWA recipient a PWA Housing and Essential Needs (HEN) Referral form, 10-651, out of Barcode, to notify the recipient they are eligible for 24 consecutive months of HEN services.
  • Contacts the PWA recipient in the office, by phone, or sends an open appointment letter to meet with the recipient to complete a First Steps Assessment.
    • To start the assessment the WFSSS clicks on the "Create New Intake Record," in the ICMS Social Service Intake screen in Barcode to open the intake/assessment screens.
    • Updates the screens with information obtained in the assessment with the PWA recipient to complete the assessment.
    • Saves the assessment in Barcode.  

During the assessment, the WFSSS:

  • Screens the recipient for Equal Access needs.
  • Screens the recipient for Protective Payee service needs.
  • Reviews the TANF Time Limit Extension hardship categories with the recipient to determine if the recipient meets any hardship criteria.
  • Screens for substance abuse treatment needs:
    • If the recipient is in need of a substance abuse assessment, make the appropriate referrals.
      • Once verification returns, if the recommendation is for substance abuse treatment, ongoing case management is required by the WFSSS.
    • If substance abuse has been ruled out and the substance abuse professional is not recommending treatment activities, case management is not required by the WFSSS.

Note: The WFSSS sets a Barcode tickle to track the case monthly. The WFSSS will make contact with the recipient monthly to determine any potential eligibility for a 60 month TANF Time Limit Extension (TLE) hardship and attempt to connect with the recipient to discuss barriers and or referral needs.

6.2.7 Assessment - Step-by-step guide

  1.  The WFPS refers a participant to a WFSSS for an assessment when:
    1. The participant is pregnant or parenting a child under 24 months;
    2. A comprehensive evaluation or participant interaction indicates further assessment is needed to determine next (or additional) steps; or
    3. There is a need for an assessment.
  2. The WFSSS conducts the assessment using the PDT and based on the findings of the assessment, provides services, refers and connects the participant to the appropriate resources, activities and services.
  3. The WFSSS and WFPS decide whether the participant is deferred from all other activities or combine issue resolution with WorkFirst participation and:
    1. Builds an IRP with the participant that reflects issue resolution services and activities.
    2. Documents any new components in eJAS.
    3. Monitors the participant's progress closely and authorize support services when necessary.
    4. Connects the participant with employment-related services as soon as possible, once issues are sufficiently resolved.

Resources

Related WorkFirst Handbook Sections

Forms & Other Resources

6.3 Participation While Resolving Issues

Created on: 
Jul 27 2018

Revised On: March 25, 2024

Legal References:

The Participation While Resolving Issues section includes:

  • 6.3.1 What is supporting participation?
  • 6.3.2 Stacking activities and issue resolution
  • 6.3.3 How do we code participation?
  • 6.3.4 What are the types of participation while resolving issues?
  • 6.3.5 How do we treat participants with medical issues who do not have Washington Apple Health?
  • 6.3.6 Participants with medical issues who do not have Washington Apple Health - Step-by-step Guide
  • 6.3.7 What kinds of documentation/evidence should I request?
  • 6.3.8 Supporting participation - Step-by-Step Guide
  • 6.3.9 What is Foundational Community Support (FCS)?
  • 6.3.10 Foundational Community Support (FCS)- Step-by-Step Guide
  • 6.3.11 What is Coordinated Entry?

6.3.1 What is supporting participation?

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:

  • Identifying how best to support the participant's self-sufficiency through employment.
  • Providing needed supports that meet the participant's identified needs.
  • Creating a long-term plan for participants who are exempt and unable to participate.
  • Helping participants who cannot participate to stabilize their situation as soon as possible when they can't participate in countable activities so they can progress.
  • Addressing issues, increasing participation and transitioning to work or employment readiness activities as soon as possible, to resolve issues like mental health, chemical dependency, family violence, learning disabilities, or working with DVR.

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:

  • Independent life skills training (code these hours under the LS eJAS component code). For more information on independent Life Skills training, please refer to section 7.3.6 - What is Independent Life Skills Training?
  • Community Work, Work Experience or Community Jobs.

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.

6.3.2 Stacking and Issue Resolution Activities

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 3.3.2section 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:

  • Multiple services/referrals are offered to the participant;
  • Appropriate information is shared;
  • The IRP is amended as appropriate;
  • Participation requirements are enforced; and
  • The participant receives appropriate support services and child care.

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:

  • A multi-disciplinary case-staffing;
  • Supervisor or higher level authority approval; or
  • Documentation provided by a health-care or other professional.

Develop an IRP that specifies the activities the 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:

  • A multi-disciplinary case-staffing;
  • Supervisor or higher level authority approval; or
  • Documentation provided by a health-care or other professional.

For information on how to treat excused and unexcused absences, please refer to section 3.7.1.5 - How do we treat excused and unexcused absences?

6.3.3 How do we code participation?

Use the appropriate "X" or referral codes in eJAS to identify the 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 AA meetings last 2 hours each (4 hours total).
  • The group therapy session is hours (2 hours total).

The actual number of hours spent in treatment-related activities is 6 hours.

Hours spent in independent life skills activities are coded in eJAS under the component code "LS". The scheduled hours of participation should be as close to 32 to 40 hours per week as possible.

The 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.

6.3.4 What are the types of participation while resolving issues?

Described below are various types of stabilization and issue resolution and specific eJAS codes used. More information can be found on each type in other sections of the WorkFirst Handbook.

Types of activities to resolve issues

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)

See 6.7 Alcohol/substance abuse/Chemical Dependency Section

XF

Family Violence Resolution (a countable core activity)

See 2.2 Support Services and 6.5 Family Violence Sections

XG

Mental health treatment or Counseling (a countable core activity)

See 6.6 Disabilities Section

XH

Resolution of Homelessness (not countable)

XJ

Learning Disabilities Services (a countable core activity)

See 6.6 Learning Disabilities

XM

Temporary incapacity undergoing medical treatment (not countable)

XN

Caring for a child with special needs who is in school full time (not countable)

See 6.4 Child with Special Needs

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.

See 5.1 Pregnancy to Employment Pathway

6.3.5 How do we treat participants with medical issues who do not have Washington Apple Health?

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?

6.3.6 Participants with medical issues who do not have Medicaid - Step-by-Step

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:

  1. Document in the appropriate eJAS note section the reason the participant is unable to participate
  2. Update the eJAS component screen with the indicator component code 'CV'

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:

  1. Update the eJAS component screen with the indicator 'CV' (in lieu of using component code 'XM' or 'XG' if the participant had Washington Apple Health coverage and was able to seek treatment services)
  2. Update the eJAS component screen with the appropriate stackable activities in which the participant is able to participate
  3. Develop the IRP for the required activities
  4. Document in the appropriate eJAS notes the number of hours per week the participant would normally be expected to participate in medical issue resolution if he/she had Washington Apple Health coverage
  5. Document the participant's other required activities in the appropriate eJAS notes

6.3.7 What kinds of documentation/evidence should I request?

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:

  • Public Health Nurse (PHN)
  • The child's school district
  • Developmental Disabilities Administration (DDA) Case Manager
  • Licensed Child Care provider
  • Certified Mental Health Professional (CMHP)
  • Certified Mental Retardation Professional (CMRP)

6.3.8 Supporting Participation - Step-by-step guide

  1. The Case Manager follows the instructions in Section 6.6, Disabilities, for emotional, mental or physical disorders
  2. For all other deferrals, the Case Manager consults with the individual and the following participants, as appropriate, to determine the need for issue resolution participation.
    1. The Case Manager or a Disability Specialist;
    2. SSI facilitator;
    3. Treatment provider; and/or
    4. Community service provider
  3. The Case Manager then:
    1. Enters the appropriate code in eJAS.
    2. Enters the specific activities, scheduled hours and the expected end date for the activities on the IRP, describing in detail the activities and/or treatment the participant is required to complete, with the exception of drug related issues or other protected information .
    3. Stacks activities to increase hours of participation to the extent the participant is able, and adds the information to the IRP.
    4. Authorizes support services needed to complete their IRP requirements.
    5. Documents the actions in eJAS.
    6. Monitors participation monthly following the procedures in Section 3.7.2, Documenting and Reporting Participation.
    7. Gets supervisor or higher approval for issue resolution IRPs that take longer than 90 days.

6.3.9 What is Foundational Community Support (FCS)?

 

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 supported housing services.

Who can receive FCS services?

Participants who are in an X component for:

  • A chronic or severe physical or mental health issue
  • Substance use disorder inpatient/outpatient treatment

What is FCS eligibility criteria?

Supported Employment participants must be one or more of the following:

  • Enrolled in Medicaid
  • Over the age of 16
  • Have a disability, injury, or health issue that keeps them from obtaining and maintaining employment
  • Have received substance use treatment in a hospital or facility

Supported Housing participants must be:

  • Enrolled in Medicaid
  • Over the age of 18
  • A history of homelessness
  • Lived in a residential or nursing facility
  • Multiple or long-term stays in a hospital or prisons
  • Ongoing complex health issues
  • History of in-home caregivers
Note: The conditions above do not guarantee eligibility.  WellPoint determines eligibility and provides a referral to services.

How does a participant enroll in FCS?

  • Participants can self-refer by contacting WellPoint directly.
    • If already engaged with FCS, Case Manager adds the appropriate X component activity to the IRP.
  • Participants can be referred to WellPoint by WorkFirst staff.
    • The Case Manager contacts WellPoint via phone on the participant's behalf to set up an intake.
    • Develops an IRP including the participant's scheduled intake date and time.

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:

  • Looking for the right job
  • Preparing for interviews
  • Focusing on helpful routines and employment related life skills
  • Maintaining employment
  • Locating safe and affordable housing
  • Working with landlords and completing applications
  • Learning independent living skills

6.3.10  Foundational Community Support (FCS)- Step-by-Step Guide

WorkFirst Staff:

  1. Provides the participant with information about FCS benefits and:
    1. WellPoint's contact information for self-referral; or
    2. Assists the participant with a phone call to WellPoint in a warm-hand-off process to schedule an intake appointment with the participant to determine eligibility for FCS benefits.
  2. Obtains a signed DSHS 14-012 Consent Form listing WellPoint to exchange information for service coordination.
  3. Develops an IRP for participation in FCS supported employment activities under Special Records.
  4. If not engaged in an issue resolution component, add the issue(s) resolution component that best fits the reason for the referral to FCS.
  5. If already engaged in an issue resolution activity, add one additional hour to the existing issue resolution component to capture the hour of FCS participation.
  6. Authorizes support services needed to complete the participant's IRP requirements.
  7. Documents the action in eJAS using the corresponding issue resolution note type.
  8. Gives the participant a copy of the eJAS WorkFirst Participation Verification form for actual hour verification and explain the reporting requirements.
  9. Monitors participation monthly following the procedures in Section 3.7.2, Documenting and Reporting Participation.
Note: A participant can't be sanctioned for choosing not to follow through with voluntary FCS.

 6.3.11 What is Coordinated Entry?

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;

  • Youth/teens
  • Survivors of Domestic Violence
  • Single Adults 
  • Families 
  • People with Disabilities

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;

  • Provide the participant the Coordinated Entry number for their local county. 
  • Call Coordinated Entry with the participant.
  • Develop an IRP with the participant to the Coordinated Entry.
    • The phone number for Coordinated Entry must be in the IRP.
    • Provide the participant the TANF Housing Service Plan to have completed by the housing provider case manager.  
      • Request the participant provide their WorkFirst case manager the completed TANF Housing Service Plan at the next meeting to support the development of their IRP.
    • Provide the participant resources as needed. 

If the participant has already contacted Coordinated Entry and are working with housing providers WorkFirst staff can complete the following actions;

  • Develop an IRP with the participant, with a XH component for the hours the participant is engaging in housing related services. 
    • The housing agency contact information must be in the IRP.
    • Provide the participant the TANF Housing Service Plan to have completed by the housing provider case manager. 
      • Request the participant provide their WorkFirst case manager the completed TANF Housing Service Plan at the next meeting to support the development of their IRP. 
    • Provide the participant resources as needed.

Resources

Related WorkFirst Handbook Chapters

Forms & Other Resources

6.4 Children: Special Needs

Revised on: March 20, 2023

Legal References:

The Children with Special Needs section includes:

  • 6.4.1 Who are children with special needs?
  • 6.4.2 Who needs help with this issue?
  • 6.4.3 What are appropriate Individual Responsibility Plan activities?
  • 6.4.4 What do I document?
  • 6.4.5 eJAS Codes
  • 6.4.6 Children with special needs - Steps-by-Step Guide

6.4.1 Who are children with special needs?

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:

  • A referral to the local Public Health Department for an initial evaluation, advice and services. Follow up evaluations can only be done with supervisory approval.
  • Assistance in finding safe, affordable, and reliable child care.
  • Referrals to other community resources to prepare the participant for future work, while meeting their child's special needs.
  • Temporary deferral from job search so a participant can assist school personnel to care for their child with special needs or to care for the child before and after school. However, participants should engage in work activities while the child with special needs is attending school.
  • Exemption from job search so a participant can provide care for their child with special needs.

6.4.2 Who needs help with this issue?

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.

6.4.3 What are appropriate Individual Responsibility Plan activities?

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.

  • Attend day care with the child to train a provider or to give the provider time to become comfortable with caring for the child.
  • Gain work experience through volunteer work at their child's school.
  • Participate in the child's therapeutic activities.

NOTE: An IRP is not required for an exemption, unless volunteering to participate.

6.4.4 What do I document?

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:

  • Public Health Nurse
  • The child's school district
  • Developmental Disabilities Administration (DDA) Case Manager
  • Licensed Child Care provider
  • Certified Mental Health Professional (CMHP)
  • Certified Mental Retardation Professional (CMRP)

6.4.5 eJAS codes

When a participant has a child with special needs, use the following eJAS codes:

  • RO (referral to a social service specialist or the Public Health Department), or
  • XN Needed in the home to care for a child with special needs deferral
  • ZC Caring for a child with special needs when the child's condition is so severe that the participant must care for the child on a full-time basis.

6.4.6 Children: Special Needs - Step-by-step guide

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:

PHN eJAS Referral Step-by-Step guide

  1. From the participant's main menu, select the 'Referrals' link.
  2. Select the 'Public Health Nurse Referral' link.
  3. The user will be taken to the 'Public Health Nurse (PHN) Referral'.
  4. The system auto-fills certain client level and worker level information based upon eJAS client demographic information and the user taking the action. The auto-filled information may be edited with the exception of the JAS id and the system posting date.
  5. The user completes the remaining fields and sections of the form with the necessary information.
  6. The user either selects the 'Print this Referral' or 'e-Msg this Referral' button.
  7. Once the user selects either of these buttons the information is stored and cannot be modified. It is part of the case record.
  8. If the user selects 'print this Referral' the form locally prints. The system posts a "Children w/Special Needs Referral to Public Health Nurse" note type with a link titled "Click here to view the PHN Referral". The user may select the link within the client note to view the referral.
  9. If the user selects 'e-Msg this Referral', the user finalizes sending the e-Msg to the nurse's user id or contracting agency code. When the nurse receives the e-Msg, the subject line text reads 'Public Health Nurse Referral'. By selecting this link, the nurse can view the referral form. In addition, the system posts a "Children w/Special Needs Referral to Public Health Nurse" note type with a link titled "Click here to view the PHN Referral". The user may select the link within the client note to view the referral.

Searching Client Notes - Step-by-step guide

  1. From the participant's main menu, select 'Client Notes'.
  2. In the Search Options, Select 'Type' and review the drop down menu.
  3. The new note type 'Referral to Public Health Nurse' has been added as an option and displays below the previously existing 'Referral' note type. 
    • The 'Referral to Public Health Nurse' note type is specific to referrals generated in the How to Make a Referral step-by-step guide.
    • The existing Referral searches client notes for all generic referrals including generic referrals created for Children with Special Needs.

Using Ad-hoc Reports - Step-by-step guide 

  1. From the participant's main menu, select 'Ad-hoc Reporting'.
  2. In the section labeled 'View Notes' review the drop down menu containing default text 'Any Type'.
  3. The new note type 'Referral to Public Health Nurse' has been added as an option and will display below the previously existing 'Referral' note type.
    • The 'Referral to Public Health Nurse' note type is specific to referrals generated in the How to Make a Referral step-by-step guide.
    • The existing Referral searches client notes for all generic referrals including generic referrals created for Children with Special Needs.

Step-by-step guide

  1. After completing the PHN referral, the WFPS or WFSSS documents permission for a public health nurse's home visit on the IRP.
  2. Obtains permission to exchange highly protected (special record) information using the DSHS 14-012(X), Authorization to Obtain/Release Information form.
  3. Develops the IRP with the participant to the public health nurse, or SSS if a public health nurse is not available in their area.
  4. Updates the IRP with the "RO" referral code. Enters contractor code if applicable. 
  5. Refers the public health nurse to the local contracted vendor if interpreter services are required. (The nurse will return the Interpreter Services verification voucher to the CSO for payment.)
  6. Faxes the DSHS 10-256(X) (If the PHN does not have/or use eJAS access), PHN Referral form and a copy of the release of information form to the local public health nurse.
  7. The public health nurse:
    1. Initiates the home visit within five working days of receipt of the referral form.
    2. Sends the DSHS 10-255, Special Needs Evaluation and Engagement Recommendations, to the case manager or social service specialist within ten days of the home visit.
  8. The WFSSS and/or WFPS then reviews the information gathered by the Public Health Nurse evaluation and determines whether the participant qualifies for deferral or exemption.
  9. If the participant is able to participate full-time (more than 30 hours per week), the WFSSS or WFPS:
    1. Meets with the participant to develop an IRP, taking into consideration information gathered during the Public Health Nurse's evaluation process.
    2. Completes the component/IRP screen in eJAS.
    3. Develop IRP based upon existing information, or public health nurse evaluation (using the DSHS 10-255, Special Needs Evaluation and Engagement Recommendations).
  10. If the participant isn't able to participate full-time, the WFSSS or WFPS:
  • Meets with the participant to develop an IRP, and discusses the case with the Public Health Nurse (if possible) and other relevant professionals as needed.
    • Places the participant in the deferral code XN or exempt code ZC, if appropriate, developing the IRP with the participant. 
    • Completes the component/IRP screen in eJAS, with a deferral length no longer than 6 months or an exemption length no longer than 12 months.
    • Explains to the participant what the deferral or exemption means, how long the deferral or exemption will be approved for and how the review process works.
    • Approves the deferral or exemption based upon the information gathered. If the documentation shows the participant can participate:
      • 11 to 30 hours per week, approves a deferral.
      • 0 to 10 hours per week, approves an exemption. (See WFHB 6.8, Exemptions, for more information.)

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.

Resources

Related WorkFirst Handbook Sections

Forms

6.5 Family Violence

Created on: 
Oct 02 2018

Revised September 28, 2023

(time-limited core)

Legal References:

The Family Violence section of the WorkFirst handbook includes:

  • 6.5.1 What is Family Violence?
  • 6.5.2 Why would individuals need help with family violence?
  • 6.5.3 What does family violence option (FVO) amendment mean for WorkFirst Cash Assistance participants?
  • 6.5.4 What are the responsibilities of DSHS staff?
  • 6.5.5 Is screening for family violence required?
  • 6.5.6 Why it is important to separate couples when screening?
  • 6.5.7 What information should DSHS staff provide?
  • 6.5.8 What is the Family Violence Screening/Evaluation?
  • 6.5.9 What are the Family Violence screening questions?
  • 6.5.10 What happens when an individual discloses family violence to a WorkFirst partner?
  • 6.5.11 What is "Good Cause" for not cooperating with the Division of Child Support?
  • 6.5.12 What is the Address Confidentiality Program?
  • 6.5.13 Individual Responsibilities Plans
  • 6.5.14 How do we code family violence participants in eJAS?
  • 6.5.15 What family violence services are federally countable?
  • 6.5.16 How are family violence services verified and reported?
  • 6.5.17 Family Violence - Step-by-step Guide
  • 6.5.18 Family violence and sanctions
  • 6.5.19 Family Violence and sanctions - Step-by-step

6.5.1 What is family violence?

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;

  • Domestic violence
  • Sexual assault,
  • Child abuse and neglect,
  • Elder abuse and neglect.

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:

  • Psychological intimidation
  • Interception of mail and phone calls
  • Controlling access to transportation or financial means
  • Direct physical threats
  • Assault

6.5.2 Why would individuals need help with family violence?

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:

  1. The physical and emotional effects of past or current abuse may hinder job performance or work search.
  2. The abuser may try to sabotage the victim's education, training and employment to keep them dependent upon the abuser.
  3. The abuser may threaten the safety of the victim, the victim's children or family members.
  4. The demands of court intervention, criminal prosecution, safety planning, physical and mental recovery, or counseling may interfere with work, education or training.
  5. The individual may need to move or disrupt work to escape an unsafe living arrangement.

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.

6.5.3 What does the Family Violence Option amendment mean for WorkFirst cash assistance recipients?

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:

  • Screen and identify adults, minor teen participants or emancipated teens receiving WorkFirst cash assistance/SFA for a history of family violence;
  • Notify adults, minor teen participants or emancipated teens receiving WorkFirst cash assistance/SFA about the FVO Amendment both verbally and in writing;
  • Maintain confidentiality;
  • Refer individuals to social services, counseling, and supportive services;
  • Waive WorkFirst requirements in cases where the requirements would make it more difficult to escape family violence, unfairly penalize victims of family violence or place victims at further risk of family violence. Requirements to be waived may include:
  1. Time limits for WorkFirst recipients, for as long as necessary (after sixty months of receiving TANF/SFA and participating as required in their family violence plan);
  2. See section 3.6.1, Time Limit Extensions, for more information about how family violence affects WorkFirst time limit extensions.
  3. Cooperation with the Division of Child Support (DCS).
    • Develop specialized activities (services) for those individuals where participation in regular work or work-related activities would place them at further risk of family violence.

6.5.4 What are the responsibilities of DSHS staff?

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:

  • WorkFirst Social Service Specialist (WFSSS)
  • On-site family/domestic violence advocate
  • Local family/domestic violence agency (for resources, to discuss safety issues and create a safety plan)
  • Counseling and support groups
  • Shelters for battered individuals
  • Medical services
  • Sexual assault and domestic violence hot-lines
  • Legal assistance and advocacy
  • Mental health services
  • Other available services

6.5.5 Is screening for family violence required?

If it is safe for the participant, screening for family violence is required:

  • At comprehensive evaluations and assessments,
  • Once per year following the initial screening,
  • Before a case can be placed into sanction (during good cause determination),
  • During the Time Limit Extension analysis in eJAS, and
  • At any point of contact with the participant if the worker thinks that family violence is an issue.

Document all family violence screenings in eJAS under the Family Violence Note. If appropriate, offer to refer the participant for additional services described above.

6.5.6 Why is it important to separate couples when screening?

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.

6.5.7 What information should DSHS staff provide?

Every adult, minor teen participant or emancipated teen must be given general information both verbally and in writing about:

  • The Family Violence option,
  • Contracted or community family violence services, and
  • Support services available.

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

6.5.8 What is the Family Violence Screening/Evaluation?

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 you let someone know that family violence is an issue for you, we can create a plan that works for you and offer community resources that might help.
  • You may answer these questions today, or you can let us know about this issue at any time and we can change your plan. 
  • Any information you give us about family violence will be kept confidential in our computer systems. Please let us know if you have concerns about anyone at DSHS accessing this information. 
  • If you tell us that any children are being hurt, we are required by law to report the information to the Department of Children, Youth and Families (DCYF) or a law enforcement agency."

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.

Note: If you suspect a minor is abused or neglected, you are required to report the circumstances to the Department of Children, Youth and Families (DCYF) by calling 1-866-ENDHARM.  

6.5.9 What are the Family Violence Screening Questions Screen ?

If it is safe to continue with the screening, workers need to gather 'yes' or 'no' responses to the following six screening questions: 

  1. Are you OK answering a few questions about your safety at home?
    • If the response is 'No' staff selects 'Not safe to screen at this time.' This ensures that the family violence indicator remains for staff to complete at a future contact where it is safe to continue with the screening. 
  2. Will collecting child support put you or your family in danger?
  3. Has a current or former partner ever:
    • Stopped you from going places like work, school, or seeing people?
    • Stalked you when you go out?
    • Dominated your finances and family resources? 
    • Verbally abused, intimidated, or tried to manipulate you? 
    • Had angry outburst or tantrums that frighten you?
    • Threatened you or your children? 
    • Made you feel fearful for any other reason? 
    • Physically harmed you or your family? 
  4. Are you currently fleeing from abuse or have you recently left an abusive partner?
  5. Have you ever obtained a restraining or no contact order to protect your safety or the safety of your family?
  6. Are you currently working with a family violence agency, advocate, or counselor? 

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:

  • Interested in resources only
  • Referral to family violence advocate
  • Referral to social services for family violence
  • Staff identify concerns, customer is opting out of family violence services at this time

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.'

6.5.10 What happens when a participant discloses family violence to a WorkFirst partner?

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:

  • Determine if the family violence prevents the participant from participating in the current activity and if so, refer the participant back to the WFPS/WFSSS.
  • If the person states that the family violence issues won't prevent the participant from participating, it will be helpful to:
    • Explain the advantages of sharing information with her/his WFPS or WFSSS.
    • Collaborate with the participant and the family violence advocate to develop necessary action steps that address the participant's immediate safety needs.
    • Not refer back the participant or prevent the person from participating when they are willing and able to participate in work-related activities.
  • Ask the participant if it is permissible to share the information with the participant's WFPS/WFSSS and then obtain a signed Consent form (DSHS 14-012), and
  • Encourage the participant to contact the WFPS/WFSSS or family violence worker, and
  • Explain that job search or other deferrals due to family violence require approval by the WFPS/WFSSS.

6.5.11 What is "Good Cause" for not cooperating with the Division of Child Support?

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.

  1. DSHS staff explain that participants have the right to claim good cause for not cooperating with DCS.
  2. An individual applying or receiving benefits completes DSHS 18-334 form “Your Options for Child Support Collection” to claim good cause.
    1. Parents and caregivers can access the DSHS 18-334 in the local Community Service Office, a copy of the form can be mailed, or they can access the form online.
  3. DSHS staff completes the steps needed to make a good cause determination.
  4. The individual must be notified of the good cause determination.

For more information, refer to the Good Cause chapter in the Social Service Handbook  and the Child Support chapter in the E-Z Manual.

6.5.12 What is the Address Confidentiality Program?

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.

6.5.13 Individual Responsibility Plans

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.

6.5.14 How do we code family violence participants in eJAS?

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:

  • The family is in a shelter because the family fled an abuser. The participant decides to continue working part time while they are finding permanent housing. In this situation, code the participant PT for the part time employment using the actual number of hours and XF for finding permanent housing using actual number of hours. Document each issue in the proper eJAS notes type making sure to only document references to family violence under the family violence category.
  • The individual is in court ordered perpetrator treatment for abuse related to family violence. The perpetrator is attending perpetrator treatment while simultaneously attending job search. This case would be coded JS and XG to reflect perpetrator treatment. Don't use XF in these cases. Document all court order related notes under legal issues in these circumstances.

When participants disclose family violence, use the XF eJAS code to:

  • Make a referral to the WFSSS, or family violence advocate for one hour, code activity using the number of engaged hours for participants already doing activities to help resolve or cope with family violence issues, and to create a safe environment for the family.

 

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.

  • The open component code in eJAS must reflect the actual number of hours per week the individual participates in a specific activity.

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.

6.5.15 What family violence services are federally countable?

As part of the Deficit Reduction Act, the XF countable core activities include:

  • Assessments,
  • Creating safety plans,
  • Participation in support groups, and
  • Obtaining required medical care or mental health services or counseling.

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.

6.5.16 How are family violence services verified and reported?

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.

6.5.17 Family Violence - Step-by-step guide

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.

  1. Offer to refer the participant to appropriate family violence services, following CSO guidelines.
  2. Defer job search or other work activities when participation would:
    1. Make it more difficult for the participant to escape family violence; or,
    2. Penalize a person who has been or is at risk of becoming a victim of family violence, or who is at further risk of abuse. Use XF code on the component code screen in eJAS.
  3. Develop an IRP to meet the participant's family violence issues by addressing whether they:
    1. Does not want or need any special program deferrals,
    2. Needs supportive services, but no deferrals from work requirements;
    3. Needs referrals to local resources and/or deferrals to gain stability before actively seeking employment; or,
    4. Include specialized activities and/or work related activities as agreed.
  4. If a participant is enrolled in the ACP, use the ACP address: PO Box 257, Olympia, WA 98507 for work and home addresses in the eJAS screens. Do not use the actual business or employer name in non-special record screening notes e.g., employment
  5. Provide support services, as necessary.
  6. Review local CSO policies and/or refer to the Good Cause chapter in the Social Services Handbook if Good Cause for non-cooperation with DCS is necessary.
  7. Give the participant or send the provider a copy of the eJAS WorkFirst Participation Verification form as family violence providers are treated as non-contracted service providers. This form will be used by the provider to verify and report the participant's actual hours of participation in domestic violence services.
    • The family violence provider completes, signs, and returns these forms to the referring WFPS/WFSSS by the fifth day of each month, and
    • The WFPS/WFSSS enters the countable core hours indicated on the form in eJAS actual hours by the 15th day of each month for the previous month's activity.

6.5.18 Family Violence and Sanctions

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. 

6.5.19 Family Violence and Sanctions - Step-by-Step

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:

  1. 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.

    1. 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

    2. Enter XF eJAS coding if family violence prevents the participant from job search or work activities to:
      1. Refer to the WFSSS, or family violence advocate and use one hour for participation hours.
      2. Use the scheduled appointment date with the DV advocate as the end date of the XF, or 10 days from the start date if there is no scheduled appointment.
      3. Once the WorkFirst participant has met with the DV advocate or trained WFSSS, update the number of hours for XF participation based on the Family Violence Service Plan.
      4. Code activity using the number of engaged hours for participants already doing activities to help resolve or cope with family violence issues, and to create a safe environment for the family.
    3. Don't proceed with the sanction process.

    4. Update the 'special record' IRP in eJAS with appropriate activities that will move the participant forward safely.

      1. 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.  

  1. Review the circumstances and follow steps above to determine whether to remove the sanction if a participant is already in sanction when they disclose family violence or when family violence begins.    

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.

 

Resources

Related WorkFirst Handbook Chapters

Forms

Other Resources

6.6 Disabilities (physical, mental & learning disabilities)

Revised September 20, 2021

(some time-limited core)

Legal References:

The Disabilities section includes:

  • 6.6.1 What are medical conditions?
  • 6.6.2 Guiding principles
  • 6.6.3 Basic Process
  • 6.6.4 How do I get medical evidence?
  • 6.6.5 How do I complete the medical evidence IRP?
  • 6.6.6 How do I pay for medical evidence?
  • 6.6.7 How do I evaluate evidence and establish participation requirements?
  • 6.6.8 eJAS Codes
  • 6.6.9 Medical Conditions - Step-by-Step Guide

6.6.1 What are medical conditions?

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.

  • A physical disorder (XM) often affects a participant's ability to perform physical tasks in a normal day-to-day setting. For example, a participant might not be able to see, hear, move freely or lift weight. The impact of a physical disorder can often be mitigated by use of adaptive accommodation such as a ramp for a participant who uses a wheelchair.
  • Mental and emotional disorders (XG) can affect a participant's ability to think clearly or respond appropriately in a work setting. For example, the participant may seem mentally preoccupied, have trouble following directions or have difficulty in getting along with others in the workplace.
  • A learning disability (XJ) is a neurological condition that impedes a participant's ability to receive, store, process or express information. It can affect one's ability to read, write, communicate, or compute math.

6.6.2 Guiding Principles

We cannot approve deferrals or exemptions without 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. Use these guiding principles when you learn a participant has a medical condition:

  • Make decisions based on the medical information provided by the participant.
  • WorkFirst helps participants define and manage limitations and build on strengths.
  • Disability and WorkFirst staff work together to get the best participant outcomes.
  • Mitigate limitations and make participation as full-time as possible, as soon as possible.
  • Encourage and help participants with chronic and severe disabilities make long-term plans (such as accessing SSI, Social Security Disability or DVR).

6.6.3 Basic Process

As shown in the Medical Evidence Evaluation Basic Flow Chart, WorkFirst will use a consistent process to respond when we become aware that a participant may have a physical disorder (XM), a mental or emotional disorder (XG) or a learning disability (XJ). Throughout the process, we accommodate limitations and require the participant to participate as full-time as possible.

Start by obtaining medical evidence so we know what the participant can and cannot do. Get the medical evidence even if you know the participant has applied for SSI on his or her own. We need the evidence to determine whether the participant qualifies for a WorkFirst deferral or exemption, and whether we will facilitate the participant's SSI application.

Once the evidence is in, triage the case with a social service specialist as needed, and assign the case as follows:

  • The WFPS handles the case when a physical, mental or emotional condition (XM or XG) is expected to last 3 months or less.
  • As conditions get longer-term or more complex, social service specialists may handle the case to make decisions and establish IRP requirements.
  • Participants with severe and chronic medical conditions will be assessed for SSI and, if they want to work, we may refer to DVR for services.
  • The SSI Facilitator helps viable candidates apply for SSI and monitors their progress.

6.6.4 How do I get medical evidence?

When the participant reports, or appears to have, a medical, mental or emotional condition that interferes with their ability to participate, obtain medical evidence to determine what the participant can and cannot do.  Types of providers you may use are found in WAC 388-310-0350.

Obtain the following information from the participant up front, so we can follow up as needed:

  • A signed consent form, DSHS 14-012, so we can share information, including any accommodations the participant needs to participate.
  • For conditions reported to last less than 3 months, a DSHS 10-353 form or alternative type of medical information documenting what the participant can and cannot do.
  • For conditions expected to last 3 months or longer, a DSHS 10-353 form (when needed) and chart notes to determine what the participant can and cannot do with their impairments. However, we must accept an alternative type of evidence, as described in the IRP, if that is what the participant turns in.
  • When the participant reports and verifies a disability that appears to be severe and chronic, gather objective medical evidence, as needed, which is described in WAC 388-449-0015.
  • An IRP requiring the participant to obtain medical evidence.

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.

We may augment this medical evidence later if it appears the participant may qualify for SSI.

6.6.5 How do I complete the medical evidence IRP?

Complete the IRP using the OR eJAS component code requiring the participant to obtain medical evidence within 30 days. Offer to help the participant obtain the evidence as needed. Get supervisory approval before you give the participant more than 30 days to obtain medical evidence.

If needed, you can extend the time in 30-day increments with supervisory approval, if you also do the following:

  • Document why more time is needed in eJAS notes
  • See if you can help the participant get evidence sooner
  • Consider referring the participant to a social service specialist for help in obtaining evidence.

The OR IRP template requires the participant to provide the DSHS 10-353 form or alternative medical evidence that provides the:

  • Diagnosis,
  • How long their medical condition is expected to last,
  • Specific limitations stemming from their medical condition,
  • Treatment plans, and
  • The number of hours per week the participant can work, look for work or prepare for work.

The OR IRP template also requires chart notes for the current medical condition unless the condition is expected to last for 3 months or less.

6.6.6 How do I pay for medical evidence?

We may use WorkFirst support services 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.

We 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 doctor, or

    • Following an SSI denial if it was overlooked and appears necessary to establish SSI eligibility.

Note:  If the participant has worked with a psychologist or psychiatrist, we may be able to get sufficient information for an SSI referral from existing chart notes.

Do not use WorkFirst support services to purchase medical evidence when:

  • Exams or testing can be paid by Washington Apple Health or are available from free clinics.
  • DDS or DVR is expected to purchase the exams or testing as part of their eligibility determination process.

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 we 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 we can purchase using support services.

6.6.7 How do I evaluate evidence and establish participation requirements?

Review 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.

  1. Determine if there are any conditions listed that limit the participant's ability to work, prepare for work or look for work. If not, do a full-time IRP as described on the medical participation requirements chart.
  2. Complete or update the participant's EA screening as needed and determine if there are countable activities where we can avoid or accommodate the limitations. If so, document the condition, provide needed accommodations and do a full-time IRP with appropriate activities.
  3. Refer complex and longer-term cases to a social service specialist, using the RR eJAS referral code until the participant has a deferral or exemption.
  4. Determine the participant's hourly participation capacity based on the medical evidence and set participation requirements as shown on the medical participation requirements chart.
  5. See WorkFirst Handbook 6.8, Exemptions, if the medical evidence shows the participant's medical condition is chronic (will last 12 months or more) and severe (they can participate 10 hours or less per week). We will need to decide whether to refer the participant to SSI and the participant may qualify for a WorkFirst exemption or long-term deferral.
     
  6. If the participant has filed an SSI application on their own, but does NOT have a chronic and severe condition, let the SSIF know so they can track the SSI application. However, we will not get additional medical evidence or provide formal SSI facilitation.
  7. Some participant's may have a DVR Plan. If so, coordinate their IRP with their DVR Plan. (See Social Services Manual and Reporting DVR Plan Hours.)
  8. Share information about any accommodations the participant needs to participate with the WorkFirst partner or contractor when you refer the participant to them for activities. This is allowable with the signed DSHS 14-012 Consent form.
  9. Establish the deferral or exemption end date based on the participant's medical evidence, not to exceed 12 months.
  10. Review the case when the deferral or exemption expires to determine whether the participant may require another deferral or exemption. If so, obtain new medical evidence following the process above and update the EA Plan as needed.

6.6.8 eJAS codes

Depending upon the participant's situation, use these eJAS codes:

  • OR (obtaining medical evidence) - used on the IRP to require medical evidence.
  • RR (review medical evidence) - used when a participant is referred to a social service specialist for IRP and SSI decisions. The code is kept in place until the exemption or IRP is done.
  • XM (temporary physical incapacity, medical treatment)
  • XJ (learning disability services)
  • XG (mental health services or treatment)

6.6.9 Disabilities - Step-by-step guide

  1. The WFPS or WFSSS uses an IRP with the OR eJAS component code to request medical evidence (the DSHS 10-353 and chart notes or an alternative type of evidence listing diagnosis, duration, specific limitations, treatment plans and the number of hours per week the participant can work, look for work or prepare for work). Also obtain a signed DSHS 14-012 and the DSHS 14-050 .
  2. Complete an EA screening or plan update to determine accommodations the participant needs to access services and/or participate.
  3. The WFPS/WFSSS, based on the medical evidence and EA screening, determines:
    1. Whether we can mitigate or accommodate limitations and the participant can participate full-time.
    2. Whether to refer to a social service specialist with the RR eJAS component code for case management or a possible SSI referral.
    3. Participation requirements. (See the medical participation requirements chart for more details.)
    4. Opens the appropriate X eJAS component codes based on the duration of the disability, but not to exceed 12 months, and eJAS codes for other required activities.
    5. Updates the IRP and provides needed support services.
  4. If the participant is suspected of having a LD, the participant is referred to the WFSSS who uses the eJAS learning needs screen:
    1. Uses all available information, participant observation, and Learning Needs note type in eJAS to determine if a LD may be the primary barrier to employment; and,
    2. If so, contacts the local Learning Disabilities Association of Washington, local community college or other LD provider to determine if it would be appropriate to refer the participant for further evaluation and additional services. Enter RO when making a referral for LD services. Enter XJ if the participant is participating in LD treatment.

Resources

Related WorkFirst Handbook Sections

Forms & Other Resources

6.7 Substance Abuse

Revised: September 20, 2021

(Time-limited core)

Legal References:

The Substance Abuse section includes:

  • 6.7.1 What is substance abuse?
  • 6.7.2 What is Chemical Dependency?
  • 6.7.3 Who does the substance abuse assessment?
  • 6.7.4 Who is financially eligible?
  • 6.7.5 Who are Priority Populations?
  • 6.7.6 What are the requirements for Modality of Care?
  • 6.7.7 What are the different Treatment Modalities?
  • 6.7.8 What are there specialized programs and services administered by the Division of Alcohol and Substance Abuse
  • 6.7.9 Confidentiality
  • 6.7.10 eJAS Codes
  • 6.7.11 Substance Abuse - Step-by-Step.

6.7.1 What is substance abuse?

Substance abuse is the misuse 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.

Abuse 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 abuse will impact the person physically, behaviorally, socially, occupationally, or in other ways and often leads to chemical dependency.

6.7.2 What is Chemical Dependency?

Chemical dependency occurs when the person's 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.

6.7.3 Who does the substance abuse assessment?

Substance Abuse Assessments must be completed by a Licensed Chemical Dependency Professional (CDP) to determine:

  • Substance abuse.
  • Chemical addiction.
  • Level of treatment (if any) that is required to address the individual's needs.

6.7.4 Who is financially eligible for substance abuse treatment?

Persons who are eligible for WorkFirst and Supplemental Security Income (SSI) 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 DASA treatment agency contracted to provide services to WorkFirst participants.

WorkFirst participants without Washington Apple Health due to citizenship verification requirements who need chemical dependency 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 his or her IRP if they don’t currently have coverage or have let their coverage lapse so they can access any needed chemical dependency assessment or treatment.  Failure to apply for Washington Apple Health without good cause will result in sanction (See WAH Application IRP for suggested IRP language).

Note:

  • Participants who do not meet the above criteria and whose income is below a specified means test are also eligible to receive outpatient treatment services under a sliding fee schedule for payment.
  • Children who do not meet the above criteria and whose family income is below a specified means test may also be eligible to receive residential treatment.

6.7.5 Who are priority populations?

Priority populations are pregnant individuals, injecting drug users, WorkFirst families (parents with dependent children), and youth.

Consider a referral for a substance abuse 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 abuse treatment.
Behavior consistent with being under the influence of excessive drug/alcohol use, such as:
  • Slurred speech,
  • An odor of alcohol,
  • Balance problems, or
  • Skin lesions indicative of drug use.
Individuals self-reporting that drug or alcohol use caused:
  • Job loss or a refusal of employment
  • Legal problems (possession, theft, assault, domestic violence, resisting arrest, or child abuse or neglect)
  • Arrest for driving under the influence (DUI)
  • Fights or arguments
  • Emergency room visits or hospitalizations
  • Needing help, seeking help in the past or getting help in the past
  • Being told by friends or family members that she or he drinks alcohol or uses drugs too much
  • Blackouts (not remembering things that one has said or done while drinking or using other drugs)

6.7.6 What are the requirements for Modality of Care?

Admission to modality of care is determined based on the American Society for Addiction Medicine patient placement criteria.

6.7.7 What are the different Treatment Modalities?

1. Detoxification Services

  • Assists individuals in withdrawing from alcohol and other chemicals.
  • Acute detoxification provides medical care and physician supervision.
  • Sub-acute detoxification provides non-medical detoxification or patient self-administration of withdrawal medications ordered by a physician and provided in a home like environment.

2. Intensive Inpatient/Residential Treatment

Provides up to 30 days of a concentrated short-term program of:

  • Individual and group counseling by a CDP.
  • Education.
  • Activities for detoxified alcoholics/addicts and their families.

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:

  • Education.
  • Individual and group counseling by a CDP.
  • Development of social and coping skills.
  • Assistance with re-entry living skills.

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.

6.7.8 Are there other specialized programs and services administered by the Division of Alcohol and Substance Abuse?

The Division of Alcohol and Substance Abuse (DASA) also administer Pregnant and Parenting Women's (PPW) programs, such as Safe Babies Safe Moms (SBSM) and Parent Child Assistance Program (PCAP), and treatment for Opiate dependence.

PPW programs address specialized needs associated with substance abuse/chemical dependency for pregnant and parenting women, including:

  • Therapeutic child care for women in residential treatment
  • Counseling to address other issues including:
    • Sexual Assault
    • Incest
    • Eating Disorders
    • Family Planning
    • Fetal Alcohol Syndrome
    • Domestic Violence
    • Mental Health Issues
    • Life Skills training
    • Vocational/Employment Services
    • Transitional Housing

Safe Babies/Safe Moms Program:

  • Professional Model available only in Whatcom, Snohomish, Benton, and Franklin Counties.
  • Targeted Intensive Case Management for up to 3 years.
  • Specialized counseling or referral to address issues as described under the Pregnant and parenting Women's Programs.

Parent Child Assistance Program:

  • Paraprofessional model of case management and up to the target child's third birthday.
  • Available only in King, Pierce, Yakima, Spokane, Grant, Cowlitz, and Skagit counties.
  • Specialized counseling or referral to address issues as described under the Pregnant and Parenting Women's Programs.

Opiate Dependency

  • Opiate substitution treatment (Methadone).
  • Outpatient treatment including individual and group counseling.

6.7.9 Confidentiality

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:

  • Treatment agencies cannot give you any information without a signed copy of the DSHS 17-063 Authorization to Release Information. This must be provided with the requested DSHS 14-310 Client Status Report, and/or the HCA 04-418, DBHR Target Treatment Activities form.
  • You cannot share any substance abuse information with other agencies without getting this same form signed by the participant (releasing information from you to the other agency).

Be particularly thorough in the completion of the form if you are requesting an exchange of information regarding a participant either:

  • With an assessment/treatment agency, or
  • To share information with another program/agency

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 abuse assessment and treatment information on the Chemical Dependency Special Records screen in eJAS notes. Do not document information about substance abuse assessment or treatment in less protected areas of eJAS.

When adding the requirement to follow through with a substance abuse assessment and any treatment requirements on the individual's IRP, the WFPS or WFSSS needs to add the requirements to the Special Records IRP available in eJAS.

6.7.10 eJAS Codes

For tracking purposes, it is very important to always enter the following appropriate eJAS code when a participant is referred for a substance abuse assessment and when an individual enters treatment.

Use the following appropriate eJAS code when an individual is referred for a substance abuse assessment or when an individual enters treatment: SR - Referred for substance abuse ASSESSMENT.

  • SR - Referred for substance abuse ASSESSMENT
  • XE - Enters substance abuse TREATMENT

6.7.11 Substance Abuse - Step-by-step guide

  1. The WorkFirst Program Specialist (WFPS) or WorkFirst Social Service Specialist (WFSSS) suspects there is a substance abuse problem and:
  • Refers the individual to a Division of Behavioral Health and Recovery (DBHR) contracted treatment agency using the following forms:
    • HCA 04-418, DBHR Target Treatment Activities form.
    • DSHS 17-063, Authorization to Exchange Confidential Information Form (having the participant sign and date the form).
    • DSHS 14-299, Adult Assessment Referral Form (flag the referral as a WorkFirst/TANF referral).
  • Uses local procedures to schedule the appointment.
  • Enters SR (substance abuse referral code) in eJAS.
  • Documents in eJAS Chemical Dependency note type and creates an IRP using the Special Records IRP available in eJAS.
  • Gives the participant or sends the provider a copy of the eJAS WorkFirst Participation Verification form
  1. If an Employment Security Department (ESD) counselor or community college employee observes signs and/or symptoms that indicate substance abuse may be impairing a participant's ability to look for work, the contractor refers the participant to the WFPS or WFSSS and document in eJAS.
  2. The treatment agency completes the assessment, and
    • Sends the Community Service Office (CSO) the 14-299 Adult Assessment Referral Form, indicating:
    • Whether the participant needs treatment and if so, where the participant will go for treatment.
  3. Both inpatient and outpatient treatment providers will use the DSHS 14-310 Client Status Change Report Form and HCA 04-418 DBHR Target Treatment Activities form. Both forms will be sent by the WFPS or WFSSS to the provider, to verify treatment activities or changes in treatment activities. 
  • The eJAS WorkFirst Participation Verification form (see 3.7.2), will be sent to the provider, will be used to verify the participant's actual hours of participation in treatment activities including AA meetings etc.
    • Providers will use the 04-418 DBHR Target Treatment Activities form for participant's treatment reporting  for the following actions:
      • The treatment plan established for the participant.
      • Failure to participate.
      • Referral to another provider.
      • Changes in the treatment provided.
      • Discharge from treatment.
      • Child care needs (when in-house child care is not provided by the facility).
  1. Both Parent Child Assistance Program (PCAP) and Safe Babies Safe  Moms (SBSM) providers will also use the eJAS WorkFirst Participation Verification form to report and verify the individual's actual hours of participation in PCAP and SBSM activities.
  2. The WFPS or WFSSS:
    • Opens XE in eJAS once the participant enters treatment.
    • Enters substance abuse information in the Special Records under the category Chemical Dependency in eJAS notes.
    • Maintains the case record in the originating CSO when placement is made outside of the catchment area if the participant plans on returning to that area.
    • Provides support services, as needed.
    • Adds other activities to the IRP when the participants is ready, in consultation with the treatment provider.
  3. If the WFPS or WFSSS finds out that a participant is already in treatment, they:
    • Do nothing, if treatment does not interfere with other required WorkFirst activities.
    • Send a DSHS 17-063 Authorization to Release Information form, a letter of referral and a copy of the participant's IRP to the treatment provider to coordinate treatment with WorkFirst requirements.
    • Establish communication with treatment staff to discuss the participant's full course of treatment. Convene a case staffing to discuss the participant's situation. Treatment plans established by CDPs may include ancillary activities outside of the treatment agency (i.e. AA meetings, anger management counseling, etc.)

Relapse During Recovery:

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.

Non-compliance:

Without good cause, failure to have a substance abuse 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 the WFPS and WFSSS.

Resources

Related WorkFirst Handbook Sections

Forms

6.8 Exemptions

Created on: 
Apr 09 2018

Revised March 20, 2023

Legal References:

The Exemptions section includes:

  • 6.8.1 What are exemptions?
  • 6.8.2 Infant and toddler exemptions
  • 6.8.3 Older needy caretaker relative exemptions
  • 6.8.4 Caring for a child with special needs
  • 6.8.5 Caring for an adult relative with disabilities
  • 6.8.6 Adults with chronic and severe disabilities
  • 6.8.7 SSI Referrals
  • 6.8.8 DVR Referrals
  • 6.8.9 Can exempt participants have mandatory participation requirements?
  • 6.8.10 Can exempt participants voluntarily participate?
  • 6.8.11  eJAS codes
  • 6.8.12 Exemptions - Step-by-Step Guide

6.8.1 What are exemptions?

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, assess their specific situation and needs, taking into consideration the entire household. Grant participants an exemption if they:

  1. Are the parent or legal guardian of a child under the age of two (see WHFB 5.1),
  2. Are a needy caregiver relative and aged 55 or older,
  3. Have a severe and chronic medically verified condition (including individuals likely to be approved for SSI or other federal benefits),
  4. Must be in the home to care for a child with special needs, or
  5. Must be in the home to care for an adult relative with a severe and chronic medical condition.

An exemption from participation may not always be appropriate. Defer 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. 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 6.4Children: 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, seek support from case managers or Social Service Specialists to staff the case, reviewing evidence together to support the participant in their goals.

6.8.2 Infant and toddler exemptions (previously known as infant exemption extensions)

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).

6.8.3 Older needy caretaker relative exemptions

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.

6.8.4 Caring for a Child with Special Needs

We may approve an exemption 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:

  • Require the individual to provide documentation within 30 days, or up to 90 days if needed, which supports the need for the exemption including medical documentation.
  • Complete a social service specialist assessment as needed
  • Review the documentation and determine exemption approval or denial. If the documentation shows the participant can participate 10 hours or less per week, approve the exemption.

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. You may also consider convening a case staffing as you review 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.

6.8.5 Caring for an adult relative with disabilities

We may approve exemptions 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. Exempt the individual if she or he can only participate 10 hours or less per week because of 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.

6.8.6 Adults with chronic and severe disabilities

We may approve exemptions or long-term deferrals for adults with chronic and severe disabilities. To make the exemption/deferral decision:

  • Follow the process described in WFHB 6.6, Disabilities to obtain medical evidence to document the need for an exemption/deferral.
  • Complete a social service specialist assessment.
  • Complete any needed Equal Access screening or update of the individual's Accommodation Plan.
  • Use the medical evidence to determine if the condition is chronic and severe.
    • Chronic means the condition is expected to last 12 months or more.
    • Severe means the person is able to participate 10 hours or less per week.

If the medical evidence shows the person has a chronic and severe physical, mental or emotional disorder:

  • Approve XB and make an SSI referral, following the process in 6.8.7 below. If the person refuses to cooperate with the SSI referral process, determine good cause for refusal to participate.
  • Also approve a 12-month XG or XM deferral if the medical condition is responsive to treatment and treatment is available. You can require the client to apply for medical coverage, as needed, to access treatment. (See WAH Application IRP for suggested IRP language).
  • If the medical condition is not expected to respond to treatment:
    • Do not add the XG or XM to monitor participation in treatment, and
    • If the participant is unlikely to qualify for SSI, approve an exemption (ZD)
      • Examples:
        • The participant does not meet the citizenship requirements for SSU.
        • The participant is denied at the SSI final level (post-appeal) and medical evidence still verifies that they have a chronic and severe disability.

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.

6.8.7 SSI Referrals

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 Disability Specialist or WorkFirst Social Service Specialist (decided locally):

  • Uses the SSI Track Flow Chart to determine who may receive facilitated SSI applications (similar to the ABD process).

  • Uses any medical evidence to determine when a participant potentially meets SSA disability criteria. See the Social Services Manual for more information.
  • Determines if additional medical evidence may be needed, including:
    • Chart notes dating back to the original diagnosis by a physician and copies of diagnostic reports (such as X-rays, blood work and MRI's.)
    • Psychological exam, which may include psychological testing to establish or rule out conditions such as cognitive impairments. The WorkFirst Social Service Specialist can use a voucher to purchase an evaluation if the participant has no current psychological evaluations or has never completed a psychological evaluation with Washington Apple Health.
  • Helps the participant obtain the evidence, as needed, and ensures they understand they do not need to pay the costs, if any.
  • Notifies the SSI Facilitator if the participant has already applied for SSI on their own, for tracking of the application.
  • If the participant has a long-term disability but appears unlikely to meet SSA criteria, the WFSSS:
    • Removes the XB component
    • Approves a ZD exemption or maintains a long-term XG or XM deferral
    • Considers a DVR referral, and
    • Refers the case back to WFPS/WFSSS
  • If the participant’s disability appears likely to meet SSA criteria, the WFSSS refers directly to the SSI Facilitator with all relevant medical records.

  • If it is unclear whether the participant’s disability will meet SSA criteria, the WFSSS 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.

The WorkFirst Social Service Specialist:

  • Issues needed support services.
  • Maintains eJAS component codes.
  • Maintains the participant's IRP.
  • Provides any desired DVR referrals.
Note: See section 6.8.8 for DRV Referrals.

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:

  • Facilitates and tracks the participant's SSI claim.
  • Reviews SSI denials to decide whether to pursue reconsideration.
  • Authorizes additional testing with an approved ETR if needed for the reconsideration.
  • Refers cases that are not appropriate for SSI reconsideration back to the WorkFirst Program Specialist or Social Service Specialist for exemption or continued long-term deferral and possible DVR referral.
  • Tracks SSI applications that participants have filed on their own, but are unlikely to meet SSA criteria.

 

 

6.8.8 DVR Referrals

WorkFirst staff may refer participants who want to work, but need assistance due to a physical, sensory, cognitive, or mental disability; follow the process in the Social Services Manual - DVR. If accepted into the program, DVR can provide:

  • Individualized services to eliminate, circumvent, or mitigate an impediment(s) to employment;
  • Support services, like transportation, adaptive devices, child care, and services to family members, if they are necessary to the individual achieving employment; and
  • Assessment, diagnostic and evaluation services to develop employability plans.
  • See Reporting DVR Plan Hours for coding and reporting hours.
  • See WFHB section 1.2.9 What if a participant doesn’t meet an exemption but can't participate in regular employment service activities?
Note: DVR is a voluntary program and the WorkFirst participant must want and agree to work.

6.8.9 Can exempt participants have mandatory participation requirements?

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:  

  • Pursuit of SSI or another type of federal disability benefit, which may include gathering objective medical evidence as described in WAC 388-449-0015 in preparation of the SSI application process; and/or
  • Participation in available treatment that is recommended by the participant's medical or mental health provider or chemical dependency professional.
  • Individuals who are pregnant or have a child under the age of two, who choose to take the Infant, Toddler, or Post-partum exemptions may be required to participate in mental health or chemical dependency treatment depending on results of their comprehensive evaluation and subsequent Pregnancy to Employment Assessment, WAC 388-310-1450. Please refer to WFHB 5.1 for additional guidance.

6.8.10 Can exempt participants voluntarily participate?

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?

  • DVR
  • Life Skills
  • Home Visiting or other Parenting Support programs
  • Financial Literacy
  • Volunteering at their child’s school

For those who choose to voluntarily participate, do not remove the eJAS exemption codes so you can ensure that sanction will not be imposed for failure to participate.

6.8.11 eJAS codes

Use the following eJAS codes when an individual is approved for an exemption or long-term deferral:

  • ZA (approved exemption for an older caretaker relative)
  • ZB (approved exemption for an individual needed in the home to care for a disabled adult relative)
  • ZC (approved exemption for an individual needed in the home to care for a child with special needs)
  • ZD (adult with severe and chronic disabilities)

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.

  • XB (pursuing SSI/L&I/VA or other benefits) - Used to indicate cases being assessed for a facilitated SSI application or accepted for SSI Facilitation.
  • XE (substance abuse treatment)
  • XG (mental health condition and required to access available, helpful treatment)
  • XM (physical condition and required to access available, helpful treatment)

6.8.12 Exemptions - Step-by-step guide

The WorkFirst Program Specialist or Social Service Specialist works with individuals as described below.

  1. Needy Caretakers : Approves exemptions for needy caretaker relatives who are age 55 or older and codes it on the eJAS component code screen as " ZA "
  2. Infant Exemptions : Follows the process in WFHB 5.1, Pregnancy to Employment, to determine eligibility for the infant exemption see WFHB 5.1, Pregnancy to Employment
  3. Caring for a child or adult : Allows individuals who are needed in the home to care for a child or adult relative:
    1. 30 days to gather needed verification.
    2. May allow up to an additional 60 days, as needed, to give the individual more time to gather documentation, reviewing the case at least every 30 days.
    3. Reviews medical or other documentary evidence, including evaluations from the SSI facilitator or public health nurse, and approves the exemption if the participants is only able to participate 0 to 10 hours per week.
    4. May set up a case staffing, as needed, following the process in section WFHB 3.4 Case Staffing, (making sure to include the appropriate staff or medical professionals).
    5. After the exemption decision is made:
      1. Makes any needed changes to the IRP.
  4. Medical Exemption : For individuals with chronic and severe physical, mental or emotional conditions:
    1. Uses the process in WFHB 6.6, Disabilities , to obtain medical evidence.
    2. Approves XB and considers SSI if the medical evidence shows the condition is expected to last 12 months or more and the individual can participate 10 hours or less per week. (See SSI Track Flow Chart for details.)
      • Requires the participant to pursue SSI or another type of federal disability benefit in their IRP which may include gathering objective medical evidence as described in WAC 388-449-0015 in preparation of the SSI application process and
      • Requires treatment in their IRP, if recommended by their treating medical or mental health provider or by a chemical dependency professional.
    3. Also approves a 12-month XG or XM deferral, requiring treatment only, if treatment is available and expected to improve the medical condition.
    4. Completes a DVR referral if the person wants to become employable.
    5. Refers the case back to WorkFirst at any point the person does not appear SSI eligible, and approves a ZD exemption or continues the XG/XM long-term deferral.

Resources

 

Related WorkFirst Handbook Chapters

Other Resources