First Steps


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


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

Medical Services

  • Prenatal care

  • Delivery

  • Post pregnancy follow-up, including family planning

  • Dental Care

  • One year of family planning services post pregnancy

  • One year of full medical for newborns


Enhanced Services

  • Maternity Support Services (MSS)
  • Infant Case Management (ICM)
  • Childbirth Education (CBE)


Expedited Alcohol and Drug Assessment and Treatment Services

  • Alcohol and drug assessment

  • Alcohol and drug treatment


Other Services

  • Expedited eligibility determination

  • Outreach

  • Transportation

  • Interpreter services


Worker Responsibilities

Provide all pregnant women with information regarding the services available through the First Steps program.

If a woman reports she is pregnant and is not active on Washington Apple Health (WAH) Medicaid, refer them to to apply for pregnancy medical.  

If a woman already has health insurance and reports she is pregnant, let her know she can access First Steps by contacting the Within Reach Family Hotline at 1-800-322-2588 or by contacting a Local First Steps provider. Additional information regarding the First Steps program can be found at