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