First Steps enhanced services

Find information about additional preventive First Steps services covered through Maternity Support Services (MSS), Infant Case Management (ICM), and Childbirth Education (CBE).

What is First Steps?

First Steps is a Washington Apple Health (Medicaid) program that helps low-income pregnant individuals get the health and social services they may need and covers a variety of services for pregnant individuals and their infants.

This page has information about enhanced pregnancy programs. Visit the pregnancy services page to learn more about other covered services.

Maternity Support Services (MSS)

Maternity Support Services (MSS) are preventive health and education services to help an individual have a healthy pregnancy and a healthy baby. Individuals can receive MSS through the First Steps Program if they are pregnant or up to 60 days postpartum and receiving Apple Health. MSS is offered in addition to medical and prenatal care.

Services can begin any time during the pregnancy or postpartum period. However, pregnant individuals are encouraged to enter the program as early as possible during their pregnancy to better help improve outcomes for both the pregnant person and infant.

Maternity Support Services may include:

  • Pregnancy and parenting information
  • Screening for possible pregnancy risk factors
  • Brief counseling for identified risk factors
  • Referral to community resources

Services are provided by a team that includes:

  • Nurses
  • Dietitians
  • Behavioral health specialists
  • Community health workers (some locations)

Services can be provided virtually or in a:

  • Clinic or office
  • Home setting
  • Community setting

Where can you find an MSS provider in Washington?

You can find MSS providers listed by county in the First Steps MSS and ICM Provider Directory or call WithinReach at 1-800-322-2588.

Infant Case Management (ICM)

Infant Case Management (ICM) helps parents access medical, social, educational, and environmental services to improve the health and wellbeing of their infants. ICM promotes a supportive network for families through referrals and connections in the community.

ICM may start any time after Maternity Support Services ends (usually when the baby is about 3 months old) and can continue up to the last day of the month of the baby’s first birthday.

Services can be provided virtually, in the provider’s office, in the family’s home, or in a community setting.

Where can you find an ICM provider in Washington?

You can find ICM providers listed by county on the First Steps Provider Directory or call WithinReach at 1-800-322-2588.

Childbirth Education (CBE)

Eligible pregnant individuals and their support person(s) can attend group Childbirth Education (CBE) classes, at no cost, when the classes are taught by a Health Care Authority-approved CBE educator who accepts Apple Health. CBE usually starts during the third trimester of pregnancy and the topics include:

  • How to have a healthy pregnancy
  • Warning signs in pregnancy and what to do
  • Nutrition
  • Breastfeeding
  • Birthing plan
  • What to expect during labor and delivery, how to manage pain and a hospital tour
  • Newborn care and changes to expect at home after the baby is born
  • Safe sleeping position, car seat safety, and well-child care

Where can you find a CBE provider in Washington?

You can find CBE providers listed by county on the First Steps Childbirth Education Provider Directory or call WithinReach at 1-800-322-2588.

WIC Nutrition Program

The WIC Nutrition Program provides access to no-cost healthy food, health screenings, nutrition education, breast and chest feeding support and more, to people who are pregnant or recently pregnant, infants, and children under age five through an easy-to-use WIC card. See if you're eligible for WIC and learn how to apply. You can also find a WIC clinic online or call 1-800-322-2588.