Introduction to WIC Services. Kathy Lee, RD Santa Clara County Public Health, WIC

Transcription

1 Introduction to WIC Services Kathy Lee, RD Santa Clara County Public Health, WIC

2 Objectives Familiarize physicians with resources and services WIC offers; how to refer to WIC. Communication between WIC and primary health providers. Encourage partnerships to maximize patient access to care and health promotion.

3 What is WIC? WIC - the Women, Infants, and Children program - is a nutrition program that helps pregnant women, mothers with infants, and children <5 eat well, be active, and stay healthy. In California, 82 WIC agencies provide services locally to over 1.4-million women, infants and children each month at over 600 sites throughout the State.

4 Program Goals Decrease pre-term birth, and pregnancy complications. Prevent low birth weight babies. Decrease iron anemia. Promote optimum growth and development of children.

5 What Does WIC Provide? Food Package Fruit, vegetables, whole grains, beans, milk, cheese, peanut butter, cereal, 100% juice Farmers Market coupon (summer) Formula, baby food Nutrition & Breastfeeding Promotion 2 nutrition classes/yr 2 nutrition assessments/yr Breast pump loan (fully breastfeeding) Peer counselors (11) 4 IBCLC, 10 RD on staff Health & Social Service Referrals Child care Dental Domestic violence Assistance (Food, Housing, Medical) Immunizations Substance abuse

6 Who Qualifies? Pregnant & breastfeeding women, and children <5 yrs of age. Applicants receiving medical, food stamps, or TANF automatically qualify. Low income families at 185% federal poverty level. Family of 4: Annual gross income $40,793

7 WIC Works! Almost 60% of infants born in CA receive WIC services. Enrollment before 30-wks pregnancy resulted in significantly longer pregnancies, fewer preterm births/deaths, and greater likelihood of receiving prenatal care. Positive outcomes on children s diet: Higher mean intakes of iron, vitamin C, thiamin, niacin and vitamin B6, without an increase in food energy intake, indicating an increase in the nutrient density of the diet. WIC participants who reported having received advice to breastfeed their babies from the WIC clinic were more likely to do so than other WIC participants or eligible nonparticipants. Source:

8 Resources for Providers Providers can order WIC handouts for free or access them online terials.aspx. All Santa Clara County residents can call the Breastfeeding Hotline for breastfeeding assistance at

9

10 How Do I Refer Patients to WIC? Healthcare provider completes pediatric referral form. Height, Weight Hemoglobin (within 90 days) Patients complete WIC Application Form Patients call WIC or go to clinic to schedule an Enrollment Appointment. Santa Clara County WIC:

11 WIC Blood Work Requirements WIC blood work requirements are specified in the table on the following page. If blood work is required, then it should be submitted within 90 days of the certification/recertification start date. On the other hand failing to submit blood work does not disqualify an applicant from participation. However it is important to get the blood work in, because the USDA can revoke the 90 day grace period if they find that missing data is a significant problem.

12 WIC Blood Work Requirements (cont d) IF THEN IN ADDITION Pregnant Breastfeeding or postpartum Blood can be dated from ANY time during pregnancy. Blood can be dated from any time after the most recent pregnancy. New blood is NOT required for recertification, even if the mom has an anemia risk. Enrolling an infant less than 9 months of age No blood is required. If blood is submitted AND it is dated from 6 to 12 months of age, then it can be used for the one-year recertification. Enrolling an infant 9 months of age or older (but less than 12 Blood is required. It can be dated from 6 to 12 months of age. months) Child months Blood is required. If blood is dated before 12 months of age, then it can be applied only to the one-year recertification. A new test dated after 12 months is required at the next recertification (Example 1). Child 2-5 years Blood is required once every 12 months. If blood is dated from 12 months of age or more, then it is good for one year unless the results are abnormal; in which case follow-up testing is required at the next certification (Example 2). If the results are abnormal, then follow-up testing is required at the next certification. Source: California WIC Training Manual Module B Certification and Subsequent Certification (recertification) 5/2/2010

13 Therapeutic Formula

14 Overview What You Will Learn Differences between therapeutic formula and contract formula. Conditions under which therapeutic formula may be prescribed. Medical documentation requirements for prescribing therapeutic formula. How to complete the Pediatric Referral CDPH 247A. Pharmacies that supply therapeutic formula.

15 Enfamil Contract Formulas Enfamil Premium Infant (powder or concentrate) Enfamil ProSobee (powder or concentrate) Enfamil Gentlease (powder) Enfamil A.R. (powder) Effective August 1, 2010, WIC no longer provides Enfamil Lipil with Iron.

16 What is Therapeutic Formula? Prescribed if the patient has a medical condition for which none of the contract formulas are appropriate. Requires completion of the Pediatric Referral CDPH 247A by a health care provider authorized by state law to write medical prescriptions. Examples are NeoSure, EnfaCare, Nutramigen, Alimentum, and PediaSure.

17 What is Therapeutic Formula? Therapeutic formula should be covered by the patient s health plan. Otherwise a letter of denial from the health plan is required in order for WIC to provide therapeutic formula. Most therapeutic formulas require a prescription every 3 months. WIC reassesses many infants by 6 months of age for tolerance and possible reintroduction of contract formula.

18 Pediatric Referral - Section I The MD will complete Section I for all referrals, whether or not therapeutic formula is prescribed.

19 Pediatric Referral - Section I (cont d) The local WIC agency will provide this information.

20 Pediatric Referral - Section I (cont d) Provide an Hgb or Hct lab result obtained within the last 12 months.

21 Pediatric Referral - Section I (cont d) After discussing breastfeeding with the mother, the MD will check the breastfeeding plan currently in use.

22 Pediatric Referral Form - Section I (cont d) The MD will check the qualifying condition for substituting soy milk and tofu for milk and cheese. If Other is checked, then personal preference is not a qualifying condition.

23 Pediatric Referral Form - Section I (cont d) WIC refers children to their health care provider for blood lead levels at age 1 year or older.

24 Pediatric Referral Form - Section I (cont d) Include the MD signature or signature stamp.

25 Example of Completed Pediatric Referral - Section I

26 Pediatric Referral - Section II MD will complete Section II only if therapeutic formula or medical food is prescribed.

27 Pediatric Referral - Section II (cont d) If Food allergy is checked, then the MD will specify the type of allergy. If Other is checked, then the MD will state the specific diagnosis.

28 Pediatric Referral - Section II (cont d) If therapeutic formula is prescribed, then the MD will check all WIC foods that should NOT be given to the patient.

29 Pediatric Referral - Section II (cont d) The MD will specify the name of the therapeutic formula or medical food that is prescribed for the diagnosis identified in this form.

30 Pediatric Referral - Section II (cont d) The MD must provide medical justification to avoid denial of coverage by health plan.

31 Example of Completed Pediatric Referral - Section II

32 Therapeutic Formula Providers Pharmacy Phone/FAX Health Plans Accepted Mini Pharmacy Phone: FAX: North American Home Health Supply, Inc Phone: FAX: MediCal Santa Clara County Health Plan Most HMOs (except Kaiser) MediCal CCS PPO Blue Cross (Anthem) Most contract health plans Shield Health Care Phone: FAX: MediCal AIM Blue Shield (MediCal) Sharp Health Plan

33 Thank you! Contact info: Kathy Lee, RD Santa Clara County WIC Program