1. WIC Program Coordinator of the Floyd County WIC Program: Krista Comer, MS, RD, CD

2. What does WIC stand for? W=Women I=Infants C=Children

3. What is WIC? WIC is a Federal grant program (each year Congress specifies how much money the program receives) WIC is a supplemental nutrition program WIC is a source for screenings and referrals

4. Who could be eligible? Pregnant women (through the remainder of the current pregnancy up to 6 weeks after delivery) Breastfeeding women (up until the infant is one year of age) Postpartum women who are not breastfeeding (up until the infant is 6 months of age) Infants (up until they are one year old) Children ( up until they are 5 years old)

5. How is eligibility determined? Each participant must qualify both nutritionally as well as financially. They are screened according to their income. They visit with a CPA (Certified Professional Authority) to determine nutritional needs.

6. Interesting Information Of all infants born in the United States, WIC serves 45%. As of 2008, the average monthly food cost per person was $39.03. There are 2,000 local agencies in 10,000 clinic sites, 50 State health departments, 34 Indian Tribal Organizations, the District of Columbia, and 5 territories (Northern Mariana, American Samoa, Guam, Puerto Rico, and the Virgin Islands).

7. How does WIC work? Clients are given an appointment time They bring “proofs” to the appointment – Proof of income, residency, identification on parent and child, and WIC id folder Proofs are screened by Clerks and entered into the database If qualify financially, they are seen by the CPA They are asked a series of questions which is also entered into the database

8. How WIC works continued… Ht/Wt/Hgb Risk factors are identified by CPA Educated nutritionally Checks printed and explained Given packet and scheduled for next appointment

9. VENA Value Enhanced Nutrition Assessment

10. What is VENA? Developed in collaboration with the Food and Nutrition Service (FNS) and the National WIC Association (NWA) It is a program designed to improve the assessment process during a WIC visit and individualize the information

11. Pre- and Post- VENA Pre – Quality of assessment is inconsistent across WIC agencies – Use of diet histories – Assessment information not always used effectively – Primary function is nutrition risk id – No presumed dietary risk criterion – Tendency to focus on deficiency findings – Not always consistent with participant-centered nutrition Post – FNS provides policy for quality nutrition assessment – No longer use diet histories – Enhances nutrition assessment – Continues to identify nutrition risk (individualized) – Inclusion of presumed dietary risk criterion – Positive approach based on desired health goals rather than deficiencies – Complements participant- centered nutrition

12. Risk Factors Series of numbers to help CPAs identify nutritional and medical needs Different ones to apply to each category of individuals Educational materials provided to increase awareness of risk factors

13. GOAL To become more client centered instead of trying to determine eligibility To have more conversations with clients and open lines of communication To individualize each visit to meet that persons needs nutritionally, educationally and physically (tailoring the food package)

14. New WIC Food Package In September of 2009, WIC started providing more variety to their clients. The amounts of the foods changed some. The types of foods still depends on the client type (i.e. prenatal, breastfeeding, postpartum, child, infant)

15. Foods Available Milk/Cheese Eggs Dried Beans/Canned Beans/Peanut Butter Juice Cereal Infant cereal Baby food Carrots* Tuna, Pink Salmon, Sardines* Formula* Fresh Fruits and Vegetables Whole grain products (bread, tortillas, rice)

16. How much is provided? Milk/Cheese = 4-6 gallons/month Eggs = 1 dozen/month Dried Beans/Peanut Butter = 1 lb/18 oz jar Juice = 2-3 units

17. How much continued….. Cereal = 36 oz/month Infant cereal = 24 oz/month after 6 months of age Baby food = 32-64 jars fruits & vegetables; 31 jars meats

18. How much continued….. Tuna, Pink Salmon, Sardines = 30 oz/month if exclusively breastfeeding Formula = approximately 910 oz/month (31 cans of concentrate or 9 cans of powder)

19. Why these foods? All of the foods selected are monitored and have to meet certain nutritional standards All food groups are represented in the food packages Calcium, iron, Vitamin C, Vitamin A and fiber are some of the main benefits to the clients

20. Checks Participants are given a folder with the names of the participants on it, the parents signature, and up to 2 proxies who have to sign in order to use the checks Each food item is printed on the checks and the quantity Could have up to 4 checks a month per participant

21. What else does WIC provide? WIC not only provides food, but also nutrition education It also provides referrals to other agencies It provides networking possibilities for clients

22. Budget Each year, I write a Grant to be approved by the USDA and State WIC I am given an amount of money according to my clinic’s caseload and then I have to figure how to distribute it That amount has to include personnel, supplies, printing, telephone, postage, breastfeeding incentives, travel and rent.

23. Budget continued…. Each month, I send a report to the State office accounting for the money used that month. Each participant falls into a priority according to their nutritional and medical need. If budget cuts occur, they could be dropped from the program (starting with the least at risk)

24. Any Questions??

25. References www.fns.usda.gov/wic www.nal.usda.gov/wic Indiana State Department of Health – Pamphlet – Training