WIC’s New Choices for Participants with Special Needs Barbara Longo, MS, RD and Karla Magie, MPH, RD California WIC Program Program Evaluation and Policy Branch April 28, 2009

What are your thoughts about therapeutic formulas?

How important are therapeutic formulas?

Together we will explore … I. I.New WIC food choices and procedures for participants with special needs: + + Food Package III + + Food Package IV II. II.Coordination with medical providers

The Big Picture 1)Medically fragile WIC participants may receive all WIC foods if prescribed. 2)Children may receive soy beverage and tofu with medical documentation. soy beverage and tofu with medical documentation.

WPM Policy Changes Obtain medical documentation before issuing: Therapeutic formula, a medical food, or any WIC foodsTherapeutic formula, a medical food, or any WIC foods Additional formula instead of food for infants 6 to 11 months of ageAdditional formula instead of food for infants 6 to 11 months of age Soy-based beverage or tofu to a childSoy-based beverage or tofu to a child

Medical Documentation for Package III

Overview of ISIS Changes Related to the New Food Package

WIC Foods for Participants Prescribed Therapeutic Formula Now Now October 1, 2009

New WIC Pediatric Referral Form New WIC Pediatric Referral Form

New ISIS Question for Package III “Are there restrictions on any WIC foods?”

Case Study #1 Mom’s 2 yr/o toddler was just diagnosed with severe cow’s milk, soy, and egg allergies and brings a prescription for Pregestimil to WIC. Her son has Molina Medi-Cal managed care health insurance. Mom’s 2 yr/o toddler was just diagnosed with severe cow’s milk, soy, and egg allergies and brings a prescription for Pregestimil to WIC. Her son has Molina Medi-Cal managed care health insurance. 1.Which food package? 2.Which WIC foods? 3.Does WIC provide Pregestimil?

Soy – Child (Food Package IV ) Soy – Child (Food Package IV )

Overview of ISIS Changes Related to the New Food Package

Soy Food Package Policy Soy beverage and tofu issuance to a child requires medical documentation.Soy beverage and tofu issuance to a child requires medical documentation. Soy documentation from a health professional with prescriptive authority only needs to be requested once.Soy documentation from a health professional with prescriptive authority only needs to be requested once. Soy documentation is not required for women.Soy documentation is not required for women.

Case Study #2 A vegan mother wants her 14 mo/o baby boy to receive soy milk. There is NO medical Condition and the family has Kaiser private Insurance. 1.Which food package? 2.Is a Rx required?

Questions?

WIC Coordination with the Health Care Community Step #1: Announce the new WIC changes... 1.WebEx conferences 2.Physician meetings and correspondence 3.Articles 4.Joint program letters 5.Presentations 6.CA WIC web pages for physicians

WIC Web Pages for Health Professionals

WIC Collaboration with the Health Care Community Step #2: Train the trainer model... Health plansHealth plans PhysiciansPhysicians NursesNurses CWA webinars in August 2009CWA webinars in August 2009

MD - WIC Collaborative Breastfeeding promotionBreastfeeding promotion Childhood obesity preventionChildhood obesity prevention Healthy habitsHealthy habits Early intervention and access to careEarly intervention and access to care

Local Agencies Coordinates with the Health Care Community Did you know…. …medical certification program for physicians promotes and supports breastfeeding in physician offices in Riverside County... …physicians teach WIC participants about breastfeeding and good nutrition in Glenn County

Who takes the child by the hand… …takes the mother by the heart.