1. WIC & Community Health Center Integration
Mary Sammer MS, RD VP Nutrition Services North County Health Services

2. Goal 1: Align WIC, Nutrition and Breastfeeding Messages
To increase the knowledge of WIC benefits, services and eligibility requirements among select NCHS support staff
Increase knowledge of infant and child nutrition among select NCHS Pediatric staff.
Method: Develop 4 Training Modules
1: All About WIC (Call Center, Pt. Resource Specialists, MA’s, Receptionists, etc.)
2: Basic Nutrition (Pediatric, Women’s Health and Adult MA’s and Health Partners)
3: Infant Nutrition (Pediatric, Women’s MA’s and Health Partners)
4: Child Nutrition (Pediatric, Women’s MA’s and Health Partners)
Objective:
100% of MA’s & Health Partners will show improvement in posttest scores for modules 2, 3 & 4

3. Results: Goal 1 Module 1 All About WIC Module 2 Basic Nutrition
Staff Count
Pre-test Score
Post-Test Score
Percent Change
Module 1
All About WIC
>200
N/A
Module 2
Basic Nutrition
5 Cohorts 55
43-67
71-91
22-65 %
Modules 3&4
Pediatric Nutrition
4 Cohorts 27
52-69
89-97
28-86 %

4. Goal 2: Improve Child Retention
To improve the participation of certified infants and children who identify NCHS as their health care provider in the San Marcos (pilot) clinic through Recruitment, Retention and & Re-engagement activities.
Methods:
Hire a WIC Coordinator (an existing, highly-skilled WNA)
Train to match appts (Peds EHR and WIC MIS)
Screen matched patients/ppts for WIC status and encounter need
Huddle with HC staff in morning to ID kids
Maintain a detailed spreadsheet of RETENTION ENCOUNTER and RETENTION ACTIVITIES: number of encounters, infant enrollments, GA education, Mailed vouchers, etc.

5. Sample Encounter Spreadsheet
Date
Parent
Child
WIC ID
Retn Cat
Provider
Last WIC
Next WIC
Next Labs Due
Notes/barriers
Outcomes
Out
come
code
8/2/18
XXXXX
XXX 1
Moser
8/1/18
9/5/18
6/3/19
A+ ppt, baby is already E, enc her to cont EBF.
8/3/18
XXXX
2.1
Zachry
7/2/18
10/16/18
3/1/19
Prob w/transport, Seen by clinic LC for latch
4.1
Morris
Goes to other WIC Agency
4.2
Russo
Never been on WIC, Revd benefits/location

6. Goal 2: Objectives
WIC Coordinator will have at least 10 face-to-face encounters per day with WIC ppts (guardian) during Pediatric visits.
WIC participation will increase by 5% above baseline among the infants and children that are also patients of NCHS San Marcos Health Center – the pilot site.
Identify opportunities & provide streamlined WIC services

7. Streamlined Pediatric Activities
Provide WIC education and issue benefits
Provide retention messages and re-engage back on to WIC
Recruit new ppts, screen for eligibility and start enrollment process/appt
Start NB enrollment using Maternal Infant Assessment from LC in Peds
Utilizing EHR information (Hgb, Ht/Wt) to remove holds, issue benefits
Assist with Therapeutic Formula process
ELIMINATE ANY BARRIERS TO PARTICPATION
New Utilize Nutrition Fast Passes and EHR for processing OB pts

8. Retention Encounters: Jan 2017-Sept 2018
RETENTION CONTACTS 1
A+ (keeps all appts)
1727
49% 2
A+, and needs to E newborn
443
12% 3
B user (misses some appts)
125 4% 4
B user, and needs to E newborn 43 1% 5
Active past/now gone *
339
10% 6
Goes to another WIC
435 7
Never on WIC *
441
TOTAL ENCOUNTERS
3553
100%

9. Sample Encounter Spreadsheet with Outcomes
Date
Parent
Child
WIC ID
Retn Cat
Provider
Last WIC
Next WIC
Next Labs Due
Notes/barriers
Outcomes
Out
come
code
8/2/18
XXXXX
XXX 1
Moser
8/1/18
9/5/18
6/3/19
A+ ppt, baby is already E, enc her to cont EBF.
Ppt went in on the 1st.
8/3/18
XXXX
2.1
Zachry
7/2/18
10/16/18
3/1/19
Prob w/transport, Seen by clinic LC for latch
Inf enrolled WIC same day 2
4.1
Morris
Goes to other WIC Agency
Gave locations 5
4.2
Russo
Never been on WIC, Revd benefits/location
E same day

10. 73% of ALL Encounters = WIC Benefits
OUTCOMES 1
A+ continues
1692
48% 2
Went to WIC same day
274 8% 3
Went to WIC later date
537
15% 4
FI’s mailed 55 2% 5
Other WIC agency
370
10% 6
Not interested
187 5% 7
Over income 78 8
No response yet
360
TOTAL ENCOUNTERS
3553
100%

11. 42% of “One-Time/Active in Past Users” Re-engaged
OUTCOME 2
Went to WIC same day 37
11% 3
Went to WIC later date
105
31% 6
Not interested 75
22% 7
Over income 18 5% 8
No response yet
104
339
100%
RE-ENGAGED

12. 20% of “Never on WIC” = New Recruits
OUTCOME 2
Went to WIC same day 23 5% 3
Went to WIC later date 68
15% 6
Not interested 96
22% 7
Over income 57
13% 8
No response yet
197
45%
441
100%
New Recruits

13. Percent of WIC Infants & Children w/NCHS Provider

14. PEDIATRIC CONTACTS 2018-Present Had contact then mailed
Date E GA
EA80
SA20 SA SR
Mail SD
Mail w/o Contact
Had contact then mailed
SUM Peds Contacts
Oct 23 17 1 12 2 55
Nov 19 13 4 14 50
Dec 20 6 10
Jan 5 11 18 52
Feb 27
Mar 41 16 3 29 92
Apr 91

15. Thank you! Any questions?