Federal Fiscal Year 2010 Georgia WIC Program State Plan GEORGIA DEPARTMENT OF COMMUNITY HEALTH DIVISION OF PUBLIC HEALTH Office of Maternal and Child Health GEORGIA WIC PROGRAM Georgia State Plan for Program Operation In the Special Supplemental Nutrition Program For Women, Infants, and Children (WIC) 142661680 Fiscal Federal Year 2010 (October 1, 2009 to September 30, 2010) Submitted in accordance with USDA Food and Nutrition Service Federal Regulations 246.4(A) - State Plan August 2009 Federal Fiscal Year 2010 Georgia WIC Program State Plan TABLE OF CONTENTS Page Abbreviations ................................................................................................................................1 Chapter 1 Goals and Objectives ............................................................................................4 I. Introduction .................................................................................................................5 II. Mission Statements .....................................................................................................6 III. Functional Area Accomplishments FFY 09 .............................................................7 IV. FFY 10 Goals and Objectives ...................................................................................17 V. VENA Plan.................................................................................................................46 VI. 2010 Food Package Plan ...........................................................................................51 Chapter 2 Program Financial Management.......................................................................54 I. Program Financial Status .........................................................................................55 II. Letter of Credit ..........................................................................................................56 III. Local Level Requirements........................................................................................57 IV. Property Management and Procurement..............................................................58 V. Case Load Management/Food Cost ......................................................................58 Chapter 3 Food Delivery/Management Information Systems.......................................60 I. Retail Delivery Method ............................................................................................61 II. Vendor Management Unit .......................................................................................63 III. Direct Delivery Method ...........................................................................................64 IV. Management Information Systems ........................................................................64 V. Food Package Design ...............................................................................................66 Chapter 4 Application and Disqualification Process for Local Agencies .....................67 I. Process for Applying to Operate a WIC Clinic.....................................................68 II. Administrative Appeal: Local Agency ..................................................................70 Chapter 5 Special Project Program .....................................................................................74 I. Introduction ...............................................................................................................75 II. Overview of Local Agency Special Project Grants...............................................75 III. Proposal Process........................................................................................................76 IV. Grant Management ...................................................................................................77 Federal Fiscal Year 2010 Georgia WIC Program State Plan Attachments: Attachment I Participant Characteristic Minimum Data Set (MDS) ................................80 Attachment II Disqualification/Not Accepting an Application Form..............................91 Attachment III Local Application Form ...............................................................................92 Federal Fiscal Year 2010 Georgia WIC Program State Plan ABBREVIATIONS LIST Administrative Law Judge .....................................................................................................ALJ Advance Planning Documents ............................................................................................APD American Academy of Pediatrics ........................................................................................AAP American Dietetic Association............................................................................................ ADA Behavior Risk Factor Surveillance System ...................................................................... BRFSS Body Mass Index ..................................................................................................................... BMI Chronic Disease Prevention and Health Promotion Program .................................. CDPHP Cash Management Improvement Act.............................................................................. CMIA Centers for Disease Control and Prevention......................................................................CDC Chief Financial Officer........................................................................................................... CFO Competent Professional Authority...................................................................................... CPA Compliance Analysis Unit ................................................................................................... CAU Cumulative Unmatched Redemption .................................................................................CUR Department of Administrative Services .......................................................................... DOAS Department of Labor .............................................................................................................DOL Department of Family and Children Services .............................................................. DFACS Department of Community Health .................................................................................... DCH Department of Health and Human Services...................................................................DHHS Division of Medical Assistance ...........................................................................................DMA Division of Payment Management..................................................................................... DPM Electronic Data Processing ....................................................................................................EDP Electronic Turn Around Document.................................................................................. ETAD Epidemiology ........................................................................................................................... EPI Federal Fiscal Year .................................................................................................................. FFY Financial Management System ............................................................................................ FMS Food and Nutrition Section ...................................................................................................FNS Food Package Codes.............................................................................................................. FDC Functional Requirements Document .................................................................................FReD SP-1 Federal Fiscal Year 2010 Georgia WIC Program State Plan Georgia Chapter American Academy of Pediatrics.......................................................GAAP Georgia Coalition for Physical Activity and Nutrition .................................................GPAN Georgia Public Health Association...................................................................................GPHA Georgia Registry of Immunization Transactions and Services ....................................GRITS Georgia WIC Information System ..................................................................................... GWIS Georgia WIC Information System-Network .............................................................. GWISnet Graphic User Interface ........................................................................................................... GUI Health Maintenance Organization .................................................................................... HMO International Life Sciences Institute ..................................................................................... ILSI Internet Check Image Viewer............................................................................................... iCIV Local Agency Special Project.............................................................................................. LASP Minimum Data Set.................................................................................................................MDS Monthly Income and Expenditure Report ....................................................................... MIER National Performance Measure .......................................................................................... NPM Neural Tube Defect................................................................................................................NTD Nutrition Message................................................................................................................... NM Nutrition Section ....................................................................................................................... NS Nutrition Service and Administration ................................................................................ NSA Office of Financial Services.................................................................................................... OFS Office of Nutrition.................................................................................................................OON Patient Flow Analysis.............................................................................................................PFA Pediatric Nutrition Surveillance System ...................................................................... PedNSS Physician Sponsor Plan ...........................................................................................................PSP Policy Management and Training Section .......................................................................PMTS Policy, Planning and Evaluation Section............................................................................. PPE Pre-Pregnancy Nutrition Surveillance System .................................................................PNSS Pregnancy Risk Assessment and Monitoring System ................................................ PRAMS Program Planning and Evaluation Unit .............................................................................. PPE Public Health State Office ...................................................................................................PHSO SP-2 Federal Fiscal Year 2010 Georgia WIC Program State Plan Random Moment Sample Study........................................................................................RMSS Registered Dietitian ..................................................................................................................RD Request for Proposal............................................................................................................... RFP Residential Child Care Institution ......................................................................................RCCI Results Based Budgeting........................................................................................................ RBB State Performance Measure .................................................................................................. SPM State WIC Office .................................................................................................................... SWO Stress Free Feeding .................................................................................................................. SFF Supplemental Data Set ........................................................................................................... SDS Supplemental Nutrition Assistance Program..................................................................SNAP Systems and Information Section ........................................................................................... SIS Take Charge of Your Health........................................................................................... TCOYH Technical Assistance and Consultation Unit .................................................................. TACU Technical Assistance for Needy Families ........................................................................ TANF To Be Determined ...................................................................................................................TBD Turn Around Document .......................................................................................................TAD United States Department of Agriculture ....................................................................... USDA United States Department of Education ...........................................................................USDE United States Department of Health and Human Services .................................... USDHHS Value Enhanced Nutrition Assessment...........................................................................VENA Vendor Integrity Profile System ..........................................................................................VIPS Vendor Management Unit ...................................................................................................VMU Voucher Codes ..........................................................................................................................VC Vouchers Printed On Demand.......................................................................................... VPOD Women, Infants, and Children............................................................................................. WIC Youth Risk Behavior Survey ...............................................................................................YRBS SP-3 Federal Fiscal Year 2010 Georgia WIC Program State Plan CHAPTER 1 GOALS AND OBJECTIVES I. Introduction II. Mission Statements III. Function Area Accomplishments FFY 09 IV. FFY 10 Goals and Objectives SP-4 Federal Fiscal Year 2010 Georgia WIC Program State Plan SECTION I - INTRODUCTION The State Plan for Georgia Women Infants and Children (WIC) Program is the governing document that provides guidance and direction for the State and Local Agencies administrating the program. In compliance with federal regulations, the Plan is updated annually to ensure the inclusion of new and revised federal and State requirements. Although the Plan is primarily based on federal regulations, it is a consolidated Plan that includes requirements and guiding principles for best practices from the State perspective and that of the National Public Health framework. It is the primary goal of the Georgia WIC Program to improve birth outcomes and promote healthy behaviors. These critical objectives are not completed in a vacuum but through the collaborative programmatic partnerships of the Georgia Office of Maternal and Child Health. The Georgia WIC Program has taken a holistic approach to energize the more than 305,544 WIC participants with the following goals: increasing prenatal and postpartum healthy behaviors identify challenging nutritional risk factors, increasing retention of all WIC eligible participants, establishing effective external partnerships to provide comprehensive service capacity, and utilizing technology to streamline administrative service delivery. The Georgia WIC Program actively embraces the Value Enhanced Nutrition Assessment (VENA) initiative from the United States Department of Agriculture's (USDA) Food and Nutrition Service (FNS) to improve nutrition services in the WIC Program. The focus of VENA initiative is the WIC nutrition assessment, which imparts a framework for collecting participant-centered information to provide relevant nutrition services for each participant. VENA not only addresses the departmental customer service initiatives, but also serves as a catalyst to create best practice initiatives within the Division of Public Health. The Georgia WIC Program has used VENA principles to provide a statewide standardization of WIC nutrition services with emphasis on rapport building, critical thinking, deficiency detection and the implementation of strategies improve the program by identifying gaps in service delivery [that can hamper programmatic sustainability]. To support WIC cost containment efforts and to make use of technology; the Georgia WIC State Plan was developed as an electronic document. The distribution media for disseminating the document are compact disk and the Internet. The Plan is specific to the needs of the State and Local Agencies. It provides a description of on-going operating strategies and procedures and is intended for anyone who has an interest in how the Georgia WIC Program delivers benefits to eligible and potentially eligible populations. SP-5 Federal Fiscal Year 2010 Georgia WIC Program State Plan SECTION II MISSION STATEMENTS Department of Community Health (DCH) Mission: x ACCESS to affordable, quality health care in our communities x RESPONSIBLE health Planning and use of health care resources x HEALTHY behaviors and improved health outcomes Department of Community Health (DCH) Vision: Stronger Families for a Stronger Georgia. Division of Public Health Mission: The Georgia Division of Public Health provides service and leadership to promote, protect and improve the health and safety of the people of Georgia. Division of Public Health Vision: Our vision is a Georgia with healthy people, families, and communities, where all sectors unite by pooling their assets and strengths to promote health for all. Decisions are made in harmony with economic and environmental concerns. Office of Maternal and Child Health Mission and Vision: We believe that healthy, well-educated children and families are the keys to optimal individual growth and development essential to maintaining safe and economically sound communities. We believe in... x prevention x community ownership x ethical decisions and actions x commitment to a scientific process Therefore, we are committed to promoting the physical, mental, spiritual, and social well-being of children and families through partnerships with communities. These beliefs will be reflected in all policies, procedures, program development and funding mechanisms (decisions) that are part of any business done by, with or on behalf of the Office of Maternal and Child Health. WIC Program: The mission of the Women Infants and Children (WIC) Program is to provide policy direction and technical assistance to ensure continuity in program administration and operation; and compliance with Georgia's Special Supplemental Food/Nutrition program regulations. SP-6 Federal Fiscal Year 2010 Georgia WIC Program State Plan SECTION III FUNCTIONAL AREA ACCOMPLISHMENTS FFY 09 Throughout the year, the Georgia WIC Program has successfully addressed and implemented activities that correspond to required USDA Functional areas. Many of these activities are in the early stages of development and implementation, the following is a summary of progress. Vendor Management Unit: To ensure the efficiency of all activities associated with selecting, authorizing, training, monitoring and investigating the Georgia WIC Vendor population for the purpose of maintaining access to WIC products and reducing the incidents of programmatic fraud and abuse. FFY 09 ACCOMPLISHMENTS: x Monitored over 10% of all Vendors x Implemented new process for identifying 50% Vendors x Updated VIPS with field to help identify 50% Vendors via filters x Reassigned front end processing of applications x Began creating electronic application x Utilized video conferencing via VIPS for Re- Authorization training Nutrition Services: The mission of the Office of Nutrition (OON) is to ensure, promote, and influence nutrition-related policies, system development, and practices Statewide in an effort to improve nutritional status and the overall health of families in Georgia. Some of the ways OON strives to accomplish our mission is by the following: x The Office of Nutrition maintains responsibility for the overall administration of the WIC Nutrition Assessment and Compliance Nutrition Services Section. This section assists in the coordination of developing WIC Nutrition Program goals across all Health Districts in Georgia. x Working with applicable internal and external partners to decrease the proportion of Georgia's children, adolescents, and adults who are obese and/or at risk for overweight. x Promoting the importance of healthy eating (increase consumption of vegetables and fruits, fiber, folic acid, Omega-3 fatty acid, iron, and calcium rich foods, and the decreased consumption of sweetened beverage, sodium, fat, and cholesterol) and active living (engaging in adequate physical activity most days of the week). x Promoting applicable nutrition science through nutrition education and counseling proven to improve pregnancy outcomes (such as adequate prenatal weight gain decreased rates of maternal mortality and morbidity, and decrease rates of infant mortality and morbidity, low birth weight and/or prematurity). SP-7 Federal Fiscal Year 2010 Georgia WIC Program State Plan x Promotion of breastfeeding benefits to increase breastfeeding initiation and duration rates in Georgia. x Assuring a competent work force through the operation of our Commission on Accreditation for Dietetic Education accredited Dietetic Internship and the provision of TA to facilitate the updating of knowledge, skills, and abilities as it relates to the practice of evidence-based nutrition science and other relevant topics by our public health nutrition workforce. x Developing and maintaining strong partnerships between the OON, internal and external, federal, State, and Local partners to support emerging public health nutrition science and practices, policy and system development. Nutrition Services: FFY 09 ACCOMPLISHMENTS: Workforce Development: The Georgia Division of Public Health Dietetic Internship (GA DPH DI) has been granted its new ten year accreditation by the American Dietetic Association Commission on Accreditation for Dietetics Education. The MCH OON graduated three (3) Nutritionists from the 2008 GA DPH DI. The 2007 GA DPH DI reported a 67% (2/3) first time exam pass rate from its graduating class. Coordinated competency based trainings in the following subject areas: Food Package Update Trainings, Nutrition Assessment Form update trainings, VENA (motivational interviewing/counseling), and Preconception Health. Some of the nutrition trainings where provided for the first time via our web-based methodology. Nutrition Special Projects: x The OON provided reflective listening trainings for "Client Centered Counseling: The Art of Reflective Listening" July 2008. x Special Formula Cost Containment - In FY 2008, the Office of Nutrition developed new State-created food packages and voucher codes for 33 frequentlyissued 999-series special formulas and medical foods and researched wholesale pricing to assist in the development of maximum prices for the new vouchers in preparation for November 2008 implementation. The anticipated result will be a 60% reduction in usage of District/clinic-created 999 vouchers which will translate into thousands of dollars in savings. Additional State-created food packages and voucher codes will be implemented in future updates to continue to reduce the need for District/clinic-created 999 voucher codes. x Nutrition Education / Increasing Secondary Contact Rates - In FY 2008, the Office of Nutrition in collaboration with the Systems Unit began preparation to design and implement multiple front-end computer system modifications to facilitate the tracking of secondary nutrition education contacts. The new SP-8 Federal Fiscal Year 2010 Georgia WIC Program State Plan computer system fields scheduled for implementation in FY 2009 will provide Georgia WIC with the first statewide computer-based tracking of secondary nutrition education contacts and with the ability to examine those contacts based on the method of nutrition education service delivery, what nutrition topics were provided, and who provided the contacts, among other options. In addition, the Office of Nutrition developed a series of monthly standard tracking reports based on these new fields to be added to GWISnet for use by clinics, Districts, and the Office of Nutrition. x MCH Nutrition Program Consultants actively participated on the State's Nursing Protocol Committee to assist with the review of all approved WIC abbreviations to ensure consistency with approved Health Department QA regarding medical terminology abbreviations used in medical records. x MCH Nutrition Program Consultants assisted with the editing of archived webbased trainings. x Videoconferencing continues to be successfully used to deliver nutrition education in two Local Agencies (Waycross and Augusta). x Waycross successfully started the FIT WIC childhood obesity pilot project in April 2009. x The State OON continues to work collaboratively with Emory University Public Health partners in securing a National Institute of Health childhood obesity research grant. x The State OON has begun collaborative work to sync the work of the WIC Farmer's Market program with the nationally recognized Farm-to-School initiative to include the "Farm-to-Preschool". x The State OON began a collaborative with the Georgia Chapter of the American Academy of Pediatrics (AAP) to survey partnering physicians' offices work towards intervening on the childhood obesity epidemic. Partnerships: x The Loving Support Peer Counselor pilot program continues to provide breastfeeding encouragement and support services in the following health districts: Rome, DeKalb, Chatham, Athens, Dublin, Augusta, Cobb/Douglas, and East Metro. The State OON collaborates with the Office of Women's Health State Breastfeeding Coordinator and WIC Lactation Consultant who provide support to Local Agencies. In June 2009, the Breastfeeding Advisory Committee (B.F.A.C.) reconvened their bi-annual meetings and met in Macon, Georgia with Health District Breastfeeding Coordinator members and WIC-Nutrition Services Directors guests. The primary work centered on coordinating statewide comprehensive breastfeeding program support with the initiation of a statewide strategic Plan. Additionally, training was provided regarding the update on W.H.O. Code and how it relates to WIC breastfeeding activities. Other applicable partnerships include the followings: SP-9 Federal Fiscal Year 2010 Georgia WIC Program State Plan x The State OON continues to contract with the Emory University School of Medicine Genetics Department to provide metabolic foods and special formulas to WIC Participants Statewide in Georgia. This agreement is expected to continue to expand as the State's newborn metabolic and genetics screening program is expanded to test for an increasing number of genetic disorders. x The State OON continues to collaborate with the Georgia Chapter of the American Academy of Pediatrics (GAAAP) to promote, support and provide technical WIC assistance to pediatricians in targeted communities: Dublin, Waycross, Macon, Valdosta, Augusta and Savannah. x The GA DPH DI has also partnered with several Registered Dietitians in various areas of dietetics to form the Dietetic Internship Advisory Board which provides resources for Local learning opportunities and guidance to the internship program. x The State OON has started collaborating with Emory University Public Health professors to explore the possibility of securing grant funding for obesity research with Georgia's WIC Program. x The State OON has started collaborating with the Farm-to-School initiative to coordinate developing a Farm-to-Preschool initiative that sync with the existing Georgia WIC Farmer's Market Program all to raise participation among Georgia WIC participants. Information Systems: The goal of this function is to oversee the implementation and administration of automated processes and procedures that ensure the collection, electronic transmission, reporting and security of data related to program operations and management. FFY 09 ACCOMPLISHMENTS: Food Packages /Vouchers: Changed the Infant Formula Vendor from Mead Johnson to Ross. Developed the Food Package database. Automated Food Package updates (verified that 939 food package codes and voucher codes in the newly designed State database are accurate and synchronized with the Data Processing Contractor, the Nutrition Section and the Procedures Manual). Removed the maximum price from the VPOD, standard manual, Computer generated and Blank Manual vouchers. Developed official State approved abbreviations for food package messages with the nutrition section. Developed and revised test scripts for system developers for the automated food package changes and corrections identified by staff and programmer. Customized 6 FPC/VC text files for each System Developers when changes occurred. SP-10 Federal Fiscal Year 2010 Georgia WIC Program State Plan DATABASE DEVELOPMENT x Peer Counseling: Developed a Peer Counseling database with a User Manual. Tested the system and proofread the User's Manual. Conducted training and implemented the system on July 1, 2009. x Monitoring Tools: Designed Monitoring Tools for Program reviewers and WIC Coordinators. x Public Comment: Added and removed several questions in three templates of the database. Modified reports and graphs. VENDOR COST CONTAINMENT: Designed and modified the Vendor Cost Containment database to view and inform Vendors of their shelf prices. Reviewed shelf-price raw data and implemented readjustments as necessary. Extrapolated any voucher with no activity for Peer Group 1-8 max. prices and prepared monthly Peer Group 8 maximum prices table for the Banking and Vendor Section. Proof read voucher calculations to ensure it collate with programmatic voucher messages. Ran Quality Control Checklist. Submitted maximum not-to-exceed table to Covansys/Vendor. Implemented Automatic Clearing House and generated the following reports: x T-Test Analysis, Vendors Listing without Food Sale Info x List of Vendors without Shelf Prices reports x Over Payment Report (Banking and Manual Process Activity) from November 6, 2006 to February 26, 2007 for USDA Claim x Monthly Vendors with 10 or More Rejected Vouchers x Total Number of Rejected Vouchers by Vendor x Vouchers most frequently redeemed x Peer Group 1 8 Maximum Prices table x Weekly Redemption Graph to keep track of frequently cashed vouchers that do not exceed Maximum Prices x Monthly Administratively paid Infant Formula Vouchers and x Effective Vendor Cost Containment report for Peer Group 8. Information Systems: FFY 09 ACCOMPLISHMENTS: x Clinic Listing Updated and maintained clinic information in the Clinic Listing database system. Prepared clinic info report and submitted to WIC coordinators for verification. Sent monthly clinic information to the DCH Web Developer and four front end developers as changes occurred. x CUR Part 1 and 2 Analysis Prepared monthly CUR part 1 and part 2 report analysis for WIC Coordinators. SP-11 Federal Fiscal Year 2010 Georgia WIC Program State Plan Informed Districts apprised of financial vulnerability caused by CUR's. Created CUR tracking database to provide true picture of reconciliation rates. x Computer Equipment 3 year Plan for computer purchases for Local Agencies and State WIC program. x Technical Assistance Work with developers and clinics to resolve computer systems issues. x Completed Systems Edits Manual Document provides programmers with complete information on each data element, cross edits, validation rules and voucher printing rules. x New Food Package Development Worked with Nutrition Section to ensure that all developers received new food package information for implementation no later than October 1, 2009. x Infant Formula Contract Extension Extended Infant Formula Rebate Contract with Ross Nutrition until September 30, 2010. x Other Items Updated and maintained Computer System Issues Database. Nutrition Services and Administration (NSA) Expenditures: The goal of the WIC Financial Management Section is to maximize the use of the Federal WIC grant. This section implements this goal by: 1. The continuous review of WIC Local Agency financial and participation reports to resolve any deficiencies, if needed. 2. To prepare a comprehensive budget and monitor Statewide WIC expenditure. 3. To oversee the contractual agreements for needed WIC services. 4. To facilitate the cost effective expenditure of formula rebate funds. FFY 09 ACCOMPLISHMENTS: x The WIC Financial Management Sections has funded the expansion of the Lagrange District by establishing a new Villa Rica WIC clinic. The review team validated the FNS-798 WIC Financial Management and Participation Reports for the fourth quarter of Federal Fiscal Year (FFY) 07. This validation included reviewing system reports, worksheets, time records and invoices. An in-depth analysis of food cost estimate was also performed. SP-12 Federal Fiscal Year 2010 Georgia WIC Program State Plan Caseload Management: The goal of this function is to enable all eligible individuals to achieve maximum requirements by publicizing available program benefits. This goal is addressed by: 1. Targeting benefits to High-Risk individuals and populations. 2. Targeting benefits to eligible populations with special health care needs and residents of non-traditional home environments. 3. Monitoring no-show rates. 4. Sustaining an Outreach infrastructure to reach eligible participants. FFY 09 ACCOMPLISHMENTS: x An electronic Local Agency Reporting form was created as a tool to assist each district in reviewing their goals, objectives, and accomplishments of the past year and in gaining insight into functional area requirements and their impact on the GA WIC Program. In an effort to provide continuous technical assistance to the WIC Local Agencies, the Planning Assessment and Resources Section (PARS) created detailed quantitative and qualitative reports addressing key performance measure mandates. x The Planning Assessment & Resources Section (PARS) collaborated with the State Nutrition Section to provide Local Agencies with updated Food Lists and programmatic technical assistance. The PARS Section communicated regularly with the American Academy of Pediatrics (AAP) and the Academy of Family Practitioners for collaboration of WIC referrals from pediatricians. PARS collaborated with Healthy Mothers, Healthy Babies to promote breastfeeding as the best nutritional choice for babies, and to encourage workplace support for breastfeeding. The aforementioned efforts and other strategies have contributed a 1.3% increase in WIC participation during FFY 09. Certification and Eligibility: This goal is to ensure accurate determination and documentation of WIC program applicant/participant eligibility. Methods to achieve the goal include: 1. Decreasing the amount of blank, end-of-year data income fields by 2%. 2. Using USDA guidelines to achieve a 100% evidencing Nutrition Risk Assessment. 3. Decreasing the number of Corrective Actions issued to Local Agencies for Verification of Certification card usage. 4. Decreasing the percentage of inter/intra State dual program participants. Compliance Analysis Unit: The goal of this unit is to prevent fraud and abuse within the WIC program through the implementation of covert investigations, consultation, and programmatic site reviews. FFY 09 ACCOMPLISHMENTS: Throughout the year, the Georgia WIC program has successfully addressed and implemented activities to comply fully with USDA Functional requirements. Many of these activities have served to improve the scope and sustainability of the WIC program SP-13 Federal Fiscal Year 2010 Georgia WIC Program State Plan throughout the State of Georgia. The following information represents a summary of progress for Federal Fiscal Year 2008. x Performed 207 compliance investigations (All High-Risk) x Disqualified 30 Vendors due to WIC non-compliance x Identified and investigated 1 Vendor involved in trafficking x Investigated 20 Vendors whose main violation was overcharging x Investigated 9 Vendors whose main violation was charging for supplemental food not received by the participant. x Investigated 47 Vendors who received first offense warnings x Found 130 Vendors who received no violations x Permanently disqualified 1 Vendor based on a referral from the Food Stamps Program x Received 15 Vendors requests for hearings x Number of Vendors who filed an Agency Review : 3 x Number of Vendors who filed in Superior Court :1 x Completed 12 Program Reviews with no significant findings To minimized the abuse of repeat Vendor offender occurrences Publicized Vendor disqualifications and violations in the Vendor news letter and the Local news papers. Issued warning letters to Vendors for minor program violations. To monitor/ investigate 20%WIC clinic sites and investigate potential clinic fraud Monitored 20% of identified clinics per districts during program reviews. Assessed voucher security and voucher issuance procedures during program reviews and other on-site clinic visits. Completed quarterly dual participation reports to ensure program compliance from participants. Provided training to clinic staff to prevent WIC clinic fraud and abuse with training and monitoring of WIC clinics. FFY 09 ACCOMPLISHMENTS: x Conducted 10 Program Reviews during FFY08. Additionally, 2 re-visits were made at the districts to ensure that the Corrective Actions put in place were working. 7 site visits were made to the Local agency. x Met with the 2010 WIC Monitoring Team to review the present Monitoring Tool to make changes. x Compiled and imputed over 10,524 public comments survey and their results. Had 200 surveys that needed translations answered by the staff. x Developed 10 Program Review reports and ensured that all documentation for Program Reviews were ready for USDA review. x Conducted 4 Patients Flow Analyses in Districts are requested by Local Agency staff. x Conducted one Statewide Civil Rights training to the State and Local agency. SP-14 Federal Fiscal Year 2010 Georgia WIC Program State Plan x Updated all Certification forms with the new non-discrimination statement. x Updated and observed the new Racial Ethnic forms being used in the clinic to ensure that ethnic data is being collected Policy Unit: The goal of the Policy Unit is to improve the overall operations of WIC clinics Statewide, Improve customer service, eliminate paper processes in the clinic and reduce the overall workload of clinic staff. The unit strives to meet these goals by: 1. Ensuring that all WIC participants are treated with respect and all complaints handled within a 24 hour period. 2. Ensuring that policies are developed with clear rules/regulations and written for State and District staff. 3. Ensuring that all WIC advocates, participants, Vendors and health department staff are offered the opportunity to give comments on the WIC program on the new WIC website. Comments will be retrieved on a monthly basis and incorporated if needed into the WIC Procedures Manual and /or State Plan. 4. Ensuring that the Local Agencies are reviewed every other year and a summary of Corrective Actions are developed. 5. Ensuring that training is provided when needed and new rules are distributed to the State and the district office. 6. Ensuring that the WIC Procedures Manual is updated yearly by August 15 of each year. 7. Ensuring that the WIC team for the Policy Unit updates its section of the State Plan yearly. 8. Developing and updating the Food Pantry booklet every other year for use by the Local agency 9. Creating an electronic complaint form that will reduce the amount of time it takes to make a monthly, quarterly or annual report on the number of complaints received by the unit. 10. Meeting with other staff in the WIC System Unit and the Strategic Plan and Partnership section to develop business rules for the elimination of paper processes. 11. Having staff attend training on the Rapid Process Improvement (RPI) Plan to reduce the number and type of Corrective Actions received by the Local Agencies. 12. Reducing the overall cost of printing paper forms in the clinic by developing business rules and incorporating the rules in the present TAD processes. 13. Having all WIC Policy, Action and Information memorandums go through a Local agency process of reviewing them prior to distribution. 14. Making unscheduled phone calls and visit to clinic sites to determine processing standards time frames in an effort to ensure that WIC clients are served in a timely manner. 15. Working with the Voter Registration office in an effort to eliminate paper SP-15 Federal Fiscal Year 2010 Georgia WIC Program State Plan reporting of WIC Voter Registration applications forms etc. 16. Reviewing all quarterly reports submitted by the Local Agency on Processing Standards for accuracy. 17. Develop quarterly reports of the status of the Public Comment Website surveys. Civil Rights: The WIC goal is to provide a customer-friendly health service environment for all applicants and participants by: 1. Evaluating Civil Rights compliance activities in each of the twenty (20) Local Agencies. 2. Increasing the State's Civil Rights training of all new and existing staff servicing WIC clients. FFY 09 ACCOMPLISHMENTS: Compiled 66 complaints (including 2 Civil Rights Complaints) by District order for USDA audit purposes. Compiled and imputed over 5,000 Public Comment surveys and their results. Coordination and Collaborative Partnerships: The WIC goal is to build strong links for leveraging the coordination of information and resources with State and Local partners in order to respond to the needs of pregnant women and young children and improve Maternal and Child Health (MCH) outcomes. This goal is being achieved through: 1. Coordination of WIC and immunization services at the State and Local levels. 2. Collaborative partnerships with other non WIC food assistance programs at State and Local levels. 3. Implementing tobacco prevention strategies to educate WIC participants and caregivers on the risk of secondhand smoke. FFY 09 ACCOMPLISHMENTS: x Worked with the Office of Health Planning and Assessment and the Evaluations and Reporting Office to develop a website to collect Public Comments. x Worked with the Evaluation and Reporting Office to develop and annual report for reporting the progress of Public Comments for 2007 and 2008. x Worked in the Nutrition staff on VENA to develop the revised the 2010 WIC Monitoring tool. x Worked with USDA to investigate 4 Civil Rights and 57 general complaints. x Work with the State WIC Office to compile all information needed to the USDA Management Evaluation. x Ensure that training was conducted for the Local Agency staff on Confidentiality and other topic via Video Conference. x Work closely with Local agency staff to resolve WIC complaints. x Work with WIC Coordinators to develop Plans to improve processing standards Statewide. x Work with Health Planning and Assessment Section and the Evaluation and Reporting sections to develop and update the WIC Public Comment website SP-16 Federal Fiscal Year 2010 Georgia WIC Program State Plan 2010 WIC Program Goals and Objectives This section illustrates the goals and objectives for the Georgia WIC Program in accordance to with USDA regulations. CFR 246.4 (a) (1). Vendor Management Unit Goal: To ensure the efficiency of all activities associated with selecting, authorizing, training, monitoring and investigating the Georgia WIC Vendor population for the purpose of maintaining access to WIC products and reducing the incidents of the program fraud and abuse. Objective 1.1: To streamline process for Vendor Selection and Authorization processes thus improving Vendor customer service. Objective 1.2: To utilize the ACCORDANT system for authorization and re-authorization training, annual and cashier training in an attempt to improve customer service and efficiency for WIC Vendors. Objective 1.3: To monitor at minimum 5% of all Vendors in a timely manner. Objective1:4: Develop and implement a web base application in which Vendors can initiate the application process. Objective 1.5: To assess the benefits and ability to conduct Vendor audits in attempt to reduce fraud and abuse of the WIC program. Objective 1.6: Adherence to procedures and guidelines for procession of rejected voucher payments during the implementation phase of Vendor Cost Containment. Objective 1.7: Increase assistance to Vendors and Local Agencies by keeping them abreast of changes in rules and regulations to the WIC program. Objective 1.8: Increase Vendor compliance in the program. Objective 1.9: Research resources to have District Personnel conduct all pre-approval visits. Research resources to increase the number of Quality Assurance personnel at the State WIC Office level. SP-17 Federal Fiscal Year 2010 Georgia WIC Program State Plan Vendor Management Unit Objective 1.1: To streamline process for Vendor Selection and Authorization processes thus improving Vendor customer service. Strategy: Revise Standard Operating Procedure and reassign front end processing of applications Baseline: Processed the front end pre-processing of the new Vendor applications (i.e. pre-screen for Vendors errors, entering limited information into VIPS and postponing decision, pre-visit price analysis, handling Vendor customer service issues, etc.) Lead Person: Vendor Management Unit Timeline: Present to FFY 11 Objective 1.2: To utilize the Accordant system for authorization and re-authorization training, annual and cashier training in an attempt to improve customer service for WIC Vendors. Strategy: To prepare the Power Point presentation, develop the test module for Vendor testing, develop the system for testing verification, develop a system to link system to VIP'S, plan the training session and execute authorization and reauthorization, annual and cashier training from the Vendor's personal computers via the Accordant system. Baseline: To develop components of the training session and execute authorization and reauthorization, annual and cashier training from the Vendors personal computers via the Accordant system. Lead Person: Vendor Management Unit Timeline: Ongoing Objective 1.3. To monitor at minimum 5% of all Vendors in a timely manner. Strategy: To begin the monitoring process by October 1 of each year and complete the process by July 1, of each year. Baseline: To ensure that all monitoring is complete and entered into VIPS before September 30 of each year. Lead Person: Vendor Management Unit Timeline: To monitor our active Vendors annually, beginning FFY 10. SP-18 Federal Fiscal Year 2010 Georgia WIC Program State Plan Vendor Management Unit Objective 1.4: Develop a web base application in which Vendors can initiate the application process. Strategy: To work in conjunction with the appropriate unit in coordination with the creation, preparation and execution of the application package in which the fields can be completed online (i.e., application, agreements and W-9 form) with the exception of printing, signing and mailing the package to the State Agency. Baseline: To work in conjunction with the appropriate unit in coordination with the creation, preparation and execution of the application package in which the fields can be completed online (i.e., application, agreements and W-9 form) with the exception of printing, signing and mailing the package to the State agency. Lead Person: Vendor Management Unit Timeline: Vendors will be able to complete the application package in its entirety, electronic signatures included by 2015. Objective 1.5: To conduct Vendor audits in an attempt to reduce fraud and abuse. Strategy: To compare Vendor total food sales to WIC redemption. Baseline: None Lead Person: Vendor Management Unit Timeline: By 2010. Objective 1.6: Adhere to procedures and guidelines for procession rejected voucher payments during the implementation phase of Vendor Cost Containment. Strategy: Create a Cost Containment Plan based on redemption. Baseline: TBD Lead Person: Project Administrator Timeline: By FFY 10. SP-19 Federal Fiscal Year 2010 Georgia WIC Program State Plan Vendor Management Objective 1.6: Adhere to procedures and guidelines for processing of rejected voucher payments during the implementation phase of Vendor Cost Containment which requires the State Agencies to establish a Vendor Peer Group System which distinguishes above-50-percent Vendors from other Vendors within the Peer Group System. Strategy: Implement a system to assess new Vendors within 6 months of authorization to determine Peer Group classification. Baseline: TBD Lead Person: Project Administrator Timeline: Ongoing Objective 1.6: Adhere to procedures and guidelines for processing of rejected voucher payments during the implementation phase of Vendor Cost Containment which requires State Agencies to establish a Vendor Peer Group System which distinguishes above-50-percent Vendors from other Vendors within the Peer Group System. Strategy: Review vouchers rejected by the bank (submitted by Vendors) to the SWO on a Return Voucher Payment Log for payment. Vouchers are examined to identity and process in accordance with the Standard Operating Procedures for voucher analysis and payment. Baseline: Review vouchers rejected by the bank submitted by Vendors to the SWO on a Return Voucher Payment Log for payment. Vouchers are examined to identify and process in accordance with the Standard Operating Procedures for voucher analysis and payment. Lead Person: Vendor Operations Unit Timeline: Ongoing Objective 1.7: Increase assistance to Vendors and Local Agencies by keeping them abreast of changes in rules and regulations to the WIC program. Strategy: Consult with Vendor Management (and other State WIC staff) to collect and review changes in regulations pertaining to Vendor relations and make changes as needed. Baseline: TBD Lead Person: Vendor Management Section Timeline: By FFY 10 SP-20 Federal Fiscal Year 2010 Georgia WIC Program State Plan Vendor Management Unit Objective 1.7: Increase assistance to Vendors and Local Agencies by keeping them abreast of changes in rules and regulations to the WIC program. Strategy: To correlate documents and materials. Baseline: To ensure that information on all levels is consistent Lead Person: Vendor Management Unit Timeline: FFY 10 Timeline: TBD Objective 1.8: Increase Vendor compliance with federal regulations. Strategy: Vendors must be authorized to accept Food Stamps prior to being authorized for the WIC Program. Baseline: Presently, Vendors do not have to be authorized as Food Stamps eligible. Lead Person: The Vendor Management Unit. Timeline: FFY 10 Objective 1.8: Increase Vendor Compliance in the program. Strategy: To review Vendor Review Forms and apply sanctions within two weeks. Lead Person: Vendor Relations Area Timeline: By FFY 10 Objective 1.9: Research resources to increase the number of Quality Assurance personnel at the State WIC Office level or to have District Personnel conduct all pre-approval visits. Strategy: Assess resources, historical data and benefits of increase staff (at the state level) or have the District Personnel conduct all pre-approval visits for new Vendor applicants. Baseline: To garner assistance with the application process until personnel resources at the state level can be rectified. Lead Person: Vendor Management Unit Timeline: By FFY 10 SP-21 Federal Fiscal Year 2010 Georgia WIC Program State Plan Information Systems Unit Goal: To structure the Bid Solicitation and Awarding process for the Infant Formula Rebate Contract. Federal Regulations: Child Nutrition Act CFR246.25. Objective: To award an Infant Formula Rebate Contract to a responsive and responsible bidder offering the lowest total monthly net price for infant formula or the highest monthly rebate (subject to paragraph (c)(4)(ii) of CFR Part 246.16) for a standardized number of units of infant formula. Strategy 1: To identify options to current contract (pertaining to the following causes: expiration, renewal, extension and rebidding). Strategy 2: To implement procedures to facilitate an extension to the current contract for one additional year (October 1, 2009 September 30, 2010). Baseline: Current Infant Formula Contract with Ross Laboratories Responsible Party: x Information Systems Unit Director x Information Systems PHSO Program Consultant I x WIC Financial PHSO Program Consultant II Timeline: By May 31, 2010 July 15, 2010 (Extension Timeline). Goal: To establish and administer processes that will ensure compliance with new food package regulations on all WIC clinic systems. Federal Regulations: Child and Nutrition Act 246.12 (a) Objective: To comply with federal regulation CFR Part 246.12 for the standardization and designing of Food Delivery Systems that compliment USDA reporting requirements. Strategy 1: To create a database/download file with all new Food Package Codes (FPC), Voucher Codes (VC) and Nutrition Messages (NM). Strategy 2: To submit new Food Package Codes and Voucher Messages to the Front-End Developers for testing, prior to "full" implementation. Baseline: Current Database Listing of existing Food Package Codes and Voucher Codes. SP-22 Federal Fiscal Year 2010 Georgia WIC Program State Plan Information Systems Unit Responsible Party: x Information Systems Unit Director x Information Systems Database administrator x Information Systems Operations Analyst I x Information Systems Operations Timeline: By November 1, 2009 Goal: To increase record keeping of the voucher issuance and reconciliation process for Cumulative Unmatched Redemption Reports and Bank Exception Reports. Federal Regulations: Child and Nutrition Act 246.25 Objective: To comply with recordkeeping requirements by maintaining full and complete records (derived from the following: voucher issuance, reconciliation, Cumulative Unmatched Redemption Reports, and Bank Exception Reports). Strategy 1: To assess the Statewide Automated Data Collection System used to monitor and report client data. Strategy 2: To verify all Front-End Systems functions in accordance with the guidelines of the Federal Requirements Document (FReD) and all other applicable requirements. Strategy 3: To require all clinics throughout the State to achieve a reconciliation rate of 100%. Strategy 4: To require all clinics within the State to complete Bank Exception Reports on a monthly basis. Strategy 5: To deduct Administrative funds from Districts that have more than $1,000.00 in un-reconcile vouchers in any given month. Baseline: Currently there are (4) WIC Clinic systems operating throughout the State of Georgia (i.e., Aegis, Mitchell and McCormick, Health Net 2, and Net Smart). Responsible Party: Information Systems Unit Director Information Systems PHSO Program Consultant I Information Systems Operations Analyst Timeline: Ongoing SP-23 Federal Fiscal Year 2010 Georgia WIC Program State Plan Information Systems Unit Goal: To manage all WIC related data processing and banking services through the use of Requests for Proposals (RFP) and Advanced Planning Documents (APD). Federal Regulations: Child and Nutrition Act 246.24 Objective: To facilitate the development and submission of RFP and APD that ensures the State Agency is the responsible authority (without recourse to USDA) regarding the settlement and satisfaction of all contractual and administrative issues arising out of procurements entered into in connection with the WIC Program. Strategy 1: To assess the Statewide Automated Data Collection System used to monitor and report client data. Strategy 2: To verify that all Front-End Systems function in accordance with the guidelines of the FReD and all other applicable requirements. Baseline: Currently there are four WIC clinic systems operating throughout the State of Georgia (i.e., Aegis, Mitchell and McCormick, Health Net 2, and Net Smart) Responsible Party: x Information Systems Unit Director x Information Systems PHSO Program Consultant I x Information Systems Operations Analyst Timeline: Ongoing Goal: To manage all WIC related data processing and banking services through the use of RFP's and APD's. Objective: To facilitate the development and submission of RFP's and APD's that ensures the State Agency is the responsible authority, without recourse to USDA, regarding the settlement and satisfaction of all contractual and administrative issues arising out of procurements entered in connection with the WIC program. Strategy 1: To extend the data processing contract (i.e., CSC/Covansys) for two six month periods. Strategy 2: To extend banking portion of the contract for 1 six month period. Strategy 3: To develop and release the RFP for the procurement of banking services. SP-24 Federal Fiscal Year 2010 Georgia WIC Program State Plan Strategy 4: To develop and release the RFP for Back-End Data Processing services. Baseline: The current contract has been extended for the initial 6 month period (which includes Banking services as well as Data Processing services). Responsible Party: x Information Systems Unit Director x Information Systems PHSO Program Consultant I Timeline: x Banking contract is scheduled for completion on November 1, 2009. x The Data Processing RFP is scheduled for release on July 10, 2009. x The Data Processing is scheduled to be operational on April 1, 2010 Goal: To facilitate the timely and accurate reporting of data based on Federal Regulations. Federal Regulations: Child and Nutrition Act 246.25 (b) Objective: To comply with the submission of program performance data to USDA (on a monthly basis), as specified by FNS to support program management and funding decisions. Strategy 1: To provide USDA/FNS with regular reports on functioning of WIC Clinic systems. Strategy 2: To ensure continuous correspondence between the State Agency and USDA on new regulations and policies that can impact reporting requirements. Strategy 3: To collaborate with other State Agency Units (including the State Office of Nutrition) to draft business rules. Strategy 4: To draft work requests and System Maintenance Requests (SMR) for developers. Information Systems Unit Baseline: Currently there are 4 WIC Clinic systems operating throughout the State of Georgia (i.e., Aegis, Mitchell and McCormick, Health Net 2, and Net Smart) that submit data to the State Agency. SP-25 Federal Fiscal Year 2010 Georgia WIC Program State Plan Responsible Party: x Information Systems Unit Director x Information Systems Operations Analyst Tech Timeline: Ongoing Goal: To monitor Local Agencies that encompasses the evaluation of Local Food Delivery Systems. Federal Regulations: Child and Nutrition Act 246.20 (2), (3), (4) Objective: To conduct monitoring reviews of each Local agency and implement additional on-site reviews as determined necessary in the interest of programmatic efficiency and effectiveness. Strategy 1: To monitor Local Agencies to ensure system security. Strategy 2: To monitor Local Agencies to ensure system functionality. Strategy 3: To ensure that clinic staff is properly trained in the use of applicable Food Delivery Systems. Baseline: Currently, there are 4 WIC Clinic systems operating throughout the State of Georgia (i.e., Aegis, Mitchell and McCormick, Health Net 2, and Net Smart). Responsible Party: x Information Systems Unit Director x Information Systems Operations Analyst II Timeline: Ongoing Goal: To monitor, evaluate and assess property acquired with Program funds through guidelines prescribed in 7 CFR Part 3016 (that pertains to the utilization and disposition of real property and equipment). Federal Regulations: Child and Nutrition Act 246.24(d) Strategy 1: Respond to inventory verifications from Local Agencies. Strategy 2: Respond to State Audit findings (pertaining to inventory management issues). SP-26 Federal Fiscal Year 2010 Georgia WIC Program State Plan Strategy 3: To register equipment with the Department of Community Health (DCH). Strategy 4: To respond to inventory audit exceptions (by District Unit) that was identified by the Office of Audits. Strategy 5: To update the inventory database of WIC equipment. Baseline: An inventory database is currently operational for the WIC program. A liaison has been established for inventory control at both the Department of Community Health and Local Agency Level. Responsible Party: x Information Systems Unit Director x Information Systems Compliance Reviewer Timeline: Ongoing Goal: To ensure that equipment purchases reflect applicable State and Local regulations and that procurement made for equipment with Program funds adhere to the standards set forth in A-130 and 7 CFR Part 3016. Federal Regulations: Child and Nutrition Act 246.25(c) Objective: To ensure that WIC sub grantees comply with the requirements of 7 CFR Part 3016 concerning the procurement of equipment. Strategy 1: To ensure that all Local agency equipment purchases adhere to State and District specification for WIC Computer equipment. Strategy 2: To identify new sources of equipment/supplies that meet State specifications of functionality and cost. x Baseline: Currently all WIC computer and computer purchases adhere to DCH and State specifications. Responsible Party: x Information Systems Unit Director x Information Systems Operations Analyst II Timeline: Ongoing SP-27 Federal Fiscal Year 2010 Georgia WIC Program State Plan Goal: The Georgia WIC Program is seeking FNS approval of the current front end clinic systems pending the acquisition of a single state WIC system. Federal Regulations: Child and Nutrition Act 246.25(d) (ii) Objective: To promote the efficient management of food and NSA funds expenditure through USDA/FNS approval of each Front-End System. Strategy 1: To submit data on all Front End systems to USDA/FNS sufficient to acquire approval for expenditure of WIC funds for purchase, operation and maintenance Baseline: Currently, Aegis is the only approved State system. Responsible Party: Information Systems: Unit Director Information Systems: PHSO Program Consultant Timeline: November 1, 2009 (is the anticipated date of USDA/FNS approval) Goal: To provide outline of goals and objectives for improving system operations within the WIC Program's State Plan submission to USDA/FNS. Federal Regulations: Child and Nutrition Act 246.4(a), (d) Objective: The timely submission of unit-specific goals and strategies to USDA/FNS for the enhancement of the WIC Program throughout the State of Georgia. Strategy 1: To identify measureable updates for insertion into the WIC State Plan and Procedures Manual for submittal to USDA/FNS. Baseline: TBD Responsible Party: Information Systems Unit Director Timeline: August 15th of each FFY Nutrition Services and Administration (NSA) Funds Management Goal: The goal of the WIC Financial Management Section is to maximize the utilization of the federal WIC grant. This section implements this goal by: 1. The continuous review of WIC Local Agency financial and participation reports to resolve any deficiencies, if needed. 2. To prepare a comprehensive budget and monitor Statewide WIC expenditures. 3. To oversee the contractual agreements for needed WIC services. 4. To facilitate the cost effective expenditure of formula rebate funds. SP-28 Federal Fiscal Year 2010 Georgia WIC Program State Plan Objective 1: To improve the capital expenditures approval process. Strategy 1: To provide all District offices with the correct Letters and approval forms. Strategy 2: To draft a plan to identify and trace WIC expenditures in the General Public Health Cost Pool (001). Strategy 3: To collaborate with Office of Financial Services (OFS) to devise an audit schedule for the Health Districts. Baseline: SFP Regional Letter No. 240-14 Lead Person: WIC Financial Management Staff. Timeline: By FFY 09 Objective 2: To review and approve Cost Allocation Plans submitted by District Health Offices. Strategy: To review Cost Allocation plan methodology and Administrative Cost Allocation. Baseline: ASMB C-10 Implementation Guide for OMB Circular A-87. Lead Person: WIC Financial Management Staff. Timeline: By FFY 09 Caseload Management Goal: The goal of this function is to ensure that Local Agencies are providing accessible and quality services to eligible individuals. This goal is addressed by: 1. Serving clients within Processing Standards. 2. Decreasing occurrences of dual participation. 3. Target benefits to eligible populations with special health care needs and residents of non-traditional home environments. 4. Monitor no-show rates. 5. Sustain an Outreach infrastructure to reach eligible participants. Objective 1: All Local Agencies will serve clients meeting Processing Standards. Strategy 1: To conduct compliance phone calls to clinics, and provide a monthly report to the WIC Coordinators. Strategy 2: To continue to review Processing Standards during scheduled Program Reviews. Baseline: TBD Lead Person: Program Review Staff and the Policy Unit Timeline: Ongoing SP-29 Federal Fiscal Year 2010 Georgia WIC Program State Plan Objective 2: To decrease the occurrences of Dual Participation. Strategy 1: To track Dual Participation Statewide and ensure that emails are being sent to confirm compliance. Strategy 2: To revise the Procedure Manual to ensure that clinic staff emphasizes the policy on Dual Participation. Strategy 3: To distribute the revised WIC Identification (ID) cards to the Districts. Baseline: TBD Lead Person: Program Review Staff and Policy Unit Timeline: By FFY 09 Objective 3: The State Office will review all new WIC sites for compliance prior to opening. Strategy 1: The Program Review team shall use the WIC Monitoring Tool to assist with evaluating the implementation of new procedures during a clinical observation. Strategy 2: Districts will be notified of the Pre-Award requirement during clinical observations conducted by State staff. Baseline: TBD Lead Person: Program Review Staff and Policy Unit Timeline: By FFY 09 Coordination and Collaborative Partnerships Goal: The WIC goal is to build strong links for leveraging the coordination of information and resources with State and Local partners to respond to the needs of pregnant women and young children; while also, improve Maternal and Child Health (MCH) outcomes. This goal is will be achieved through: 1. Coordination of WIC and immunization services at the State and Local levels. 2. Collaborative partnerships with other non -WIC Food Assistance Programs at State and Local levels. 3. Implement Tobacco Prevention Strategies to educate WIC participants and caregivers on the risk of second-hand smoke. Objective 1: To Develop Outreach Plan to promote WIC services and increase caseloads by January 2010. Strategy 1: To review current Outreach materials by March 2010 Strategy 2: To develop Outreach/Marketing materials for various mediums for dissemination to internal and external partners. Strategy 3: To create a database for tracking on-going Outreach material. Baseline: TBD Lead Person: Program Review Staff and Policy Unit SP-30 Federal Fiscal Year 2010 Georgia WIC Program State Plan Timeline: By FFY 09 Objective 2: To communicate with inter-agencies, other States and USDA regarding program data and assessment results. Strategy 1: To build and Maintain collaborative partnerships to promote WIC service. Strategy 2: To maintain WIC Program Contract Management processes. Baseline: TBD Lead Person: Program Review Staff and Policy Unit Timeline: FFY 09 Certification Eligibility Goal: To ensure accurate determination and documentation of WIC Program applicants'/participants' eligibility. Methods to achieve the goal include: 1. Decreasing the amount of blank, end-of-year data income fields by 2%. 2. Use USDA guidelines to achieve a 100% evidencing Nutrition Risk Assessment. 3. Decrease the number of Corrective Actions issued to local Agencies for Verification of Certification Card use. 4. Decrease the percentage of inter/intra State dual program participants. Objective 1: To review and edit all WIC clerical forms. Require the Local Agencies to use fill able by 2010. Strategy 1: To change all forms to be fill able by 2010. Ensure that all business rules by the System Section [this objective will ensure that when a form is used by clinic staff; it will not have to be processed as a hard copy] Baseline: 100% of forms used in the clerical clinics are hand written presently. Lead Person: Program Review Staff and Policy Unit Timeline: By FFY 09 Objective 2: To decrease the occurrences of Dual Participation. Strategy 1: To track Dual Participation statewide and ensure that e-mails are being sent to confirm compliance. SP-31 Federal Fiscal Year 2010 Georgia WIC Program State Plan Strategy 2: To revise the Procedure Manual to ensure that clinic staff emphasizes the policy on Dual Participation. Strategy 3: To distribute the revised ID cards to the Districts. Baseline: TBD Lead Person: Program Review Staff and Policy Unit Timeline: By FFY 09 Compliance Analysis Unit : Goal: To prevent WIC Vendors and WIC Clinic Fraud and Abuse. Federal Regulations: Child and Nutrition Act 246.12 Objective: To investigate the state agency's Vendor population for the purpose of reducing fraud and abuse in the WIC Program. Strategy 1: To complete High-Risk List and send notification to the Vendors. Strategy 2: To investigate complaints received against alleged abusing Vendors. Strategy 3: To conduct compliance buys for the High-Risk Vendors which received the High-Risk Notification letter Strategy 4: To Complete all necessary paperwork pertaining to the investigation. Strategy 5: To access WIC Banking to retrieve copies of vouchers used in the investigation. Strategy 6: To complete files and submit to Assessment Unit for investigations. Baseline: To conduct 5% of High-Risk Vendor investigation presently. Responsible Party : Compliance Investigators, Senior Investigators Timeline: October 1, 2009 September 30, 2010 Goal: Assess Sanctions of investigated Vendors to ensure compliance. Federal Regulations: Child and Nutrition Act 246.12 and Vendor Handbook. Objective: To access all applicable sanctions for the investigated Vendors. Strategy 1: To receive complete file from Investigator Specialist. Strategy 2: To review files for correct Sanction assessment. Strategy 3: To prepare appropriate sanctions letters. Straggly 4: To enter sanctions information in VIPS. Baseline: To complete all sanctions in a timely manner. Responsible Party: WIC Operations Specialist and Operation Analyst Unit Director. SP-32 Federal Fiscal Year 2010 Georgia WIC Program State Plan Compliance Analysis Unit : Goal: To monitor Local Agencies to ensure Food Instrument accountability, maintenance and security. Federal Regulations: Child and Nutrition Act 7 CFR 246 Objective: To monitor Local Agencies for Voucher Security and Accountability. Strategy 1: To work in conjunction with the Policy Section to create a review schedule. Strategy 2: To Complete CUR Report on a monthly basis. Strategy 3: To gather materials needed for Review. Strategy 4: To perform daily reviews at chosen locations. Strategy 5: To compile findings into report to create a Conclusion report. Strategy 6: To perform additional training at Local Agencies based on review findings. Baseline: Half of the Local Agencies are already being reviewed. Responsible Party: WIC Operations Specialist and Operation Analyst. Timeline: October 1, 2009 August 30, 2010 Goal: To track participants who are enrolled in more than one WIC program at the same time (Dual Participation). Federal Regulations: Child Nutrition Act 7 CFR 246. Objective: To prevent participants from participating in more than one WIC clinic Strategy 1: To receive State Dual Participation Report from Data Processing System and the completed reports from the Local Agencies. Strategy 2: To access information to determine if participants are actual dual participants. Strategy 3: To request additional information for suspected dual participants Strategy 4: To retrieve copies of cashed vouchers from the Bank to determine the repayment of fraudulent benefits. Strategy 5: To notify Nutrition Service Directors of findings and request Letters be sent to Dual Participants to request repayment of fraudulent benefits. Strategy 6: To continue to monitor participants for Dual Participation. Baseline: To eliminate Dual Participation in the WIC Program. Responsible Party: WIC Operations Analyst 3 Unit Director Timeline: Monthly SP-33 Federal Fiscal Year 2010 Georgia WIC Program State Plan Compliance Analysis Unit : Goal: To identify all High-Risk Vendors. Federal Regulations: Child and Nutrition Act 7 CFR 246 .12. Objective: To identify High-Risk criteria for all Vendors. Strategy 1: To Create High-Risk Vendor Listing using indicators A, B, H, and M. Strategy 2: To Review the List for current investigations and investigate in the past year. Strategy 3: To Create High-Risk-Vendor profiles for Vendors. Strategy 4: To prepare letters for High-Risk Vendors. Strategy 5: To mail letters for High-Risk Vendors. Strategy 6: To give copies of letters to investigators to create an investigative file. Baseline: To ensure all High-Risk Vendors are notified of their High-Risk status and schedule Compliance investigations. Responsible Party: Investigator Specialist and Operations Analyst 3 Unit Director Timeline: November and February of each fiscal year. Goal: To ensure Vendors rights to appeal any adverse action through administrative hearings. Federal Regulations: Child and Nutrition Act 7 CFR 246 Objective: To ensure that all Vendors have rights to the appeal process. Strategy 1: To receive request from Vendors for Administrative review. Strategy 2: To notify Vendor's attorneys that the request was received and gathered information for Hearing Packet. Strategy 3: To mail the Hearing Packets to DCH legal services, SWO attorneys, and Vendor/Vendor's attorney and give copies to WIC staff. Strategy 4: To attend Hearings and wait for decisions. Strategy 5: To receive decision and close file. Baseline: To follow procedures for ensuring Vendors receive an Administrative Hearing when requested. Responsible Party: Compliance Unit Director, Operations Analyst Tech, WIC Director, Vendor Unit Director Timeline: As requested SP-34 Federal Fiscal Year 2010 Georgia WIC Program State Plan Compliance Analysis Unit : Goal: To coordinate investigations with Supplemental Nutrition Assistance Program (SNAP) and other Federal Agencies. Federal Regulations: Child and Nutrition Act 7 CFR 246.12. Objective: To ensure collaboration with other Federal agencies to ensure Vendors comply with Federal and State Regulations. Strategy 1: To set up and conduct joint investigations with Food Stamps and the Office of Inspector General. Strategy 2: To notify Food Stamps of all WIC Vendors receiving investigations on a continuous basis. Strategy 3: To notify Food Stamps when Vendors have been disqualified from the WIC Program and all appeals have been exhausted. Baseline: Reciprocal action between WIC and Food Stamps. Responsible Party: WIC Operations Specialist Timeline: Ongoing Goal: To interpret and implement new regulations and policies. Federal Regulations: Child and Nutrition Act 7 CFR 246.12 Objective: To ensure all regulations are implemented in a timely manner and interpreted accurately. Strategy 1: To incorporate new rules in the Vendor Handbook and Procedures Manual. Strategy 2: To mail out Addendums to Vendors informing them of the new changes. Responsible Party: Compliance Unit Director Timeline: Ongoing SP-35 Federal Fiscal Year 2010 Georgia WIC Program State Plan Policy Unit Goal: Administer and evaluate processes for continual on-site Programmatic Management Review of District and Local Agency activities to monitor compliance with program regulations, policies and procedures. Objectives I: To conduct ten (10) Program Reviews for FFY 10 per USDA requirements. Strategy: To meet with all section (in May 2010) within the WIC Programs and the Nutrition Section to determine Districts that need a review and/or to be revisited in FFY 10. Develop a calendar of all Program Review dates. E-mail the District Office the dates and times. Baseline: To reviewed 10 Districts in FFY 09 and made 7 re-visits. Ten more districts need to be reviewed in FFY 10 to meet our goal. Lead Person: Lynn Flen, Kimberly Menefee and Karen Turner. Objective II: To review all new clinics sites for compliance with State and Federal regulations prior to opening. Strategy: To review all new clinics to ensure that no clinic open in the State without a Pre-Approve/Pre-Award Clinic Compliance Review. Additionally review all clinics for approval as well as ensure that no site signs a written Agreement (to open a clinic) without the State approval. Baseline: TBD Lead Person: Lynn Flen, Kimberly Menefee and Karen Turner Objective III: To use the 2010 WIC Monitoring Tool with the new rules and regulations designed by the VENA committee. Strategy: To audit all clinics in 2010 to determine if the new 2010 WIC Monitoring Tool will need to be revised/changed based on clinic findings. Lead Person : Lynn Flen SP-36 Federal Fiscal Year 2010 Georgia WIC Program State Plan Policy Unit: Objective IV: To update WIC Clerical Forms with the new Non-Discrimination statement by 2010. Strategy: To mail the clinics the new Clerical Forms with the Non-Discrimination statement on them to ensure compliance with new rules and regulations. Baseline: 100% of forms used in the Clerical Clinic area are hand written presently. Lead Person: Joan Cummings Objective V: To monitor the WIC Public Comment Website quarterly to determine the status of the WIC program. Strategy: To work with the Systems unit to determine the status of Public Comments quarterly. Review comments to determine what changes need to be made for the 2011 WIC Procedures Manual. Baseline: Paper Public Comment Surveys. Lead Person: Kimberly Menefee, Karen Turner and Viva Sherard. Objective VI: To meet Processing Standards by FFY 10. Strategy: To ensure that each District is meeting Processing Standards by reviewing clinics on site and by telephone. WIC Coordinators are also reviewing District Processing plans to ensure that the state is in compliance. Baseline: TBD Lead Person: Joan Cummings Objective VII: To review all documentation in the clinics that are given to the WIC general population for the NonDiscrimination statement by October 2010. Strategy: To audit all clinic pamphlets and flyers given to the general public to ensure that the correct Nondiscrimination statement are on the forms. Baseline: Old Discrimination Statement Lead Person: Karen Turner, Kimberly Menefee and Lynn Flen SP-37 Federal Fiscal Year 2010 Georgia WIC Program State Plan Objective VIII: To ensure that any new WIC clinic that open within the State contacts the Policy Unit prior to opening any new clinics (due to Federal Requirements to conduct a Pre-Award and Compliance Review). Strategy: To review all new clinics to ensure compliance with federal/state regulations. Baseline: TBD Lead Person: Karen Turner and Lynn Flen Objective IX: To update the WIC Procedures Manual, State Plan Guidance and State Plan prior to August 15, 2010. Strategy: To ensure that all Units within the Nutrition Section and State WIC Program are given a calendar of when each section of the WIC Procedures Manual and State Plan Guidance are due. Additionally, update the State Plan to ensure that the federal requirement date of August 15, 2010 is met. Baseline: 100 % of all of these documents must be completed by August 15 of each year. Lead Person: Lynn Flen, Ricky Brown, Joan Cummings, Karen Turner and Abeda Hannan. Objective X: To meet with the System Staff in WIC to develop business rules to reduce the amount of paper forms located in the local clinics. Strategy: To meet with System staff to develop the business rules for reducing all the clerical forms in the clinic. Once the rules are developed, send the draft to the staff who will review all policy for approval. Work with staff that will be trained in Rapid Process Improvement to ensure that the local agency has input. Baseline: Presently using paperless Lead Person: Lynn Flen, Joan Cummings, Karen Turner and Abeda Hannan Objective XI: To work with the staff at the Secretary of State Office to reduce the amount of paper work that Local clinic staff must complete and send to their office. Strategy: To meet with the Secretary of State Office staff to begin the development of these processes. Baseline: All processes for completing the application and batch process are paper. Lead Person: Lynn Flen, Joan Cummings, Karen Turner and Abeda Hannan SP-38 Federal Fiscal Year 2010 Georgia WIC Program State Plan Nutrition Services Objective 1: To documented 1% average increase in the percentage of children ages 2-5 that are within normal weight range in the WIC program Strategy: To coordinate with Local Agencies, State, Federal and Academic Partners to develop a framework for addressing obesity in the WIC population (through obesity conferences, taskforces, and coalitions). Baseline: TBD Lead Person: Program Consultant Timeline: FFY 09 - 10 Objective 2: Collaborate with WIC and the Epidemiology section to monitor and disseminate Surveillance data pertaining to obesity trends in children and adolescents. Strategy: To coordinate with Local Agencies, State, Federal and Academic Partners to develop a framework for addressing obesity in the WIC population (obesity conferences, taskforces, and coalitions). Baseline: Pediatrics Nutrition Surveillance System (PEDNSS), Behavorial Risk Factor Surveillance System (BRFSS), Pre-Pregnancy Nutrition Surveillance System (PNSS) GWIS Data: February 2008 - RFC 113- 14.6% Lead Person: Program Consultant Timeline: Ongoing Objective 3: To collaborate with WIC and the Epidemiology section to monitor and disseminate Surveillance data related to children and adolescent obesity trends. Strategy: To support Georgia's Fruit and Vegetable Promotion programs by: Assessing baseline fruit and vegetable consumption for WIC children 2-5 years. Educate parents on the availability of healthy choices and how to make healthy choices for family meals. Coordinate with Districts, promotion of fruit and vegetables consumption through participation in the WIC Farmer's Market Nutrition Program. Baseline: WIC Farmer's Market Program data. WIC FMNP consumption survey (developed for 2008 program). Lead Person: Program Consultant Timeline: By FFY 08 - 09 SP-39 Federal Fiscal Year 2010 Georgia WIC Program State Plan Nutrition Services Objective 4: To collaborate with WIC and the Epidemiology section to monitor and disseminate Surveillance data related to children and adolescent obesity trends. Strategy: To implementation of the FIT WIC Pilot project in the Waycross District. Baseline: Phase 1 inception October 2007. PEDNSS Data: Overweight children in 2005 - 14.3% GWIS Data: To acquire data from the WIC contractor on obesity. Lead Person: Program Consultant Timeline: By FFY 08 - 10 Objective 5: To increase the breastfeeding initiation and duration rates by 2% each year. Strategy: To increase the breastfeeding initiation and duration rates by 2% for FFY 09. Baseline: Phase 1 inception October 2007. PEDNSS Data: Overweight children in 2005 - 14.3% GWIS Data: February 2008 - Overweight children 2-5 yrs 15.6% Lead Person: Program Consultant Timeline: By FFY 08 - 10 Objective 6: To increase the breastfeeding initiation and duration rates by 2% each year. Strategy: To continue supporting the Loving Support Program and to increase the number of Peer Counselors in the breastfeeding pilot project. Baseline: Eight Health Districts are participating in the pilot project presently. Lead Person: Breastfeeding Coordinator Objective 7: Increase the breastfeeding initiation and duration rates by 2% each year. Strategy: To continue to promote the State Office Lactation Room for DCH employees. Baseline: One lactation room on the 11th floor at Two Peachtree Street. Lead Person: Breastfeeding Coordinator Timeline: By FFY 08 - 09 SP-40 Federal Fiscal Year 2010 Georgia WIC Program State Plan Objective 8: To increase the breastfeeding initiation and duration rates by 2% each year. Strategy: To work with the WIC Data Team to maintain breastfeeding initiation and duration data. Baseline: TBD GWIS Data: February 2008 Initiation rate 48.8%, BF 13-24 wks 34.7% and BF >48 wks 0.6% Lead Person: Breastfeeding Coordinator Timeline: By FFY 08 - 09 Objective 9: To increase the breastfeeding initiation and duration rates by 2% each year. Strategy: To continue to provide breastfeeding training and support activities conducted within the Local Agency Breastfeeding programs. Baseline: TBD Trainings conducted: WIC 101 class was conducted November 2007. Lactation Management: July 11 13, 2007. Lead Person: Breastfeeding Coordinator Timeline: By 2010 Objective 10: To increase the breastfeeding initiation and duration rates by 2% each year. Strategy: To continue to support the Loving Support Program and manage Peer Counselors Breastfeeding Pilot Project. Baseline: Eight Health Districts participating presently. Lead Person: Breastfeeding Coordinator Timeline: By September 30, 2009 Objective 11: Develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics by 2009. Strategy: To develop and distribute Annual Training surveys to assess competency training needs throughout the State. Baseline: Last survey distributed May 2007 SP-41 Federal Fiscal Year 2010 Georgia WIC Program State Plan Objective 12: Develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics by 2009. Strategy: To implement a New Employee Orientation Checklist to track staff competency. Baseline: TBD Lead Person: Local Agency Nutrition Service Director or Designee Timeline: By FFY 09 Objective 13: Develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics by 2009. Strategy: Provide WIC 101 training materials to Local Agency to new and current WIC staff (quarterly). Baseline: Face to face trainings were conducted October 2007. Timeline: By FFY 09 Objective 14: Develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics by 2009. Strategy: To coordinate training opportunities based upon the "Fruit and Vegetable More Matters" campaign. Baseline: TBD Timeline: By 2010 Objective 15: Develop and maintain strong partnerships between the State Nutrition Section, Federal, State, and Local partners to support emerging Public Health issues through FFY 09. Strategy: To coordinate trainings related to the new WIC Food Packages. Conduct WIC 101 Training. Baseline: TBD Lead Person: Program Consultants Timeline: By 2010 Objective 16: Develop and maintain strong partnerships between the State Nutrition Section, Federal, State, and Local partners to support emerging Public Health issues through FFY 09. SP-42 Federal Fiscal Year 2010 Georgia WIC Program State Plan Strategy: Expand the use of new technologies to offer greater flexibility and participation in information delivery for WIC participants and clinic staff. Baseline: Face to face meetings and Video Conference Training. Lead Person: Program Consultants Timeline: By 2009-2010 Objective 17: Develop and maintain strong partnerships between the State Nutrition Section, Federal, State, and Local partners to support emerging Public Health issues through FFY 09. Strategy: To review and provide feedback and technical assistance to local agencies on WIC Nutrition and Breastfeeding Plans. Baseline: TBD Lead Person: Program Consultant Timeline: By 2010 Objective 18: Develop and maintain strong partnerships between the State Nutrition Section, Federal, State, and Local partners to support emerging Public Health issues through FFY 09. Strategy: To establish and maintain written policies and procedures for a WIC Program Nutrition Anthropometric Equipment Guide. Baseline: Current policies regarding Anthropometric Equipment and visual inventory of equipment used in Districts during Local Agency Program Reviews. Lead Person: Program Consultants Timeline: Annually Objective 19: Develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics by 2009. Strategy: To provide American Dietetics Association (ADA) online Nutrition Care Manual subscriptions as statewide approved Nutrition Reference Guide. Baseline: 34 Subscriptions used April 1, 2007- March 31, 2008 Lead Person: Program Consultant Timeline: Annual Subscription renewal SP-43 Federal Fiscal Year 2010 Georgia WIC Program State Plan Objective 20: Develop a competent work force through continuous updating of knowledge and skills in Nutrition and other relevant topics by 2009. Strategy: To establish and maintain a written progression policy and procedure for exempt Infant formulas and Metabolic foods. Baseline: Current policies and procedures. Current WIC formula database (WIC Works and Georgia WIC Web page). Lead Person: Program Consultant and American Academy of Physicians (AAP) physician. Timeline: By FFY 09 Objective 21: Develop a competent work force through continuous updating of knowledge and skills in Nutrition and other relevant topics by 2009. Strategy: To promote Local Agency and community participation in the Georgia Department of Public Health (DPH) Dietetic Interns (DI) to assist Public Health Nutritionists to become Registered Dietitians. Baseline: Interns graduated in 2008. Lead Person: Dietetic Internship Director Timeline: By FY 2008-2009 Objective 22: Develop a competent work force through continuous updating of knowledge and skills in Nutrition and other relevant topics by 2009. Strategy: Maintain policies and procedures for the management of the Georgia Department of Public Health (DPH) Dietetic Interns (DI). Baseline: American Dietetic Association Lead Person: Dietetic Internship Director Timeline: By FY 08 - 18 Objective 23: Develop and maintain strong partnerships between the State Nutrition Section, Federal, State, and Local partners to support emerging Public Health issues through FFY 09. Strategy: To work with Nutrition Section Standards and Protocols unit, Section Nutrition and Physical Activity Unit and other Maternal/Child Health and Healthy Behaviors Partners to establish and maintain Nutrition policies, standards and protocols. Baseline: Current standards and protocols for Women's, Infant and Children's Health, Children's 1st, Children with Special Needs, and Infant genetics. Lead Person: Program Consultants Timeline: Annual reporting. SP-44 Federal Fiscal Year 2010 Georgia WIC Program State Plan Objective 24: Develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and local partners to support emerging public health issues through FFY 09. Strategy: Coordinate State and Local agency nutrition related observances: Fruit and Vegetable Month, National Nutrition Month, Breastfeeding Week Baseline: Current activities held Lead Person: Program Consultant Timeline: FFY 08 - 09 Objective 25: Decrease from baseline the proportion of children with low hemoglobin/iron deficiency anemia in WIC by 2010. Strategy: Work with WIC, Data, and Planning and EPI section to disseminate surveillance data to Districts. GWIS Data 2/2008: 6% total WIC participants PEDNSS/PNSS data Timeline: FFY 08 - 09 Objective 25: Decrease from baseline the proportion of children with low hemoglobin/iron deficiency anemia in WIC by 2010. Strategy: Coordinate with Local Agencies to ensure standardized training on lab process for taking blood samples. WIC 101 training and Local agency orientation. Lead Person: Program Consultant, Local Agency NSD or designees Timeline: FFY 08 - 09 Objective 25: To decrease from baseline the proportion of children with low hemoglobin/iron deficiency anemia in WIC by 2010. Strategy: Partner with EPI and WIC to identify and establish action plans for districts with high anemia rates. Baseline: GWIS data 2/2008:% of Georgia WIC clients with low Hgb - 6% Lead Person: Program Consultant Timeline: FFY 08 - 09 SP-45 Federal Fiscal Year 2010 Georgia WIC Program State Plan VENA Priority Area Nutrition Assessment and Practices Activities/Strategies Work with MIS to develop electronic assessment form for business rules, edits, data fields needed including nutrition and physical activityrelated surveillance data fields Pilot one electronic anthropometric program in one district Develop policy and procedures for electronic anthropometric system with business rules and edits. Train and implement on policy and program use. Develop process for computerized documentation of nutrition education follow-up. Develop process for computerized documentation of nutrition education follow-up. Timeline April 2008October 2009 January 2008January 2010 January 2009 January 2009-Sept 2010 October 2008 Anticipated Costs Status Integration and implementation has begun. Athens Health District currently piloting district developed program and gathering lesson learned data for State. Athens Health District currently piloting district developed program. In planning phase. MIS developing business ruleson target. Notes SP-46 Federal Fiscal Year 2010 Georgia WIC Program State Plan VENA Priority Area Management Information Systems Support Policy Activities/Strategies Work with Monitoring and Quality Assurance work group to write policy and procedure for revised monitoring tool. Identify needs for changes to MIS systems to enhance the Nutrition Assessment Process Work with Nutrition Assessment group to develop specifications for electronic anthropometric programs Work with Nutrition Assessment group to develop electronic format of new assessment questionnaire. Work with Quality Assurance and Monitoring work group to develop electronic monitoring tool. Work with Quality Assurance and Monitoring work group to develop electronic monitoring tool Timeline October 2009 April 2007 September 2007 April 2008September 2009 October 2009September 2010. October 2009September 2010. Anticipated Costs Status On target, initial monitoring tool draft completed On going, but have worked with Nutrition Assessment work group for systems revisions and implemented on October 2008 On target. Piloting one district currently. On target. Planning phase. On target. Planning phase. On target. Planning phase. Notes SP-47 Federal Fiscal Year 2010 Georgia WIC Program State Plan VENA Priority Area Training and Competency Activities/Strategies Revise and update tool, submit revisions to state and local agency designees Submit monitoring tool for review to Program Director, Legal, USDA Provide training on conducting self reviews with new monitoring tool Work with MIS to develop electronic monitoring tool Identify statewide training needs by providing annual training survey to local agency staff Identify local agency nutrition education/training designee to facilitate training opportunities Plan and conduct FY 2009 trainings to include: effective counseling skills, customer service, cultural competency, nutrition education/goal setting, critical thinking skill Timeline January 2009- April 2009 April 2009Current October 2009 October 2009September 2010 Each January October 2009 October 2009September 2010 Anticipated Costs Status Feedback incorporated. In planning phase. Ready for submission In planning phase. In planning Revised date to April 2008 due to staff. In progress. Drafting policy memo for staff shortage On target. In planning phase. Possibly will be utilizing contract services in lieu of Nutrition Education Program Consultant. Notes SP-48 Federal Fiscal Year 2010 Georgia WIC Program State Plan VENA Priority Area Marketing Procedures, Assessment, and Regulations (PAR) Activities/Strategies Timeline Anticipated Status Costs Working on a marketing campaign through recognized media outlets (PSA) for the implementation of the update WIC Food Package Reevaluate High-Risk criteria with possible reclassification of High-Risk criteria. July 2009December 2009 October 2009 On target. In planning phase. In planning phase. Establish training policy to ensure accurate assessments of WIC clients by CPAs Standardize anthropometric and hematological equipment and techniques Develop protocol and provide guidance for High-Risk follow- up care and nutrition care plan Establish competencies and training requirements for CPAs providing High-Risk follow up October 2009 October 2009 January 2010 January 2010 In planning phase. In planning phase. In planning phase. In planning phase. Notes PAR work group was included to VENA committee November 2007 to eliminate multiple committee dates SP-49 Federal Fiscal Year 2010 Georgia WIC Program State Plan VENA Priority Area Activities/Strategies Timeline Anticipated Status Costs Notes Define the roles of RDs, RN, LPN and Nutritionists with regard to High-Risk follow up. Define exempt infant formula and metabolic foods for WIC program by: - reviewing current policy - developing training - policy - establish deliverables with Georgia Chapter of American Academy of Pediatrics (GA AAP) to provide guidance in formula progression January 2010 December 2009 In planning phase. Meeting with GA AAP April 2008. SP-50 Federal Fiscal Year 2010 Georgia WIC Program State Plan 2010 FOOD PACKAGE PLAN GOAL 1: TO implement the New WIC Food Packages OBJECTIVE 1.1: To establish 100% of the new Food Package criteria by October 1, 2009. Strategy Planning and Research Activities Define and develop criteria for the 7 Food Package groups. Identify standard voucher character length. Develop voucher messages. Develop and issue participant cereal surveys. Coordinate project specifications for training videos. Timeline March 2008October 1, 2008 Development Contract other State WIC Programs for Food Package sharing. Establish cost containment methods for each Food Package group. Develop Food Package III criteria and systems design. Develop new WIC approved food list for general and homeless Food Packages. Work with OTWD to develop training videos. Develop education materials. New pocket reference guides. Risk criteria handbooks, and prescription pads. SP-51 Federal Fiscal Year 2010 Georgia WIC Program State Plan 2010 FOOD PACKAGE PLAN OBJECTIVE 2: To provide new Food Package training to all WIC Vendors, Participants, Staff (State and District) and stakeholders by October 1, 2009. Strategy Activities Timeline Planning and Research Identify training needs of all Vendors, participants, staff and stakeholders. Contract services to develop training video (s) and exhibit boards. March 2008October 1, 2008 Development Develop education materials. New pocket reference guides. Risk Criteria Handbooks, and Medical Documentation Forms. Training, Piloting and Implementation Provide trainings and materials to Vendors, WIC staff and participant. Present and exhibit at professional and community stakeholder functions. October 1, 2008- April 1, 2009 April 1, 2009October 1, 2009 OBJECTIVE 3: To complete all Vendor Management processes related to the new WIC Food Packages by October 1, 2009. Strategy Activities Timeline Planning and Research Work on cost containment methods by Peer Groups. Establish minimum inventory requirements for each new food group. March 2008October 1, 2008 Authorize approved farmer's to include both Farmer's Market and cash value vouchers. Find out how the Food Stamps Program handles taxes for Cash Value overages. Development Develop mock up vouchers to provide for Vendor training. Contact Vendor Advisory Group for initial Vendor training. October 1, 2008-April 1, 2009 SP-52 Federal Fiscal Year 2010 Georgia WIC Program State Plan 2010 FOOD PACKAGE PLAN OBJECTIVE 4: To implement new Food Package edits to all Front and Back End Systems by October 1, 2009. Strategy Activities Timeline Planning and Research Work on cost containment by Peer Groups, data collection, monitoring, voucher layout and pricing. March 2008October 1, 2008 Make automatic Food Package progression rules for infant Food Packages. Develop special override consideration for Food Package III. Develop numbering system for Food Package and voucher codes. Automate prorating system to lose maximum voucher last. Development Develop mock up vouchers. Work with Front and Back End Systems as they develop revisions for new Food Package implementation. October 1, 2008-April 1, 2009 Training, Troubleshooting any food revisions as needed. Piloting and implementation April 1, 2009October 1, 2009 SP-53 Federal Fiscal Year 2010 Georgia WIC Program State Plan CHAPTER 2 Program Financial Management SP-54 Federal Fiscal Year 2010 Georgia WIC Program State Plan SECTION I - PROGRAM FINANCIAL STATUS Narrative Descriptions: A. DCH Financial Administration The Office of Financial Services (OFS) of DCH maintains the financial records in a manner that reflects separate accountability for each activity administered by DCH, utilizing disbursement classifications as required by the state auditor and the various federal agencies. The financial system uses a combination of both data processing and manual entries. The process of writing checks, preparing check registers and other mass detail work, is performed by data processing systems. The records kept in the county Health Departments are subsidiary or supplemental. County departments submit monthly reports to the Office of Financial Services according to prescribed uniform reporting procedures. These reports cover the financial operations that will be reimbursed by the Department of Community Health. Supporting data for other county department administrative expenditures are not submitted directly to OFS; they are retained in the county department finance offices. County Health Departments' contract with Certified Public Account (CPA) firms to audit their records. The State of Georgia Department of Audits performs both financial and program audits. State law mandates that the State Auditors perform a financial audit of the books and accounts of the Department of Community Health each fiscal year. The state auditors perform programmatic audits of specific programs as deemed necessary. The WIC Program Financial Management Section also contracts with outside professional service providers to review 50% of the eighteen (18) health districts and two (2) contracted local agencies annually. B. Time Reporting Random Moment Sample Study (RMSS) is a method used by the State of Georgia to measure the proportion of time spent by employees performing work duties within every state program to allocate costs appropriately. This method uses a statistically valid sample to determine the amount of time employees expend on individual programs. The results of the quarterly RMSS are used as a basis to determine the distribution of each quarter's cost. This detailed process is included in Appendix B of the Cost Allocation Plan. A copy of the Cost Allocation Plan can be obtained from the Office of Financial Services. SP-55 Federal Fiscal Year 2010 Georgia WIC Program State Plan C. Cost Allocation Plan The Department of Community Health has a federally approved Cost Allocation plan. Therefore, it does not employ an indirect cost agreement. The revised plan was submitted to the Department of Health and Human Services on June 14, 2009. DCH is currently awaiting comments and approval. SECTION II - LETTER OF CREDIT The Director of the Office of Financial Services functions as cash manager of the Department of Community Health. State funds are drawn from the Department of Administrative Services' Office of Treasury and Fiscal Services on an as-needed basis. State funds are requested by warrant. Federal funds are requested and drawn through the electronic funds transfer process and transferred into a central bank account for subsequent distribution to the appropriate disbursing bank accounts as needed (payroll account, operating account, etc.). All transfers of federal funds are drawn in accordance with regulations of the United States Department of the Treasury, Georgia's Cash Management Improvement Act (CMIA), agreements with the Treasury and other cash management policies and procedures as designated by the Division of Payment Management (DPM) of the United States Department of Health and Human Services (DHHS), the United States Department of Education (USDE), and the United States Department of Agriculture (USDA). Quarterly, cash draws are reconciled and balanced with actual expenditures. Both federal program fiscal officers and the DPM receive reports of expenditures. Each grant award is recorded, balanced, and reported quarterly as designated. The ratios of the different federal and state funds that comprise each type of expenditure are determined by analyzing the department's annual budget. This is called the funding mix. Disbursements from the operating, grant-in-aid and payroll accounts are entered into a computer program containing the funding mix and the historical check-clearing patterns of these three bank accounts. The computer program adds the total funds eligible for reimbursement from the three bank accounts by day and stores this information in a program ledger. When reimbursement is requested, the draw represents the projected expenditures clearing in those bank accounts from the previous two to three days. Clearing patterns and the funding mix are updated periodically to insure that projections are as accurate as possible. Near or at the end of each month, it will be determined whether conversion authority exists. If conversion authority exists, the administrative expenditures to date will be compared to the amount of availability on the administrative Letter of Credit. When rebate funds are received from the formula contractor, the cash manager notifies the DCH Office of Financial Services, Public Health WIC Accountant. The cashier SP-56 Federal Fiscal Year 2010 Georgia WIC Program State Plan records the payment against the receivable by customer number and by invoice number. The cash manager takes the amount of the rebate into consideration before making any future draws on the Letter of Credit. SECTION III - LOCAL LEVEL REQUIREMENTS The local level requirements are as follows: A. The Master Agreement for the Division of Public Health requires that local agencies maintain their Financial Management Systems in accordance with 45 CFR Parts 74.60 and 74.61 (Subpart H) and Official Code of Georgia Annotated (OCGA), Section 31-3-8. A copy of the Master Agreement for Public Health may be obtained from the Financial Management Section of the WIC Program. The DCH Administrative Policy and Procedures Manual and the DCH Grants to Counties Manual give specific instructions on the operation of a financial management system at the local level. B. Each month local agencies must submit a Monthly Income and Expenditure Report (MIER) to the Public Health Grant-In-Aid office. WIC Program staff monitors these reports against approved budgets. During program reviews, equipment and computer inventories are reviewed to ensure program compliance. C. The Public Health Master Agreement requires an annual audit of all local agencies. The DCH Office of Audits is responsible for overseeing this requirement. Non-compliance results in the immediate suspension of payments to the delinquent agency. The financial management staff of each local agency, in keeping with state agency requirements, is charged with oversight and accountability for WIC Program budgets and expenditures according to DCH and USDA Food and Nutrition Services (FNS) guidelines and instructions. D. The allocation of Nutrition Service and Administration (NSA) Grant funds is based on methodology developed by the WIC Program and the WIC Allocation Advisory Committee, with final approval from the Director of the Division of Public Health. Funds available for allocation to local agencies are determined by subtracting the cost of operations of the WIC Program, the WIC Nutrition Section and the centralized costs for management of the food grant, from the total NSA grant received from USDA. The balance is allocated to local agencies based on participation. SP-57 Federal Fiscal Year 2010 Georgia WIC Program State Plan E. The WIC Allocation Advisory Committee is charged with assisting the Program and the Division of Public Health with developing an acceptable methodology for allocating federal grant funds to local agencies. The State of Georgia WIC Program approved funding formula has been well accepted by local agencies due to its accuracy and fairness. Additionally, the Georgia WIC Allocation Advisory Committee makes recommendations to the WIC Program concerning caseload management strategies. A district heath director chairs the committee. F. Operational and administrative funds are distributed to local agencies by contractual agreements. WIC funding to Georgia's eighteen lead counties is part of the DCH Public Health Master Agreement. Funding to two non-profit organizations is made through a standard DCH contract. G. Budgets for local agencies are changed by means of contractual amendments. SECTION IV PROPERTY MANAGEMENT and PROCUREMENT A. See paragraph #204 of the DCH Public Health Master Agreement for property management requirements. B. All purchases are made in accordance with laws governing purchases, OCGA, 50-5-50 through 50-5-124 and the Rules and Regulations of the Georgia Department of Administrative Services, Purchasing Division. Consultants and certain other contracts in excess of $250,000 must be approved by the State Office of Planning and Budget with exemptions to this requirement as stated in the Department of Administrative Services (DOAS) Georgia Procurement Manual, Chapter 2, and Section 3. A copy can be obtained from the WIC Program Financial Management Section. SECTION V CASELOAD MANAGEMENT/FOOD COST Food Cost may come from three sources. A description of each source is listed below: 1. Covansys (the State's Data Processing and Banking Contractor) complies a monthly Reconciliation Report (EWRR860G) report using a series of four reports: x Monthly Report of Food Expenditures x Bank Exception x Unmatched Redemption x Bank Listing SP-58 Federal Fiscal Year 2010 Georgia WIC Program State Plan This data is based on the redeemed month that includes all of the voucher activity that occurred during the month, regardless of the issue date of the vouchers. The State's Office of Financial Services enters the information from the Reconciliation Report (EWRR860G) into the state's financial system (People Soft). 2. The Vendor Section authorizes administrative payments to Vendors for returned vouchers. Vouchers may be returned for the following reasons: x Post and Stale date x Signature of participant missing x Exceeded maximum amount allowed x Altered vouchers x Missing Vendor stamp Post and Stale dated vouchers are not approved for payment. Once these vouchers have been individually researched and payment had been authorized, the information is entered into People Soft. The Office of Financial Services will then release payment. 3. Orders from Special Formula are placed by clinics through the State Nutrition Section. These orders are reviewed for approval prior to the purchase of formula. Once approved, the formula is ordered and the information placed into People Soft for Office of Financial Services to process. 4. Once the Office of Financial Services has received all of the information, the final cost the redeemed month is entered into the FNA-798 Report. SP-59 Federal Fiscal Year 2010 Georgia WIC Program State Plan CHAPTER 3 FOOD DELIVERY/MANAGEMENT INFORMATION SYSTEMS I. Retail Delivery Method II. Vendor Management Unit III. Direct Delivery Method IV. Management Information Systems V. Food Package Design SP-60 Federal Fiscal Year 2010 Georgia WIC Program State Plan SECTION I - RETAIL DELIVERY METHOD A. For a description of all Food Delivery systems that the State Plan uses during the year including any special provisions for the homeless or for the delivery of special formulas [CRF 246.4(a)(14)(I), 246.4(a)(14)(ix)]. See the Food Delivery Section of the Procedures Manual. B. For a description of any special Food Delivery procedures in the event of a natural disaster [CRF 246.4(a) (14) (I)]. See the Disaster Plan in the Procedures Manual. C. For copies of all Food Instrument types [CRF 246.4(a) (14) (v)]. See the Food Package Section of the Procedures Manual. D. For a description of food instrument security and accountability procedures at the State level [CRF 246.4(a) (14) (v), 246.12(1)]. See the Food Delivery and Compliance Analysis Unit of the Procedures Manual. E. For a description of procedures for shipment of food instruments between all points [CRF 246.4(a) (14) (v), 246.12(1)]. See the Food Delivery Section of the Procedures Manual. F. The names of companies, excluding retail s, under contract to operate or assist the State in operating the food delivery system [CRF 246.4(a) (14) (vii)] are as follows: Covansys/CSC, United Community Bank, Ross Nutritional, Mitchell & McCormick, Net Smart (DeKalb System), and Health Net 2 (Athens System). G. For a description of State procedures for follow-up on reports of lost or stolen food instruments [CRF 246.4(a) (14) (v)]. See the Compliance Analysis Unit of the Procedures Manual. H. A report on the reconciliation rate for the previous year and an assurance that the state agency will fulfill food instrument reconciliation requirements in the coming year [CRF 246.12(n)] follows. SP-61 Federal Fiscal Year 2010 Georgia WIC Program State Plan The reconciliation rate for FFY 08 was 99.96%. The current rate for FFY 09 to date is 99.97%. Georgia WIC Program Reconciliation Rates FFY 08 and 09 to date Month FFY 08 FFY 09 OCT 99.91% 99.92% NOV 99.92% 99.96% DEC 99.96% 99.91% JAN 99.96% 99.90% FEB 99.83% 99.90% MAR 99.94% 99.96% APR 99.99% 99.99% MAY 99.99% JUN 99.96% JUL 99.98% AUG 99.97% SEP 99.99% Average 99.95% 99.93% Reconciliation The Georgia WIC Program, in conjunction with its automated data processing contractor, Covansys/CSC, uses the following monthly reports to completely track every voucher issued. Bank Transaction Listing provides each voucher cleared by the bank during the processing month by serial number, date cleared, dollar amount, and transaction code. Bank Exception Report identifies vouchers that cannot be reconciled with the issued records, either because the voucher number is not recognized as currently valid, or because the voucher number has already been placed in final status. Closeout Reconciliation Report provides a one to one reconciliation report that shows details on each voucher created during the month currently being closed out. Voucher Reject by the Bank lists detailed data on vouchers rejected by the contract bank during the screening and prepayment audit. The report is SP-62 Federal Fiscal Year 2010 Georgia WIC Program State Plan summarized at the county level within each district/unit. The list includes both computer and manual vouchers. For Manual Vouchers (including those prepared by clinics using automated systems) there are Unmatched Redemption Reports, including Cumulative Unmatched Redemption (CUR) reports that show vouchers that cannot be matched to an issue record, a valid WIC identification number or a certification period. Vouchers Paid by Administrative Checks list describes vouchers rejected by the bank for being over the maximum amount, but subsequently approved for payment by the WIC Program. This combination of reports and the WIC Banking system allows the WIC Program to track every voucher and determine its final disposition. In addition, the WIC Program receives records for all vouchers processed during the month on CD-ROM. A PC Internet Program, Check Image Viewer (iCIV), provides fast and easy access to all WIC vouchers processed by the bank. On April 1, 2004, the Georgia WIC Program entered into a new contract with Covansys/CSC (d.b.a. PDA, Inc.) for data processing services. The contract has been extended through September 30, 2009. In addition, Covansys has developed a WIC Banking secure website that allows users to view checks processed by the bank within three (3) days of their submission. The WIC Program and Covansys control access to the secure site. For a description of the State Plan to monitor local agency compliance with Food Delivery and accountability requirements [7CRF 246.19(b)], see the Monitoring Section of the Procedures Manual. SECTION II - VENDOR MANAGEMENT UNIT See the Vendor Management Unit and Compliance Analysis Unit of the Procedures Manual for the descriptions provided for letters A F below. A. A description of the Vendor Management Unit (food delivery) system as it operates at the State agency level, including instructions for the local agency [7CRF 246.4(a) 14(I)]. B. A narrative description of Vendor selection, including a list of selection criteria, limitation criteria, if applicable and the application form [7CRF 246.4(a) 14(ii)]. SP-63 Federal Fiscal Year 2010 Georgia WIC Program State Plan C. A copy of the standard written Vendor Agreement between Food Vendors and the State (or local) Agency [7CRF 246.4(a) (14) (iii)]. D. A description of the procedures designed to control Vendor abuse of the program [7CRF 246.12(k) (2)]. E. A description of the system for monitoring Food Vendors to ensure compliance and prevent fraud, waste and abuse [7CRF 246.4(a) (14) (iv)] including: 1. The functional breakdown between state and local agency responsibilities for Vendor management. 2. Monitoring system. 3. High-Risk criteria. 4. Investigation system. 5. Sanction system. 6. Vendor/participant complaint system. 7. Cost Containment F. Administrative appeal procedures for food Vendors (may be placed in fair hearing section of the Procedures Manual) [7CRF 246.4(a) (17)]. SECTION III - DIRECT DELIVERY METHOD A description of how Infant Formula requiring a Physician's Prescription is issued to WIC participants, see the Food Package Section of the Procedures Manual. SECTION IV MANAGEMENT INFORMATION SYSTEMS A narrative summary of changes made to the WIC Management Information System(s) in the past year are listed below: A. Health Outcomes and Service Tracking (HOST) and Automated TAD and Voucher System (ATVS) Aegis has replaced HOST in all but eleven (11) clinics. Only the clinics in D/U 01-1 (12) remain on HOST. Five (5) of that District's clinics are using the Mitchell and McCormick System. Plans are currently being made to convert both D/U 01-1 and 01-2 to the Health Net 2 (Athens) System within the next 12 to 24 months. SP-64 Federal Fiscal Year 2010 Georgia WIC Program State Plan In a related move, the Savannah (D/U 09-1) and Brunswick (D/U 09-3) have been combined into one District (09-1). This District is also exploring the possibility of converting to the Athens HN2 system within the next 12 to 24 months. All of the remaining Automated TAD and Voucher System (ATVS) clinics in D/U 03-2; D/U 08-1 and D/U 12-0 have been converted to Aegis. With the closing of ATVS, the entire state will be able to be on full VPOD, which will result in an overall savings of approximately $48,700 per year in printing costs alone. B. Georgia WIC Information System (GWIS)/GWISnet. The Georgia WIC Information System (GWIS) became available in February 2003. This system replaced the paper and microfiche reports as well as the state developed, DOS based Automated Reporting and Management Information System (ARMIS). GWIS operates over a secure website with daily updates done electronically. Monthly reports are received in the State and District offices via monthly CD ROM. In 2004 GWISnet, the State's data processing contractor, Covansys/CSC, developed an Internet version of GWIS. In addition to the functions of GWIS, GWISnet also contains a Clinic Feedback section that will allow Clinic, District and State staff to view critical errors, batch rejections and acknowledgements in real time. GWISnet is available to all sites with Internet access. Currently, there are over 400 users with access to GWISnet. C. Vendor Integrity Profile System (VIPS) VIPS will continue as a stand-alone system for the present time. Long-term plans call for the incorporation of VIPS into GWIS and GWISnet. The FFY 05 requirements for The Integrity Profile report (TIP) have been incorporated into the latest version of VIPS. D. WIC Banking Covansys established a secure WIC Banking website in June 2003. The WIC Program controls access to the system. This website allows users to view check images as early as three (3) days and as late as six (6) months of processing by the bank. SP-65 Federal Fiscal Year 2010 Georgia WIC Program State Plan E. Internet Check Image Viewer (iCIV) All WIC vouchers processed by the bank are imaged onto CD-ROM. Since 1997, WIC Program staff has been able to retrieve and print electronic images of all vouchers in this manner. Recently, Covansys has expanded the old Check Image Viewer (CIV) to include Internet capability. This allows users to access images posted within the last three (3) days via the WIC Banking website. F. Participant Characteristic Study See Attachment I for the checklist. SECTION V - FOOD PACKAGE DESIGN See the Food Package Section of the Procedures Manual for letters A C below. A. A description of the standard or commonly used Food Package for each participant category including Food Packages I - VII that the State Plans to use during the year including any special provisions for the homeless [7CRF 246.10(c)]. B. A list of all State-Approved Infant Formulas (including the standard contract formulas), exempt infant formulas, special formulas and medical foods [7CRF 246.10(f)]. C. A copy of the current State authorized food list [7CRF 246.10(b)]. SP-66 Federal Fiscal Year 2010 Georgia WIC Program State Plan CHAPTER 4 APPLICATION AND DISQUALIFICATION PROCESS FOR LOCAL AGENCIES I. Process for Applying to Operate a WIC Clinic II. Administrative Appeal: Local Agency SP-67 Federal Fiscal Year 2010 Georgia WIC Program State Plan SECTION I - PROCESS FOR APPLYING TO OPERATE A WIC CLINIC Local agencies must be public or private, health or human service agencies, in accordance with WIC regulations as defined in 7CFR246.5 (d). The application must demonstrate the agency's ability to operate a WIC Program in accordance with WIC Federal Regulations and state policies. The Georgia WIC Program operates in all 159 counties within the state by local public health departments and two Atlanta-based contracted agencies (Grady Health System and Southside Medical Center). During FFY 04, Georgia WIC continued to explore expanding WIC services into non-public health agencies/providers. These new WIC sites may include migrant health centers, health maintenance organizations, community health centers, schools and/or private provider offices. Applications will be accepted for the purpose of expanding services in a current program area. In considering such an application, the State agency will evaluate the performance of existing programs in the areas in question. An application will be considered for approval if the existing agency/agencies is/are not able to expand the services to the residents/participants of the area. Availability of food/administrative funds will also be considered. Upon request from a Local agency interested in operating a WIC Program, the State agency will supply, within fifteen days of inquiry, a pre-application information package consisting of the following documents: 1. A cover letter explaining, at minimum, the overall application process, time frames involved, criteria for selecting Agencies and information concerning the appeal process, in the event that the application is denied. 2. A copy of the WIC Program Regulations [7CRF Part 246]. 3. A list of basic requirements to be included in the Local agency's application to operate a WIC Program including: staffing and equipment requirements, as well as clinical and nutritional regulatory mandates. 4. A listing of State and Local agency resources. 5. A copy of the Memorandum of Understanding between the state agency and the local agency, (the Memorandum of Understanding is included in the Administration Section of the Procedures Manual). 6. A copy of the most current State Plan, Procedures Manual and Georgia WIC Information Packet. SP-68 Federal Fiscal Year 2010 Georgia WIC Program State Plan 7. Examples of Nutrition Education Materials and Participant Training Tapes. Selection criteria for local agencies will be consistent with the requirements of 7 CFR 246.5. [7CRF 246.7 (M)]. Applications will also be reviewed for assurance that at minimum: 1. The Local Agency has corrected all past substantiated Civil Rights problems and/or non-compliance situations. 2. The Civil Rights Assurance is included in the State/Local Agency WIC Program Agreement. 3. Civil Rights Complaints are being handled in accordance with procedures outlined in the Rights and Obligations Section of the WIC Procedures Manual. 4. Clinic sites, Certification offices, Vendors and other Food Distribution Sites do not deny access to any person because of his/her race, color, national origin, language, sex, age, or disability. 5. Appropriate staff, volunteers and/or other translation resources is available in areas where a significant proportion of non-English or limited English-Speaking persons reside. 6. A description of the racial/ethnic makeup of the service area is included in the application. 7. The agency has the ability to provide appropriate WIC services to applicants and participants in accordance with USDA and State WIC regulations and policies. 8. The agency space availability is adequate to provide WIC services. 9. The agency demonstrates the ability to manage financial obligations in accordance with USDA and state regulations and policies. 10. The agency will demonstrate the ability to ensure the security of WIC vouchers at all times. 11. The agency agrees to have all agency staff attend any required meetings and training programs. 12. The agency agrees to comply with all USDA and Georgia WIC Reporting and documentation requirements. SP-69 Federal Fiscal Year 2010 Georgia WIC Program State Plan 13. The agency demonstrates the ability to comply with all WIC Program Automated Data Processing requirements. 14. The agency agrees to make all documents and records available for review and audits. 15. An agency serving homeless participants agrees to ensure that the homeless facility does not: a. Accrue financial or in-kind benefits from a resident's participation in the program. b. Subsume foods provided by the WIC Program into a communal food service. WIC foods must only be available to the WIC food recipient. c. Allow the homeless facility to place constraints on the ability of the participant to partake of the supplemental foods and nutritional education available under the Program. 16. The local agency agrees to contact the homeless facility periodically to ensure continued compliance with these conditions. 17. The local agency requires the homeless facility to notify the state or local agency if it ceases to meet any of these conditions. SECTION II - ADMINISTRATIVE APPEAL: LOCAL AGENCY A. The State Agency must provide full Administrative Review to Local Agencies. The local agency has the right to appeal a state agency's decision for the following: 1. Denial of Local Agency's Application. 2. Disqualification of a Local Agency. 3. Any other adverse action that affects a local agency's caseload. The State Agency must provide written notification of the adverse action, the procedures to follow to obtain an Administrative Review, and the cause(s) for effective date of the action (See attachments II and III). SP-70 Federal Fiscal Year 2010 Georgia WIC Program State Plan Action Not Subject to Administrative Review The State Agency may not provide Administrative Reviews on Local Agencies that appeal the following: 1. Expiration of the Local Agency's agreement. 2. Denial of a Local Agency's application, if the State Agency's Local Agency Selection is subject to the procurement procedures of the Department of Community Health. B. Effective Date of Adverse Actions Against Local Agencies The state agency must make denials of Local agency applications effective immediately. The State agency must make all other adverse actions effective no earlier than sixty (60) days and no later than ninety (90) days after the date of the notice of adverse action or, in the case of an adverse action that is subject to administrative review, no later than the date the local agency receives the review decision. C. Full Administrative Review Procedures Procedures for a full administrative review of adverse actions are listed below: The local agency may appeal the state agency's decision when an application to participate in the WIC Program is denied or terminated, or when a decision is made which adversely affects the local agency's participation in the program, such as a reduction in food or administrative funds. The local agency must request an administrative review from the state agency within thirty (30) days after the action appealed was taken. The hearing must be scheduled no later then thirty (30) days after the request for hearing is received by the state agency. The local agency must be given fifteen (15) days advance notice of the time and place of the hearing. The proposed adverse action must be postponed from the time a hearing is requested until a decision is reached. The local agency may reschedule a hearing date one (1) time upon request. Sixty (60) days advance notice must be provided to a local agency before disqualification from WIC Program participation. The local agency will have many opportunities to present its case at the hearing, including the opportunity to confront and cross-examine adverse witnesses. Counsel may represent the local agency, if desired. The local agency may review the case file before the hearing. SP-71 Federal Fiscal Year 2010 Georgia WIC Program State Plan D. Local Agency Hearing Procedures To request a hearing, the local agency will send a written request to the WIC Program. Should a hearing be requested before the deadline stated in the disqualification notice, the local agency authorization shall remain unchanged until final resolution has been attained at the administrative level. If a hearing request is received after the deadline stated in the disqualification notice, the local agency shall no longer be authorized for WIC Program participation. Local Agencies may appeal decisions of the WIC Program when an application to participate in the WIC Program is denied, when participation is terminated, or when other actions are taken that adversely affect the local agency's participation in the program. The Local Agency must submit a written request for a hearing to the WIC Program within fifteen (15) days from the date of notification of an adverse action they wish to appeal. The WIC Program will notify the Office of State Administrative Hearings of a local agency's request for a hearing. The Office of State Administrative Hearings will schedule a hearing date within forty-five (45) days of the hearing request. The Local Agency will be notified of the time and place fifteen (15) days before the hearing date. All hearings will be held in the county where the local agency is located. The proposed adverse action must be postponed from the time an Administrative Hearing is requested until the Administrative Law Judge (ALJ) reaches a decision, or appeals have been exhausted. The Local Agency or the WIC Program may reschedule Local Agency hearings one (1) time. The Local Agency will have many opportunities to present its case at the hearing, including the opportunity to confront and cross-examine adverse witnesses. Counsel may represent the Local Agency, if desired. The appellant may review the case file before the hearing. The Administrative Law Judge (ALJ), Office of State Administrative Appeals, is an impartial decision maker with no personal involvement or interest in the outcome of the hearing. The ALJ's decision shall rest solely on the evidence presented at the hearing with the statutory and regulatory provisions governing the program. The basis for the decision shall be stated in writing, although it need not amount to a full opinion or contain formal findings of fact and conclusions of law. SP-72 Federal Fiscal Year 2010 Georgia WIC Program State Plan The ALJ and the WIC Program shall provide written notification of the decision to the Vendor within ninety (90) days from the date of the original request for a hearing. The Local Agency must continue to comply with all written agreements if program participation continues during the appeal process. The ALJ will explain any additional appeal mechanism upon request, including the right to a Judicial Review. If the Local Agency desires to appeal after an Administrative Hearing Decision that has been granted in the state's favor, the Local Agency must follow the provisions of the Georgia Administrative Procedure Act (Code Section 50-13-16 and 50-13-17). SP-73 Federal Fiscal Year 2010 Georgia WIC Program State Plan CHAPTER 5 SPECIAL PROJECT PROGRAM I. Introduction II. Overview of Local Agency Special Project Grant III. Proposal Process IV. Grant Management SP-74 Federal Fiscal Year 2010 Georgia WIC Program State Plan SECTION I - INTRODUCTION New ideas and concepts that stimulate growth, collaborative partnerships and program effectiveness are the foundational principles that guide the Georgia WIC Special Project Program. In fiscal year 1999, the WIC Program initiated the Special Funding Program for new Program Interventions developed by Local WIC Agencies. The program offers financial support to Local Agencies desiring to explore nontraditional means of providing WIC benefits to eligible participants. Resources are available to the Local Agencies in the form of Local Agency Special Project (LASP) grants. When funds are available, the Georgia WIC Program sets aside Nutrition Service Administration Funds to distribute as LASP Grant Awards. This section of the plan outlines the purpose and processes for local agencies wishing to participate in the Georgia WIC Local Agency Special Project Program. In instances where grant processes are linked to routine program procedures, the related procedures are referenced and must be followed. SECTION II - OVERVIEW OF LOCAL AGENCY SPECIAL PROJECT GRANTS (LASP) A. Project Purpose and Priority LASP grants provide financial support to local agencies endeavoring to implement new program enhancements. The primary intent of the special project grant is to support the efforts of local agencies to plan, design and implement innovative initiatives that will improve access to WIC benefits, and ultimately increase statewide participation. Priority is given to projects proposing new concepts that can be replicated, are sustainable after the initial funding, can be implemented and completed within twelve months, and demonstrates collaborative partnerships. The focus areas for new program enhancements include: 1. Non-traditional service delivery sites and collaborative partnerships. 2. Special outreach to hard to reach clients. 3. Breastfeeding initiation and duration. 4. Linguistically and culturally appropriated nutrition education. 5. Efficiency measures for staff and participants. SP-75 Federal Fiscal Year 2010 Georgia WIC Program State Plan B. Project Period The LASP grant is a twelve-month non-renewable award. Applicants are encouraged to consider the grant period when deciding the complexity and scope of the project. Project proposals selected for funding must illustrate the potential to complete implementation within twelve months. LASP grant funds must be expended by September 30 of the federal fiscal year in which grant is awarded. The WIC Program plans to award grants to selected local agencies by October 1. SECTION III PROPOSAL PROCESS All interested local agencies must submit a proposal. Grants are awarded to an individual local agency or to a consortium of local agencies. Local agencies are encouraged to consider collaborating with other WIC agencies on proposals. A local agency may submit only one proposal per fiscal year. If an agency submits a project proposal as part of a consortium of agencies, it may not submit a separate individual application. A. Request for Proposal The WIC Program conducts an annual solicitation for Special Project Proposals to give Local Agencies the opportunity to propose new program initiatives for the upcoming fiscal year. The request for proposals (RFP) outlining funding requirements and deadlines are distributed to all WIC local agencies in April of each year. The RFP package includes the following: 1. Application procedures 2. Proposal requirements 3. Project criteria 4. Proposal format 5. Focus areas 6. Proposal Evaluation criteria and weights 7. Application checklist Completed proposals must be received in the WIC Program by August 1 of each year. SP-76 Federal Fiscal Year 2010 Georgia WIC Program State Plan B. Proposal Review Process It is the intent of the WIC Program to select proposals that offer new and innovative concepts that address one of the focus areas, and have the best chance to continue beyond the initial funding period. Each proposal is reviewed and ranked by a proposal review committee. The committee is comprised of representatives from the WIC Program, Nutrition Section of the Office of Maternal and Child Health, District WIC Nutrition Services Directors who did not submit an Application, and a non-WIC Public Health Program. After reviewing and ranking proposals, WIC Program representatives may interview agencies on site before making selection decisions to: 1. clarify questionable concerns identified in the application review process, and 2. to collect information that validates the agency's capacity to successfully implement the proposed project. Selected proposals have two funding possibilities: Georgia WIC Special Project Funds or USDA Infrastructure Grant Funds. The State submits USDA Applications in behalf of Local Agencies. State staff will provide technical assistance to Local Agencies to enable full development of proposals to meet USDA requirements. Both funding possibilities are subject to the availability of USDA funds. SECTION IV GRANT- MANAGEMENT The Health Director of Local Agencies awarded Special Project Grants must sign the DCH Master Agreement Addendum to Annex J Terms and Conditions with the Director of the WIC Program agreeing to implement the project and to use the funds as described in the proposal. Special stipulations or instructions are stated in the agreement. The LASP funds will transfer to Local Agencies as Grant-in-Aid Funds. Funds will not be transferred until the agreement has been signed. A. Reports General administration of these grants includes Quarterly reports of Expenditures, Performance progress, a final Closeout Summarizing Project Outcomes and Financial Reconciliation. Local Agencies are required to submit a Quarterly Financial Status reports on Standard Form 269A. The due dates for Quarterly reports are as follows: January 15 May 15 SP-77 Federal Fiscal Year 2010 Georgia WIC Program State Plan September 15 December 31 (Final report) The final summary of project accomplishments and a final Standard Form 269A must be submitted to the WIC Program no later than 90 days after the last day of the Federal Fiscal year to closeout the project. Additionally, grantees are required to submit copies of Educational Curricula, Videos or other tangible products produced with LASP funds with the final report. B. Monitoring The WIC Program will monitor grantees as specified in the Agreement. If program interventions create a new service delivery site, the Policy Management and Consultation Section, Management Evaluation Unit will conduct a monitoring visit. In addition, the Systems Information Section must assign a unique Clinic number. Once the grantee receives permission to proceed with Operational plans, a monitoring visit will be conducted. Before the Monitoring Visit, the Local Agency is required to complete and submit an inventory of the Special Project purchases. SP-78 Federal Fiscal Year 2010 Georgia WIC Program State Plan GEORGIA DEPARTMENT OF COMMUNITY HEALTH DIVISION OF PUBLIC HEALTH GEORGIA WIC PROGRAM ATTACHMENTS STATE PLAN FFY 10 SP-79 Federal Fiscal Year 2010 Attachment SP-1 ATTACHMENTS PARTICIPANT CHARACTERISTICS MINIMUM DATA SET (MDS) The Participant Characteristics Minimum Data Set (MDS) contains data items that are reported to FCS electronically by state agencies for one report month on all or a sample of participants. The MDS has required data items that must be collected and reported. The Supplemental Data Set Specifications (SDS) comprised of optional data items that state agencies may collect and report. Please check those data items the state agency currently collects in its Management Information Systems and those data items it is planning to collect within the next two years. REQUIRED: Participant Characteristics Minimum Data Set State Agency MIS: Collects X State agency ID. A unique number that permits linkage to the WIC state agency where the participant was certified. X Local agency ID. A unique number that permits linkage to the local agency where the participant was certified as eligible for WIC benefits. X Service Site ID. A unique number that permits linkage to the service site where certified. Either local agency ID or service site ID may be reported according to the level the state agency feels appropriate. At a minimum, state agencies must provide agency names and addresses for each ID provided on their files. X Case ID. A unique record number for each participant that maintains individual privacy at the national level. General Instructions: Participant or Case IDs for each participant should continue to maintain individual privacy at the national level. States are requested to generate these IDs in the same manner that was applied for PC92 to allow longitudinal tracking of participant characteristics. This task can be accomplished by applying the PC92 algorithm to construction of PC98 participant IDs. X Client Date of Birth: Month, day and year of participant's birth reported in MMDDYYYY format. Client Race/Ethnicity: The classification of the participant into one of the five (5) racial/ethnic categories: white; black; Hispanic; American Indian or Alaskan Native; or Asian or Pacific Islander. The ethnic categories, white and black, X include only those persons who are not of Hispanic origin. SP-80 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST State State Agency Agency Performs Plans Function/Capabilities NUTRITION EDUCATION AND HEALTH SURVEILLANCE Maintain Nutrition Education Data X Maintain appointment schedules for enrollees that are to receive nutrition education X Maintain appointment schedule of available nutrition education sessions X Provide appointment notice to enrollee X Track participation in education X Track types of nutrition education provided Perform Individual Client Health Monitoring X Capture and monitor changes in individual client health status X Provide individual client data to other health agencies Perform individual client nutrition education and diet monitoring Capture and monitor changes in individual client dietary behavior Perform Analysis of WIC Population Nutrition Education and Health Surveillance Monitor changes in WIC participant population health status X Monitor clients' views of WIC program services Monitor changes in WIC participant population dietary behavior Provide WIC health statistics to other health agencies X Provide WIC participant population data to other state health agencies Provide WIC participant population data to Centers for Disease X Control FOOD INSTRUMENT PRODUCTON Maintain Food Package Database X Record list of approved foods and food package data X Record food package variations and food instrument types X Prorating food quantities for clients with late pick-up Print Food Instruments on Demand X Print regular food instruments for participants on demand X Print food instruments for multiple months Print Vendor-specific food instruments X Print prorated food instruments X Print custom-tailored food instruments SP-81 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST Print and Distribute Food Instruments in Advance of Pick-Up X Print food instruments in advance of participant pick-up X Print food instruments for multiple months Print Vendor-specific food instrument Monitor Food Instrument Stock X Record stock receipt, shipment and usage of food instruments FOOD INSTRUMENT PAYMENT AND RECONCILIATION Void Unissued and Unredeemed Food Instruments X Void unissued and unredeemed food instruments produced on demand X Void unissued and unredeemed food instruments printed in advance Reconcile Redeemed Food Instruments X Process food instruments redeemed by Vendors X Produce rejection reports for food instruments not paid to Vendors X Check for valid Vendors on redeemed food instruments X Check for redeemed but unissued food instruments Produce Vendor Payment Detail X Produce payment detail for checks (where applicable) X Produce payment detail for vouchers (where applicable) CASELOAD MANAGEMENT Allocate Caseload Determine maximum state caseload which could be served with X available funds X Prepare Local agency caseload allocation estimates X Record caseload allocations assigned to local agencies Monitor Caseload X Track actual participation against caseload levels X Produce FNS reports on participation VENDOR MANAGEMENT Support Vendor authorizations X Capture and maintain data on authorized Vendors X Produce Vendor history information on individual Vendors X Track Vendor authorization process Determine High-Risk Vendors X Determine High-Risk Vendors using basic statistical analysis (e.g. low variance, high mean) Determine High-Risk Vendors by using additional analysis tools SP-82 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST Monitor Vendor Education X Record Vendor education sessions scheduled for each Vendor X Record attendance at Vendor education sessions by Vendor Track Investigations and Routine Monitoring Capture compliance buys and routine monitoring data performed on X Vendors X Support constructing a sampling of Vendors for investigation Support record audits with data needed to evaluate Vendor inventory of X WIC foods Monitor Compliance Cases and Sanctions Maintain data for in-state Vendor investigation cases and sanctions X applied Maintain compliance data for abusive out-of-state Vendors X Accumulate sanction points for Vendor abuse Coordinate With Food Stamps Program X Maintain FSP violation data on WIC Vendors X Report WIC sanctions to Food Stamps Program Support Vendor Communications X Produce Vendor lists and labels X Produce Vendor correspondence OPERATIONS MANAGEMENT Monitor Administrative Operations Maintain staffing, client load and operational characteristics on local agencies and clinics Produce client and food instrument activity reports on local agencies and X clinics Maintain Client Outreach Maintain client lists for local agencies to use for Outreach X Track referrals of WIC participants to other health and social services FINANCIAL MANAGEMENT Record Grants and Budgets Record nutrition services, administration and food grants for State X agency X Maintain local agency budget information X Maintain state agency budget information SP-83 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST Monitor Expenditure X Monitor nutrition services, administration and food obligations and expenditures X Monitor cash flow X Produce FNS 498 Report Process Manufacturer Rebates X Estimate total annual rebates X Bill manufacturer(s) for rebate X Monitor rebate collections from manufacturer(s) SYSTEM ADMINISTRATION Maintain System Data Tables X Maintain system data tables Administer System Security X Maintain user identification X Maintain user capabilities X Monitor unauthorized access Archive System Data X Archive and restore historical data X Purge unnecessary data SP-84 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS State Agency MIS: Collects X Certification category. One of five (5) possible categories--under which a person is certified as eligible for WIC benefits: pregnant woman; breastfeeding woman; postpartum woman (not breastfeeding); infant (under twelve (12) months); or child (12-59 months). X Expected date of delivery or week's gestation. For pregnant women, the projected date of delivery (MMDDYYYY format) or the number of weeks since the last menstrual period as determined at WIC Program certification. X Date of certification. The date the person was declared eligible for the most current WIC Program certification as of April 1998. Month, day and year should be reported in MMDDYYYY format. X Sex. For infants and children, male or female. X Priority level. Participant priority level for WIC Program certification at the time of the most recent WIC Program certification as of April 1998. X Participation in TANF/AFDC, Food Stamps, Medicaid. The participant's reported participation in each of these programs at the time of the most recent WIC Program certification as of April 1998. X Migrant status. Participant migrant status according to the federal WIC Program definition of a migrant farm worker (currently counted in the FNS 498 report). X Number in family or economic unit. The number of persons in the family or economic unit upon which WIC income eligibility was based. A self-declared number in the family or economic unit may be reported for participants whose income was not required to be determined as part of the WIC certification process. These participants are adjunctively incomeeligible due to TANF/AFDC, Food Stamps Program, or Medicaid participation or are deemed income eligible under optional procedures available to the state agency in Federal WIC Regulations, Section 246.7(d)(2)(vi-viii). This means tested programs identified by the state for automatic WIC Program income eligibility, such as income eligibility of Indian and in-stream migrant farm-worker applicants. SP-85 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS State Agency MIS: Collects X Family or economic unit income For persons for whom income is determined during the certification process, the income amount that was determined to qualify them for the WIC Program during the most recent certification as of April 1998. FNS will convert income expressed in different measures (weekly, monthly, yearly, etc.) to annual amounts. For descriptive purposes only, participants whose income was not required to be determined as part of the WIC Program certification process use the self-reported income at the time of certification. These participants include adjunctively income-eligible participants and those persons deemed eligible under optional procedures available to the state agency in Federal WIC Regulations, Section 246.7(d) (2) (vi-viii). Zero should not be used to indicate income values that are missing or not available. Zero should indicate only an actual value of zero. X Nutritional risks present at certification. The three highest priority nutritional risks present at the WIC Program certification current in April 1998. X Hemoglobin or hematocrit. That value for the measure of iron status that applies to the WIC Program certification. It is assumed that the measure was collected within sixty (60) days of the certification date. X Weight. The participant's weight measured according to the CDC nutrition surveillance program standards [nearest one-quarter (1/4) pound]. If weight is not collected in pounds and quarter pounds, weight may be reported in grams. X Height. The participant's height (or length) measured according to the CDC nutrition surveillance program standards [nearest one-eight (1/8) inch]. If height is not collected in inches and eighth inches, height may be reported in centimeters. X Date of height and weight measures. The date of the height and weight measures that were used during the most recent WIC Program certification period as of April 2002 in MMDDYYYY format. X Currently breastfed. For infant participants between the ages of seven and eleven months, whether or not the participant is currently receiving breast milk. Ever breastfed. For infants between the ages of seven and eleven months, X whether or not the infant was ever breastfed. SP-86 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS State Agency MIS: Collects X Length of time breastfed. For infants between the ages of seven and eleven months, the number of weeks the infant received breast milk. X Date breastfeeding data collected. For infants between the ages of seven and eleven months, the date on which breastfeeding status was reported in MMDDYYY format. Food packages. The food package code(s) for the WIC food package or for all X food instruments prescribed for the participant during the month. SP-87 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS State Agency Collects MIS Plans to Collect Supplemental Data Set (OPTIONAL) X Date of first WIC certification: Date the participant was first certified for the WIC Program in MMDDYYYY format. For pregnant, breastfeeding and postpartum women, this applies to the current/most recent pregnancy and not to prior pregnancies. X Educational level: For pregnant, breastfeeding and postpartum women, the highest grade or year of school completed. For infants and children, the highest grade or year of school completed by mother or primary caretaker. X Number in household on WIC: The number of people in the participant's household receiving WIC benefits. Source of prenatal care: For pregnant, breastfeeding and postpartum women, source of care for current/most recent pregnancy. X Date when prenatal care began: For pregnant, breastfeeding and postpartum women, the date when prenatal care began for the most recent pregnancy in MMDDYYYY format. Date previous pregnancy ended: For pregnant women, the date previous pregnancy ended in MMDDYYYY format. Total number of pregnancies: For pregnant women, the total number of times the woman has been pregnant, including this pregnancy, all live births and any pregnancies resulting in miscarriage, abortion or stillbirth. Total number of live births: For pregnant women, the total number of babies born alive to this woman, including those who may have died shortly after birth. Pre-pregnancy weight: For pregnant women only, the participant's weight immediately before pregnancy. Pre- pregnancy weight may be reported either in pounds and X ounces or in grams. SP-88 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS State Agency Collects MIS Plans to Collect Supplemental Data Set (OPTIONAL) Weight gain during pregnancy: For breastfeeding and postpartum women, the participants weight gain during pregnancy as taken immediately at or before. Weight gain during pregnancy may be reported in both pounds and ounces or in grams. X Birth weight: For infants and children, the participant's weight at birth measured according to the CDC nutrition surveillance program standards (lbs./ounces). Birth weight may be reported in either pounds or ounces or in grams. X Birth length: For infants and children, the participant's length measured according to the CDC nutrition surveillance program standards (1/8 inches). Birth length may be reported in either inches or eighth inches or in centimeters. X Date of last routine check-up or immunization: Month, day, and year of the last routine check-up or immunization for infants and children reported in MMDDYYYY format. Length of time mother on WIC during pregnancy: For infant participants, the length of time mother was on WIC during this infant's prenatal period. Individual States may report the following items at their discretion. Erythrocyte protoporphyrin. That value for the measure of iron status that applies to the WIC Program certification current in April 1998. Participation in the Food Distribution on Indian Reservations Program. The participant's reported participation in this program at the time of the most recent WIC Program certification as of April 1998. SP-89 Federal Fiscal Year 2010 Attachment SP-1 (cont'd) MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST The following checklists were taken from the WIC Functional Requirements Document (FRD), which was provided as guidance to state agencies on functions they should consider incorporating in their Management Information Systems. Please check those functions/capabilities, which the state agency system currently performs or plans to perform within the next two years. State State Agency Agency Function/Capabilities Performs Planned CERTIFICATION X X X X X X X X X X X X X Determine Basic Eligibility of Applicant Capture basic eligibility characteristics on persons applying for WIC Maintain appointment schedule availability and produce daily appointment schedules Provide appointment notice to applicant Determine Nutritional Risk of Client Capture required client nutrition and health characteristics needed for certification Capture additional client nutrition and health characteristics Assign the nutritional risk of the client Certify Eligible Applicants Capture and maintain enrollee data on certified clients Issue identification card to client Food Package Issuance/Data Prescribe enrollee food package Maintain appointment schedule for enrollee food instrument pickup Select and record enrollee Vendor selection Check for Dual Participation/Process Transfers List dual enrollees List dual participants Process transfer of enrollee Capture Investigator Data Capture enrollee record for compliance investigators SP-90 Federal Fiscal Year 2010 Attachment SP-2 Division of Public Health WIC Program Two Peachtree Street, NW Atlanta, Georgia 30303 Disqualification/Not Accepting an Application Form The WIC Program is disqualifying / not accepting an application from (Circle One) ________________________________ for the following reason(s): Local Agency Name 1. ________________________________________________________________ ________________________________________________________________ 2. ________________________________________________________________ ________________________________________________________________ 3. ________________________________________________________________ ________________________________________________________________ 4. ________________________________________________________________ ________________________________________________________________ ___________________________________ WIC Program Director's Signature SP-91 ______________ Date Federal Fiscal Year 2010 Attachment SP-3 LOCAL AGENCY APPLICATION FOR CONSIDERATION AS A PROVIDER OF SERVICES FOR THE SPECIAL SUPPLEMENTAL NUTRITIONAL PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) Purpose The purpose of this application is to provide information to the WIC Program regarding the applicant's desire, qualifications and capacity to deliver WIC Program services to eligible clients/patients. Upon review of the completed application, WIC Program staff will make an initial determination of the agencies suitability for participation in the program. Final determinations will be made pending decisions regarding coordination with existing service providers. Initial approval will be based on the following factors: 1. The need for WIC services within the service area. 2. An estimate of the number of individuals to be served by the applicant. 3. The capacity of the agency to deliver quality services. 4. The availability of staff required meeting federal guidelines for WIC service providers. AGENCY NAME ADDRESS CITY, STATE & ZIPCODE TELEPHONE NUMBER CONTACT PERSON ALTERNATE # _________________________________________________________ NAME OF CEO ____________________________________________________ SP-92 Federal Fiscal Year 2010 LOCAL AGENCY APPLICATION Page 2 Attachment SP-3 (cont'd) Identify whether the agency is nonprofit, federally funded, Physician Sponsor Plan (PSP), HMO, clinic plan, local health department, private practice, community health center, etc. TYPE OF AGENCY AGENCY NAME Describe your service area including geographic area (counties), demographics of the population served, and percent of patients on Medicaid: Number of pregnant women served: Number of hours for obstetric (OB) services: __________________ Number of hours for pediatric services: __________________ Number of hours for general services: __________________ AGENCY STAFFING Number of physicians by specialty: __________________ Do you have a registered dietitian (RD) on staff? _________________ Number of hours per week an RD is available: __________________ Number of registered dietitians on staff: __________________ SP-93 Federal Fiscal Year 2010 LOCAL AGENCY APPLICATION Page 3 Attachment SP-3 (cont'd) Number of Nutritionists with a B.S. in nutrition and/or Dietetic Technician Registered: Number of registered nurses (RN) on staff: _________ Number of staff to weigh and measure and perform hemoglobin and hematocrits: _________ CLINIC/FACILITY CAPACITY How many clinic locations do you operate? List the name and location of each clinic to provide WIC services: AGENCY NAME: Describe the discussions with your county WIC agency regarding provision of WIC services by your agency. SP-94 Federal Fiscal Year 2010 LOCAL AGENCY APPLICATION Page 4 Attachment SP-3 (cont'd) PROPOSED WIC SERVICES AND ESTIMATE OF NEED FOR WIC SERVICES WIC Program eligibility is prescribed in the Code of the Federal Register (CFR) Title 7 Part 246. To be eligible for participation in the WIC Program, clients/patients must meet income and categorical eligibility requirements. Eligible clients include Women, Infants and Children to age five (5) years who are at or below 185% of the federal poverty level and have a medical or nutritional risk. Residents and Migrants meeting these requirements can be offered program benefits. How many WIC eligible clients reside in your service area? Number of WIC eligible clients served by your agency/clinic: Number of pregnant women currently being served: Number of WIC clients you will serve in the first year: Maximum number of persons you can/will serve after the first year: What is the date and source of the information provided above (census data; actual count, etc.)? SOURCE AGENCY: SP-95 Federal Fiscal Year 2010 Attachment SP-3 (cont'd) LOCAL AGENCY APPLICATION Page 5 CLINIC/FACILITY CAPACITY How much space do you plan to designate for WIC service delivery in each clinic location? Can you perform required Laboratory procedures at each location? Do you have equipment available to perform Anthropometric (weight, height/length and hematocrit/hemoglobin) Measurements? What other health-related services do you provide at each clinic location? SP-96 Federal Fiscal Year 2010 LOCAL AGENCY APPLICATION Page 6 Attachment SP-3 (cont'd) BUDGET ESTIMATE Number of WIC clients you will serve in the first year. First year costs of serving eligible WIC clients. Monthly per client cost for year two and beyond. _______ Signature of Chief Executive Officer (CEO) or Contact Person For additional information, contact Samuel Sims at (404) 657-2900. Please return completed form with documents required to: Division of Public Health WIC Program Two Peachtree Street, Suite 10- 495 Atlanta, GA 30303-3182 Date SP-97