Georgia state plan for program operation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) fiscal year 2001

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2001
GEORGIA DEPARTMENT OF HUMAN RESOURCES
DIVISION OF PUBLIC HEALTH STATE WIC BRANCH
Georgia State Plan for Program Operation in the Special Supplemental Nutrition Program
for Women, Infants, and Children (WIC)
Fiscal Year 2001 (October 1, 2000 to September 30, 2001)
Submitted in accordance with USDA Food and Nutrition Service
Federal Regulations 246.4(A) - State Plan August 2000

State WIC Plan

DPHP00.05

TABLE OF CONTENTS

WIC
Chapter 1 Chapter 2
I. II. III. Chapter 3 I. II. III. IV. V. Chapter4

Page
Goals and Objectives for FFY 2001 .......................................................................2 Financial Management ..........................................................:................................ 13 Program Financial Status ....................................................................................... 14 Letter of Credit....................................................................................................... 15 Local Level Requirements: 16 Food Delivery/Management Information Systems ................................................19 Retail Delivery Method...............................::..........................................................20 Vendor Management.....................................................................'.........................22 Direct Delivery Method .........................:.........................:.....................................23 Management Information Systems ........................................................................24 Food Package Design...........;.....................................................................;,...........26 Process for Applying to Operate A WIC Clinic ..........................:.........................27

Attachments: Attachment 1 - Participant Characteristic Minimum Data Set (MDS) ..........................................32 Office of Nutrition - Goals and Objectives ....................................................................................43

STATE WIC PLAN - 2001

STATE WIC BRANCH

CHAPTERl
. GOALS AND
OBJECTIVES

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I. INTRODUCTION
The mission of the Department of Human Resources (DHR) is to assist Ge.orgians in achieving their highest levels of health,' development, independence and self-sufficiency. The Division of Public Health's emphasis is on an integrated service system that assures comprehensive health. services, in an environment which fosters personal dignity and promotes optimal attainment of individual health. The WIC Program serves as a gateway to comprehensive health services for maternal and child health clients.
The purpose of the WIC Program is to provide supplemental foods and nutrition education to participants at no cost. The program shall serve as an adjunct to good health care during critical times of growth and development, in order to prevent the occurrence of health problems, including drug and other harmful substance abuse, and to improve the health status of program participants. The program shall be a supplement to any program under which foods are distributed to needy families.
A. FEDERAL FISCAL YEAR 2001
FOOD FUNDS MANAGEMENT
OBJECTIVE I:
By October 1, 2000, increase or maintain the numbers of infants on contracted formula to 98%. As of April 2000, the use of concentrated formula is 98.77%, powdered-formula is 99.22% and ready-to-feed formula is 100_%.
EVALUATION DESIGN:
Assess percentage of WIC infants receiving contract, iron fortified formula.

Action Steps Activities/Methods
l. Continue statewide policy concerning utilization of sole source milk based infant formula for all well WIC infants.
2. Monitor Concentrate Rebate Compliance Report.
3. Review Trend Analysis of Compliance Report as needed.
4. Educate parents and health care providers on policy.

Resources
State WIC Branch (SWB) -

SWB, Syst~rns Information Unit (SIU), Office of Nutrition (OON)

SIU, OON

-

OON, SWB, SIU, Georgia Chapter American Academy of Pediatrics

Milestones
- On-Going
Monthly
As Needed ; On-Going

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FEDERAL FISCAL YEAR 2001 OBJECTIVE

OBJECTIVE II:

'

.

By September 30, 2000, review all financial and participant reports that are provided by the

automated systems to ensur~ accuracy.

EVALUATION DESIGN:

The accuracy will be assessed monthly by comparing projected food costs for each month with the final expenditures for the month. (closeout)..

Action Steps Activities/Methods

1.

Calculate, review and submit monthly food

obligations to DHR for submission to the

USDA Regional Office.

2.

Maintain monthly table, which

summarizes needed percentage of accuracv.

3.

Monitor the state% of Food Obligations

to expenditure.

4.

Monitor the vouchers paid by

Administrative check.

-

5.

Change in incidents of Cumulative

Unmatched Redemption (CUR) Reports

Resources
SWB, SIU, Financial Management Unit (FMI)
FMI

Milestones
On-Going -
..
Monthly

SIU

Monthly

SIU

Monthly

SIU

Monthly

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FEDERAL FISCAL YEAR 2001 OBJECTIVE CASELOAD MANAGEMENT

OBJECTIVE III:
By September 30, 2001, increase the percentage of prenatal WIC participants certified in the first trimester from 54.9 % to 60 %.

EVALUATION DESIGN:
The quarterly Trimester of Enrollment Report will be reviewed and the percentage of total prenatal WIC participants certified in the first trimester will be assessed.

/
Activities, Steps, Activities/Methods

Resources

1. Assist Local Agencies in developing strategies to

Program Management and

ensure prenatal participants are enrolled during the Review Unit (PM&R), SWB,

first trimester.

OON

2. Provide technical assistance to local agencies that have difficulty enrolling prenatal women early in pregnancy.

Same as #1

3. Develop public employer and physician awareness SWB, OON Department of

campaign concerning WIC Program and use of the Medical Assistance, District

Referral Form.

Coordinators, Department of

Labor, OHR

4. Continue to explore the expansion ofWIC Services SWB, OON, DMA, Georgia

to community health centers, health maintenance

Primary Care Association,

organizations, and private obstetricians and to

Medical Association of

migrant and rural health centers.

Georgia, Georgia Academy of

Pediatrics, Migrant and Rural

Health Association, HMO

Affiliates.

Milestones
On-going
I
On-Going
On-Going
-
On-Going

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FEDERAL FISCAL YEAR 2001 OBJECTIVE

COMPLIANCE ANALYSIS SECTION
OBJECTIVE IV: By Septem~er 30, 2001, complete\continue C?mpliance investigations on ~geted WIC vendors. EVALUATION DESIGN: Comparison of High Risk Vendors designated for investigations and reports o~ completed investigations will be reviewed and evaluated.

Actions Steps Activities/Methods

Resources

I. Identify I 0% of High Risk Vendors to be targeted for SWB, Vendor and

compliance investigations and/or compliance

Compliance Analysis.

trainings.

Section staff

2. Initiate compliance investigations of the l 0% vendors targeted.
3. Represent State at Vendor Administrative hearings.

Same as #1 ..
Same as #I

Milestones
'On-Going
'. As identified Upon Request

OBJECTIVE V:

By September 30, 2001, update the Compliance Analysis Plan with new information which

would enhance curre~t regulations.



EVALUATION DESIGN: Continue to enhance Compliance Analysis guidelines and procedures to address potential program abuse.

Action Steps Activities/Methods
l. Continue to research available resources to evaluate compliance analysis strategies.
2. Results to be presented at the Coordinator's meeting and in the Procedures Manual.
3. Provide technical assistance and training regarding implementation of updated plan to local agencies, as needed.

Resources

SWB, Compliance Analysis

Section

-

Same as #1

Compliance Analysis Section, Program Management and Review Section

Milestones
On-Going
On-Going
.
On-Going

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FEDERAL FISCAL YEAR 2001 OBJECTIVE

COMPLIANCE ANALYSIS SYSTEM
OBJECTIVE VI:
During FFY 2001, continue to work with internal and external agencies to deter clinic fraud and abuse.
EVALUATION DESIGN: Compile data from the results of periodic investigations.

Action Steps Acti\itin/1\letbod
I. Confer with local agency to ,mfy mcadent. 2. Contact contract bank to obcam ,ouchers.
3. Contact Georgia Office of Fraud and Abuse.
4. Conduct on-site visit to chnac.

Resources

Milestones

Local Agency

Within three (3) days

Bank

Immediately upon receiving notice of missing vouchers

Georgia OHR Office As Needed of Fraud and Abuse

Local Agency, District As Needed Office/SWB

PROGRAMMATIC AD!\ll~ISTRATION

OIU[CTl\'F. VII:

R~ September 30, 2001, ten ( 101 Local Agencies will have been re,iewed to ensure their

J1h'frarnmatic compliance with Fcd~ral and State Regulations.

'

'

r,:\l.l'ATION DESIGN:

1 "-n I I01 Local Agency programmatic and financial rev_iews will be conductL-d by Sept. 30, 2001.

Action Steps Acti\'ities/l\lethods

Resources

I l.ocal Agency review schedule for 1-"FY 200 I finalized.

SWB, OON. Local Agencies -

2. Prepare Local Agency reviews'techmcal assistance

SWB,OON

reports and submit to Local Agency.

;

3. Analyze and summarize FFY 200 I Local Agency

SWB,OON

reviews/technical assistance sessions, now sheets and

submit to Program Directors.

Milestones
5/01 On~going
9/01

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FEDERAL FISCAL YEAR 2001 OBJECTIVE

Action Steps Activities/Methods 4. Close all FFY 2001 Local Agency reviews.

Resources
SWB,OON

Milestones
10/01/01

OBJECTIVES VIII:

By August 15, 2000, the Federal Fiscal Year 2001 State Plan and Procedures Manual will be revised as needed and submitted to the USDA Regional WIC Office.

EVALUATION DESIGN: The Federal Fiscal Year 2001 State Plan and Procedures Manual will be submitted on time.

Action Steps Activities/Methods

Resources

1. Receive final USDA approval ofFFY 2001 State Plan and Procedures Manual.

USDA, SWB, OON

2. Print and distribute the Procedures Manual ', and State Plan to Local Agencies, Clinics

and others as requested.

... c

Department of. Administrative Services (DOAS),
SWB

3. Develop and distribute Procedures Manual revisions throughout FFY 2001 as necessary.

Program Management and Review Unit
(PMRU), SWB, OON

4. Mail public hearing materials to Local Agencies.

P.M.R.U., SWB
. .,

Milestones 09/15/00 10/15/00
On-going 2/01

5. Mail public comment letters to solicit comments and notify participants and advocacy groups of statewide regional public hearings.
6. Conduct statewide regional public hearings.
7. SWB units to submit State Plan revisions to the Program Management_ and Review Unit.
8. Compile and analyze public comments to

P.M.R.U.

3/01

,.

Local Agencies, SWB -
SWB

4/01
6/01
'.

P.M.R.U., sWB

6/01

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FEDERAL FISCAL YEAR 2001 OBJECTIVE

Action Steps Activities/Methods
be included in the FFY 2002 State Plan-as appropriate.

9. OON to submit revisions to the FFY 2001

State Plan.

-~

.. . ' ..

OBJECTIVE IX:

Resources OON Section

Milestones
8/1/01
'

To ensure that during FFY 2001, immunization assessments are done on every child 0-2 years old in each WIC clinic.

EVALUATION DESIGN: Conduct Assessments of children 0-2 years old for the status 'of immunization.

Action Steps Activities/Methods

Resources

1. Provide technical assistance to local agencies.
-
2 . Collaborate with State Immunization Program
- and retrieve data on impact of program collaboration.
3. Work with the Immunization Section to obtain a measure of WIC success based on chart review.

State Immunization Program & Program Management and Review Unit
State Immunization Program, Systems Information Unit, Policy Management and Review Unit
PMRU, Immunization

Milestones On-Going
Quarterly
Yearly

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FEDERAL FISCAL YEAR 2001 OBJECTIVE

OBJECTIVE X:

SYSTEMS INFORMATION MANAGEMENT
..
By October 1, 2001, all districts will be printing Voucher Printed on Demand (VPOD) Vouchers

EVALUATION DESIGN:

ACTION STEPS ACTIVITIES/MEIBODS

RESOURCES

MILESTONES

I.The following Districts/Units are. now prociucig all WIC.vouchers in thekclin.ics:

-

Cobb

D/U03-l

Clayton Gwinnett

D/U03-3 D/U 03--4

Brunswick Southside

D/U 09-3 D/U 11-0

SilJ, Electronic
Data. Proces~ing (EDP) Coordinators
"

:On~Going

Districts with one or more clinics producing all WIC ; vo:uchers:

Dalton Gainesville Dublin
-

D/U 01-2

,.

D/U02-0

D/U 05-1

/

..

-

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FEDERAL FISCAL YEAR 2001 OBJECTIVE
VENDOR MANAGEMENT
OBJECTIVE XI:
During FFY 2001, conduct two (2) retail advisory Board Meetings to ensure Vendor Management procedures are followed.
EVALUATION DESIGN:
All new policies and procedures will be incorporated into Federal Fiscal Year 2001 Vendor materials and State Plan and Procedure Manual.

Action Steps Activities/Methods 1. Reconvene Retailers Advisory Board to
discuss Vendor Management policies and procedures that govern WIC.retailer issues.
,,

Resources

Milestones

SWB Representative. USDA Representative Retail Association Representative, Retailer Representatives, Wholesalers

Novemper 2000 And
March2001

OBJECTIVE XII:
By October l, 2000, revise process for implementing .federal regulations concerning civil money
penalties.

Action Steps Activities/Methods

, Resources

Milestones

1. Convene the Civil Money Penalty Committee to revise the Civil Money Penalty Procedures incorporated into the Vendor Handbook, Vendor Agreement and the Sanction System.
2 Incorporate Civil. Money Procedures into the Vendor Handbook, Vendor Agreement and the Sanction System.
3. Train all retailers on procedures for collection of Civil Money Penalties (CMP)

Review the procedures of other states to incorporate effective procedures for implementing Civil Money Penalties.
USDA Regulations, Vendor Unit Staff, Quality Iniprovement Staff
;
Vendor Unit

April 2000May2000
May 2000June 2000
August 2000 September 2000

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FEDERAL FISCAL YEAR 2001 OBJECTIVE

Action Steps Activities/Methods during annual training sessions.

Resources

Milestones

4. Implement Civil Money Penalties for Federal.Fiscal Year 2001

Vendor Unit ,

October 2000

Complianc:e Analysis Unit

'

(CAU)

PROGRAM INTERVENTION

OBJECTIVE XIII:
By Jwie '2001, State WIC Branch will review all local agencies for compliance with new
legislation action steps/activities/methods (identification, residency, and income.

EVALUATION DESIGN:

During FFY 2001, review all local agencies for' compliance with the new legislation (on income,

residency, and identification.

'

Action Steps Activities/Methods

Resources

Milestones

1. Develop more training to d_etermine . ~olicy Unit . Problems or needs for taking action.

08/00 ..

2. Contact local agencies in FFY 2000 to Policy Unit inform them ofthe site visit.

06/0'1

-

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FEDERAL FISCAL YEAR 2001
CHAPTER2 FINANCIAL MANAGEMENT .
I. Program Financial Status II. Letter of Credit
III. Local Level Requirements

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FEDERAL FISCAL YEAR 2001 SECTION I- PROGRAM FINANCIAL STATUS

A. Narrative Description

I . DHR Financial Administration

The Office of.Financial Scr\"iccs (OFS) of OHR maintains the financial records in a manner that reflects separate accountability for each activity administered by DHR, utilizing disbursement classifications as required by the State Auditor lllld the various
federal agencies. The financial system uses a,combination of both data processing as
well as manual entries. The process of writing checks, preparation of check registers, and other mass detail work is rcrformed by data processing systems. The records kept in the county health dcpanments arc of a subsidiary or supplemental nature. Monthly reports are submitted hy all county departments to the Office of Financial Services in accordance with a prescribed uniform reporting procedure. These reports cover the financial operations that will he reimbursed by the Department of Human Resources. Supporting data for other administrative expenditures of the county departments is not submitted directly to OFS hut is retained in the finance office of the county department. The records of the county health departments are audited by CPA firms contracted by the county departments.

Th<. Stat~ Auditors of G1.."<lr~1a perform both financial and program audits. State law mandates that the Stall. Audaton. perform a financial audit of the books and accounts of the Department of Human Resources each fiscal year. Programmatic audits of specific pro~r.uns arc pcrfonnc<l h~ thr Stat1.. Auditor as deemed necessary.

" Tamc Reponing

Random Moment Sample Stud) (RMSS) is a method of measuring time worked per

rro:;ram by employees for cost allocation. This method uses a statistically ,alid sample

to dc:tcm1ine the amount of time employees expend on indi,idual programs. The

r1..-suhs of the quarterly R!\1SS arc used as a basis for the distribution of each quarter's

cost. A comprehensin: an<l tkt;1ikd procedural methodology of this process is included

m Appendix B of the Cost Allocation Plan. A copy of the Cost Allocation Plan can be

obtained from the State \\'IC Branch Financial Unit.

-

3. Cost Allocation Plan

The Department of Human Resources has a federally approved cost allocation plan and therefore, does not employ an indirect cost agreement. The revised plan was submitted to the Department of Health and Human Services on June 14, 2000. DHR is cun-ently awaiting comments and approval.

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SECTION II - LETTER OF CREDIT

The Director of the Office of Financial Services functions as cash manager of the Department.of Human Resources. 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 Departnient of the Treasury, Georgia's-CashManagement Improvement Act (CMIA), agreement 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 with actual expenditures and balanced. Reports of expenditures are made to both federal program fiscal officers and to DPM. Each grant award is recorded, balanced and reported quarterly as designated.

The Department's annual budget is analyzed to determine the ratios of the different federal and state funds. that comprise each type of expenditure. This is called the funding mix. Pisbursement 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 can he 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. If the Letter of Credit does not have any availability and conversion authority exists, the WIC Program Branch Accountant will make _an entry in the DHR accounting records to use food funds for administrative cost. A copy of the entry will be given to the cash manager so the cash manager will be aware of the need to draw the food funds immediately rather than during the reconciliation process.

'When rebate funds are received from the formula contractor. the cash manager notifies the WIC

Progran1 Branch Accountant. The cashier 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.

;

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FEDERAL FISCAL YEAR 2001

SECTION III - LOCAL LEVEL REQUIREMENTS

The local level requirements are as follows:

A. The. Master iAgreement for.the Division of Pubiic Healt:4 .requires that .local agencies
~amtairi:.t4eir finan~ial. mana.gement systems in accordance:with:45 CFR Parts ?4.60 .and
74~61:(Subpart H) and.OffjciaLCode ofGeorgiaAnnotated(OCGA)/Section31~3-8. A copy
ofthe Master Agreement for Public Health maybe obtained from the FinancialSection of the
State.WIC Branch.

The :OHR Administrative -Policy and Procedumr::Manual:'8lld:the:OHR..,Grants,to Counties

Manual gives :.specific instructions in the ,operation ofa financial managementsystem .at the

Jocal level (see the Public Health Master Agreement which can: obtained from the State WIC

Branch Financial Unit).







a B. Local agencies must submit, on monthly basis, a Monthly Income and Expenditure Report
(MIER) to the Public Health grant-in-aid office. . The state agency staff monitors. these reports against approved budgets. During program reviews, expenditures and supporting documentation are reviewed to ensure program complianc~.

C. The Pubiic Health Master Agreement requires all local agencies to be audited. annually. The DHR 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 DHR 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 State WIC Office and the WIC Allocation Advisory

Committee, with final approval by the Director of the Division of Public l:lealTh. _. Funds

available for allocation to local agencies are determined by subtracting the cost of operations

of the State WIC Office, the wic Office of Nutrition 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.



E. The WIC Allocation Advisory C011)mittee is charged with assisting the State Agency and the Division of Public Health with developing an a9ceptable methodology for allocating federal grant funds to Local Agencies. The Georgia WIC approved funding formuia has been well accepted by local agencies due to its accuracy and fairness. Additionally, the Georgia WIC Allocation Advisory Committee makes recommendations to the State Agency/Division of Public Health concerning caseload management strategies. A District Heath Director chairs the committee. Each coordinator, manager or director has one representative from a small, medium and large size district. The committee meets a minimum of two times per year, first in January or after the federal grant award notification; and in July or August to determine

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FEDERAL FISCAL YEAR 2001
reallocation funds distribution and the succeeding year's ca_seload strategies. However, meetings are convened on an as needed basis. Committee members rotate every two ye~rs. To ensure committee continuity and integrity, one member from each category becomes a member of the succeeding rotation.
F. Operational and administrative funds are distributed to local agencies by contractual agreements. WIC funding to Georgia's nineteen lead counties is part of the DHR Public Health Master Agreement Funding to two non-profit organizations is made through a standard DHR contract.
G. Budgets for local agencies are changed by means of a contractual amen<:fments

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FEDERAL FISCAL YEAR 2001

Section IV - Property Management and Procurem.~

A. See paragraph #204 of the DHR Public Health Master Agreement for property management

requirements.







B. AU purchases areQ:J.ade in accordance.with laws.governing purchases, OCGA, 50-5-:50
through 50-5-124 and the Rti)es and Regulations-ofthe State Department of Aruinistrative

Services, Purchasing Division. Consultant and certain other contracts in exc:e~s .of

ofthe $250,000.00 state funds.must be approved by the State Office ofPlanning and Bu<iget.
Professional services.rendered.by individuals ororganizatioris that are not a part

Department ofHuman.Resources.are required to have.prior approval ofthe awarding

federal agency if federal funds ~e involved.



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FEDERAL FISCAL YEAR 2001
CaAPTER3
FOOD. DELIVERY/MANAGEMENT .INFORMATION SYSTEMS
I. RetaiLDelivery Method II. Vendor Management . III. Direct Delivery Method IV. Management Information Systems V. Food Package Design

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FEDERAL FISCAL YEAR 2001
SECTION I - RETAIL DELIVERY METHOD

I. A description of all food delivery systems that the State plans to use during the year including any special provisions for the homeless or for the delivery of special formulas [CRF 246.4(a)(14)(i1246.4(a)(14)(ix)].

See the Food Delivery Section of the Procedures Manual.

II. 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.

III. Copies of all food instrument types [CRF 246.4(a)(14)(v)].

. See the Food Package S~tion of the Procedures Manual.

IV. A description of food.instrument security and accountability procedures at the State level

[CRF 246.4(a)(l4)(v), 246.12(1)).

.

See the Food Delivery and Quality Improvement Sections of the Procedures Manual.

V. A description of procedures for shipment of food instruments between all points [CRF 246.4(a)(l4)(v), 246.12(1)).

See the Food Delivery Section of the Procedures Manual.

VI. Names of companies, other than vendors, under contract to operate or assist the State in operating the food delivery system [CRF 246.4(a)(l4)(vii)].

Viking Computing, Southern National, Ross Laboratories, Mitchell and McCormick, Human Soft, Inc. (DeKalb System).
VII. A description of State procedures for follow-up on reports of lost or stolen food instruments [CRF 246.4(a)(l4)(v)].

See the Quality Improvement Section of the Procedures Manual.

VIII. 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)].

;

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Reconciliation
The Georgia WIC Program, in conjunction with its ADP contractor, Viking Computing, utilizes a series of monthly reports that provide complete tracking for every voucher issued.
These include:
Bank Transaction Listing lists each voucher cleared by the bank during the processing month by serial number, date cleared, dollar amourit and transaction code.

Bank Exception Report identifies vouch,ers which cannot be reconciled to the Issue Records either because the voucher number is not recognized as currently valid, or because the voucher number has already been placed in a final status. .
Closeout Reconciliation Report provides a one to one reconciliation report that shows .. at a detailed voucher level. the disposition of each voucher which was created during the month that is currently being closed out.
Voucher Reject B) The Bank lists detailed data of vouchers rejected by the contract bank during the screening and prepayment audit. The report is summarized at the county level within each District 'Unit. The list includes both computer and manual vouchers.
For Manual Voucher.; (including those prepared by clinics using automated systems) there are Unmatched Redemption Reports which include Cumulative Unmatched Redemption's showing those \'Ouchers that cannot be matched to either an issue record, a vaJid \VIC ID or a Cenificatton period.
\'ouchers Paid By Admini,trathe Checks list in detail those vouchers rejected by the bank for reasons such as bcmg O\'er the maximum amount but subsequently approved by the \\'IC Office for payment. This combination of reports and microfilm allows the WIC program to track every ,oucher and determine its final disposition.
In addition, the State \\'IC Office receives records of all vouchers processed during the month on CD-ROM. A PC Program, Georgia Imagin Rctrit:\"al. pro,i<lcs fast and easy access to all WIC vouchers processed by the bank.
On January I, 1997 the Georgia WIC Program entered into a new contract with Viking for Data Processing services. The contract has been extended through September 2000.
IX. A description of the State plan to monitor local agency complianc6 with food delivery and accountability requirements [CRF 246.19(b)].
See the Monitoring Section of the Procedures Manual.

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SECTION II - VENDOR MANAGEMENT

I.

A description of the vendor management (food delivery) system as it operates at tpe State

agency level, including instructions for the local agency [CRF 246.4(a) 14(i)].

II. A narrative description of vendor selection, including a list of selection criteria, limitation criteria, if applicable and the application form [CRF 246.4(a) 14(ii)].

ill. A copy of the standard written v~ndor agreement between food vendors and the State (or local) agency [CRF 246.4(a)(l~)(iii)J.


IV. A description of the procedures d~signed to. contr<;>l participant abuse of the program

[CRF. 246.12(k)(2)].

.

V. A description of the system for monitoring food ~endors to ensure compliance and

prevent fraud, waste and abuse [CRF 246.4(a)(l4)(iv)], including:

I

.

- The functional breakdown betwee~ Stat~ and local agen~y responsibilities for

vendor management

- Monitoring system

- High risk criteria .

I

- Investigation system

- Sanction system

- Vendor/participant complaint system

.

,

.

VI. Administrative appeal. procedures for food vendqrs (may be placed in fair hearing section

of the Procedures Manual) [CRF 246.4(a)(l 7)].

. VII.

A description of the prncedur~s to review food instruments for errors or overcharges, including pre-payment_ and. post-payment edits, reclaim, rejection and adjustment procedures .(May ,be , included m general food delivery system description) [CRF 246.4(a)(l4)(vii)].

See the Vendor Section of the Procedures Manual for items I - VII above..

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SECTION ID ~'DIRECT DELIVERY METHOD

I.

A description of how infant fonnula requiring a physician's prescription is issued to WIC

participants.

'

See Food Package Section of the Procedures Manual.

STATE WIC PLAN - 200 I

23

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001
SECTION IV - MANAGEMENT INFORMATION SYSTEMS

A narrative summary of changes made to the WIC management information system(s) in the past

Year is listed."b'-elow:





AUTOMATED DATA PROCESSING l
HEALTH OUTCOME and SERVICES TRACKING (HOST)
HOST has been re-written to comply with Y2K requirements. The new program, re-named AEGIS, uses an Oracle database with Visual Basic Graphic User Interface (GUI) in a Windows environment.
t
AEGIS has been installed in Dalton, Macon and Southside. All remaining HOST sites are scheduled to be converted to AEGIS by July 31, 2000.
AUTOMATED REPORTING and MANAGEMENT INFORMATION SYSTEM (ARMIS)
Plans are for ARMIS to be re-written to meet Y2K requirements. The new system will operate over a secure WEB site. Monthly data updates will be done electronically by Viking thus eliminating the need for CD's or diskettes.
Access to the data will be faster and easier for District!U_nit staff who will no longer be responsible for ,;naintaining their own systems. Built in security and customizing of user. accessibility will ensure protection of data while maximizing its usefulness to State and District level personnel.

VENDOR INTEGRITY PROFILE SYSTEM (VIPS)
The Vendor Integrity Profile System has been enhanced to include a District/Unit version that has been installed in available to local agencies.
VOUCHER ANALYSIS SYSTEM (YAS)
The Voucher Analysis System continues to be in use by the State WIC Office. VAS, a Visual Basic program, is used to assist the Vendor Unit in comparing vendor food package and voucher code prices with the state average and peer groups. VAS additionally provides peer group analysis and food package, voucher code and voucher maximum price references.;

STATE WIC PLAN - 200 I

24

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001
GEORGIA IMAGE RETRIEVAL SYSTEM (GA IRS)
All WIC vouchers processed by the bank are now being imaged onto CD-ROM. Since 1997 State WIC Office staff have been able to retrieve and print electronic images of all vouchers from CD-ROM. Plans for the future include expanding GA IRS to include reports, voided vouchers and possibly other documents.
PARTICIPANT CHARACTERISTIC STUDY
See Attachment I for the checklist.

STATE WIC PLAN - 2001

25

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001
SECTION V - FOOD PACKAGE DESIGN
I. A description of the standar<:l 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 ~pecial provision~ for the homeless [CRF;.246.lO(c)j.
II. A list of all State approved infant formulas (including the standard contract formulas), exempt infant formulas, special formulas and medical foods [C~ 246.l0(f)].
ID. A copy of the current State authorized food list [CRF 246.l0(b)].
See Food Package Section of the Procedures Manual for items I - III above.

STATE WIC PLAN - 2001

26 ,

STATE WIC BRAN<;::H

FEDERAL FISCAL YEAR 2001 .
CHAPTER4 PROCESS FOR APPLYING
TO OP.ERATE A WIC CLINIC

STATE WIC PLAN - 2000

27

STATE WIC OFFICE

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 SeGtion.245>-S(~) of the WIC Regulations. The application must demonstrate the agency's ability to operate"il'"WfC Program in accordance with WIC Federal Regulations and State policies.

The Georgia WIC Program operates in all 159 counties in the State and is operated by public health departments and two Atlanta-based contracted agencies (Grady Hospital and Southside Health Care, Inc.). During FFY'OO, Georgia WIC continued its goal of exploring the expansion of WIC services to non-public health agencies/providers. These new WIC sites may include Migrant Health Centers, Health Maintenance Organizations, Community Health Centers and/or private provider offices.

Applications will be accepted for the purpose of expanding services in a current Program area. hi 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. al m1mmum, the overall application process, time frames involved, criteria for selection of agencies and information concerning the appeal process in the event that the application is denied.

:! A copy of the WIC Program Regulations, 7 CRF Part 246.

3. A hst of basic requirements for inclusion in the local agency application to operate a WIC Pwgram. This will include staffing and equipment requirements, as well as clinical and nutnt1onal regulatory mandates.

4 A hsung of State and Local Agency resources.
5 A copy of the Memorandum of Understanding between the Stale Agency and the local a~cncy. (The Memorandum of Understanding is included in Section Administration of the Procedures Manual).

<>. A copy of the most current State Plan, Procedures Manual and Georgia WIC Information Packet.

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. [CRF 246.7 (M)]. Applications will also be reviewed for assurance that at minimum:

. STATE WIC PLAN 200.1

28

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

1. The local agency h~ 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 Branch Agreement.

3. Civil rights complaints are being handled in accordance with procedures outlined in ~e 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 or her race, color, national origin,

language, sex, age, or disability.

'

5: Appropriate staff, volunteers and/or other translation resources are 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 trainings.
12. The agency agrees to comply with all USDA and Georgia WIC reporting and documentation requirements.

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:

STATE WIC PLAN - 2000

29

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

.a. Accrue financial .pr in-kind benefits from a residents participation m the program;

b. Subsume foods. provid.ed by the WIC Program into a communal food service,
but are available exclusively to the WIG participant for whom they were issued;

c. .,Allow the homel~ss facility to place constraints on t4e ability of the participant

to partake of the supplemental .foods ~d .~utritional education available under

the Program.



16. nie local ~gency agrees to .contact the ,ho~eleSS facility periodically to ensure

continued

compliance

with these
(.,,

conditions..



,

17.. The local agency requires the homeless facility to notify the State or iocal agency if

it

.ceases

to

meet '

any.of

these

conditions.



)

STATE WIC PLAN -2000

30

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

,
Attachment I

GEORGIA DEPARTMENT OF HUMAN RESOURCES DIVISION OF PUBLIC HEALTRH STATE WIC OFFICE
FFY 2001 STATE PLAN

STATE WIC PLAN-2001

31

STATE WIC OFFICE

FEDERAL FISCAL YEAR 2001

ATTAC~NTS

Attachment I

PARTICIPANT CHARACTERISTICS MINIMUM DATA SET (MOS}

The Participant Characteristics Minimum Data Set (MOS) contains data items, that are reported to FCS electronically by State agencies for one report month on all or a sample of participants. The MOS has required data items that must be collected and reported. The Supplemental Data Set Specifications (SOS) comprised of optional data items which 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 n> 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 which 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.

X

Client Race/Ethnicity: The classification of the participant into one of the five (5) raciaVethnic

categories: white; black; Hispanic; American Indian or Alaskan Native; or Asian or Pacific

Islander. The ethnic categories, white and black, include only those persons who are not of

Hispanic origin.

32

STATE WIC PLAN -2001

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

Attachment I

III. MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST

State Agency Performs

State Agency 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 ofavailable nutrition education

sessions

- - - -
-

--x x

-

Provide appointment notice to enrollee Track participation in education , Track types of nutrition education provided

Perform Individual Client Health Monitorin2

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
- - - Monitor clients' views ofWIC 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

X

- - - Provide WIC participant population data to Center for Disease Control

FOOD INSTRUMENT PRODUCTON

Maintain Food Packa2e Database

X

- - - Record list of approved foods and food package data

X

- - - Record food package variations and food instrument types

X

- - - Pro-ration of food quantities for clients with iate 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 pro-rated food instruments

X

Print custom-tailored food instruments

33

STATE WIC PLAN - 2001

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

Attachment I

III. MANAGEMENT INFORMATION SYSTEM
WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST I '

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

- - - 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 vendor on redeemed food instruments

X

- - - Check for redeemed but unissued food instrum,ents

Produce Vendor Payment Detail

X

- - - Produce payment detail for checks (where applicable)

X

----,-- Produce.pa~ent detail for vouchers (wh~re applicable)

CASELOAD MANAGEMENT

Allocate Caseload

X

- - - Detemiine maximum state caseload which could .be served with available funds

X

- - - Prepare local agency caseload allocation estimates ..

X

- - - Record caseload allocations assigned to local agencies

Monitor Caseload

X

___ Track act11al participation against caseload -levels .

X

___ produce .FNS reports on participation

VENDOR MANAGEMENT '

Support vendor authorizations

X

_ _ Capture and maintain data on. authorized vedors

X

_ _ Produce vendor history information on .individual vendors

X

- - Track vendor authorization process

Determine, hi2h-risk vendors

X

Determine high risk vendors using basic statistical analysis (e.g. low variance,

- - - high mean)



;

- - - Dete~ine high risk vendcirs by using additional analysis tools

34

STATE WIC PLAN - 200 I

STATE WIC BRANCH

FEDERAL FISCAL YEAR2001
III. MANAGEMENT INFORMATION SYSTEM

Attachment I

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 In,estigations and Routine Monitoring

X

_ _ Capture compliance buys and routine monitoring data performed on vendors

X

Support constructing a sampling of vendors for investigation

X

Support record audits with data needed to evaluate vendor inventory ofWIC foods

Monitor Compliance Cases and Sanctions

X

_ _ Maintain data for in-state vendor investigation cases and sanctions applied

Maintain compliance data for abusive out-of-state vendors

X

_ _ Accumulate sanction points for vendor abuse

Coordinatt \\'ith Food Stamps Program

X

Maintain FSP \'iolation data on WIC vendors

X

_ _ Report WIC sanctions to Food Stamp Program

Support \'rndor Communications

X

Produce vendor lists and labels

X

_ _ Produce \cndor correspondence

OPERATIONS MANAGEME~a
Monitor Administrative Operations

_ _ Maintain staffing. client load and operational characteristics on local agencies and

clinics

X

_ _ Produce client and food instrument activity reports on local agencies and clinics

Maintain Client Outrt>ach
Maintain client lists for local agencies to use for outreach

X

_ _ Track referrals of \\'IC participants to other health and social scnices

RSASCIAL MANAGEMEl\1

Record Grants and Budgets

X

_ _ Record nutrition scnices, administration and food grnnts for state agency

X

_ _ Maintain local agency budget information

X

_ _ Maintain state agency budget information

35

STATE WIC PLAN -2001

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

Attachment I

III. MANAGEMENT INFORMATION SYSTEM

WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST

Monitor Expenditure

X

_ _ Monitor nutrition services, administration and food obligatio~s and

expendi~es



.



X

- - Monitor cash flow

X

- - Produce FNS 498 Report

Process Manufacturer Rebates

X

- - Estimat~ total annual rebates

X

- - Bill manufacturer(s) for rebate .

X

- - Monitor rebate collections from manufacturer(s)

SYSTEM ADMINISTRATIQN

Maintain System Data Tables

X

- - Maintain system data tables .

Administer SystemSecurity

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

36

STATE WIC PLAN -2001

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

Attachment I

III. 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 12 months); or child (12-59 months).

_ _x_ _ Expected date of delivery or weeks 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 yearshould 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



_ _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 coun~ed in tlie 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.

as A self-declared number in the family or economic unit may be reported for
participants whose income was not required to be determined part of'the WIC certification process. These participants include adjunctively income-eligible participants (due to TANF/AFDe, Food Stamp Program, or Medicaid participation) and those participants 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 identi:fied by the State for automatic WIC Program income eligibility, income eligibility oflndian and instream migrant farm worker applicants).

37

STATE WIC PLAN -2001

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

. .

-

III. MANAGEMENT INFORMATION SYSTEM

PARTICIPATION CHARACTERISTICS

Attachment I

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 w~ 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 pwposes 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 incomeeligible participants and those persons deemed eligible under optional procedures available to the State Agency in Federal WIC Regulations, Section 246.7(d)(2)(viviii).

Zero should not be used to indicate income values that are missing or not available. Zero should indicate only an actu~l value of zer~.
_ _x_ _ Nutritional risks present at certification. The three highest priority nutritional risks
present at the WI~ Program certificatio_n current in Apri~ 1998.

X . ' Hemoglobin or he~atocrit. That valu~ 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 _

c. ollecte. d.in

pounds '

and

quarter

pounds,

weight

may

be

reported

in

grams



X Height. The participant's height (~r :length) measured according to the CDC

nutrition surveillance program standards [nearest one-eight (US) inch]. If height is -

. not collec_t~d in inch~s and eighth inches, height may be reported ih centimeters.





'

~-

f

~

X Date of'height and weight measures.' The date o(the height and weight measures

.,, . that were used during the most recent. WIC Program cert_ification period as of April

1998 in MMDDYYYY format.

X Currently brea~t feq. Fo~ infant participants between the ages of seven and eleven . months, whether or_not t~e participant is currently receiving breast milk

X Ever breast fed. For infants between the ages of seven and eleven months, whether or not the infant was ever breast fed.

38

STATE WIC PLAN-2001
, ,. .

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

Attachment I

III. MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS
State Agency MIS:
Collects
__x__ Length of time breast fed. 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.
_..;;.x;;___ Food packages. The food package. code(s) for the WIC food package or for all food
instruments prescribed for the participant during the month.

39

STATE WIC PLAN - 200 I

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001
III: MANAGEMENT .INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS

Attachment I

State Agency Collects
X

MIS Plans to Collect Supplemental Data Set (OP_TIONAL)
- - - - - Date of first WIC certification: Date theparticipant 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 ofprenatal 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 he 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.

X

- - - - - Pre-pregnancy weight: For pregnant women only, the participant's

weight immediately prior to pregnancy: Pre-.pregnancy weight may be

reported either in pounds and ounces or in grams.

STATE WIC PLAN - 2001

40 STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

Attachment I

III. MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS

State Agency Collects

MIS Plans to Collect Supplemental Data Set (OPTIONAL)
_____ Weight gain during pregnancy: For breastfeeding and postpartwn women, the participants weight gain during pregnancy as taken immediately at or prior to delivery. Weight gain during pregnancy may be reported in either 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 and ounces or in grams.

_ _ _ _ _ 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 and eighth inches or in centimeters.

_ _ _ _ _ Date oflast 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.

The following items may be reported at the discretion of individual States.

- - - - - 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.

41

STATE WIC PLAN - 2001

STATE WIC BRANCH

FEDERAL FISCAL YEAR 200I
III. MANAGEMENT INFORMATION SYSTEM

Attachment I

WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST
The following checklists were taken from the WIC Functional Requirements Document (FRO) who was provided as guidance to State agencies on functions they_should consider incorporating in their Management Information Systems. Please check those function/capabilities, which the State Agenc:y system currently perfonns or plans to perform within the next two years.

State

State

Agency Agency Performs Planned Function/Capabilities

CERTIFICATION

.
Determine

Bask

'
Eli2ibility

of

Applicant

X

____ Capture basic eligibility characteristics on persons applying for WIC

X

____ Maintain appointment schedule availability and produce daily

appointment schedules

of - - - - X Provide appointment notice to applicant Determint' !'.utritional Risk Client

X

____ Capture required client nutrition and health characteristics needed

for cenification
-~x;....__ Capture additional client nutritionand health characteristics

X

____ Assign the nutritional risk ofth~ client

Certify Elieihle Applicants .

X

____ Capture and maintain enrollee ~ata on cenified clients

X

Issue identificauon card to client

Food Packagr h\uance/Data

- - - - Prescribe enrollee food package
- - - - Maintain appointment schedule for enrollee food ins.u:ument pick-

up

- - - - Select and record enrollee vendor selection

.Check For Oual Participation/Process Transfen ,

X

- - - - List dual enrollees ...

X

------- List dual panicipants

- - - - Process transfer of enrollee

Capture lnwstigator Data

- - - - Capture enrollee record for compliance investigators

42

STATE WIC PLAN -2001

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2001

Attachment I

OFFICE OF.
NUTRITION
GOALS. AND
OBJECTIVES

43 STATE WIC PLAN -2001

STATE WIC OFFICE

i '

FHB Work Plan

. Section, Office, Population Team or other Unit: Office of Nutrition

Work Plan Date: 8-31-99

Total Pages: 35

I

Work Plan for Year: October 1, 1999 ~ September 30, 2002

Page 1 of 35

FHB 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.

FHB Mission:

Thetefore, we are committed to promoting the physical, mental, spiritual, ar,id 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 Family Health Branch.





Unit Purpose: "

The Office of Nutrition (OON) promotes the health of Georgia residents by providing nutrition services and

nutrition education. The OON works in partnership with both the public and private sector to promote healthier

lifestyles for Georgians.



unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Health Status
Goal # 1: Improve the overall health of the population of Georgia

Page 2 of 35

Objective # 1.1: Decrease the incidence of low birth weight from 6.4% to 5.9% by 2002 for ail Georgians (1997 Georgia PNSS). Related Indicator (if applicable):

Strategy
'
I. Improve the number of women who meet the national recommendation for weight gain during pregnancy.

Indicators
PedNSS/PNSS Population

Baseline
In 1997, 31.6% in the US and 29.9% in GA gained less than the recommended weight during pregnancy.
1997 Prenatal Nutrition Surveillance System (PNSS), Table IC

'

. *

All

monies

allocated

for

training

Is

.
specified

on

page

21.

Tasks
'
A. Explore the possibility of obtaining WIC Program data on low birth weight . babies born to WIC participants, and total .weight gain of prenatal participants (based on pregravid weight
and last weight before delivery).
B. Assist district staff in developing strategies to target non-Hispanic black women who show highest risk for LBW
C. Assist districts in developing strategies to target women under age 19 that are the most likely to be underweight in pre-pregnancy. (PNSS, 1997)
D. Encourage district and clinic staff to
refer women at risk to programs to assist with smoking cessation, substance abuse, mental health, and other resources that address risk behaviors.
E. Collaborate with Office of Women's Health, and others, to influence preconceptional health and facilitate early referrals.
F. Work to improve outreach and enrollment into the WIC program.

Resources Needed
'
CBS FHB-WH FHB-AHYD GWP Family Connections Rural Health Nurses QA Team TCOYH Campaign

Time Line
September 2002

Unit: Office of Nutrition.1999-2002 State Strategic Plan Improving Health Status

Page 3 of 35

Goal # 1: Improve the overall health of the population of Georgia

Objective# 1.1: Decrease the incidence of low birth weight from 6.4% to 5.9% by 2002 for all Georgians (1997 Georgia PNSS).

Related Indicator (if applicable):

Strategy
2. Support the districts to
ensure client has adequate food supply, food preparation skills, knowledge of good food choices and access to grocery stores.
:: .

'
Indicators ..

"

-

-.

.

'

'"

I,

I

Baseline .
'.

. Tasks

A: Identify and/or develop teaching
resources and methods; train staff in
use.

Super Market Tours

Respond to recommendations of Nutrition Education, Communication, and Networking Sub-committee in procuring educationalinforination/handouts.

B. Explore possibility of mock grocery

stores as a teaching tool in WIC

clinics.

..

C. Utilize the Take Charge of Your Health (TCOYH) messages to teach proper nutrition and lifestyle.
D. C'ontinue assessing the feasibility of a
statewide training center.

E. Encourage districts to develop a referral checklist for clients that 'lncludes DFCS, Family Connections and other community resources concerned with food procurement, preparation, safety and access.

F. Encouragefood preparation demonstrations and workshops for clients through community resources
. such as the Cooperative Extension
Servjce, Electric Membership Corporation demonstration kitchens, and others as identified.

Resources Needed
FHB-WH FHB-AHYD GWP MH TCOYH Campaign Family Connections CDC Teleconference (monthly) GCNE Grocery Stores Nursing QA Team Rural Health Religious_Community

Time Line
September 2002
..

unit: Office of Nutrition 1999-2002 State Strategic Plan
Improving Health Status
Goal # 1: Improve the overall health of the population of Georgia

Page 4 of 35

Objective # 1.1: Decrease the incidence of low birth weight from 6.4% to 5.9% by 2002 for all Georgians (1997 Georgia PNSS).
Related Indicator (if a i>Dlicable}:

Strategy
3. Promote healthy lifestyles
among women during the pre-conceptional and prenatal periods

Indicators

Baseline

Tasks
A. Train district and clinic level staff to develop a referral resource that includes contact information for: GA OHR Division of Mental Health, Epidemiology, Minority Health, Rural Health, local obstetricians, Farmer's Market Program, church outreach groups, programs from within the Family Health Branch (e.g., Women's Health, Children First, Immunizations Healthy Mothers/Healthy Babies, local school requirements).

Resources Needed
Smoking Cessation Substance Abuse-Mental Health Parental Skills Resourc~ Mgt. Class Obstetricians
-

B. Train district and clinic staff to refer to Nutrition Guidelines for Practice as a standard for Medical Nutrition Therapy

C. Increase number of high-risk clients counseled by nutritionists.

4. Develop and promote
broad-based public health initiatives.

A. Promote TCOYH messages and other social market programs via billboards, radio PSAs , newspaper articles and exhibits.

Mass Media CDC GCNE CVD-PI

B. Provide consultative services to

districts and clinics in developing





relationships with local radio stations, newspapers, and other community

population centers.

C. Publish WIC 800 toll free number on billboards and bus cards and other outreach materials.

D. Promote appropriate environmental
** Take Charge of Your Health (TCOYH) campaign proposed alloacndatpi-oolincyscahranegessp. ec.ified on page 10.

Time Line
September 2001

unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Health Status

Page 5 of 35

Goal # 1: Improve the overall health of the population of Georgia.

Objective# 1.2: Develop an action plan for addressing obesity in the child and adolescent populations in Georgia;

Related Indicator (if aoolicablel:

Strategy

Indicators

Baseline

Tasks

.
I Resources Needed Time Line

I. Identify successful models and practices in working with child and adolescent populations on overall health

2002 PedNSS Table 10:
8.0 % Children overweight

1997 PNSS Table C: 38.8% overweight in pre-pregnancy,

FHB-DT

A. Collaborate with appropriate entities to identify prevalence of obesity among

CDC

children and adolescents, as well as high-risk Emory

population groups.

.

DOE

practices and healthy

B. Follow up on research findings from CDC AAP/ GA Chapter

lifestyle.
2. Collaborate with appropriate partners to explore issues of obesity in adolescents and children.

1998 PedNSS Table 10:
8.6% children overweight

focus groups that were conducted on child feeding practices, for purpose of incorporating fmdings into nutrition education interventions.

Fit Kids CHS Head Start

C. Collaborate with Emory University to research intervention methodologies for

Day Care Centers Cooperative Extension

.

possible implementation in the Georgia WJC Nursing .Q A Team

Program.

FHB-AHYD

'

D. Collaborate with appropriate entities to

GWP

identify recommended interventions to be

used in the target populations.

Office of Nutrition Task

Force on Child and

E. Work with districts to implement

Adolescent Obesity

recommended interventions at the local

level.

!LSI

F. Partner with Obesity Task Force partners to UGA

design an effective evaluation component MCG

for obesity interventions.

G. Explore possibility of forming an Obesity

Task Force as a sub-group of GCNE.

'



..

'

.

p_1__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Health Status

Page 6 of 35

Goal # 1: Improve the overall health of the population of Georgia.

Objective# 1.3: Increase the percentage of infants in the WIC program who initially breastfeed from 43.9% (FFY 1998) to 51% (FFY

2002).

Related Indicator (if applicable):
.

Strategy

Indicators Baseline

Tasks

Resources Needed Time Line

I. Establish breastfeeding as a
societal norm by developing 2000-51%

broad-based public health

initiatives.

2000-45%

Ir

Georgia WIC Program Infant Feeding Characteristics Report, 1997 43.9% 1997 PNSS Table IC: 39.4% ever breastfed'
'.

A. Through a collaborauve elfon "uh the
FHB populations teams, pwnJc technical assistance and uammg for districts and community agencies.
B. Work with local agencies in the development of breastfeeding education . and support during prenatal and postpartum periods.
c. Evaluate local WIC agency breastfeeding '
activities through monitoring of health records, staff interviews, and annual breastfeeding plan upJtes.
D. Worl v.uh the lo.:I ~en.:ie, to e>1Jbh,h "u1dcluu:;, luJ pu:11o1II\ c duu..: cU\ uumucnl th.al cnJu1 >C:1 h1c.a,1JccJmg ~) the prckrn:J mcthuJ uf mi.aul fr:cJ111g

MJ l\kdia GTfFB BfAC-WIC LaLeche League FHB Population Teams NAWD USDA/FNS CDA GA-AAP $200,000 \VIC funds TC0\'11 C,mp,ign B1cJ~tkcJ111g CJmpaign

I: Worl v.llh lo.:I ~cii.:1<> to Je,elup

S).'Sh:ms for assunug th.11 mothers who

are separated from their infants are able 10 continue providing their infants with breast milk.
F. Work with local agencies to assure that

l

regular educationJI upponunnu:s are

available to ~taff.mJ lhc i:ommu1111y

'

Sept. 2002

Unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Health Status

Page 7 of 35

.Goal # 1: Impr9ve the overall health of the population of Georgia.
Objective# 1.3: Increase the percentage of infants in the WIC program who ir)itially breastfeed from 43.9% (FFY 1998) to 51% (FFY 2002). Related Indicator (if applicable):

Strategy ..

Indicators Baseline

.,

' .

' .

Tasks

G. Employ the TCOYH and Breaslfeeding
social marketing campaigns stalewide.

H. Conlinue to encourage the expansion of the role of breas1feeding coordinalors in order to provide services and training across programs.

L Work with local agencies in the expansion

of breas1feeding services through such

means as peer counselor programs,

support programs, and coordination with

the.Medicaid Program.. :.

-.

Resources Needed

.

,.

Time Line

unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Health Status

Page 8 of 35

Goal # 1: Improve the overall health of the population of Georgia.

Objective# 1.3: Increase the percentage of infants in the WIC program who initially breastfeed from 43.9% (FFY 1998) to 51% (FFY
2002).

Related Indicator (if applicable):

Strategy
2. Support districts in providing breastfeeding services, referrals, and counseling.

Indicators

Baseline

Tasks A. Encourage local agencies to establish
referral system.
B. Assist clinics in procuring and using breastfeeding materials.

..
Resources Needed Time Line
Sept. 2002
'

a

C. Continue to encourage employment of

full-time Breastfeeding Coordinator for

each district.

3. Continue to identify social
and environmental factors that influence breastfeeding.
.
'.

A. Monitor the implementation of the

legislation passes during the 1999 Georgia

General Assembly to allow breastfeeding

in public. .

1

B. Monitor implementation of federal regulations.

C. Publicize MCH Help Line (Healthy Mothers, Hc;althy Babies) and WIC hotline number in under-served counties.
D. Increase community involvement in
identifying issues related to breastfeeding (i.e. focus groups)

E. Work towards establishing an appropriate

'.

policy for expressing and storing breast milk.

'"'

Unit: Unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Health Status

Page 9 of 35

Goal # 1: Improve the overall health of the population of Georgia.
Objective# 1.4: Decrease the incidence of iron deficiency anemia In the pediatric WIC population from 15.2% to 14.5% in children ages 23-35 months and from 12.4% to 11.4(0 in children ages 36-59 months by FFY' 2002 (PedNSS, CDC, 1998).

Related Indicator (if applicable):

Strategy
I. Design and implement a system to keep health care providers up to date on current and reliable infant feeding practices.
'
.
. .
-
\

Indicators 2002,23-35 months: 14.5% 2002, 36-59 months: 11.4%
-

Baseline

Tasks

Resources Needed

CDCPedNSS, I 998, Table I 0:
15.2% (23-35 mos.)
12.4% (36-59 mos.)

A. Promote bottle weaning by one year of
' age through training and appropriate educational materials provided to district .
_ and clinic staff. (Education will include noting that breastfeeding beyond one year is encouraged.)
B. Promote use of screening to identify infants at risk for iron deficiency.
C. Encourage use of Georgia 1997 Nutrition Guidelines for Practice in clinics for identification, education and follow-up of children with anemia.
D. Improve accuracy of hemoglobin (Hgb) and hematocrit (Hct) measurements.
Improve clinic staff technique in measuring Hgb and Hct by providing training opportunities to the districts.
.Improve data collection of Hgb and , Hct measurements by providing training ~nd establishing a written protocol and policy.
Monitor local agencies for accuracy and use of universal precautions.
E. Monitor pediatric anemia rates using
PedNSS report.

CDC AAP/GA Chapter , Hemo-Cue WIC Program Review Tm. Nursing QA Team FHB-MCH Pop. Team
NES-C

Time Line

unit: Office of Nutrition 1999~2002 State Strategic Plan Improving Health Status

Page 10 of 35

Goal # 1: Improve the overall health of the population of Georgia.
Objective# 1.4: Decrease the incidence of iron deficiency anemia in the pediatric WIC population from 15.2% to 14.5% in children ages 23-35 months and from 12.4% to 11.4% in children ages 36-59 months by FFY 2002 (PedNSS, CDC, 1998)

Related Indicator (if applicable):

Strategy
2. Provide appropriate
educational materials on infant feeding, iron-rich food sources.

Indicators
!

Baseline

Tasks
A. Include in annual Competency Based
Nutrition Skills Workshops.
B. Encourage districts to include education about iron deficiency anemia in regular staff training sessions at the local level.
C. Evaluate, obtain and distribute educational materials based on recommendations from the Nutrition Education Sub-Committee.

Resources Needed
'

Time Line

'
3. Participate with MCH
Population technical

Respond to requests by Family Health Branch offices to participate in site visits.

assistance site visit team to

assist the districts in resolving anemia issues.

' "





'

Unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Health Status

Page 11 of 35

Goal # 1: Improve the overall health of the population of Georgia.
Objective # 1.5: Increase the number of Georgians who realize there are health-related reasons to eat five servings of fruits and vegetables each day from 64:9% to 72% by FFY 2000.

Related Indicator (if applicable):

Strategy

Indicators

l. Promote 5-A-Day and
other Take Charge of Your Health awareness messages.

FHB ResultBased Budget
Indicator for OON

-

Baseline
OONPhone Survey by UGA in 1997-64.9%

Tasks
A. Implement campaign throughout the state, disseminating understandable, attentiongetting, action oriented culturally appropriate nutrition education messages.
B. Promote Take Charge of Your Health
through billboards, bus cards, radio public service announcements and other marketing venues.
C. Provide training in social marketing for
health districts and other agencies.
D. Promote activities such as: health fairs,
group classes, community outreach, individualized nutrition education via video and KIOSK, grocery store tours/demonstrations.
E. Promote campaign among Public llealth
offices arid DHR.
F. Identify, develop and distribute materials.

Resources Needed
..
-

Time Line

.

--

-
-

J

unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Health Status

Page 12 of 35

Goal # 1: Improve the overall health of the population of Georgia.
Objective # 1.5: Increase the number of Georgians who realize there are health-related reasons to eat five servings of fruits and vegetables each day from 64.9% to 72% by FFY 2000.

Related Indicator (if ao >licable):

Strategy

Indicators

2. Develop an evaluation
system for monitoring the effectiveness of the campaign.

Baseline

Tasks
A. Report data on exposure to billboards and other media sources.
B. Compile information from districts on
their participation in campaign.
C. Follow-up telephone survey.

.
Resources Needed
$300,0Q0-Central Supply

Time Line
June2000

3. Collaborate with GA WIC
Program to support and expand the Farmer's Market Program.

4. Identify, develop and use
appropriate materials through work with the Education, Communication, and Network Subcommittee.

'
5. Support a pilot project to

promote Taki: Charge of

Your Health messages in

Dekalb County elementary

schools to use as a model

,.

for developing statewide

school programs.

A. Cooperate with WIC committee on planning
B. Offer Take Charge of Your Health
resources in promoting the program.

A. Research current elementary education programs.

B. Analyze data and evaluate focus groups.

..

C. Collaborate with Dept. of Education, Head Start, Office of School readiness

Adolescent Health and Youth Dev.

'

unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Health Status

Page 13 of 35

Goal # 1: Improve the overall health of the population of Georgia.
Objective# 1.5: Increase the number of Georgians who realize there are health-related reasons to eat five servings of fruits and vegetables each day from 64.9% to 72% by FFY 2000. (Baseline: 1997 OON phone survey, UGA)

Strate.gy .
6. Promote 5-A-Day
awareness through Take Charge of Your Health to the religious community.

Indicators
'.

Baseline

Tasks
Network with existing faith commumty channels to provide training and/or technical support toward implementing the campaign.

Resources Needed Time Line


unit: Office of Nutrition 1999-2002 State Strategic Plan
Improving Services

Page 14 of 35

Goal # 1: Improve the overall health of the population of Georgia,

Objective #1.6: To improve the nutritional outcomes of Department of Human Resources' facility residents

participating in the National School Lunch Program by ensuring that at least 100% of DHR resident facilities are in
compliance with federal reaulations and state guidermes. ,.

Strategy

Indicators Baseline

Tasks

Resources Needed Time Line

1. Monitor the
implementation of Federal Regulations and State Guidelines regarding food service.

100% for 2002

Report Average for 1996-1999

A. Maintain or increase the number of DHR
school breakfast and lunch services that meet nutrition standards in the Dietary Guidelines for America.
B. Anend meetings and training provided by .
USDA funding source.
C. Continue to make p<riodic on-site visits.
D. Meet USDA regulation requirements during site visit, conducted every four years.

DOE MH ' DHR Commissioner

September 99 -Ongoing
February I,
2000

E. Monitor data from participating facilities.

F. Complete annual report of monitoring visits to OON Director.

G. Update procedures manual when necessary.

H. Facilitate the signing of the 'free & reduced' lunch policy statement by the DHR Commissioner.

2. Continue to expand
current promotional efforts to provide food

A. Share updates and information with
facility staff.
B. Share health promotion campaigns.

service beyond the minimum requirements.

3. Train health,. food service
educational staffs in nutrition and food service areas.

A. hnmediately forward Food Safety and Health Alerts to facility staff.
B. Include facility staff in training provided
by OON and/or Districts..

unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Services

Page 15 of 35

Goal # 1: Improve the overall health of the population of Georgia.

Objective # 1.6: To improve the nutritional outcomes of Department of Human Resources' facility residents

participating in the National School Lunch Program by ensuring that at least 85% of OHR resident facilities are in

compliance with federal regulations and state guidelines.



Strategy
4. Develop collaborative relationships with departments, individuals or organizations that can provide support to facility 1esidents.

Indicators .

Baseline

.

Tasks A. Collaborate with Mental Health and
Rehabilitation when necessary. B. Provide_ an annual report to Mental Health
.

Resources Needed Time Line
September 99 -Ongoing

-

-

-

-

unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Services

Page 16 of 35

Goal # 2: Improve service delivery to residents of Georgia by improving systems, communication, and collaboration with internal partners.
Objective # 2.1: To collaborate with internal partners to capitalize on resources and expand 100%.
Related Indicator (if applicable):

' Strategy

Indicators Baseline

1. Work with all infant and child programs to maximize efficiency in providing referrals, support and services

FHB

June 1999, , OON Activity report shows collaboration withFHB.

'
-

2. Collaborate with
Women's Health programs to maximize efficiency in providing referrals, support and services.

same

same

Tasks

'

Resources Needed
'

A) Assist district and clinic staff with linking children with primary health care provider.
B) Assist district and clinic staff with services for those with special health care needs
C) Assist district and clinic staff to develop a referral system to link clients with screenings for: vision, hearing, health checks, scoliosis, sickle cell anemia, SIDS, perinatal counseling oral health, and Food Stamps.
D) Provide training to district and clinic staff on nutrition assessment for children with special needs.

OON Staff
I
CBS*
'

A) Develop an action plan to identify how district and clinic nutrition staff can support program objectives to: reduce unintended pregnancies, decrease infant mortality and low birth weight, reduce racial disparities in infant mortality.

Time Line
Sept. 99:... ongoing

Unit: Office of Nutrition 1999-2002 State Strategic Plan

Page 17 of 35

Improving Services

Goal # 2: Improve service delivery to residents of Georgia by improving systems, communication, and collaboration with internal partners.

Objective # 2.1: To collaborate with internal partners to capitalize on resources and expand 100%.

Related Indicator (if applicable):

Strategy

Indicators Baseline

. Tasks

Reso,urces Needed Timeline

3. Collaborate with
Adolescent Health and Youth Development programs to maximize efficiency in providing '- referrals, support and services.
.

same

same
.

.

4. Continue relationship

same

and work activities in

collaboration with The

Branch of Chronic

Disease Prevention and

Health Promotion. '

same

'

A. Support reduction in teen pregnancy through collaboration with state level staff
B. Explore possibilities and opportunities to
integrate messages, programs, and services that impact adolescent population regarding health and disease.
C. Assist district and clinic level staff in developing resources and referral information to high-risk clients.
. D. Provide training to district a_nd clinic level staff regarding issues of t~en risk

A. Participate as a member of the Chronic Disease Prevention Program grant team to . decrease CVD, stroke, and obesity by way ofpolicy and environmental changes.

B. Perform assignments as requested.

C. Ovli'rsee the inclusion of the TCOYH

. '

campaign in this initiative.

D. Respond to requests for program support

for: annual Mayor's Walk, Golden

Olympics, Arthritis Grant, Hypertension,

Osteoporosis and others as requested.

.

E. Support staff and districts iri Diabetes

support and education.

" F. Work ~th tobacco use prevention groups and office ofWomen's health to develop an educational video for health clinics.

,
.

unit: Office of Nutrition 1999-2002 State Strategic Plan Improving Services

Page 18 of 35

Goal # 2: Improve service delivery to residents of Georgia by improving systems, communication, and collaboration with internal partners.
Objective # 2.1: To collaborate with internal partners to capitalize on resources and expand 100%.
Related Indicator (if applicable):

Strategy

Indicators Baseline

Tasks

Resources Needed

5. Support the Public
Health Nursing Office though collaboration and consultative services.

same

6. Conduct district/
community technical assistance site visit
with MCH population
team to assist the districts in resolving issues

same

same same
,.

A. Revise annually, the nutrition information

'

in the Nursing Protocol Manual.

B. Maintain dialog with Nursing leadership
about shared issues, policies, programs, and initiatives.

C. Continue to work with and support Quality Assurance Site Review Team

A. Collaborate with state WIC office on essential program functions.
B. Work with state WIC office to streamline and combine strategic plans with mandated plans and reports.
C. Work with state WIC office to establish protocols/policies governing the function of the strategic plan sub-committees.
D. Work with state WIC office to inco!porate evaluation of the Nutrition Education Plan as a component of the program review.
E. Work with state WIC office to develop an action plan for resolving data issues. (See Building System Capacity section of this document)
F. Collaborate with state WIC office and
Nutrition Services Directors to improve efficiency and quality of nutrition education expenditures.

Time Line

Onit: Office of Nutrition 1999-2002 State Strategic Plan Improving Services

Page 19 of 35

Goal # 2: Improve service delivery to residents of Georgia by improving systems, communication, and collaboration with internal partners. Objective # 2.1: To collaborate with internal partners to capitalize on resources and expand 100%.
Related Indicator (if applicable):

Strategy.

Indicators Baseline

Tasks

Resorces Needed

7. Maintain, enhance, and same

same

cultivate relationships

with other Branches,

Divisions, state offices

. .

. ..

. -

A. Maintain and enhance contact

Mental Health Mental

with: DFCS, Family Connection, . Retardation Substance

Division of Aging, Mental Health, Abuse

Epidemiology, Minority Health, Rural Health, Oral Health, and others.

Dept. of Ed Div. of Rehab. Division of Aging

Oral Health

Rural Health

Minority Health

Epidemiology

Family Connections CDC

USDA

HHS

AAP- GA Chapter

Lactation Consultants

Time Line

unit: Office of Nutrition 1999 - 2002 State Strategic Plan Improving Services

Page 20 of 35

Goal # 3: Improve service delivery to residents of Georgia by improving systems, communication, and collaboration with external partners.

Objective # 3,1: To collaborate with external partners 100%.

Related Indicator (if applicable}:

Strategy
1. Continue to work with
and support the Georgia Coalition for Nutrition Education.
2. Continue to work with
and support Georgia Folic Acid Awareness Promotion.

Indicators

Baseline
OONMonthly Activity Reports
for July will
reflect contact 100%

Tasks
A. Assist in quclrterly mecungs. B. Provide consultation and materials "'hen
appropriate. C. Evaluate the Coalition's progress and
submit a report.

A. Continue to develop statewide folic acid plan.
B. Attend meetings regularly.
C. Assi$t in annual campaaGn anJ d1stnbute 111,1tenab.

Resources Needed Time Line

DOE GCNE ' GSU UGA. Family Connections DFCS AAP-GA Chapter CDC USDA Spina Difida Assoc. Mrch of Dimes

Ongoing

3. Collaborate in smoking
cessation train-the trainer program.

4. Collaborate with GA

Task Force for

Breastfeeding.

,

In aw.;wt1on .,,th the Olli of Women Health coorJmatc uam-theumer efforts m collaborallon wnh Amcru:an C.m~cr Society.

American CA Society \Vil DCH CVD Branch

A. Plan and co-chair meetings.

FHB-Population Teams



B. Work with Task Force to 1Jentify focus

GWP

,

and implement sUaleG

Hospital Lactation Staff

C. Continue to 1dent1fy anJ recruit potential member>.

ll.oche League

SI: l.a<1a11on Consultants

A))L>\:

Unit: Office of Nutrition 1999 - 2002 State Strategic Plan Improving Services

Page 21 of 35

Goal # 3: Improve service delivery to residents of Georgia by improving systems, communication, and collaboration with external partners.

Objective# 3.1: To collaborate with external partners 100%.

Related Indicator (if applicable):

Strategy 5. Collaborate with
Emory University.
6. Collaborate with professional organizations requesting nutrition input, consultatio11, or support.
.
7. Continue collaborative
efforts with other appropriate external partners.

Indicators Baseline
Current States of Partnership

Tasks
A. Work w11h genetics staff 10 assure appropriate prescnp11ons and followup for the WIC population with metabolic disorders.
B. Collaborate with Emory Rollins School of Public Health lo develop obesity interventions for the GA WIC Program.
C. Collaborate with Emory Rollins School of Public Health to develop nutrition & physical activity interventions in GA Faith community.
D. Collaborate with FDA on nutrition interventions.
A. Inform colleagues of initiatives.

Resources Needed
Emory Division of Medical Genetics F.H Office of Genetics Emory
FDA FDA Associated Partners
Carter Center
Cancer Diabetes Heart Assoc. GDA ADA GNC

Time Line
September 99 -September 2001
Ongoing

unit: Office of Nutrition 1999- 2002 State Strategic Plan Improving Services

Page 22 of 35

Goal # 4: Improve service delivery to residents of Georgia by improving Office of Nutrition Systems.

Objective # 4.1; To ensure that all WIC clinics in the state of Georgia are in compliance with the federal regulations as

well as state policies and standards.



Related Indicator (if applicable):

Strategy
1. To ensure that WIC clinics are provided with up-to-date and appropriate nutrition education materials.

Indicators
WIC federal regulations

Baseline

Tasks
A. Evaluate and update Central Supply nutrition education materials.
B. Procure new or updated nutrition education materials for Central Supply as needed.

Resources Needed
'
NESC

Time Line
Ongoing

,

I

,

C. Collaborate with printing department 1

to develop needed nutrition education

materials, when appropriate materials

cannot be obtained from existing

.

'

sources.

D. Obtain supplemental, (additional to Central Supply), nutrition education materials, as funding allows.

'
I

unit: Office of Nutrition 1999 - 2002 State Strategic Plan Improving Services

Page 23 of 35

Goal # 4: Improve service delivery to residents of Georgia by improving Office of Nutrition systems.
Objective# 4.1: To ensure that all WIC clinics in the .state of Georgia are in compliance with the federal regulations as well as state policies and standards.

Related Indicator (if applicable):

Strategy

Indicators

2. Manage Food Pack~ge same issues for the Georgia
\VIC Program

Baseline

I
'
'

Tasks

.
Resou'rces Needed Time Line

A. Communicate with USDA Food Federal WIC

and Nutrition Services regarding regulations and policies, governing

.

' regulations, USDA,
GWP

the WIC food packaging.

Local agency staffs

B. Work with WIC Vendor.and

systems units in establishing

criteria, implementing changes and

disseminating information

regarding selection of WIC

'

approved foods.

:

C: Coordinate activities of the WIC Program FoodPackage Committee.

D. Develop policies needed and make annual c~anges to the procedures manual.

E. Serves as the first point ofcontactfor food package questions from local agencies, vendors, food . manufacturers, and the public.

Ongoing
.

,.

unit: Office of Nutrition 1999 - 2002 State Strategic Plan Improving Services

Page 24 of 35

Goal # 4: Improve service delivery to residents of Georgia by improving Office of Nutrition systems.
Objective# 4.1: To ensure that all WIC clinics in the state of Georgia are in compliance with the federal regulations as . well as state policies and standards.

Related Indicator (if applicable):

Strategy
3. Continue to monitor the appropriate implementation of the National Risk Criteria.

Indicators
Federal WIC regulations

Baseline

Tasks
A. Update the WIC Risk Criteria handbook as mandated.
B. Assist the state office in the
revision of the WIC Nutrition Assessment/Certification Forms.
C. Monitor the appropriate implementation of the WIC Risk Criteria during program services.
D. Update tlie Risk Criteria section of the WIC Policy and Procedure manual.

Resources Needed
'
Federal WIC regulations USDA,
GWP

Time Line Annually

4. Encourage local WIC agencies to use the Nutrition Guidelines for Practice as the standard for nutrition counseling.

'

A. Provide technical assistance to

Professional experts in Ongoing

local agencies regarding the

specific areas of

Nutrition Guidelines for Practice. medical nutrition

. B. Update the Nutrition Guidelines for th~rapy

Practice as needed.

unit: Office of Nutrition 1999 - 2002 State Strategic Plan
Improving Services
Goal # 4: Improve Service delivery to residents of Georgia by improving Office of Nutrition systems.

Page 25 of 35

Objective # 4.1 To ensure that all WIC clinics in the state of Georgia are in compliance wit(l the Federal regulations as well as State P.olicies and Standards.

Related Indicator {if applicable):

Strategy
5. Conduct biannual
reviews ofWIC program operations in conjunction with the State WIC office (GWP)

Indicators
Federal WIC regulations

'
6. Work with State WIC
office to update and . revise the Georgia WIC program procedures handbook' on an annu_al basis.

Baseline

.
Tasks
A. Select clinics to be reviewed each year.
B. Coordinate random selection of health records to be reviewed.
C. Revise and update monitoring tool annually.
D. Conduct reviews. according to set policies and standards.
E. Develop reports and provide technical assistance to local agencies in developing corrective action plans.
F. Evaluate local agency program operations, using key indicators.
A. Revise and update the following sections: Breastfeeding, Food Package, Nutrition Education, Certification and Monitoring.
B. Collaborate with local WIC agencies in making appropriate changes.
C. Incorporate new policies and procedures required by USDA

Resources Needed Time Line

Federal WIC regulations
GWP Procedures handbook GWP USDA

2 year cycle 2000/2001
2002/2003

.

Federal regulations Georgia WIC Program Procedures handbook. State WIC office USDA

Annually

.
.

Unit: Office of Nutrition 1999 - 2002 State Strategic Plan Building Capacity .
Goal# 5: Improve service delivery to residents of Georgia by improving staff competency.

Page 26 of 35

Objective# 5.1: Maintain and enhance the skills of qualified and competent nutrition staff to provide optimal nutrition services.

Related Indicator (if applicable):

Strategy

Indicators Baseline

Tasks

Reso1,1rces Needed Time Line

1. Provide annual staff training events: Competency Based Nutrition Skills I, II, III; L~ctation Management, Nutrition Assistants, 2-day training, Nutrition for Children with . Developmental Disabilities.
'

Federal WIC regulations.

2. In FFY 99-00 provide 3 two and a half day events in management. These will include annual training on planning and evaluation, as well as, other management skills development topics.

Six Annual
Trainings
Number of
persons attending?

A. Meet with planning committee to gain input from districts, evaluate previous programs, and recommend content for upcoming training sessions .
B. Work with contractor to provide programs and services.

$147,000

A. Establish a planning committee with Policy, Planning, and Evaluation.
B. Plan training to develop skills in management.

VGA

'

Annually
Feb-May 2000

unit: Office of Nutrition 1999 - 2002 State Strategic Plan Building Capacity

Page 27 of 35

Goal # 5: Improve service delivery to residents of Georgia by improving staff competency.

Objective # 5.1: Maintain and enhance the skills of qualified and competent nutrition staff to provide optimal nutrition ~ervices.

Related Indicator (if applicable):

Strategy
3. Assess which districts
employ one nutritionist per 1200 WIC clients and one licensed nutritionist per I 000 high-risk clients.
.,

Indicators

Baseline

--
Tasks
A. Incorporate this assessment into the
program review assessment.
B. Continue to update directory of state
and district staff. C. Conduct a caseload assessment.
D. Integrate information on the benefits
of licensed nutrition staff. E. Begin to draft a distri ct profile
dawba5e.

Reso4rces Needed Time Line

ARMIS

September 2000

'

4. Tei better meet tl)e -
needs of districts, establish a system at

Federal WIC TBD
regulations.

A. bt,bhh ba:.clmc and mdu:ators 10 dctemunc perccntagc uf Ji.mets bemg served by 00N trammg.

UGA

the state level to assess

-

district participation at

OON training sessions.

B. Set up a system to Irack which districts are participating in training provided by OON.

-

C. Evaluate this informauon to assist in

determining the c~tcnno "h"h OON

is meeting the needs of J,.tncts

D. Determmc "hcthcr o ,-nol J1)lfh,:I

-

-

training need .uc be111~ 111,1, 11 nut,

'

an develop adwn pl.an ht .&JJn." n

-
'

-

needs of wider .encJ ..,....

Unit: Office of Nutrition 1999 - 2002 State Strategic Plan Building Capacity

Page 28 of 35

Goal # 5: Improve service delivery to residents of Georgia by improving staff competency.
Objective # 5.1: Maintain and enhance the skills of qualified and competent nutrition staff to provide optimal nutrition services.
Related Indicator (if applicable):

Strategy
5. Develop the Georgia
Nutrition Services Corps and implement into the OHR Dietetic Internship program.

Indicators Baseline Tobe determined by staff retention survey.
'

Tasks

Resources Needed Time Line

A. Continue to provide internship opportunities for srudents seeking licensure. Applicants from public health will be given first priority in acceptance process.
B. Survey district to determine the number of nutritionists who do not hold state licensure. Work with districts and clinics
to encourage nutritionists to seek state
licensure.
C. Form a task force to assess the possibility of accepting one or two interns per year who would commit to an agreed upon time of service in an under served area of GA in exchange for internship ruition.
D. Develop Nutrition Services Corps standards.

$60,000 two entrylevel positions
$10,000
$60,000 two entrylevel positions

September 99 - September
2001
2001

6. Provide opportunities
for District Nutrition Directors and staffto participate in CDC's monthly teleconference.

Number of

A. Serve as state liaison and notify health CDC

participants per

districts of conference call topics.

training for

B. Connect all local callers to participate

..

1999

in teleconference.

Ongoing

unit: Office of Nutrition 1999 - 2002 State Strategic Plan

Page 29 of 35

Building System Capacity

Goal # 6: Better serve the residents of GA by improving communication between districts and state offices in planning, expanding and improving data collection, dissemination and use; and increasinQ resource base.

Objective# 6.1: Continue to use and refine the three-year strategic planning tool.

Related Indicator (if applicable):

Strategy
1. Continue the work of the strategic planning sub-committees as a means of effectively and efficiently targeting areas ofneed and matching resources with those aieas.

Indicators
-

-
-
2. Establish a _system for prioritizing use of nutrition education monies.

Baseline

.
Tasks
A. Maintain the following subcommittees: 1. Data, 2. Education, Communication and Network.ing, 3. Resource, 4. Staffing and Training.
B. Meet on a regular basis to carry on
work indicated by the strategic plan,
C. Revise plan annually to include new I areas of need and report on accomplishments.
D. Add new members as necessary due to attrition or ,is identified as a key resource group. Include State WIC office staff, Gen Hunter, Lynn Flen.

'
Resources Needed

Time Line
Ongoing
.

A. Explore options with NESC Sub-
Committee.

NESC

September 99 - September
2000

unit: Office of Nutrition 1999 - 2002 State Strategic Plan

Page 30 of 35

Building System Capacity

Goal # 6: Better serve the residents of GA by improving communication between districts and state offices in planning, expanding and improving data collection, dissemination and use; and increasing resource base.

Objective # 6.2: Improve data systems to increase the accuracy of data.

Related Indicator (if applicable):

' Strategy
' 1. Effectively manage the Pediatric and Pregnancy Nutrition . Surveillance Systems (PedNSS & PNSS) information at the state level.

Indicators Baseline
1997 PNSS records accepted by CDC was 35,000; 200,000 for PedNSS

Tasks

'

A. Continue to disseminate Pediatric and Pregnancy Nutrition Surveillance Systems data reports from CDC to district Nutrition Services Directors.

Resources Needed Time Line

CDC '

Bi-Annual

.

2. Work with district WIC staff, state WIC
staff, Viking, and
others as identified to upgrade,enhance,and improve the ARMIS data system.
"
3. Work with Strategic planning data subcommittee to develop clinical standard for data sets.

A. Evaluate the system used to identify sources of data errors.
B. Develop an action plan to assess resource needs necessary to implement corrections or changes.
A. Examine Healthy People 20 I0 Objectives, WJC standards and other sources as identified by the committee.
B. Review Trends C. Make recommendations regarding
standards for population groups as
determined by the committee

District Nutrition Services Directors contracted Data System Providers
VIKING Data Sub-Committee Information Technology
WIC

September 99 - September 2001

Data Sub-committee State WIC Director

September 2000- 2001

Unit: Office of Nutrition 1999 - 2002 State Strategic Plan
Building System Capacity

Page 31 of 35

Goal # 6: Better serve the residents of GA by improving communication between districts and state offices in planning, expanding and improving data collection, dissemination and use; and increasing resource base.

Objective # 6.2 Improve data systems to increase the accuracy of data.

Related Indicator (if applicable):

Strategy
4. Produce annually a
reference handbook displaying national, state, district, and clinic indicators for all data collected. J

Indicators

Baseline

Tasks
A. Fonn a working advisory group to develop an annual report.
B. Print and disseminate
.

Resources Needed Time Line

Nutrition Service Directors CDC PPE-FHB OON Data Team

March 2001 September 2001

.

5. Provide individual

consultation and

inservice training for

.

districts in use and

interpretation of CDC

data.

A. Develops and provide training sessipn(s) ..
B. Provide on-site consultation to health districts .
-
'

CDC FHB Data Team
GWP

January 2000 -January 2001

.

unit: Office of Nutrition 1999 - 2002 State Strategic Plan

Page 32 of 35

Building System Capacity

Goal # 6: Better serve the residents of GA by improving communication between districts and state offices in planning,

expanding and improving data collection, dissemination and use; and increasing resource base.



Objective # 6.3: Expand data base and communications capabilities to include non-WIC clients and broader statewide, access to all populations.

Related Indicator (if applicable):

Strategy

Indicators

1. Identify at least one data source to establish baseline information on these non-traditional groups: adolescents, children with special heal! care needs, men, the elderly and minorities with health disparities.

Baseline

Tasks
A. Arrange a meeting with FHB Data . Team.
B. Identify data resources. C. Promote availability of resources.

Resdurces Needed
- FHB Data Team
MCHEpi
Health Assessment Office

Time Line
September
20()0-
February
2001

2. Improve communication capabilities within Offics,: ofNutrition to facilitate timeliness of social marketing and other graphic materials required for effective healtll promotions and nutrition education programs.

A. Purchase Mac computer with large graphics capability , 21" monitor screen and appropriate software.
B. Purchase color printer compatible with Mac computer.
C. Explore possibility of this purchase as a cooperative venture with Family Health Branch.

$10,000

October 99September
2000

unit: Office of Nutrition 1999 - 2002 State Strategic Plan Building System Capacity

Page 33 of 35

Goal # 6: Better serve the residents of GA by improving communication between districts and state offices in planning,

expanding and improving data collection, dissemination and use; and increasing resource base.



Objective# 6.3: Expand data base and-communications capabilities to include non-WIC clients an(I broader statewide, access to all populations.

Related Indicator (if applicable):

Strategy
.
3. Detennine demographic purchasing practices of
' Georgia.

Indicators

Baseline

Tasks
A. Identify data sources. B. Initiate collaborations to track
purchasing practices.

Resources Needed
DOA Super Mkt. Chains Health Assessment Office

Time Line
.
September
2001 -
September
2002
"

"

Unit: Office of Nutrition 1999 - 2002 State Strategic Plan

Page 34 of 35

Building System Capacity

Goal # 6: Better serve the residents of GA by improving communication between districts and state offices in planning, expanding and improving data collection, dissemination and use; and increasing resource base.

Objective # 6.4: Develop and support initiatives to expand financial resources.

Related Indicator (if applicable):

Strategy
l. Consult with districts to develop an action plan to encourage billing for nutrition services.
.

Indicators Baseline
Tobe determined by survey.
.
.

Tasks
A. Arrange for OON staff and chosen Health Director to do a presentation of"Billing for Nutrition Services" at a health director's meeting.
B. Provide training and technical assistance
to clinic staff to help them establish a system by which they may generate revenue via DSPS/CIS medical and contract billing.
C. Assist districts in exploring possibility of contracting with other agencies to provide billable services that would generate revenue.

Resources Needed Time Line

District NSD

January 2000 -September 2002

. . .

2. Provide training and
technical support in resource identification and grant writing.

A. Explore federal, state, local grant opportunities.
B. Designate state staff members to receive,
search for and explore grant opportunities.
C. Encourage district to designate staff to
write grants.
D. Develop training with Public Health Grant Writer to teach skills.
E. Provide technical assistance to
districts.

PH Grant Writer

January 2000 - September 2001

unit: Office of Nutrition 1999 - 2002 State Strategic Plan

Page 35 of 35

Building System Capacity

Goal # 6: Better serve the residents of GA by improving communication between districts and state offices in planning, expanding and improving data collection, dissemination and use; and increasing resource base.

Objective #

6.5 Prepare a proposal that would make Public Health nutritionists compensation .

levels compe.titive with

other agencies and organizations that employ nutritionists.

Related Indicator (if applicable): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __,___ _ _ _ _ _ _ __

Strategy
1. Conduct a survey to determine salary levels regionally.
J

Indicators
'

Baseline

Tasks Use survey to plol!l further actions.

'

. Resources Needed

Time Line
January 2000 -January 2001

.
.