\.1111 Hioo.?8 $ \ FC? 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 STATE WIC PLAN - 200 I 2 STATE WIC BRANCH 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 STATE WIC PLAN - 2001 3 STATE W' IC BRANCH 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 STATE WIC PLAN - 200 l 4 STATE WIC BRANCH 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 STATE WIC PLAN - 200 I 5 STATE WIC BRANCH 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 STATE WIC PLAN-2001 STATE WIC BRANCH 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 STATE WIC PLAN-2001 7 STATE WIC BRANCH 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 STATE WIC PLAN -2001 8 STATE WIC BRANCH 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 STATE WIC PLAN"- 200 I 9 STATE WIC BRANCH 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 / .. - STATE WIC PLAN -2001 10 STATEWICBRANCH 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 STATE WIC PLAN-200I I I STATE WIC BRANCH 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 - STATE WIC PLAN -2001 12 STATE WIC BRANCH FEDERAL FISCAL YEAR 2001 CHAPTER2 FINANCIAL MANAGEMENT . I. Program Financial Status II. Letter of Credit III. Local Level Requirements STATE WIC PLAN - 2001 13 STATE WIC BRANCH 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.."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.. STATE WICPLAN-,2001. 22 STATE WIC ~RANCH FEDERAL FISCAL YEAR 2001 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. 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 . .