Georgia state plan for program operation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) fiscal year 2002

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 2002 (October 1, 2001 to September 30, 2002)
Submitted in accordance with USDA Food and Nutrition Service
Federal Regulations 246.4(A) - State Plan
August 2001

TABLE OF CONTENTS

WIC
Chapter 1 Chapter 2
I. II. III. IV. Chapter 3 I. II. III. IV. V. Chapter 4 Section I. Section II.

Page
Goals and Objectives for FFY 2002 .......................................................................2 Financial Management...........................................................................................14 Program Financial Status .......................................................................................15 Letter of Credit.......................................................................................................16 Local Level Requirements .....................................................................................17 Property Management and Procurement ................................................................19 Food Delivery/Management Information Systems................................................20 Retail Delivery Method..........................................................................................21 Vendor Management..............................................................................................23 Direct Delivery Method .........................................................................................24 Management Information Systems ........................................................................25 Food Package Design.............................................................................................27 Application and Disqualification Process for Local Agencies ..............................28 Process for Applying to Operate a WIC Clinic ......................................................29 Administrative Appeal Local Agency.................................................................32

Attachments: Attachment I - Participant Characteristic Minimum Data Set (MDS)..........................................36 Attachment II Disqualification/Not Accepting an Application Form.........................................47 Attachment III Application Form ...............................................................................................48 Attachment IV - Nutrition Section - Goals and Objectives ...........................................................54

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CHAPTER 1
GOALS AND
OBJECTIVES

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I. INTRODUCTION
The mission of the Department of Human Resources (DHR) is to assist Georgians 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.

FEDERAL FISCAL YEAR 2002 GOALS AND OBJECTIVES:
FOOD FUNDS MANAGEMENT
OBJECTIVE I:
By October 1, 2001, increase or maintain the numbers of infants on contracted formula to 98%. The October 2000 percent of infants on contracted formula is 98.78%. As of April 2001, the use of concentrated formula is 98.87%, powdered formula is 99.20% and ready-to-feed formula is 100%.
EVALUATION DESIGN:
Assess percentage of WIC infants receiving contract, iron fortified formula.

Action Steps Activities/Methods
1. Continue statewide policy concerning utilization of sole source milk based infant formula for all healthy 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, Systems Information Section (SIS), Nutrition Section (NS) SIS, NS
NS, SWB, SIS, Georgia Chapter American Academy of Pediatrics

Milestones
On-Going
Monthly
As Needed On-Going

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FEDERAL FISCAL YEAR 2002 OBJECTIVE
OBJECTIVE II:
By September 30, 2001, review all financial and participant reports that are provided by the automated systems to ensure 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.

Resources
SWB, SIS, Financial Management Section (FMS)

2.

Maintain monthly table, which

summarizes needed percentage of accuracy.

FMS

3.

Monitor the state % of Food Obligations

SIS

to expenditure.

4.

Monitor the vouchers paid by

SIS

Administrative check.

5.

Change in incidents of Cumulative

SIS

Unmatched Redemption (CUR) Reports

Milestones
On-Going
Monthly Monthly Monthly Monthly

CASELOAD MANAGEMENT
OBJECTIVE III: By September 30, 2002, increase the percentage of prenatal WIC participants certified during the first trimester from 53.25 % 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.

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FEDERAL FISCAL YEAR 2002 OBJECTIVE

Activities, Steps, Activities/Methods

Resources

1. Assist Local Agencies in developing strategies to Program Management and

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

first trimester.

SWB, NS

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, NS Division of Medical

campaign concerning the WIC Program and use of Assistance, District

the Referral Form.

Coordinators, Department of

Labor, DHR

4. Continue to explore the expansion of WIC Services SWB, NS, DMA, Georgia

to community health centers, health maintenance Primary Care Association,

organizations, private obstetricians and to migrant Medical Association of

and rural health centers.

Georgia, Georgia Academy of

Pediatrics, Migrant and Rural

Health Association, HMO

Affiliates.

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

COMPLIANCE ANALYSIS SECTION
OBJECTIVE IV: By September 30, 2002, complete\continue compliance investigations on targeted WIC vendors. EVALUATION DESIGN: Comparison of authorized Vendors designated for investigations and reports of completed investigations will be reviewed and evaluated.

Actions Steps Activities/Methods
1. Identify 10% of authorized Vendors to be targeted for compliance investigations.
2. Initiate compliance investigations for 5% of the vendors targeted.
3. Represent State at Vendor Administrative hearings.
4. Conduct training sessions for Administrative Law Judges and WIC appointed attorney.

Resources
SWB, Vendor and Compliance Analysis Section staff
Same as #1
Same as #1
Vendor and Compliance Analysis Section staff

Milestones
On-Going
As identified Upon Request
9/30/02

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FEDERAL FISCAL YEAR 2002 OBJECTIVE
OBJECTIVE V:
By September 30, 2002, update the Compliance Analysis Plan with new information which would enhance current regulations.
EVALUATION DESIGN: Continue to enhance Compliance Analysis guidelines and procedures to address potential program abuse.

Action Steps Activities/Methods
1. 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

COMPLIANCE ANALYSIS SECTION
OBJECTIVE VI:
During FFY 2002, 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 Activities/Method
1. Confer with local agency to verify incident. 2. Contact contract bank to obtain vouchers.
3. Contact Georgia Office of Fraud and Abuse.
4. Conduct on-site visit to clinic.

Resources

Milestones

Local Agency Contract Bank

Within three (3) days
Immediately upon receiving notice of missing vouchers

Georgia DHR Office As Needed of Fraud and Abuse
Local Agency, District As Needed Office/SWB

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FEDERAL FISCAL YEAR 2002 OBJECTIVE
PROGRAMMATIC ADMINISTRATION
OBJECTIVE VII:
By September 30, 2002, eleven (11) Local Agencies will have been reviewed to ensure their programmatic compliance with Federal and State Regulations.
EVALUATION DESIGN:
Eleven (11) Local Agency programmatic and financial reviews will be conducted by Sept. 30, 2002.

Action Steps Activities/Methods
1. Local Agency reviews schedule for FFY 2002 finalized.
2. Prepare Local Agency reviews/technical assistance reports and submit to Local Agency.
3. Analyze and summarize FFY 2002 Local Agency reviews/technical assistance sessions, flow sheets and submit to Program Directors.
4. Close all FFY 2002 Local Agency reviews.

Resources
SWB, NS, Local Agencies SWB, NS SWB, NS
SWB, NS

Milestones
5/02 On-going
9/02
10/01/02

OBJECTIVES VIII:
By August 15, 2002, the Federal Fiscal Year 2002 State Plan and Procedures Manual will be revised as needed and submitted to the USDA Regional WIC Office.

EVALUATION DESIGN: The Federal Fiscal Year 2002 State Plan and Procedures Manual will be submitted on time.

Action Steps Activities/Methods
1. Receive final USDA approval of FFY 2002 State Plan and Procedures Manual.
2. Print and distribute the Procedures Manual and State Plan to Local Agencies, Clinics and others as requested

Resources
USDA, SWB, NS
Department of Administrative Services (DOAS),
SWB

Milestones 09/30/01
10/15/01

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FEDERAL FISCAL YEAR 2002 OBJECTIVE

Action Steps Activities/Methods

Resources

3. Develop and distribute the Procedures

Program Management

Manual revisions throughout FFY 2002 as and Review Section

necessary. Place Procedures Manual on CD (PMRS), SWB, NS

Rom by December 2001.

4. Mail public comment materials to Local Agencies.
5. Mail public comment letters to solicit comments and notify participants and advocacy groups of statewide regional public comment period.

P.M.R.S., SWB P.M.R.S.

6. SWB units to submit State Plan revisions to the Program Management and Review Unit.

SWB

7. Compile and analyze public comments to be included in the FFY 2002 State Plan as appropriate.

P.M.R.S., SWB

8. NS to submit revisions to the FFY 2002 State Plan.

NS Section

9. Submit Procedures Manual and State Plan to DHR/PH attorneys.

SWB

Milestones On-going
4/02 4/02
6/02 6/02 6/02 7/1/02

OBJECTIVE IX:
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. State Immunization Program & Program Management and Review Section

Milestones On-Going

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FEDERAL FISCAL YEAR 2002 OBJECTIVE

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, Systems Information Section, Policy Management and Review Section
PMRS, Immunization

Quarterly Yearly

OBJECTIVE X:
The WIC Branch will work with agencies and providers to establish and maintain a response and recovery capacity for emergency events both natural and man-made.

EVALUATION DESIGN: Compile data from the affected districts/local agencies to assess action to be taken.

Action Steps Activities/Methods
1. Continue to update the SWB Disaster Plan in the event of a natural or man-made disaster.

Resources SWB and District Staff

Milestones On-Going

2. Inform District Health Directors/Physical Health Directors of the Plan of Action.

WIC Director or Assignee

When Necessary

3. Contact District Staff to develop a Plan of Action during the disaster.
4. Contact formula companies and/or vendors for supplies of food and formula.
5. Make site visits to make the necessary decision for WIC operations.

WIC Manager WIC Manager WIC Manager

When Necessary
When Necessary
When Necessary

OBJECTIVE XI:
The WIC Branch will ensure adherence to relevant federal and Georgia laws, regulations, rules, policies, and standards.

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FEDERAL FISCAL YEAR 2002 OBJECTIVE
EVALUATION DESIGN:
Develop policy/action/information memorandums to inform local agency staff of changes in federal regulations and state policy.

Action Steps Activities/Methods
1. The SWB will follow current federal rules and regulations.
2. Ensure that the new federal regulations are put in place and updated in the current Procedures Manual and State Plan.
3. Monitor the local vendors/agencies to ensure compliance with the new federal regulations.

Resources
Policy Unit, Systems Unit and Compliance Analysis Sections
SWB
Policy Unit, Compliance Analysis and Finance Sections

Milestones On-Going
Yearly
On-Going

OBJECTIVE XII: SYSTEMS INFORMATION MANAGEMENT By October 1, 2001, all districts except 03-2, 08-1 and 12-0 will be printing Voucher Printed on Demand (VPOD) Vouchers. EVALUATION DESIGN: See next page.

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FEDERAL FISCAL YEAR 2002 OBJECTIVE

ACTION STEPS ACTIVITIES/METHODS

RESOURCES

MILESTONES

1.The following Districts/Units are now producing all WIC vouchers in their clinics:

Rome Dalton Gainesville Cobb Clayton Gwinnett DeKalb LaGrange Dublin Macon Columbus Albany Waycross Brunswick Southside

D/U 01-1 D/U 01-2 D/U 02-0 D/U 03-1 D/U 03-3 D/U 03-4 D/U 03-5 D/U 04-0 D/U 05-1 D/U 05-2 D/U 07-0 D/U 08-2 D/U 09-2 D/U 09-3 D/U 11-0

SIS, Electronic Data Processing (EDP) Coordinators

On-Going

Districts with one or more clinics producing all WIC vouchers:

Augusta Athens Valdosta

D/U 06-0 D/U 10-0 D/U 08-1

VENDOR MANAGEMENT
OBJECTIVE XIII:
During FFY 2002, 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 2002 Vendor materials and the State Plan and Procedure Manual.

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

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

Milestones
November 2001 And
May 2002

OBJECTIVE XIV:

By February 2002, implement the new Vendor Regulations.

Action Steps Activities/Methods
1. Interpret the new regulations and develop new materials.
2. Send a newsletter to Vendors informing them that new requirements are coming soon.
3. Develop new Vendor Handbook and Vendor publications.
4. Consult Retail Advisory Group.
5. Send draft Vendor Section and publications etc. to USDA for approval.
6. Send approved publication etc. to publications for typeset.
7. Send new vendor materials and publications to print.
8. Develop the training materials, location and the dates for training the vendors.
9. Send letter to vendors informing them of the Vendor Training.
10. Train all Vendors by September 30, 2002.
11. Ensure that new regulations are implemented by October 1, 2002.

Resources Vendor Section Vendor Section
Vendor Section Vendor Section Vendor Section Vendor Section Vendor Section Vendor Section Vendor Section Vendor Section Vendor Section

Milestones 10/1/01 11/01/01
02/15/02 02/20/02 03/15/02 04/15/02 06/01/02 07/01/02 07/01/02 09/30/02 10/01/02

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ADMINISTRATION OBJECTIVE XV: The WIC Branch will provide technical assistance and consultation to organizations and communities to promote healthy lifestyles and reduce infant mortality. EVALUATION DESIGN: Develop outreach strategies to reach WIC applicants.

Action Steps Activities/Methods
1. Conduct outreach activities (such as health fairs) to increase the number of participants on the WIC Program and reduce infant mortality.
2. Contact the newspapers and radio stations to inform the general public about the WIC Program.
3. Visit community organizations in an effort to develop new contacts to start WIC Programs.

Resources SWB and NS
PAR PAR

Milestones On-Going
On-Going On-Going

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FEDERAL FISCAL YEAR 2002
CHAPTER 2 FINANCIAL MANAGEMENT
I. Program Financial Status II. Letter of Credit
III. Local Level Requirements

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SECTION I - PROGRAM FINANCIAL STATUS
Narrative Descriptions:
1. DHR Financial Administration
The Office of Financial Services (OFS) of DHR 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 and 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 performed by data processing systems. The records kept in the county health departments are of a subsidiary or supplemental nature. Monthly reports are submitted by 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 be reimbursed by the Department of Human Resources. Supporting data for other administrative expenditures of the county departments is not submitted directly to OFS but 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.
The State Auditors of Georgia perform both financial and program audits. State law mandates that the State Auditors perform a financial audit of the books and accounts of the Department of Human Resources each fiscal year. Programmatic audits of specific programs are performed by the State Auditor as deemed necessary.
2. Time Reporting
Random Moment Sample Study (RMSS) is a method of measuring time worked per program by employees for cost allocation. This method uses a statistically valid sample to determine the amount of time employees expend on individual programs. The results of the quarterly RMSS are used as a basis for the distribution of each quarter's cost. A comprehensive and detailed procedural methodology of this process is included in Appendix B of the Cost Allocation Plan. A copy of the Cost Allocation Plan can be obtained from the State WIC Branch Financial Section.
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 currently 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 Department of the Treasury, Georgia's Cash Management 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. Disbursement 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 be 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 financial management staff 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 Program 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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SECTION III - LOCAL LEVEL REQUIREMENTS
The local level requirements are as follows:
A. The Master Agreement for the Division of Public Health requires that local agencies maintain their financial management systems in accordance with 45 CFR Parts 74.60 and 74.61 (Subpart H) and Official Code of Georgia Annotated (OCGA), Section 31-3-8. A copy of the Master Agreement for Public Health may be obtained from the Financial Section of the State WIC Branch.
The DHR Administrative Policy and Procedures Manual and the DHR Grants to Counties Manual gives specific instructions in the operation of a financial management system at the local level (see the Public Health Master Agreement which can obtained from the State WIC Branch Financial Unit).
B. Local agencies must submit, on a 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 compliance.
C. The Public 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 Health. 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 Committee is charged with assisting the State Agency and the Division of Public Health with developing an acceptable methodology for allocating federal grant funds to Local Agencies. The Georgia WIC approved funding formula has been well accepted by local agencies due to its accuracy and fairness. Additionally, the Georgia WIC Allocation Advisory Committee makes recommendations to the 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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reallocation funds distribution and the succeeding year's caseload strategies. However, meetings are convened on an as needed basis. Committee members rotate every two years. 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 amendments.

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Section IV Property Management and Procurement
A. See paragraph #204 of the DHR Public Health Master Agreement for property management requirements.
B. All purchases are made in accordance with laws governing purchases, OCGA, 50-5-50 through 50-5-124 and the Rules and Regulations of the State Department of Administrative Services, Purchasing Division. Consultants and certain other contracts in excess of $250,000.00 state funds must be approved by the State Office of Planning and Budget. Professional services rendered by individuals or organizations that are not a part of the Department of Human Resources are required to have prior approval of the awarding federal agency if federal funds are involved.

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FEDERAL FISCAL YEAR 2002
CHAPTER 3
FOOD DELIVERY/MANAGEMENT INFORMATION SYSTEMS
I. Retail Delivery Method II. Vendor Management III. Direct Delivery Method IV. Management Information Systems V. Food Package Design

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FEDERAL FISCAL YEAR 2002
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)(i), 246.4(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 Section of the Procedures Manual.
IV. A description of food instrument security and accountability procedures at the State level [CRF 246.4(a)(14)(v), 246.12(1)].
See the Food Delivery and Compliance Analysis Sections of the Procedures Manual.
V. A description of procedures for shipment of food instruments between all points [CRF 246.4(a)(14)(v), 246.12(1)].
See the Food Delivery Section of the Procedures Manual.
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)(14)(vii)].
PDA, Inc., Southern National Bank, Ross Laboratories, Mitchell and McCormick, QS (DeKalb System), Athens System.
VII. A description of State procedures for follow-up on reports of lost or stolen food instruments [CRF 246.4(a)(14)(v)].
See the Compliance Analysis 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)].
The reconciliation rate for FFY 2000 was 99.71%. For FFY 2001 to date the rate is 99.33%. (The drop is attributable to two months where a large district was experiencing transmission problems with their data. Continuous monitoring indicates that the rate is improving.)

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Reconciliation
The Georgia WIC Program, in conjunction with its ADP contractor, PDA, Inc., 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 amount and transaction code.
Bank Exception Report identifies vouchers 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 By 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 Vouchers (including those prepared by clinics using automated systems) there are Unmatched Redemption Reports which include Cumulative Unmatched Redemption's showing those vouchers that cannot be matched to either an issue record, a valid WIC ID or a Certification period.
Vouchers Paid By Administrative Checks list in detail those vouchers rejected by the bank for reasons such as being over the maximum amount but subsequently approved by the WIC Office for payment. This combination of reports and microfilm allows the WIC program to track every voucher and determine its final disposition.
In addition, the State WIC Branch receives records of all vouchers processed during the month on CD-ROM. A PC Program, Georgia Imaging Retrieval, provides fast and easy access to all WIC vouchers processed by the bank.
On January 1, 1997 the Georgia WIC Program entered into a new contract with PDA, Inc. for Data Processing services. The contract has been extended through December 2001.
IX. A description of the State plan to monitor local agency compliance 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 the 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)].
III. A copy of the standard written vendor agreement between food vendors and the State (or local) agency [CRF 246.4(a)(14)(iii)].
IV. A description of the procedures designed to control participant abuse of the program [CRF 246.12(k)(2)].
V. A description of the system for monitoring food vendors to ensure compliance and prevent fraud, waste and abuse [CRF 246.4(a)(14)(iv)], including:
- The functional breakdown between State and local agency responsibilities for vendor management
- Monitoring system - High risk criteria - Investigation system - Sanction system - Vendor/participant complaint system
VI. Administrative appeal procedures for food vendors (may be placed in fair hearing section of the Procedures Manual) [CRF 246.4(a)(17)].
VII. A description of the procedures to review food instruments for errors or overcharges, including pre-payment and post-payment edits, reclaim, rejection and adjustment procedures (May be included in general food delivery system description) [CRF 246.4(a)(14)(vii)].
See the Vendor Section of the Procedures Manual for items I - VII above.

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SECTION III - DIRECT DELIVERY METHOD I. A description of how infant formula requiring a physician=s prescription is issued to WIC
participants.
See Food Package Section of the Procedures Manual.

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SECTION IV - MANAGEMENT INFORMATION SYSTEMS
A narrative summary of changes made to the WIC management information system(s) in the past year is listed below:
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.
AEGIS has been installed in Dalton, Macon, Southside. Savannah, Augusta, Dublin and Valdosta (the latter three in some but not all clinics); as well as one clinic in the Athens district. The recently created Georgia Technology Authority (GTA) has directed that all further installation and modifications to Aegis be halted while the State explores the possibility of going to a single system. A consultant firm has been hired to develop a Request for Information (RFI) and Request for Proposals (RFP) for the purpose of obtaining a single, statewide clinical system.
AUTOMATED REPORTING and MANAGEMENT INFORMATION SYSTEM (ARMIS)
Plans for ARMIS to be re-written are still pending. The new system will operate over a secure WEB site. Monthly data updates will be done electronically by PDA, Inc. thus eliminating the need for CD's or diskettes.
Access to the data will be faster and easier for District/Unit staff who will no longer be responsible for maintaining 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 at local agencies.
VOUCHER ANALYSIS SYSTEM (VAS)
The Voucher Analysis System continues to be in use by the State WIC Branch. 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.

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GEORGIA IMAGE RETRIEVAL SYSTEM (GA IRS)
All WIC vouchers processed by the bank are now being imaged onto CD-ROM. Since 1997 State WIC Branch 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.

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SECTION V - FOOD PACKAGE DESIGN
I. A description of the standard or commonly used food package for each participant category including Food Packages I - VII that the State plans to use during the year including any special provisions for the homeless [CRF 246.10(c)].
II. A list of all State approved infant formulas (including the standard contract formulas), exempt infant formulas, special formulas and medical foods [CRF 246.10(f)].
III. A copy of the current State authorized food list [CRF 246.10(b)].
See Food Package Section of the Procedures Manual for items I - III above.

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CHAPTER 4 APPLICATION AND DISQUALIFICATION PROCESS FOR LOCAL AGENCIES

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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 Section 246.5(d) of the WIC Regulations. The application must demonstrate the agency=s ability to operate a WIC Program in accordance with WIC Federal Regulations and State policies.
The Georgia WIC Program operates in all 159 counties 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'00, 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, schools and/or private provider offices.
Applications will be accepted for the purpose of expanding services in a current Program area. In considering such an application, the State Agency will evaluate the performance of existing programs in the areas in question. An application will be considered for approval if the existing agency/agencies is/are not able to expand the services to the residents/participants of the area. Availability of food/administrative funds will also be considered.
Upon request from a local agency interested in operating a WIC Program, the State agency will supply, within fifteen days of inquiry, a pre-application information package consisting of the following documents:
1. A cover letter explaining, at minimum, the overall application process, time frames involved, criteria for selection of agencies and information concerning the appeal process in the event that the application is denied.
2. A copy of the WIC Program Regulations, 7 CRF Part 246.
3. A list of basic requirements for inclusion in the local agency application to operate a WIC Program. This will include staffing and equipment requirements, as well as clinical and nutritional regulatory mandates.
4. A listing of State and Local Agency resources.
5. A copy of the Memorandum of Understanding between the State Agency and the local agency. (The Memorandum of Understanding is included in the Administration Section of the Procedures Manual).
6. A copy of the most current State Plan, Procedures Manual and Georgia WIC Information Packet.
7. Examples of nutrition education materials and participant training tapes.

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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:
1. The local agency has corrected all past substantiated civil rights problems and/or non-compliance situations.
2. The Civil Rights Assurance is included in the State/Local Agency WIC Branch Agreement.
3. Civil rights complaints are being handled in accordance with procedures outlined in the Rights and Obligations Section of the WIC Procedures Manual.
4. Clinic sites, certification offices, vendors and other food distribution sites do not deny access to any person because of his 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.

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15. An agency serving homeless participants agrees to ensure that the homeless facility does not:
a. Accrue financial or in-kind benefits from a residents participation in the program;
b. Subsume foods provided by the WIC Program into a communal food service, but are available exclusively to the WIC participant for whom they were issued;
c. Allow the homeless facility to place constraints on the ability of the participant to partake of the supplemental foods and nutritional education available under the Program.
16. The local agency agrees to contact the homeless facility periodically to ensure continued compliance with these conditions.
17. The local agency requires the homeless facility to notify the State or local agency if it ceases to meet any of these conditions.

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SECTION II ADMINISTRATIVE APPEAL LOCAL AGENCY
A. The State agency must provide full administrative review to local agencies. The local agency has the right to appeal a state agency's decision for the following:
1. Denial of local agency's application. 2. Disqualification of a local agency. 3. Any other adverse action that affects a local agency's caseload.
The State agency must provide written notification of the adverse action, the procedures to follow to obtain an administrative review and the cause(s) for effective date of the action (See attachments II and III).
Action Not Subject to Administrative Review The state agency may not provide administrative review to local agencies that appeal the following:
1. Expiration of local agency's agreement. 2. Denial of a local agency's application, if the state agency's local agency selection is
subject to the procurement procures of the Department of Human Resources.
B. Effective Date of Adverse Actions Against Local Agencies The State agency must make denials of local agency applications effective immediately. The State agency must make all other adverse actions effective no earlier than sixty (60) days after the date of the notice of the adverse action and no later than ninety (90) days after the date of the notice of adverse action or, in the case of an adverse action that is subject to administrative review, no later than the date the local agency receives the review decision.
C. Full Administrative Review Procedures Procedures for a full administrative review of the adverse actions is listed below:
The local agency may appeal the state agency's decision when an application to participate in the WIC Program is denied or terminated, or when a decision is made which adversely affects the local agency's participation in the program, such as a reduction in food or administrative funds.
The local agency must request a Administrative review from the State agency within thirty (30) days after the action, which is being appealed, was taken. The hearing must be scheduled no later then thirty (30) days after the request for hearing is received by the State agency with the local agency being given fifteen (15) days advance notice of the time and place of the hearing. The proposed adverse action must be postponed from the time a hearing is requested until a decision is reached. Upon request, the local agency

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may reschedule a hearing date one (1) time. Sixty (60) days advance notice must be provided to a local agency before disqualification from Program participation.
The local agency will have ample opportunity to present its case at the hearing, including the opportunity to confront and cross-examine adverse witnesses. Counsel may represent the local agency. If desired. The local agency may review the case file prior to the hearing.
D. Local Agency Hearing Procedures
To request a hearing, the local agency will send a written request to the State WIC Branch. Should a hearing be requested prior to the deadline stated in the disqualification notice, the local agency authorization shall remain unchanged until final resolution has been attained at the administrative level. If a hearing request is received after the deadline stated in the disqualification notice, the local agency shall no longer be authorized for WIC Program participation.
Local agencies may appeal decisions of the State WIC Branch when an application to participate in the WIC Program is denied, when participation is terminated, or when other actions are taken which adversely affect the local agency's participation in the program.
The local agency must submit a written request for a hearing to the State WIC Branch within fifteen (15) days from the date of notification of an adverse action they wish to appeal.
The State WIC Branch will notify the Office of State Administrative Hearings of a local agency's request for a hearing.
The Office of State Administrative Hearings will schedule a hearing date within fortyfive (45) days of the hearing request. The local agency will be notified of the time and place fifteen (15) days prior to the hearing date. All hearings will be held in the county where the local agency is located.
The proposed adverse action must be postponed from the time an administrative hearing is requested until a decision is reached by the Administrative Law Judge (ALJ). Local agency hearings may be rescheduled one time by the local agency or the State WIC Branch.
The local agency will have ample opportunity to present his case at the hearing, including the opportunity to confront and cross-examine adverse witnesses. The local agency may be represented by counsel, if desired. The appellant may review the case file prior to the hearing.
The Administrative Law Judge (ALJ), Office of State Administrative Appeals, is an impartial decision maker with no personal involvement or interest in the outcome of the hearing. The ALJ `s decision shall rest solely on the evidence presented at the hearing

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and the statutory and regulatory provisions governing the program. The basis for the decision shall be stated in writing, although it need not amount to a full opinion or contain formal findings of fact and conclusions of law.
The ALJ and the State WIC Branch shall provide written notification of the decision to the vendor within ninety (90) days from the date of the original request for a hearing.
The local agency must continue to comply with all written agreements if program participation continues during the appeal process.
The ALJ will explain any additional appeal mechanism upon request, including the right to a judicial review. If the local agency desires to appeal after an administrative hearing decision that has been granted in the State's favor, the local agency must follow the provisions of the Georgia Administrative Procedure Act (Code Section 50-13-16 and 5013-17).

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Attachment I

GEORGIA DEPARTMENT OF HUMAN RESOURCES DIVISION OF PUBLIC HEALTH STATE WIC BRANCH
FFY 2002 STATE PLAN

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ATTACHMENTS

Attachment I

PARTICIPANT CHARACTERISTICS MINIMUM DATA SET (MDS)

The Participant Characteristics Minimum Data Set (MDS) contains data items, that are reported to FCS electronically by State agencies for one report month on all or a sample of participants. The MDS has required data items that must be collected and reported. The Supplemental Data Set Specifications (SDS) comprised of optional data items 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 ID may be reported according to the level the State Agency feels

appropriate. At a minimum, State agencies must provide agency names and addresses for each

ID provided on their files.

X

Case ID. A unique record number for each participant 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) racial/ethnic

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.

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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 of available nutrition education

sessions

Provide appointment notice to enrollee

X Track participation in education

X Track types of nutrition education provided

Perform Individual Client Health Monitoring

X

Capture and monitor changes in individual client health status

X

Provide individual client data to other health agencies

Perform Individual Client Nutrition Education and Diet

Monitoring

Capture and monitor changes in individual client dietary behavior

Perform Analysis of WIC Population Nutrition Education and Health Surveillance Monitor changes in WIC Participant Population Health Status Monitor clients' views of WIC Program Services Monitor changes in WIC participant population dietary behavior

Provide WIC Health Statistics to Other Health Agencies

X

Provide WIC participant population data to other state health agencies

X

Provide WIC participant population data to Center for Disease Control

FOOD INSTRUMENT PRODUCTON

Maintain Food Package Database

X

Record list of approved foods and food package data

X

Record food package variations and food instrument types

X

Pro-ration of food quantities for clients with late pick-up

Print Food Instruments on Demand

X

Print regular food instruments for participants on demand

X

Print food instruments for multiple months

Print vendor-specific food instruments

X

Print pro-rated food instruments

X

Print custom-tailored food instruments

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Attachment I

III. MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST

Print and Distribute Food Instruments In Advance of Pick-Up

X

Print food instruments in advance of participant pick-up

X

Print food instruments for multiple months

Print vendor-specific food instrument

Monitor Food Instrument Stock 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 instruments

Produce Vendor Payment Detail

X

Produce payment detail for checks (where applicable)

X

Produce payment detail for vouchers (where applicable)

CASELOAD MANAGEMENT

Allocate Caseload

X

Determine 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 actual participation against caseload levels

X

Produce FNS reports on participation

VENDOR MANAGEMENT

Support vendor authorizations

X

Capture and maintain data on authorized vendors

X

Produce vendor history information on individual vendors

X

Track vendor authorization process

Determine high-risk vendors

X

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

high mean)

Determine high risk vendors by using additional analysis tools

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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 Investigations 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 of WIC 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

Coordinate With Food Stamps Program

X

Maintain FSP violation data on WIC vendors

X

Report WIC sanctions to Food Stamp Program

Support Vendor Communications

X

Produce vendor lists and labels

X

Produce vendor correspondence

OPERATIONS MANAGEMENT

Monitor Administrative Operations

Maintain staffing, client load and operational characteristics on local agencies and

clinics

X

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

Maintain Client Outreach Maintain client lists for local agencies to use for outreach

X

Track referrals of WIC participants to other health and social services

FINANCIAL MANAGEMENT

Record Grants and Budgets

X

Record nutrition services, administration and food grants for state agency

X

Maintain local agency budget information

X

Maintain state agency budget information

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Attachment I

III. MANAGEMENT INFORMATION SYSTEM

WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST

Monitor Expenditure

X

Monitor nutrition services, administration and food obligations and

expenditures

X

Monitor cash flow

X

Produce FNS 498 Report

Process Manufacturer Rebates

X

Estimate total annual rebates

X

Bill manufacturer(s) for rebate

X

Monitor rebate collections from manufacturer(s)

SYSTEM ADMINISTRATION

Maintain System Data Tables

X

Maintain system data tables

Administer System Security

X

Maintain user identification

X

Maintain user capabilities

X

Monitor unauthorized access

Archive System Data

X

Archive and restore historical data

X

Purge unnecessary data

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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 year should be reported in MMDDYYYY format.
X Sex. For infants and children, male or female.

X Priority level. Participant priority level for WIC Program certification at the time of the most
X Participation in TANF/AFDC, Food Stamps, Medicaid. The participant's reported participation in each of these programs at the time of the most recent WIC Program certification as of April 1998.
X Migrant status. Participant migrant status according to the federal WIC Program definition of a migrant farm worker (currently counted in the FNS 498 report).
X Number in family or economic unit. The number of persons in the family or economic unit upon which WIC income eligibility was based.
A self-declared number in the family or economic unit may be reported for participants whose income was not required to be determined as part of the WIC certification process. These participants include adjunctively income-eligible participants (due to TANF/AFDC, 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 identified by the State for automatic WIC Program income eligibility, income eligibility of Indian and instream migrant farm worker applicants).

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Attachment I

III. MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS
State Agency MIS:
Collects
X Family or economic unit income
For persons for whom income is determined during the certification process, the income amount that was determined to qualify them for the WIC Program during the most recent certification as of April 1998.
FNS will convert income expressed in different measures (weekly, monthly, yearly, etc.) to annual amounts.
For descriptive purposes only, participants whose income was not required to be determined as part of the WIC Program certification process use the self-reported income at the time of certification. These participants include adjunctively 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 actual value of zero.
X Nutritional risks present at certification. The three highest priority nutritional risks present at the WIC Program certification current in April 1998.
X Hemoglobin or hematocrit. That value for the measure of iron status that applies to the WIC Program certification. It is assumed that the measure was collected within sixty (60) days of the certification date.
X Weight. The participant's weight measured according to the CDC nutrition surveillance program standards [nearest one-quarter (1/4) pound]. If weight is not collected in pounds and quarter pounds, weight may be reported in grams
X Height. The participant's height (or length) measured according to the CDC nutrition surveillance program standards [nearest one-eight (1/8) inch]. If height is not collected in inches and eighth inches, height may be reported in centimeters.
X Date of height and weight measures. The date of the height and weight measures that were used during the most recent WIC Program certification period as of April 1998 in MMDDYYYY format.
X Currently breast fed. For infant participants between the ages of seven and eleven months, whether or not the 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.

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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.

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Attachment I

III. MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS

State Agency Collects
X

MIS Plans to Collect Supplemental Data Set (OPTIONAL)
Date of first WIC certification: Date the participant was first certified for the WIC Program in MMDDYYYY format. For pregnant, breastfeeding and postpartum women this applies to the current/most recent pregnancy and not to prior pregnancies.

X

Educational level: For pregnant, breastfeeding and postpartum

women, the highest grade or year of school completed. For infants and

children, the highest grade or year of school completed by mother or

primary caretaker.

X

Number in household on WIC: The number of people in the

participant's household receiving WIC benefits.

Source of prenatal care: For pregnant, breastfeeding and postpartum women, source of care for current/most recent pregnancy.

X

Date when prenatal care began: For pregnant, breastfeeding and

postpartum women, the date when prenatal care began for 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.

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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 postpartum 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 of last routine check-up or immunization: Month, day, and year of the last routine check-up or immunization for infants and children reported in MMDDYYYY format.

Length of time mother on WIC during pregnancy: For infant participants, the length of time mother was on WIC during this infant's prenatal period.

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.

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III. MANAGEMENT INFORMATION SYSTEM

Attachment I

WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST
The following checklists were taken from the WIC Functional Requirements Document (FRD) 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 Agency system currently performs or plans to perform within the next two years.

State

State

Agency Performs

Agency Planned

Function/Capabilities

CERTIFICATION
X X
X

Determine Basic Eligibility of Applicant Capture basic eligibility characteristics on persons applying for WIC Maintain appointment schedule availability and produce daily appointment schedules Provide appointment notice to applicant

Determine Nutritional Risk of Client

X

Capture required client nutrition and health characteristics needed

for certification

X Capture additional client nutrition and health characteristics

X

Assign the nutritional risk of the client

Certify Eligible Applicants

X

Capture and maintain enrollee data on certified clients

X

Issue identification card to client

Food Package Issuance/Data

X

Prescribe enrollee food package

X

Maintain appointment schedule for enrollee food instrument pick-

up

Select and record enrollee vendor selection

Check For Dual Participation/Process Transfers

X

List dual enrollees

X

List dual participants

X

Process transfer of enrollee

Capture Investigator Data Capture enrollee record for compliance investigators

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Georgia State WIC Branch 2 Peachtree Street, NW Atlanta, Georgia 30303
Disqualification/ Not Accepting an Application Form

Attachment II

The State WIC Branch is disqualifying/ not an accepting application from __________________

(circle one)

Local Agency Name

______________________________for the following reason(s).

1. __________________________________________________________________________________ __________________________________________________________________________________

2. __________________________________________________________________________________ __________________________________________________________________________________

3. __________________________________________________________________________________ __________________________________________________________________________________

4. __________________________________________________________________________________ __________________________________________________________________________________

______________________________________________ Georgia WIC Director's Signature

___________________________ Date

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Attachment III

LOCAL AGENCY APPLICATION FOR
CONSIDERATION AS A PROVIDER OF
SERVICES FOR THE SPECIAL SUPPLEMENTAL NUTRITIONAL PROGRAM
FOR WOMEN INFANTS AND CHILDREN (WIC)

Purpose
The purpose of this application is to provide information to the state WIC Program regarding the applicant's desire, qualifications and capacity to deliver WIC Program services to eligible clients/patients. Upon review of the completed application, state WIC program staff will make an initial determination of the agencies suitability for participation in the program. Final determinations will be made pending decisions regarding coordination with existing service providers.
Initial approval will be based on the following factors:
1. The need for WIC services within the service area. 2. An estimate of the number of individuals to be served by the applicant. 3. The capacity of the agency to deliver quality services. 4. The availability of staff required meeting federal guidelines for WIC service providers.

AGENCY NAME ADDRESS TELEPHONE NO. CONTACT PERSON NAME OF CEO

____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________

48
STATE WIC PLAN - 2002

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2002

Attachment III

LOCAL AGENCY APPLICATION Page 2
Identify whether the agency is nonprofit, federally funded, Physician Sponsor Plan (PSP), HMO, clinic plan, local health department, private practice, etc. TYPE OF AGENCY ________________________________________________
AGENCY NAME
Describe your service area including geographic area, demographics of population served, % of patients on Medicaid:

Number of pregnant women served Number of hours for OB services Number of hours for pediatric services Number of hours for general services AGENCY STAFFING Do you have a registered dietitian (RD) on staff Number of hours per week an RD is available Number of registered dietitians on staff
49
STATE WIC PLAN - 2002

__________________ __________________ __________________ __________________
__________________ __________________ __________________
STATE WIC BRANCH

FEDERAL FISCAL YEAR 2002

Attachment III

LOCAL AGENCY APPLICATION Page 3 Number of nutritionists with a B.S. in nutrition and/or Dietetic Technician Registered _________
Number of registered nurses on staff ___________
Number of staff to weigh and measure and perform hemoglobin and hematocrits ___________
CLINIC/FACILITY CAPACITY How many clinic locations do you operate?
List the name and location of each clinic to provide WIC services should this application be approved.

AGENCY NAME
Describe your discussions with the WIC agency in your county regarding provision of WIC services by your agency.

50
STATE WIC PLAN - 2002

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2002
LOCAL AGENCY APPLICATION Page 4

Attachment III

PROPOSED WIC SERVICES AND ESTIMATE OF NEED FOR WIC SERVICES WIC Program eligibility is prescribed in the code of federal regulation under 7 CFR 246. To be eligible for participation in the WIC Program, clients/patients must meet income and categorical eligibility requirements. Eligible clients include women, infants and children to age 5 years who are at or below 185% of poverty and have a medical or nutritional risk. Residents and migrants meeting these requirements can be offered program benefits.

How many WIC eligible clients reside in your service area?

_________________

Number of WIC eligible clients served by your agency/clinic

_________________

Number of pregnant women currently being served

_________________

Number of WIC clients you will serve in the first year

_________________

Maximum number of persons you can/will serve after first year

_________________

What is the basis for the information provided above (i.e., census data; actual count, etc.)?

AGENCY
51
STATE WIC PLAN - 2002

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2002

Attachment III

LOCAL AGENCY APPLICATION Page 5
CLINIC/FACILITY CAPACITY
What amount of space do you plan to dedicate for WIC service delivery in each clinic location?

Can you perform required laboratory procedures at each location? Do you have equipment available to perform anthropometric measurements? What other health-related services do you provide at each clinic location?

52
STATE WIC PLAN - 2002

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2002
LOCAL AGENCY APPLICATION Page 6 BUDGET ESTIMATE Number of WIC clients you will serve in first year ______________ First year cost for serving eligible WIC clients ___________________ Monthly per client cost for year two and beyond __________________

Attachment III

Signature CEO or Contact Person

___ Date

For more information please contact Samuel Sims at (404) 657-2900. Please return completed form with document if required to: Samuel Sims State WIC Office, 2 Peachtree Street, and Suite 10- 400, Atlanta, GA 30303-3182.

53
STATE WIC PLAN - 2002

STATE WIC BRANCH

FEDERAL FISCAL YEAR 2002

Attachment IV

NUTRITION SECTION
GOALS AND
OBJECTIVES

54
STATE WIC PLAN - 2002

STATE WIC BRANCH

NUTRITION SECTION DIVISION OF PUBLIC HEALTH GEORGIA DEPARTMENT OF HUMAN RESOURCES
Georgia State Plan for Nutrition Education
In the Special Supplemental Food Program for
Women, Infants, and Children (WIC)
Fiscal Year 2002 (October 1, 2001 through September 30, 2002)
Submitted in accordance with USDA Food and Nutrition Service
Federal Regulations 246.4 State Plan Federal Regulations 246.11 Nutrition Education
August 15, 2001

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NUTRITION SECTION Director
Frances Hanks Cook, M.A., RD, L.D. WIC Nutrition Program Consultants NPC - WIC (1) Carol MacGowan, M.P.H., R.D., L.D. NPC- WIC (2) Shirley E. Cooper, M.M.Sc., R.D., L.D. NPC- WIC (3) Beth Holloway, M.Ed., R.D., L.D. NPC WIC (4) Hans Hammer M.S., R.D. NPC WIC (5) Todd Stormant R.D., L.D.
State Breastfeeding Coordinator NPC WIC (1) Carol MacGowan, M.P.H., R.D., L.D.
Support Staff SS (1) Kathryn Thompson, Program Assistant
SS (2) Chancey Harris, Program Associate

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Family Health Branch, Nutrition Section Work Plan

Section, Office, Population Team or other Unit: Nutrition Section Work Plan Date: 7-1-00

Work Plan for Years: 2000-2005

Total Pages 11

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: Therefore, we are committed to promoting the physical, mental, spiritual, and social well being of children and families through partnerships with communities. These beliefs will be reflected in all policies, procedures, program development and funding mechanisms (decisions) that are part of any business done by, with or on behalf of the Family Health Branch.

Unit Purpose: The Nutrition Section promotes the health of Georgia residents by providing nutrition services and nutrition education. We work in partnership with both the public and private sector to promote healthier lifestyles for Georgians.

Unit Goal: To improve the nutritional status and overall health of families in Georgia.

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 1: To improve nutritional status as it relates to conditions with preventable morbidity and mortality.

Page 2

Strategy 1: Using the APIE (Assessment, Planning, Implementation, Evaluation) model, collaborate and coordinate with public and private partners, inter and intra departmental agencies to develop and implement population based services addressing child and adolescent obesity.

Tasks
A. Assessment

Baseline Indicators Resources Needed Time Line

1. Establish an Obesity Data Work Group from staff within Policy, Planning and Evaluation (PPE) Section, Nutrition Section (NS), Data Warehouse, Data Team and the Epidemiology (EPI) Branch, to examine and develop an effective data system, which will determine the statewide prevalence and incidence of childhood obesity and identify one or more priority populations to target future interventions.

8.6% children overweight [1998 Pregnancy Nutrition Surveillance System (PNSS) Table 10]

TBD

A1 & A2. EPI Section, Data A1. September

Warehouse, PPE, Data

30, 2001

Team

2. Work with PPE, Data Team, EPI Branch, Data Warehouse Staff, Family Health Branch's (FHB) Health Communications Coordinator, and the International Life Sciences Institute (ILSI), to collect, publish and/or disseminate, prevalence and incidence data, community health profiles which include community perceived needs, demographics, health status and community resources that relate to obesity.

A2. Health Communications Coordinator (FHB) ILSI Obesity Data Work Group

A2. September 30, 2001

Status
A1. Data group was not formally formed. However funding was granted to enter into contract with UGA to conduct nutrition and PA research on 1400 Ga students.
A2. Alice Trainer worked with internal and external partners to produce the 2000 Obesity Report.

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 1: To improve nutritional status as it relates to conditions with preventable morbidity and mortality.

Page 3

Strategy 1: Using the APIE model, collaborate and coordinate with public and private partners, inter and intra departmental agencies to develop and implement population based services addressing child and adolescent obesity.

Tasks
3. Collaborate with the Centers for Disease Control and Prevention (CDC) to geomap pockets of obesity in Georgia in the WIC population.
4. Conduct focus groups with the target families and communities, identified geomapping, to determine the best intervention model and products.
5. Pursue alternative, non-traditional Youth Risk Surveillance sites to reach target audiences for data collection.
6. Conduct a literature search to identify successful models and best practices for prevention and treatment of obesity.
7. Track obesity in preschool population.
8. Establish nutrition, physical and environmental interventions in Head Start programs, day care centers and Schools.

Baseline

Indicators Resources Needed Time Line

Status

A3. CDC Division of Nutrition and Physical Activity.

A3. September 30, 2001

Completed. Results are on a Power Point presentation on Share Directory

A4. Outside contractor
A5. Outside contractor and Department of Education (DOE) School Food and Community Nutrition, School Health Nurse Coordinator (FHB), Parent Teacher Associations (PTA), Churches, Boys and Girls Clubs, Private Schools
A6. ILSI, CDC
A8. Ken Resnicow (Rollins School of Public Health)

A4. March 2002

A.4 no contract written to accomplish this activity.

A5. September 30,

2001

A5Deleted

A6. September 30, 2000
A7. September 2002

A.6 Completed. Part of CBW III Workshop Notebook A7 Instrument piloted to track obesity through work of OAN A8 not Accomplished

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 1: To improve nutritional status as it relates to conditions with preventable morbidity and mortality.

Page 4

Strategy 1: Using the APIE model, collaborate and coordinate with public and private partners, inter and intra departmental agencies to develop and implement population based services addressing child and adolescent obesity.

Tasks
9. Assess the organization and community capacity to address this health problem.
10. Analyze height and weight data from the asthma survey.
B. Planning
1. Establish an Obesity Prevention work group to develop population based pilot interventions, based on the results of data collected through focus groups, literature searches, best practices and community health profiles.
2. Establish an Advisory committee that would provide recommendations to the Family Health Branch Nutrition Section.

Baseline

Indicators Resources Needed
A9. Obesity data Work Group, Dietetic Interns

Time Line

A10. Chronic Disease Branch Epidemiology Branch

B1. Outside Contractor and Ken Resnicow (Rollins School of Public Health), Alice Smith (Children's Healthcare of Atlanta), Selected Nutrition Service Directors, Nutrition Section Consultants

September 30. 2001

B2. Outside contractor, selected stakeholders, and Public and private partners

Status
A9. No formal document exists to define the Branch or GDPH capacity to address problem. A10. Completed by Epi Branch. Data was not clean or useful.
B1Work group has not been formed for this purpose. However obesity conference provided listing of interventions to conferencees B2.Completed.Obe sity Action Network is considered the Advisory Group.

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 1: To improve nutritional status as it relates to conditions with preventable morbidity and mortality.

Page 5

Strategy 1: Using the APIE model, collaborate and coordinate with public and private partners, inter and intra departmental agencies to develop and implement population based services addressing child and adolescent obesity.

Tasks
C. Implementation
1. Provided training/technical assistance to the health districts and community agencies on community assessment, program implementation and evaluation regarding obesity prevention.
2. Coordinate and communicate FHB's obesity prevention activities with public/private partners through meetings, training, technical assistance, participation in advisory boards, task forces, committees, annual reports, newsletters, etc.
D. Evaluation
1. Conduct an evaluation of the effectiveness of the processes used to carry out the assessment, planning and implementation phases.

Baseline

Indicators

Resources Needed
C1 & C2. Nutrition Section Consultants, FHB's Health Communication Coordinator, Competency Based Nutrition Skills (CBNSW) annual training, FHB Annual Meeting, Community Based Nutrition training, ("Moving to the Future Workshop") Georgia Public Health Association (GPHA), American Public Health Association (APHA) and/or other national meetings
D1. Manager Planning, Policy Development Unit. Nutrition Section's CQI team members

Time Line
D1. June 30, 2002

Status
Completed Moving to the Future workshop (4/2001) Completed Statewide BMI Training. Trained over 1000 health providers per/yr.
Completed a Statewide Obesity training, Stress Free Breastfeeding training. Developed the Obesity Action Network. Produce the Status of Obesity in Georgia 2000 Report.
Ongoing

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 1: To improve nutritional status as it relates to conditions with preventable morbidity and mortality.

Page 6

Strategy 2: Collaborate with the Women, Infants and Children (WIC) Program Branch, FHB Pop Teams and Family

Connections to Increase the number of women who meet the national recommendation for weight gain during pregnancy.

Tasks

Baseline Indicators Resources Needed Time Line

Status

A. Compile and evaluate WIC Program data on WIC low Birth

low birth weight babies, total prenatal

weight rates

weight gain and high-risk issues, by county, 6.4%, 1997

health district and State.

Georgia Prenatal

Nutrition

B. Assist district staff in developing strategies Surveillance

to target women who show highest risk for System (PNSS)

having low birth weight infants.

To be determined based on trends in data from 1997-2000.

C. Assist districts in developing strategies to target women who are most at risk for low weight gain during pregnancy.
D. Collaborate with the WIC Branch and FHB population teams to assist the districts to improve outreach, 1st trimester and total enrollment into the WIC Program and health status indicators.
E. Compile a graphic report of Health Status, Indicators, using PNSS data, for each Health District.

29.9% of Georgia WIC Prenatal participants gained less than the recommended weight during pregnancy (1997 PNSS)
Georgia % low birth weight 1997, 8.8% (Kids count Book)

16 point Contractor
Data Team, Data Warehouse, CBNSW

A. Annually by March 1st

Community-Based Nutrition Training Local Agency Health District Directors

B. Ongoing

Family Health Branch (FHB) Population Teams

C. Ongoing

Georgia WIC Program Branch (GWPB), WIC coordinators meetings, WIC Plans, nutrition services directors, Family Connection Nursing Quality Assurance Team

D. Annually

Ongoing
Ongoing Ongoing Ongoing

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 1: To improve nutritional status as it relates to conditions with preventable morbidity and mortality.

Page 7

Strategy 3: Collaborate with public and private partners to decrease the incidence of iron deficiency anemia among infants

and children in Georgia, specifically targeting birth through age 5.

Tasks

Baseline Indicators Resources Needed Time Line

Status

A. Collaborate with ILSI to geomap pockets of anemia in Georgia and analyze trends.
B. Improve district staff technique in measuring Hemoglobin and Hemocrit by providing training, established written protocols and policy, and monitoring local agencies for accuracy and use of universal precautions.

A. Incidence is 15.2% in 2335 month old children
B. Incidence is 12.4% in 3659 month old children

A. Reduce the incidence in 23-35 month old children to 14.5% by 2002
B. Reduce the incidence in 36-59 month old children to 11.4% by 2002

CDC American Academy of Pediatrics/Georgia Chapter (AAP/GA), Hemo-Cue, Inc., WIC Program Review Team, Nursing QA Team, FHB population teams, Nutrition Education Resources Committee (NERC), ILSI

C. Monitor pediatric anemia rates using the Pediatric Nutrition Surveillance (PedNSS) Report.

C. PedNSS, 1998 Table 10

C. PedNSS, 1998, Table 10

Data Team

A. October 2000December 2002
B. Ongoing
C. Ongoing

Completed, Nutrition Education Plans have been summarized to determine which Districts have a Anemia Prevention action steps
Ongoing

D. Compile a graphic report of Health Status Indicators on PedNSS data for Health Districts.

D. Ongoing

Ongoing

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 1: To improve nutritional status as it relates to conditions with preventable morbidity and mortality.

Page 8

Strategy 4: Collaborate and communicate with the WIC and Chronic Diseases Branch, and the Division of MH/MR/SA (et. al)

to provide training, technical assistance, monitoring and CQI that enhance nutrition and physical activity services to

Georgians.

Tasks

Baseline Indicators Resources Needed Time Line

Status

A. Ensure that federally funded nutrition

7 Consolidated A. Program

Programs are in compliance with

Federal

review

USDA/federal regulations through periodic Regulations,

findings

program reviews, development of policies Chapter 11

and procedures, and maintenance of

(WIC), Parts 210

updated program manuals.

and 200,

Residential Child B. Training

B. Provide annual staff training to include:

Nutrition

program

Competency Based Nutrition Skills

Program,

evaluations

Workshops, I, II and III, Competency Based (RCNP), also

Lactation Management Skills Workshop, know as the

Nutrition Assistants Workshop, Children National School

with Development Disabilities Workshop, Lunch Program

etc. C. Division of

C. Revise and update program manuals Annually or as needed: Nutrition Guidelines for Practice, Nurse Protocol, etc.

Public Health review and approval;

USDA

review and

approval

A. Nutrition Section program and nutrition consultants; federal regulations; program and policy manuals

A. Annually, by September 30

B. Outside contractor; Nutrition Section consultants

B. Annually, by September 30

C. Nutrition Section program and nutrition consultants; federal regulations; program and policy manuals

C. Annually, by September 30

A8 conducted Onsite review of 10 School Lunch Program facilities.
B. Completed
C. Gave input into the revision of the Hypertension Manual, Chronic Disease Branch and the Nursing Protocol Manual.

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 1: To improve nutritional status as it relates to conditions with preventable morbidity and mortality.

Page 9

Strategy 4: Collaborate and communicate with the WIC and Chronic Diseases Branch, and the Division of MH/MR/SA (et. al)

to provide training, technical assistance, monitoring and CQI that enhance nutrition and physical activity service to

Georgians.

Tasks

Baseline Indicators Resources Needed Time Line

Status

D. Conduct periodic reviews of WIC nutrition Services as a component of the Nursing QA Site Visit Team.

D. Nursing Quality Assurance Team

D. Ongoing monthly

Completed Revised the Nurse QA manual. Carol MacGowan and

E. Dietetic Interns will exceed on 80% pass rate on the National Credential Exam. Provide guidance to Districts.

89% Passing Rate

Beth Holloway ride along with the State Nursing Team.

F. Revise job descriptions and compensation levels for the nutrition classification series.

F Job Reclassification Committee, Compensation and Human Resources Specialist, 16 point Contractor

F. July 1, 2000 June, 2001

E. 100% of the Dietetic Interns have passed the Nation Accreditation Exam (4th Term). Established (2) positions for the Internship in Nutrition.

16 Point contract with Fox Lawson and found that Nutrition salaries were(9%) below market rate

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 2: Promote healthy life styles to reduce maternal, infant, and childhood morbidity.

Page 10

Strategy 1: Collaborate with public and private partners to promote the Take Charge of Your Health (TCOYH) and other

nutrition and physical activity social marketing campaign messages, to prevent nutrition related health conditions.

Tasks

Baseline

Indicators Resources Needed Time Line Status

A. Provide technical assistance and resources to the health districts and community partners to support the promotion of healthy nutrition and physical activity.
B. Collaborate with internal and external partners to research, develop, and evaluate innovative nutrition and physical activity interventions and strategies.
C. Provide training to district staff and community partners on current and innovative messages, strategies, and interventions for promoting healthy nutrition and physical activity.

July 1998 phone survey (University of Georgia Survey Research Center) 52.8% of WIC compared to 45.1% of gen. respondents had household member >30 lbs. overweight. 20.5% of Georgians eat 5 a day (1998 BRFSS) 18.7% of Georgians are obese (CDC)
1991-1998 Georgia reported greatest rate of increase in obesity (CDC) (101%)

9.45% of Georgia children enrolled in WIC ages 1-5 were obese (1999PedNSS)

(NERC)

A. Ongoing

Children's Healthcare of

Atlanta (CHOA)

(FHB) Population Teams

GWPB

Take Charge of Your

Health TCOYH materials

Georgia Coalition For

Physical Activity and

Nutrition (GPAN) Religious Community

B. Ongoing

Family Connections

(DFACS)

Rollins School of Public

Health, Emory

CDC, Division of Nutrition

And Physical Activity

Georgia Folic Acid Task

Force

National 5 a Day Campaign

C. Ongoing

ILSI

Better Brains for Babies

A. Provided resources to orientation to AAP, Black Exposition to promote nutrition and PA.
B. Developed a formal partnership with Children Health Care of Atlanta, Which meets quarterly.
C. Identify and write/market Nutrition PA messages for Radio, TV and Magazines

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Unit: Nutrition Section 2000-2005 Work Plan Improving Health Status
Objective 3: Work in partnership with families to promote their ability to raise healthy children.

Page 11

Strategy 1: Collaborate with the WIC Branch and other private/public partners to increase the percentage of infants who initially breastfeed and continue to breastfeed for at least 6 months.

Tasks

Baseline Indicators Resources Time Line

Status

Needed

A. Conduct a need assessment and produce breastfeeding materials that are culturally and language appropriate for the diverse population of Georgia.
B. Analyze trends by different population groups.
C. Provide training and technical assistance district staff in meeting the federal regulations regarding breastfeeding promotion, education and support.

WIC Program Breastfeeding initiation rate 37.6% (1997 Georgia WIC Program Infant Breastfeeding Characteristics Report)
WIC Program 6 month breastfeeding continuation baseline to be established in 2001 Population initiation rate.

WIC 2002, desired initiation rate 48.6%
Population 2002, desired initiation rate 56%

Georgia WIC Program, Breastfeeding Advisory Committee
Viking
Georgia Task Force for Breastfeeding

A. September 30, 2002
B. Ongoing C. September
30, 2002 D. September
30, 2002

D. Review existing services and programs to address breastfeeding promotion, education and support activities.
E. Maintain network of partners to assist in developing and implementing breastfeeding plans to address the needs of the local communities.

Georgia general population breastfeeding initiation rate 54% (1997 Prams Report) Georgia general population continuation breastfeeding rate; 18% breastfed more than 10 wks (1997 PRAMS Report)

WIC Funding, Georgia E. Ongoing WIC Program, EPI Branch, CDC

A. Proposal written for FFY 2001 was turned down. A revised plan will be developed for 2002.
B. To be completed in 2002.
C. Ongoing: program monitoring, policies developed, data provided to districts.
D. Revised from 2001 to 2002 timeline.
E. Meetings of Georgia Task Force for Breastfeeding held every two months; WIC Breastfeeding Advisory Committee twice a year; worked with Healthy Mothers Healthy Babies and GA AAP; set up plans and activities for the next fiscal year.

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