Georgia State Plan for Program Operation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), 2006

GEORGIA DEPARTMENT OF HUMAN RESOURCES
DIVISION OF PUBLIC HEALTH WIC BRANCH
Georgia State Plan for Program Operation in the Special Supplemental Nutrition Program
for Women, Infants, and Children (WIC)
58-1130678
Fiscal Federal Year 2008 (October 1, 2007 to September 30, 2008)
Submitted in accordance with USDA Food and Nutrition Service
Federal Regulations 246.4(A) - State Plan
August 15, 2007

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TABLE OF CONTENTS
Page
Abbreviations ................................................................................................................................1

Chapter 1 I. II. III. IV.

Goals and Objectives ............................................................................................4 Introduction ...........................................................................................................5 Mission Statements ...............................................................................................6 Function Area Accomplishment FFY 2006........................................................6 FFY 2008 Goals and Objective...........................................................................12

Chapter 2 I. II. III. IV. V.

Program Financial Management.......................................................................90 Program Financial Status ...................................................................................91 Letter of Credit ....................................................................................................92 Local Level Requirements..................................................................................93 Property Management and Procurement........................................................94 Case Load Management / Food Cost ..............................................................94

Chapter 3 I. II. III. IV. V.

Food Delivery/Management Information Systems.......................................96 Retail Delivery Method ......................................................................................97 Vendor Management..........................................................................................99 Direct Delivery Method ...................................................................................100 Management Information Systems ................................................................100 Food Package Design .......................................................................................102

Chapter 4 I. II.

Application and Disqualification Process for Local Agencies ...................103 Process for Applying to Operate a WIC Clinic.............................................104 Administrative Appeal: Local Agency ..........................................................106

Chapter 5 I. II. III. IV.

Special Project Program ...................................................................................110 Introduction .......................................................................................................111 Overview of Local Agency Special Project Grants.......................................111 Proposal Process................................................................................................112 Grant Management...........................................................................................113

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Attachments: Attachment I Participant Characteristic Minimum Data Set (MDS) ...........................116 Attachment II Disqualification/Not Accepting an Application Form .........................127 Attachment III Application Form ........................................................................................128

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ABBREVIATIONS LIST
Administrative Law Judge .....................................................................................................ALJ American Academy of Pediatrics ........................................................................................AAP American Dietetic Association............................................................................................ ADA Automated TAD and Voucher System ............................................................................. ATVS Behavior Risk Factor Surveillance System ...................................................................... BRFSS Body Mass Index ..................................................................................................................... BMI Chronic Disease Prevention and Health Promotion Branch ................................... CDPHPB Cash Management Improvement Act.............................................................................. CMIA Centers for Disease Control and Prevention......................................................................CDC Certified Public Accountant ................................................................................................. CPA Compliance Analysis Section ............................................................................................... CAS Cumulative Unmatched Redemption .................................................................................CUR Department of Administrative Services .......................................................................... DOAS Department of Labor .............................................................................................................DOL Department of Family and Children Services .............................................................. DFACS Department of Human Resources ...................................................................................... DHR Division of Medical Assistance ...........................................................................................DMA Division of Payment Management..................................................................................... DPM Electronic Data Processing ....................................................................................................EDP Epidemiology ........................................................................................................................... EPI Family Health Branch.............................................................................................................FHB Financial Management System ............................................................................................ FMS Food and Nutrition Section ...................................................................................................FNS Functional Requirements Document ...................................................................................FRD Georgia Chapter American Academy of Pediatrics.......................................................GAAP

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Georgia Coalition for Physical Activity and Nutrition .................................................GPAN Georgia Public Health Association...................................................................................GPHA Georgia Registry of Immunization Transactions and Services ....................................GRITS Georgia WIC Information System ..................................................................................... GWIS Graphic User Interface ........................................................................................................... GUI Health Maintenance Organization .................................................................................... HMO Health Outcome and Services Tracking .......................................................................... HOST International Life Sciences Institute ..................................................................................... ILSI Internet Check Image Viewer............................................................................................... iCIV Local Agency Special Project.............................................................................................. LASP Minimum Data Set.................................................................................................................MDS Monthly Income and Expenditure Report ....................................................................... MIER National Performance Measure .......................................................................................... NPM Neural Tube Defect................................................................................................................NTD Nutrition Section ....................................................................................................................... NS Nutrition Service and Administration ................................................................................ NSA Office of Financial Services.................................................................................................... OFS Patient Flow Analysis.............................................................................................................PFA Pediatric Nutrition Surveillance System ...................................................................... PedNSS Physician Sponsor Plan ...........................................................................................................PSP Planning and Resources Section ........................................................................................ PARS Policy Management and Training Section .......................................................................PMTS Policy, Planning and Evaluation Section............................................................................. PPE Pre-Pregnancy Nutrition Surveillance System .................................................................PNSS Pregnancy Risk Assessment and Monitoring System ................................................ PRAMS Program Planning and Evaluation Unit .............................................................................. PPE Public Health State Office ...................................................................................................PHSO Random Moment Sample Study........................................................................................RMSS Registered Dietitian ..................................................................................................................RD

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Request for Proposal............................................................................................................... RFP Residential Child Care Institution ......................................................................................RCCI Results Based Budgeting........................................................................................................ RBB State Performance Measure .................................................................................................. SPM Stress Free Feeding .................................................................................................................. SFF Supplemental Data Set ........................................................................................................... SDS Systems and Information Section ........................................................................................... SIS Take Charge of Your Health........................................................................................... TCOYH Technical Assistance and Consultation Unit .................................................................. TACU Technical Assistance for Needy Families ........................................................................ TANF Turn Around Document .......................................................................................................TAD United States Department of Agriculture ....................................................................... USDA United States Department of Education ...........................................................................USDE United States Department of Health and Human Services .................................... USDHHS Vendor Integrity Profile System ..........................................................................................VIPS Vendor Management Section ...............................................................................................VMS Voucher Analysis System ..................................................................................................... VAS Vouchers Printed On Demand.......................................................................................... VPOD Women, Infants, and Children............................................................................................. WIC Youth Risk Behavior Survey ...............................................................................................YRBS

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CHAPTER 1
GOALS AND
OBJECTIVES
I. Introduction
II. Mission Statements
III. Function Area Accomplishments FFY 2006
IV. FFY 2008 Goals and Objectives

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INTRODUCTION
The State Plan for Georgia Women Infants and Children (WIC) Program is the governing document that provides guidance and direction for the state and local agencies administrating the program. In compliance with federal regulations, the plan is updated annually to ensure the inclusion of new and revised federal and state requirements. Although the plan is primarily based on federal regulations, it is a consolidated plan that includes requirements and guiding principles for best practices from the state perspective and that of the National Public Health framework.
Although the State WIC Plan references a single document, it has two major components that are presented as two separate documents. Part I of the plan is the program-operating plan, and Part II is the Policies and Procedures Manual. Part I of the plan contains 1) The state goals and objectives 2) Summary of accomplishment of the previous federal fiscal year and 3) The ongoing strategies and ideologies for state operations and administration. To the extent possible, the state goals address the core functional areas of the WIC Program. These functional areas are: vendor management, nutrition services, information system, organization and management, food funds management, caseload management, certification and eligibility, coordination of service, food delivery and food instrument accountability, monitoring and audits, and civil rights. The goals and objectives are state specific and function as a guide for enhancing program effectiveness and efficiency.
The Procedure Manual stands on its own as an instructional document. In similar fashion as the program goals, the WIC Program policies and procedures are presented under appropriate functional areas as stated above. The Procedures Manual is an important tool to assist the state agency with monitoring the efficiency and effectiveness of the local agency. In most instances, the Procedure Manual describes actions of the local agencies to assure compliance with program regulations and policies.
The VENA Implementation Plan, a new addition to the State Plan, will ensure VENA implementation by October 1, 2009. Like the Procedure Manual, the VENA plan stands on its own and contains an evaluation tool to access the progress of the VENA initiative. The FFY 2008 State WIC Plan has incorporated client based goals and objectives to create a VENA compliant environment statewide. Faster, friendlier, and easier service are the tenets instituted by the state's governing body and the VENA initiative will strategically expand this established best practice. The Georgia WIC program will use VENA as a vehicle to address important program operations such as clinic flow construction, innovative nutrition assessment procedures, training mechanisms, and VENA quality assurance and monitoring protocols.
To support WIC cost containment efforts and to make use of technology, the Georgia WIC Plan is produced as an electronic document. The distribution media for disseminating the document are compact disk and the Internet.
Much care and work have gone into preparing a plan that is user friendly and useful to the agencies delivering WIC benefits to the more than 260,000 low income women, infants and children in Georgia. The plan is specific to the needs of the state and local agencies. It provides a description of on-going operating strategies and procedures and is intended for anyone who

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has an interest in how the Georgia WIC Program delivers benefits to eligible and potentially eligible populations.

SECTION II MISSION STATEMENTS
DHR Mission: To strengthen Georgia's Families- supporting self sufficiency and helping them protect their vulnerable children and adults by being a resource to their families, not a substitute.
DHR Vision: Stronger Families for a Stronger Georgia.
Division of Public Health Mission: The Georgia Division of Public Health provides service and leadership to promote, protect and improve the health and safety of the people of Georgia.
Division of Public Health Vision: Our vision is a Georgia with healthy people, families, and communities, where all sectors unite by pooling their assets and strengths to promote health for all. Decisions are made in harmony with economic and environmental concerns.
WIC Branch Mission: The mission of the Women Infants and Children (WIC) Branch is to provide policy direction and technical assistance to ensure continuity in program administration and operation; and compliance with Georgia's Special Supplemental Food/Nutrition program regulations.

SECTION III FUNCTION AREA ACCOMPLISHMENTS FFY 2006
Throughout the year, the Georgia WIC Program has successfully addressed and implemented activities that correspond to the required USDA Function areas. Many of these activities are in the early stages of development and implementation, the following is a summary of progress.
Vendor Management: The goal of the Vendor Section is to develop an operating system within the Vendor Management Section that will enhance current operations, improve efficiency in day-to-day operations and improve vendor customer service. In doing so, the Vendor Management section will be able to better serve vendors, farmers and farmers market, handle duties associated with the unit (not limited to selecting, authorizing, training, monitoring, initiating investigations, vendor customer service, audits, process voucher rejections,

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terminations, reciprocal terminations) and reduce fraud and abuse in the WIC Program food delivery system.
ACCOMPLISHMENTS: The Vendor Section accomplished the following within FFY 2006: a.) The Vendor Cost Containment plan was submitted and approved; b.) Annual Vendor Training for all 2,800+ vendors was completed; c.) Established partnership with Team Agriculture Georgia; d.) Regional Farmers' Market Nutrition Program meeting for all states within the Southeast Region was held August 2006; e.) Presented Farmers' Market at the American Public Health Association; f.)Vendor application placed on website g.) Farmers' Market article published in the USDA newsletter.
Nutrition Services: The goal of the Nutrition Section is to improve the nutritional status and overall health of families in Georgia. The Nutrition Section strives to meet this goal by; 1) decreasing the proportion of Georgia's children, adolescents, and adults who are overweight; 2) increasing the proportion of Georgia families who improve healthy eating and active living (vegetable and fruit consumption, folic acid, iron, calcium, physical activity and TV viewing); 3) contributing to improved pregnancy outcomes (weight gain during pregnancy, low birth weight and pre-maturity); 4) increasing the breastfeeding initiation and duration rates in Georgia; 5) developing a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics and; 6) developing and maintaining strong partnerships between the State Nutrition Section, internal and external, federal, state, and local partners to support emerging public health issues.
ACCOMPLISHMENTS: Workforce Development:
x The Family Health Branch Nutrition Section graduated 7 Nutritionists from the Georgia Public Health Dietetic Internship Program.
x The Nutrition Section contracted with Georgia Southern University to provide and coordinate 11 competency based, nutrition education trainings to over 300 local district staff.
x The WIC Certification Pocket Reference Manual was updated and distributed to staff. x Educational workshops were provided on: Nutrition Special Projects: x Videoconferencing is successfully being used to deliver nutrition education in two local
agencies. x Creative educational centers are being implemented to teach nutrition education, like
mock food stores, demonstration kitchens and a WIC caf. Partnerships
x The Loving Support Peer Counselor program continues to be implemented in 8 local agencies.
x The Nutrition Section partnered with the American Association of Pediatricians (AAP) to promote WIC and other public health services and programs to pediatricians in targeted communities.

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x Wellstar Hospital and the Timber Ridge Conference Center were added to the list of agencies providing clinical and foodservice opportunities respectively, for our dietetic interns.
x The Nutrition Section continues to work closely with Emory to facilitate the nutrition and medical care services given to especially high-risk infants and children.
x Conducted pilot project (July 2006-December 2006) of provision of multivitamins containing 400 mcg of folic acid and education on benefits of folic acid to all family planning clients. Proposal submitted to provide ongoing support for this project.
x Serve as a representative of DHR on CDC's national Preconception Health Workgroup and Select Panel on Preconception Care. Developed and disseminated Preconception Nutrition Position Paper, and Preconception Health for Providers WIC staff as well as other health practitioners within and outside of the public health system
Information Systems: The goal of this function is to oversee the implementation and administration of automated processes and procedures that ensure the collection, electronic transmission, reporting and security of data related to program operations and management.
ACCOMPLISHMENTS: The voucher printing on demand (VPOD) was implemented at all local agencies. Completed the front end edits manual and addendum. All front-end systems are completed and up-to-date, and risk code table was properly cross-indexed to WIC type and Priority.
Nutrition Services and Administration (NSA) Expenditures: The goal of this function is to properly maximize the use of USDA funds by 1) Allocating funds to local agencies to adequately serve WIC clients and participants and 2) Ensuring that the GA WIC program meets spending targets.
ACCOMPLISHMENTS: Waycross Perinatal Health Partner Nutrition Education Video Pilot. The pilot will include at a minimum: nursing staff showing the videos in the home to further nutrition education provided, participation logs, completion of random customer satisfaction
Food Funds Management: This function is the responsibility of both the Information System and Finance Management Sections, and the goal is to maximize the utilization of WIC food funds by ensuring that formula-fed infants who receive services are nourished with the state's contracted formula provider product.
ACCOMPLISHMENTS: Met 97% of the food expenditures requirement. Maximized formula rebate funds while saving $3 million dollars in food dollars.

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Caseload Management: The goal of this function is to enable all eligible individuals to achieve maximum requirements by publicizing available program benefits. This goal is addressed by: 1) Targeting benefits to high-risk individuals and populations. 2) Targeting benefits to eligible populations with special health care needs and residents of non-traditional home environments. 3) Monitoring no-show rates. 4) Sustaining an outreach infrastructure to reach eligible participants.
ACCOMPLISHMENTS: During FFY 2006, WIC participation increased by 2.6%. The PARS Section reviewed Local Agency Federal Fiscal Year (FFY) 2006 End of Year Accomplishments, FFY 2007 Strategic Plans, and FFY 2007 1st Triad Summary Reports to identify successful strategies and activities that helped enhance the participation rates. The PAR Section is assessing reported strategies and activities from Local Agency Triad Reports to identify promising ways to improve continued enrollment rates. The PAR Section has collaborated with the State Nutrition Section to provide Local Agencies with updated Food Lists and feedback on triad progress summaries. The PARS Section is communicating with the American Academy of Pediatrics (AAP) and the Academy of Family Practitioners for collaboration of WIC referrals from pediatricians. PARS also collaborated with Healthy Mothers, Healthy Babies to promote breastfeeding as the best nutritional choice for babies, and to encourage workplace support for breastfeeding. A partnership was also formed with the GA OB/GYN Society to promote women's health. The PAR Section oversaw the Peer Counseling Program during FFY 2006, which is a program intended to increase breastfeeding rates. The WIC Program continues to support non-traditional clinics and provide technical assistance and opportunities to expand such sites. A baseline for specific high-risk populations was established FFY 2006.
Certification and Eligibility: This goal is to ensure accurate determination and documentation of WIC program applicant/participant eligibility. Methods to achieve the goal include: 1) Decreasing the amount of blank, end-of-year data income fields by 2%. 2) Using USDA guidelines to achieve a 100% evidencing Nutrition Risk Assessment. 3) Decreasing the number of corrective actions issued to local agencies for Verification of Certification card usage and 4) Decreasing the percentage of inter/intrastate dual program participants.
ACCOMPLISHMENTS: The Policy Section accomplished the following within FFY 2006: a.) Through the implementation of a new computer function, the number of non-populated income fields has been reduced to nearly zero. b.) Verification of Certification card corrective action has significantly decreased with the implementation of the electronic VOC system. c.) The percentage of dual participant has decreased with the implementation of the sample dual participation notification letter that is used to notify clients.
Food Delivery/Food Instrument Accountability and Control: This function is the responsibility of the WIC Compliance Analysis Section, and the goal is to minimize WIC vendor and WIC client fraud and abuse. This is achieved by; 1) Conducting and

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completing WIC Vendor Covert Investigations on at least 5% of the vendor sites; 2) Monitoring and investigating at least 20% of WIC client sites to investigate potential clinic fraud; 3) Minimize repeat vendor offender occurrences.
ACCOMPLISHMENTS: Conducted and completed a minimum of 5% WIC vendor covert investigations.
x Performed 137 compliance buy investigations x Found 30 vendors overcharging and 1 vendor trafficking x Found 2 vendors substituting unauthorized foods. x Disqualified 30 vendors due to WIC non-compliance x Referred 12 vendors to the food stamp program for program disqualification x Appealed 15 cases
Minimized the abuse of repeat vendor offender occurrences
x Publicized vendor disqualifications and violations in the vendor news letter and the local news papers.
x Issued warning letters to vendors for minor program violations.
Monitor/ investigate 20%WIC clinic sites and investigate potential clinic fraud
x Monitored 20% of identified clinics per districts during program reviews x Assessed voucher security and voucher issuance procedures during program reviews and
other on-site clinic visits. x Completed quarterly dual participation reports to ensure program compliance from
participants. x Provided training to deter WIC clinic fraud and abuse with training and monitoring of
WIC clinics.
Monitoring and Audits: The goal of the Monitoring and Audits function is to monitor Georgia's twenty (20) local agencies and conduct on-site audit visits to each local agency every two years. This goal is achieved by: 1.) Reviewing local agencies and newly established clinics to ensure programmatic compliance with Federal and State Regulations, 2.) Coordinating with Georgia licensed Certified Public Accountants (CPA) to review and complete local agency financial reviews for federal regulation compliance.
ACCOMPLISHMENTS: The Policy Section accomplished the following within FFY 2006: a.) Monitored nine health districts, one contract agency and conducted three revisits in FFY 2006. b.)Successfully conducted a state wide Public Comment Process. Valuable feedback was received form WIC

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Colleagues, Participants and Vendors. Responses were used to improve WIC Service delivery in all aspects of the program
Civil Rights: The WIC goal is to provide a customer-friendly health service environment for all applicants and participants by: 1.) Evaluating Civil Rights compliance activities in each of the twenty (20) local agencies, 2.) Increasing the State's Civil Rights training of all new and existing staff servicing WIC clients.
ACCOMPLISHMENTS: Civil Rights trainings were presented via video conferencing to every district. Those districts that were unable to attend during the initial presentation were given video copies for future reference.
Coordination and Collaborative Partnerships: The WIC goal is to build strong links for leveraging the coordination of information and resources with state and local partners in order to respond to the needs of pregnant women and young children and improve Maternal and Child Health (MCH) outcomes. This goal is being achieved through: 1) Coordination of WIC and immunization services at the state and local levels. 2) Collaborative partnerships with other non-WIC food assistance programs at state and local levels. 3) Implementing tobacco prevention strategies to educate WIC participants and caregivers on the risk of second-hand smoke.
ACCOMPLISHMENTS: a.) WIC has ongoing collaboration with immunization services. A representative from WIC has attended each of the quarterly coordinator meetings. Through the use of the current information systems, it has been determined that greater than 95% of WIC children are adequately immunized for age. b.) A written agreement between WIC and epidemiology has allowed the sharing of data to identify areas at risk for elevated lead levels in children less than five years of age. c.) A representative from the WIC branch is actively involved in information sharing with HMHB through the newborn linkage advocate group.

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SECTION IV FFY 2008 GOALS AND OBJECTIVES

State Plan

Program Function Area: Vendor Management

Goal 1: To ensure the efficiency of all activities associated with selecting, authorizing, training, monitoring and investigating the Georgia WIC vendor population for the purpose of maintaining access to WIC products and reducing the incidents of program fraud and abuse.
Objective 1.1: To streamline process for Vendor Selection and Authorization processes thus improving vendor customer service. Objective 1.2: To utilize videoconferencing for reauthorization training, annual and cashier training in an attempt to improve customer service
for WIC vendors. Objective 1.3: To increase the percentage of vendors monitored. Objective 1.4: To develop a web-based application in which vendors can initiate the application process. Objective 1.5: To conduct vendor audits in attempt to reduce fraud and abuse of the WIC Program. Objective 1.6: Adherence to procedures and guidelines for processing of rejected voucher payments during the implementation phase of
Vendor Cost Containment which requires State agencies to establish a vendor peer group system which distinguishes above50-percent vendors from other vendors within the peer group system. Objective 1.7: Increase assistance to vendors and local agencies by keeping them abreast of changes in rules and regulation to the WIC Program. Objective 1.8: Increase vendor compliance in the program.

Objective

Strategies/Activities

Baseline

Indicators

Lead Position

Timeline

Resources

1.1

a. Processed the front end pre- TBD

processing of the new vendor

applications (i.e. pre-screen

for vendor errors, entering

limited information into VIPS

and postponing decision, pre

visit price analysis, handling

vendor customer service

issues, etc.).

The addition of new vendors to the program within 60 days of application ultimately depending on vendor readiness.

Temporary employees

Present to FFY 2009

Available: GSAMS statewide site listing
Needed:

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State Plan

Program Function Area: Vendor Management

Goal 1: To ensure the efficiency of all activities associated with selecting, authorizing, training, monitoring and investigating the Georgia WIC vendor population for the purpose of maintaining access to WIC products and reducing the incidents of program fraud and abuse.

Objective 1.1: Objective 1.2:
Objective 1.3: Objective 1.4: Objective 1.5: Objective 1.6:
Objective 1.7:
Objective 1.8:

To streamline process for Vendor Selection and Authorization processes thus improving vendor customer service. To utilize videoconferencing for reauthorization training, annual and cashier training in an attempt to improve customer service for WIC vendors. To increase the percentage of vendors monitored. To develop a web-based application in which vendors can initiate the application process. To conduct vendor audits in attempt to reduce fraud and abuse of the WIC Program. Adherence to procedures and guidelines for processing of rejected voucher payments during the implementation phase of Vendor Cost Containment which requires State agencies to establish a vendor peer group system which distinguishes above50-percent vendors from other vendors within the peer group system. Increase assistance to vendors and local agencies by keeping them abreast of changes in rules and regulation to the WIC Program. Increase vendor compliance in the program.

Objective 1.1

Strategies/Activities
b. During the contract year, applications will not be accepted between July 1st and September 30th as to allow timely processing of the reauthorization applications and contracts and to ensure that old contracts are not distributed during the new contract issuance period.

Baseline TBD

Indicators
The addition of new vendors to the program within 60 days of application ultimately depending on vendor readiness.

Lead Position Temporary employees

Timeline
Present to FFY 2009

Resources Available: GSAMS statewide site listing
Needed:

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State Plan

Program Function Area: Vendor Management

Goal 1: To ensure the efficiency of all activities associated with selecting, authorizing, training, monitoring and investigating the Georgia WIC vendor population for the purpose of maintaining access to WIC products and reducing the incidents of program fraud and abuse.

Objective 1.1: Objective 1.2:
Objective 1.3: Objective 1.4: Objective 1.5: Objective 1.6:
Objective 1.7:
Objective 1.8:

To streamline process for Vendor Selection and Authorization processes thus improving vendor customer service. To utilize videoconferencing for reauthorization training, annual and cashier training in an attempt to improve customer service for WIC vendors. To increase the percentage of vendors monitored. To develop a web-based application in which vendors can initiate the application process. To conduct vendor audits in attempt to reduce fraud and abuse of the WIC Program. Adherence to procedures and guidelines for processing of rejected voucher payments during the implementation phase of Vendor Cost Containment which requires State agencies to establish a vendor peer group system which distinguishes above50-percent vendors from other vendors within the peer group system. Increase assistance to vendors and local agencies by keeping them abreast of changes in rules and regulation to the WIC Program. Increase vendor compliance in the program.

Objective 1.2

Strategies/Activities
a. To prepare the Power Point presentation, plan the training session and execute reauthorization and cashier training in the local agency offices via VICS (Video Interactive Conference System) with the assistance of the district coordinators

Baseline TBD

Indicators
Cost utilized in implementing reauthorization training and cashier trainings will be reduced. Vendor attendance at training sessions. Error rate in processing vouchers will decrease. .

Lead Position Temporary employees

Timeline
Present to FFY 2009

Resources Available: GSAMS statewide site listing
Needed:

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Program Function Area: Vendor Management
Goal 1: To ensure the efficiency of all activities associated with selecting, authorizing, training, monitoring and investigating the Georgia WIC vendor population for the purpose of maintaining access to WIC products and reducing the incidents of program fraud and abuse.
Objective 1.1: To streamline process for Vendor Selection and Authorization processes thus improving vendor customer service. Objective 1.2: To utilize videoconferencing for reauthorization training, annual and cashier training in an attempt to improve customer service
for WIC vendors. Objective 1.3: To increase the percentage of vendors monitored. Objective 1.4: To develop a web-based application in which vendors can initiate the application process. Objective 1.5: To conduct vendor audits in attempt to reduce fraud and abuse of the WIC Program. Objective 1.6: Adherence to procedures and guidelines for processing of rejected voucher payments during the implementation phase of
Vendor Cost Containment which requires State agencies to establish a vendor peer group system which distinguishes above50-percent vendors from other vendors within the peer group system. Objective 1.7: Increase assistance to vendors and local agencies by keeping them abreast of changes in rules and regulation to the WIC Program. Objective 1.8: Increase vendor compliance in the program.

Objective 1.3
1.4

Strategies/Activities
Increase the percentage of vendors monitored each year by 5 percent maxing out at 25%.

Baseline TBD

Indicators
Vendor sanctions, abuse and fraud will decrease.

Lead Position
WIC Operations Specialist

To work in conjunction with the TBD appropriate unit in coordinating the creation, preparation and execution of the application package in which the fields can be completed online (i.e., application, agreements and W9 form) with the exception of printing, signing and mailing the package to the state agency.

Elimination of excessive paper handling, mail-outs and application requests. Vendors will be better serviced by cutting out the wait for the packet thus aiding in speeding up the application process.

Timeline
To annually monitor at least 25% of our active vendors by 2011.
Vendors will be able to complete the application package in its entirety, electronic signatures included by 2015.

Resources Available:
Needed:

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Program Function Area: Vendor Management
Goal 1: To ensure the efficiency of all activities associated with selecting, authorizing, training, monitoring and investigating the Georgia WIC vendor population for the purpose of maintaining access to WIC products and reducing the incidents of program fraud and abuse.
Objective 1.1: To streamline process for Vendor Selection and Authorization processes thus improving vendor customer service. Objective 1.2: To utilize videoconferencing for reauthorization training, annual and cashier training in an attempt to improve customer service
for WIC vendors. Objective 1.3: To increase the percentage of vendors monitored. Objective 1.4: To develop a web-based application in which vendors can initiate the application process. Objective 1.5: To conduct vendor audits in attempt to reduce fraud and abuse of the WIC Program. Objective 1.6: Adherence to procedures and guidelines for processing of rejected voucher payments during the implementation phase of
Vendor Cost Containment, which requires State agencies to establish a vendor peer group system which distinguishes above50-percent vendors from other vendors within the peer group system. Objective 1.7: Increase assistance to vendors and local agencies by keeping them abreast of changes in rules and regulation to the WIC Program. Objective 1.8: Increase vendor compliance in the program.

Objective 1.5
1.6

Strategies/Activities
Comparison of the vendors WIC inventory receipts to their actual inventory receipts and their WIC redemption receipts to their actual inventory receipts.
Review vouchers rejected by the bank submitted by vendors to the SWO on a Return Voucher Payment Log for payment. Vouchers are examined to identify and process in accordance with the standard operating procedure for voucher analysis and payment.

Baseline TBD
TBD

Indicators
Program fraud and abuse will be reduced.

Lead Position
WIC Operations Specialist

WIC Banking system; Vendor Integrity Profile System (VIPS) and Peoplesoft Financial website.

Timeline
Present to FFY 2009

Resources Available:
Needed:

All in-house rejected voucher processes to be automated by the ACH (Automated Clearing House) system process using a scan card method by 2008

Available: Needed:

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Program Function Area: Vendor Management
Goal 1: To ensure the efficiency of all activities associated with selecting, authorizing, training, monitoring and investigating the Georgia WIC vendor population for the purpose of maintaining access to WIC products and reducing the incidents of program fraud and abuse.
Objective 1.1: To streamline process for Vendor Selection and Authorization processes thus improving vendor customer service. Objective 1.2: To utilize videoconferencing for reauthorization training, annual and cashier training in an attempt to improve customer service
for WIC vendors. Objective 1.3: To increase the percentage of vendors monitored. Objective 1.4: To develop a web-based application in which vendors can initiate the application process. Objective 1.5: To conduct vendor audits in attempt to reduce fraud and abuse of the WIC Program. Objective 1.6: Adherence to procedures and guidelines for processing of rejected voucher payments during the implementation phase of
Vendor Cost Containment which requires State agencies to establish a vendor peer group system which distinguishes above50-percent vendors from other vendors within the peer group system. Objective 1.7: Increase assistance to vendors and local agencies by keeping them abreast of changes in rules and regulation to the WIC Program. Objective 1.8: Increase vendor compliance in the program.

Objective 1.7

Strategies/Activities
Consult with vendor management and other state WIC staff to collect changes in regulations.

Correlate documents and materials.

Baseline TBD

1.8

Review Vendor Review forms

TBD

and apply sanctions within two

weeks.

Indicators
Distribute two annual newsletters to keep vendors and local agencies abreast of changes in WIC program policies.

Lead Position
WIC Operations Specialist

Mail Outs Increase the turnaround time to notify vendors of program violations.

Timeline FFY 2008
FFY 2008

Resources Available: Needed:
Available: Needed:

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Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.1
2.2

Strategies/Activities
a. Generate a list of vendors and the corresponding bank account and routing numbers.

Baseline TBD

a. Create a directory that matches the 900 voucher codes with common criteria.

Current 900 series voucher codes

Indicators
The number of bank account and routing numbers derived from the vendor information. The numbers of standardized 900 voucher codes.

Lead Position PHSO Program Director
PHSO Program Director

Timeline Ongoing
Ongoing

Resources Available:
Needed:
Available: Voucher Codes Needed:

18

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.3

Strategies/Activities
a. Monitor trouble calls from clinic staff.

Baseline TBD

b. Provide hardware support TBD for clinic/state staff operating the FMNP system.

Indicators

Lead Position Operations Analyst 1

Timeline Ongoing

Operations Analyst 1 As needed

c. Assist with data batching

TBD

problems.

Batching problems identified and solved

Operations Analyst 1 Ongoing

Resources Available:
Needed:
Available:
Needed: New Risk Codes from USDA/Nutrition Section Available:
Needed:

19

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.4

Strategies/Activities
a. Develop an access database with a Visual Basic front-end for data input.

Baseline TBD

Indicators

Lead Position Operations Analyst 2

Timeline
September 30, 2008

Resources
Available: Monitoring Tool Needed: Reports needed as requested by the Management Evaluation, Compliance Analysis, and Nutrition Sections

20

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System

Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective

Strategies/Activities

Baseline

Indicators

Lead Position

Timeline

Resources

2.4

b. Train the Review Team and TBD

Utilization of the VENA Operations Analyst 2 December 1, 2008 Available:

District Coordinators to use

based Electronic

Computer

the Program Review

Monitoring Tool for

Monitoring Tool.

onsite management

evaluations and local

agency self-reviews by

the WIC Branch

Review Team and

local agency

Coordinators

Needed:

21

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.5

Strategies/Activities
a. Develop an access database for data input for the PFA by 2008.

Baseline TBD

Indicators Completed tool

Lead Position Operation Analyst 2

Timeline
September 30, 2008

Resources
Available: Computers and software
PFA Forms 11 and 12 of the Monitoring Tool in the Georgia WIC Procedure Manual Needed:

22

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.5

Strategies/Activities
b. Train the Review Team and District Coordinators.

Baseline TBD

Indicators
Utilization of the Electronic PFA tool by the WIC Branch Review Team and local agency Coordinators

Lead Position

Timeline December 1, 2007

Resources Available:

Needed: Needed:

23

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.6

Strategies/Activities
a. Complete all statewide installation and training by 9/30/2008.

Baseline TBD

b. Provide on-going support for TBD clinic staff.

Indicators
All Clinics will be using the Peer Counseling application beginning 10/01/2008

Lead Position

Timeline

Operations Analyst 2 10/01/2008

Operations Analyst 2 Ongoing

Resources Available: Needed:
Available: Needed:

24

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.7

Strategies/Activities

Baseline

a. Require all front-end systems TBD to utilize AutoComm software.

b. Establish client registry file

TBD

updates for local agency

systems similar to current

GWIS function.

b. Provide on-going support for TBD

clinic staff.

Indicators
All systems utilizing AutoComm

Lead Position
PHSO Program Director

Timeline 07/01/2008

Reduction in number of transaction Critial Errors statewide

PHSO Program Director
Operations Analyst 2

07/01/2008 Ongoing

Resources Available: Needed: Available: Needed: Available: Needed:

25

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective

Strategies/Activities

2.8

a. Pilot a new report format.

Baseline TBD

Indicators New format used

Lead Position
PHSO Program Director/PHSO Consultant

Timeline 06/01/2008

Resources Available: Needed:

b. Establish client registry file

TBD

updates for local agency

systems similar to current

GWIS function.

Reduction in number of transaction Critial Errors statewide

PHSO Program Director

Ongoing

Available: Needed:

26

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.9

Strategies/Activities
a. Research available technologies for electronic signatures.
b. Develop databases as needed for tracking documents such as Action/Information/Policy Memos.
c. Purchase/Install required Hardware and software to pilot at State office.
d. Work with front-end system developers to
make electronic signature available in clinics.

Baseline TBD

Indicators
a. Information on available technologies collected and feasibility established
b. PAPD and/or IAPD approved. c. Hardware and software
purchased

Lead Position Timeline Resources

PHSO Program Ongoing Direcror

WIC Program Consultant

Front-end developers

WIC Contractor

DHR-OIT

Systems DBA

Needed:

27

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.9

Strategies/Activities

Baseline TBD

Indicators
d. Front-end developers install and test system at selected pilot sites.
e. Electronic signature capability installed in all WIC clinics and offices

Lead Position
PHSO Program Direcror

Timeline

Resources

Ongoing

WIC Program Consultant

Front-end developers

WIC Contractor

DHR-OIT

Systems DBA Needed:

28

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.10

Strategies/Activities
a. Assess the status of clinic batch notification receipts.

b. Collaborate with GWIS administrators and devise a strategic plan for system upgrades.

Baseline TBD

Indicators
100% of clinics will receive bath notification receipts.

Lead Position
PHSO Program Director

Timeline
Ongoing-As Needed

Resources

29

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports and include all sections reporting needs, modifications, validity, etc. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.11
2.12

Strategies/Activities
a. Assess all functions needed on GWIS.net

Baseline
Desktop GWIS functions

a. Collaborate with all WIC

TBD

sections to determine report

modifications, usefulness, and

validity.

Indicators
GWIS.net has the same functions as the desktop GWIS.

Lead Position
PHSO Program Director/PHSO Consultant

Timeline
On-going-AsNeeded

Resources

30

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Information System
Goal 2: Automate all processes of the Georgia WIC Program
Objective 2.1: Implement a collaborative project with Covansys to create an ACH (Automatic Clearing House). Objective 2.2: Standardize the 900 series voucher codes. Objective 2.3: To monitor the systematic operation of the Farmers' Market Nutrition Program. Objective 2.4: Automate Program Review Monitoring tool and Plan for Correction Report form to use during on-site Management Evaluation
visits. Objective 2.5: Automate the Patient Flow Analysis (PFA) tool for utilization by the WIC Branch and districts/local agencies. Objective 2.6: Complete Installation and Training for Electronic Peer Counseling. Objective 2.7: Ensure front end systems will complete all automatic actions. Objective 2.8: Pilot redesigned System Maintenance Indicators (SMI) report for use by program. Objective 2.9: Develop electronic signature capability for the State Office and Local Agencies. Objective 2.10: Upgrade system to ensure that 100% of clinics will receive Batch Notification Receipts via GWIS. Objective 2.11: Replicate all desktop GWIS functions for GWIS.net implementation. Objective 2.12: Complete a comprehensive review of all recorded reports. Objective 2:13: Establish a statewide EBT System. Objective 2:14: Revise the 30 day rolling month voucher issuance system.

Objective 2.13

Strategies/Activities
a. Collaborate with the Nutrition Section to revise food packages by cultural standards.

Baseline
Printed Vouchers

2.14

b. Conduct an EBT Feasibility study
a. Revise voucher system to print vouchers by month.

Vouchers are issued by rolling month

Indicators
An effective EBT system implemented statewide

Lead Position
PHSO Program Director/PHSO Consultant

Average Food Cost PHSO Program and Average Food Director/PHSO Cost per Participant Consultant

Timeline Oct. 1, 2009
October 1, 2008

Resources

31

FEDERAL FISCAL YEAR 2008
Program Function Area: Food Funds Management
Goal 3: Maximize the utilization of WIC food funds
Objective 3.1: By September 30, 2008, expand the usage of 97% of all food dollars.

Objective 3.1

Strategies/Activities
a. Streamline the financial distribution process

Baseline
Special Project Application Ongoing Local Agency Financial Reports

Indicators
100% of food dollars are accounted for

Lead Position
PHSO Program Director

b. Institute a financial auditing tool to monitor Local Agency fiscal procedures and distribute corrective actions as needed.

$433,000.00 returned due to financial audit discrepancies.

100% of Local Agencies are in financial compliance

PHSO Program Director

Timeline Ongoing
Ongoing

State Plan
Resources Available:
Needed: Additional financial staff at the State Office Available: Needed:

32

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Caseload Management

Goal 4: Effectively reach all eligible individuals and achieve the maximum caseload capacity to serve the greatest number of women, infants and children.
Objective 4.1: Increase the percentage of high-risk individuals receiving benefits by directly targeting resources to high risk populations. Objective 4.2: By September 30, 2008, develop strategies for targeting benefits to eligible populations with special health care needs and/or
residing in non-traditional home environments. Objective 4.3: By September 30, 2008, devise methodology and performance standards for monitoring and improving no-show rates
statewide. Objective 4.4: By September 30, 2008, sustain an outreach infrastructure and consistently market program eligibility and benefits.

Objective

Strategies/Activities

Baseline

Indicators

Lead Position

Timeline

Resources

4.1

a. Increase the enrollment of pregnant

52% (FFY GWIS Report

Operations Analyst I, Ongoing/

Available:

women within the first trimester by

06)

EWER113G

Program Planner

Monthly

Report EWER113G

1%. Increased
Trimester

Needed: Consistent Data

Enrollment Percentage

Data Field Specifications

b. Increase the early enrollment of

81% (FFY GWIS Report to Operations Analyst II, Ongoing/

Available:

infants within first six weeks of life by 06)

be established Program Planner

Monthly

Monthly GWIS Report

1%.

Needed:

c. Increase the proportion of children receiving benefits beyond their second birthday by 1%.

52% (FFY 06)

GWIS Report to Operations Analyst II, Ongoing/

be established Program Planner

Monthly

Available: Monthly GWIS Report Needed:

d. Increase average monthly participation of pregnant women in the WIC program by 4%
e. Increase average monthly participation number of infants enrolled in the WIC program by 4%
f. Increase breastfeeding initiation and duration percentages among WIC enrolled postpartum women by 2%

49,696 (FFY 06)
88,268 (FFY 06)
53% and 25% respectively (FFY 06)

GWIS report to be established GWIS Report
GWIS report

Operations Analyst II
Program Planner, Operations Analyst II
PHSO Consultant II and Program Planner

Ongoing/ Monthly
Ongoing/ Monthly
Ongoing

Available: Monthly GWIS Report
Needed: Needed:
Available: Needed: Monthly GWIS report

33

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Caseload Management

Goal 4: Effectively reach all eligible individuals and achieve the maximum caseload capacity to serve the greatest number of women, infants and children.
Objective 4.1: Increase the percentage of high-risk individuals receiving benefits by directly targeting resources to high risk populations. Objective 4.2: By September 30, 2008, develop strategies for targeting benefits to eligible populations with special health care needs and/or
residing in non-traditional home environments. Objective 4.3: By September 30, 2008, devise methodology and performance standards for monitoring and improving no-show rates
statewide. Objective 4.4: By September 30, 2008, sustain an outreach infrastructure and consistently market program eligibility and benefits.

Objective

Strategies/Activities

Baseline

Indicators

Lead Position Timeline

Resources

4.2

a. Establish partnerships with culturally

TBD

diverse organizations to identify and

locate non-English speaking eligible

individuals

Effective assessment of nonEnglish speaking participants

WIC Operations Specialist, Program Planner

Ongoing

Available:
Needed: Assessment Tool

County Population

Statistics from USDA

b. Strategize mechanisms to identify children 16 hospitals,

Computer-related Program Planner, Ongoing/

Available:

in foster care who are enrolled and

5 military bases,

receive WIC benefits

4 DFACS centers

c. Initiate strategies to assess the proportion

documentation tool Planner

for foster care

Associate,

participants

Operations

Monthly

Needed:

of children with special needs enrolled

Analyst II

Computer-related

and receiving benefits.

documentation tool

d. Continue to support the delivery of benefits in non-traditional clinic sites.

# of children under 5 years old in foster

care

4.3

a. Conduct an assessment to identify local TBD; need to

Effective

Program valuator Ongoing/Bi-

Available:

agency strategies to address no-show

conduct listing

assessment tool

PHSO Consultant annually

rate.

from LAP.

II

Needed:

Staff time

b. Convene a work group to review current practices and recommend best practices.

TBD; workgroup to be composed of Coord.

Work group results

Program valuator PHSO Consultant II Program Planner

September 30, 2008

Assessment tool Available: Needed:

34

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Caseload Management
Goal 4: Effectively reach all eligible individuals and achieve the maximum caseload capacity to serve the greatest number of women, infants and children.
Objective 4.1: Increase the percentage of high-risk individuals receiving benefits by directly targeting resources to high risk populations. Objective 4.2: By September 30, 2008, develop strategies for targeting benefits to eligible populations with special health care needs and/or
residing in non-traditional home environments. Objective 4.3: By September 30, 2008, devise methodology and performance standards for monitoring and improving no-show rates
statewide. Objective 4.4: By September 30, 2008, sustain an outreach infrastructure and consistently market program eligibility and benefits.

Objective 4.3

Strategies/Activities
a. Establish protocol for sharing local agency strategies and accomplishments.

Baseline
TBD, overall, cumulative feedback summary

Indicators
Standards and protocol documents

Lead Position Planner Associate

4.4

a. Assess, identify, and evaluate TBD

outreach resources needed to

target specific populations

that under utilize WIC

services.

Evaluation and assessment results

WIC Operation Specialist, Planner Associate

b. Use results from Public

TBD

Comment period to explore

mechanisms to better tailor

and reach public health

providers.

WIC Operations Specialist Program Associate

Timeline
September 30, 2008

Resources Available:
Needed: Standards and protocol documents

Internal Planner staff Ongoing/Quarterly Available:

September 30, 2008

Needed: Evaluation and Assessment Tool
Focus Group assessments Available:
Needed: Public Comment Results

35

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Caseload Management
Goal 4: Effectively reach all eligible individuals and achieve the maximum caseload capacity to serve the greatest number of women, infants and children.
Objective 4.1: Increase the percentage of high-risk individuals receiving benefits by directly targeting resources to high risk populations. Objective 4.2: By September 30, 2006, develop strategies for targeting benefits to eligible populations with special health care needs and/or
residing in non-traditional home environments. Objective 4.3: By September 30, 2008, devise methodology and performance standards for monitoring and improving no-show rates
statewide. Objective 4.4: By September 30, 2008, sustain an outreach infrastructure and consistently market program eligibility and benefits.

Objective 4.4

Strategies/Activities
a. Compile information on local agency interventions to reach potentially eligible high-risk individuals in all segments of the service area.

Baseline TBD

Indicators
Local Agency Plans, Quarterly reports and End of Year Reports

Lead Position
PARS PHSO Consultant II Program Planner

b. Assess and summarize

TBD

responses received during the

Public Comment Period to

potentially be used as

implementation strategies for

the State FFY 08 Plan.

Public Comments Results Spreadsheet

Policy Section Program Evaluator

Timeline Ongoing

Resources Available:

Ongoing/Annually

Needed: Baseline information for target populations of employed applicants/participants, migrants, homeless and non-English speaking participants Available: Public Affairs Office

Needed:

36

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Coordination and Collaborative Partnerships

Goal 5: Build strong links for leveraging the coordination of information and resources with State and local partners in order to respond to the needs of pregnant women and young children that will lead to improve Maternal and Child Health outcomes
Objective 5.1: Continue the coordination efforts of WIC and immunization services at the State and local levels with an expansion to include GRITS by September 2008.
Objective 5.2: Continue efforts to increase collaborative partnerships with other food assistance programs at the state. Objective 5.3: Continue collaborations with programs/agencies that promote healthy families and serve potentially eligible participants. Objective 5.4: By September 2008, continue collaborative efforts with Georgia Childhood Lead Poisoning Prevention Program Objective 5.5: By September 2008, implement statewide media and marketing strategies to promote program activities.

Objective

Strategies/Activities

Baseline

Indicators

Timeline

Resources

5.1

a. District WIC Coordinators to schedule GRITS

TBD

WIC Staff will be able to

July 2007, WIC Staff will be

IZ Program

training for WIC clerical staff

access GRITS system to

trained

Consultant

determine IZ status

b. Annual MOA to be updated

TBD

WIC Director and IZ

The updated MOA will be

Program Director

Director will review and

completed by October 1, 2007 and MOA author

signed the agreement

c. Prepare the WIC/IZ Linkage Profile Report

TBD

Total number of WIC sites Annual Report Profile will be

WIC IT System

IZ will be documented

completed, signed and

Total number of infants

delivered to CDC by February

and children screened will 28, 2008

be documented

5.2

a. Train Local Agencies to record the proportion of TBD

Baseline data

Jan. 2008, WIC Staff will be

WIC participants who also receive Food Stamps.

trained

b. Assess and analyze data to establish state and

Statewide network of

local agency baseline

program information and

c. Build capacity for ongoing coordination of food

collaboration efforts

assistance services. Disseminate WIC

information amongst all partnered services.

37

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Coordination and Collaborative Partnerships
Goal 5: Build strong links for leveraging the coordination of information and resources with State and local partners in order to respond to the needs of pregnant women and young children that will lead to improve Maternal and Child Health outcomes
Objective 5.1: Continue the coordination efforts of WIC and immunization services at the State and local levels with an expansion to include GRITS by September 2008.
Objective 5.2: Continue efforts to increase collaborative partnerships with other food assistance programs at the state. Objective 5.3: Continue collaborations with programs/agencies that promote healthy families and serve potentially eligible participants. Objective 5.4: By September 2008, continue collaborative efforts with Georgia Childhood Lead Poisoning Prevention Program Objective 5.5: By September 2008, implement statewide media and marketing strategies to promote program activities.

Objective

Strategies/Activities

5.3

Coordinate with FHB to address "repeat

births" among adolescents

Baseline

Indicators

TBD

Patterns will be identified by district

a. Compile data on the pregnancies of girls between 15 and 19 years of age
b. Target districts with high 2nd birth rates for TBD intervention

Those districts that have more than three (3) incidents of 2nd birth will be identified

Timeline Quarterly

Resources WIC Info System

Quarterly

WIC Info System

c. Develop a plan for interpenetration

TBD

Plans will address the issue of teenage pregnancy September Multidiscipline

prevention

2007

Group

38

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Coordination and Collaborative Partnerships
Goal 5: Build strong links for leveraging the coordination of information and resources with State and local partners in order to respond to the needs of pregnant women and young children that will lead to improve Maternal and Child Health outcomes
Objective 5.1: Continue the coordination efforts of WIC and immunization services at the State and local levels with an expansion to include GRITS by September 2008.
Objective 5.2: Continue efforts to increase collaborative partnerships with other food assistance programs at the state. Objective 5.3: Continue collaborations with programs/agencies that promote healthy families and serve potentially eligible participants. Objective 5.4: By September 2008, continue collaborative efforts with Georgia Childhood Lead Poisoning Prevention Program Objective 5.5: By September 2008, implement statewide media and marketing strategies to promote program activities.

Objective 5.3

Strategies/Activities
Collaborate with Healthy Mothers/Healthy Babies on "The Newborn Linkage"

a. Discuss strategies for assuring the well-being of newborn

Baseline
Unified, multifarious health facilities that serve both mother and child are found to be preferred among participants. This way, both mother and baby can be seen by a healthcare provider.

Indicators
Methods of delivering needed services to newborn babies and mothers will be explored

Timeline
Semimonthly meetings

Resources
Multidiscipline Advocate Group

5.3

Collaborate with

TBD

intergenerational services to

better assist grandparents and

other caretakers.

Major barrier to public health services will be documented

January 2008

Multidiscipline Group

b. Identify barriers to service for grandparents raising children
c. Explore the cause and solution to TBD barrier

Cause of barrier will be identified

January 2008

Multidiscipline Group

39

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Coordination and Collaborative Partnerships
Goal 5: Build strong links for leveraging the coordination of information and resources with State and local partners in order to respond to the needs of pregnant women and young children that will lead to improve Maternal and Child Health outcomes
Objective 5.1: By September 2008, continue the coordination efforts of WIC and immunization services at the State and local levels with an expansion to include GRITS
Objective 5.2: Continue efforts to increase collaborative partnerships with other food assistance programs at the state. Objective 5.3: Continue collaborations with programs/agencies that promote healthy families and serve potentially eligible participants. Objective 5.4: By September 2008, continue collaborative efforts with Georgia Childhood Lead Poisoning Prevention Program Objective 5.5: By September 2008, implement statewide media and marketing strategies to promote program activities.

Objective

Strategies/Activities

5.3

j. Develop networking system for grandparents

Baseline

Indicators

TBD

Some of the "red tape" to

service will be removed

Timeline

Resources Multidiscipline Group

5.4

k. Develop letter of support of Georgia Childhood TBD

Documenting the

Lead Poisoning Prevention Program (GCLIPP)

collaboration between

WIC/GCLIPP

February 2008

WIC designated staff and GCLIPP designated staff

l. Evaluated/Covansys data from GCLIPP and WIC TBD

Regions at risk for evaluated September lead levels will be identified 2007

WIC demographic info

40

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Coordination and Collaborative Partnerships
Goal 5: Build strong links for leveraging the coordination of information and resources with State and local partners in order to respond to the needs of pregnant women and young children that will lead to improve Maternal and Child Health outcomes
Objective 5.1: By September 2008, continue the coordination efforts of WIC and immunization services at the State and local levels with an expansion to include GRITS
Objective 5.2: Continue efforts to increase collaborative partnerships with other food assistance programs at the state. Objective 5.3: Continue collaborations with programs/agencies that promote healthy families and serve potentially eligible participants. Objective 5.4: By September 2008, continue collaborative efforts with Georgia Childhood Lead Poisoning Prevention Program Objective 5.5: By September 2008, implement statewide media and marketing strategies to promote program activities.

Objective

Strategies/Activities

5.4

Attend periodic multi discipline

meetings sponsored by GCLIPP

Baseline TBD

Indicators
Information necessary to develop intervention strategies is readily available

Timeline Periodically

Resources HUD, CDC, WIC, GCLIPP
Poison Control

5.5

Draft tentative plan and Logic

Tentative plan and Logic Comprehensive media campaign 3 year plan to be WIC

Model for project.

model complete by June to target all eligible participants. implemented

designated

1, 2007

staff

41

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Certification and Eligibility
Goal 6: Administer standardize processes for determining and documenting participants eligibility, nutrition risks, standards and criteria; ensure the coordination of certification activities with other health services
Objective 6.1: Conduct ten (10) on site visits/year to ascertain the compliance of the agency to federal regulations Objective 6.2: Access the coordination of WIC with other health services provided Objective 6.3: Determine the eligibility of clients for the Georgia WIC Program Objective 6.4: Develop and implement training modules to enhance the ability of district and local staff to provide WIC services

Objective 6.1

Strategies/Activities
a. Each district will have clinics reviewed and the results documented

Baseline Indicators

TBD

Statistical data of the review process

Long Term Outcome
Within each clinic, the results will be conveyed to the staff

Resources

b. Follow-up visits will be done if TBD warranted by the review process

Follow-up visits will be done if the overall score of the survey falls below 75%

Clinics will improve to no longer warrant follow-up visits

6.2

c. Review documentation to

TBD

% of client referred to the health services

Total integration of services within

determine coordination

from the WIC program

the health department

activities with health services

42

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Certification and Eligibility
Goal 6: Administer standardize processes for determining and documenting participant's eligibility, nutrition risks, standards and criteria; ensure the coordination of certification activities with other health services
Objective 6.1: Conduct ten (10) on site visits/year to ascertain the compliance of the agency to federal regulations Objective 6.2: Access the coordination of WIC with other health services provided Objective 6.3: Determine the eligibility of clients for the Georgia WIC Program Objective 6.4: Develop and implement training modules to enhance the ability of district and local staff to provide WIC services

Objective

Strategies/Activities

6.3

d. Review client records to ascertain the

eligibility requirements for the WIC Program

Baseline TBD

Indicators
Actual documentation of whether the client meets the eligibility requirements

Long Term Outcome
Each client assessed will have documented eligibility requirements

Resources

e. Appropriate references of the client to other TBD services within the health department as well as other programs

Document actual referrals with follow-up documentation regarding the client's access to other programs

Each client served will have documented referrals in the clinics

6.4

f. Each staff member will be required to

TBD

The district will be required to ensure Ensure that each staff

complete twelve (12) hours annually of

that each staff member performing member performing WIC

training regarding various aspects of the WIC

WIC services complete training

services has a working

Program

annually

knowledge of WIC

43

FEDERAL FISCAL YEAR 2008
Program Function Area: Food Delivery/Food Instrument Accountability and Control
Goal 7: Deter WIC Vendor and WIC Clinic Fraud and Abuse
Objective 7.1: To conduct and complete a minimum of 5% WIC Vendor Covert Investigations. Objective 7.2: To minimize the abuse of repeat vendor offender occurrences. Objective 7.3: To monitor/investigate 20% WIC Clinics sites and investigate potential clinic fraud.

State Plan

Objective 7.1

Strategies/Activities
a. Identify High Risk WIC Vendors and conduct Covert Investigations.

b. Notify vendors and UDSA of Investigation outcomes.

c. Represent the State at Administrative Hearings.
d. Train Administrative Law Judges and appointed attorneys regarding federal requirements.

Baseline Completed 5% of Covert investigations in FFY 2006
FFY 2006 = 100%
None

Indicators VIPS/WIC Banking
Sanction System
Vendor Disqualification

Lead Person

Timeline

Investigative Specialist Ongoing

Resources
Available: VIPS & WIC Banking

Operations Analyst 3
PHSO Program Director

2 weeks after investigation cases are closed
Complete within 60 days of hearing request

Needed: SMR as required OIG as required Available:
Needed: CAS Program Assistance Available:
Needed: Available backup staff

Georgia WIC Vendor Policies and Guidelines

Vendor Training Check List

PHSO Program Director

As Needed

Available:
Needed: Communication Support

44

FEDERAL FISCAL YEAR 2008
Program Function Area: Food Delivery/Food Instrument Accountability and Control
Goal 7: Deter WIC Vendor and WIC Clinic Fraud and Abuse
Objective 7.1: To conduct and complete a minimum of 5% WIC Vendor Covert Investigations. Objective 7.2: To minimize the abuse of repeat vendor offender occurrences. Objective 7.3: To monitor/investigate 20% WIC Clinics sites and investigate potential clinic fraud.

State Plan

Objective 7.2

Strategies/Activities
a. Publicize vendor violations and disqualifications.

Baseline TBD

b. Administer State sanctions TBD as advised by court decisions.

7.3

a. Assess Voucher Security in

20% of

WIC Clinics.

identified

clinics per

district during

each Program

Review

b. Investigate Reports of Missing 25 or more

Vouchers from WIC Clinics

missing

and contact contract bank to vouchers

obtain vouchers.

c. Conduct on-site clinic visits to TBD assess fraudulent activities.

Indicators
Vendor News Letters and Local News Papers

Lead Position

Timeline

Investigative Specialist Ongoing/Annually

PHSO Program Director

As needed

Monitoring Tool

Operations Analyst 3

October 1, 2008through September 30, 2009

Missing Voucher Summary from Districts Statewide
Report of potential fraud

PHSO Program Director
PHSO Program Director

Within 3 days As Needed

Resources Available
Needed: Available: Needed: Available:
Needed:
Available:
Needed: Available: Procedure Manual guidelines GWIS Needed:

45

FEDERAL FISCAL YEAR 2008
Program Function Area: Food Delivery/Food Instrument Accountability and Control
Goal 7: Deter WIC Vendor and WIC Clinic Fraud and Abuse
Objective 7.1: To conduct and complete a minimum of 5% WIC Vendor Covert Investigations. Objective 7.2: To minimize the abuse of repeat vendor offender occurrences. Objective 7.3: To monitor/investigate 20% WIC Clinics sites and investigate potential clinic fraud.

Objective 7.3

Strategies/Activities
a. Report potential employee fraudulent activities to the Georgia Office of Investigative Services.

Baseline TBD

Indicators

Lead Position
PHSO Program Director

Timeline As Needed

b. Deter WIC Clinic fraud and abuse with training and monitoring of WIC clinics.

FFY 2008 = No identified WIC clinic fraud and abuse occurrences

System Reports and Monitoring Tool

Operations Analyst 3

Ongoing

State Plan
Resources Available: Clinic records Needed: Onsite clinic review report Available: System Reports and WIC Banking Needed: One (1) additional fulltime staff

46

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Monitoring and Audits
Goal 8: Administer and evaluate processes for continual on-site programmatic management review of district and local agency activities to monitor compliance with program regulations, policies and procedures.
Objective 8.1: Monitor ten (10) districts/local agencies and newly established clinics to ensure programmatic compliance with Federal and State Regulations.
Objective 8.2: To evaluate, analyze and improve our capacity to provide technical assistance to our districts and local agencies Objective 8.3: To update the Georgia Monitoring Tool for VENA compliance by 2010

Objective 8.1

Strategies/Activities
a. Finalize the FFY 2008 local agency monitoring schedule

Baseline

Indicators

TBD

Establish a flow sheet for FFY 2008

Long Term Outcome
Review each of Georgia's twenty (20) local agencies by conducting an on-site monitoring visit every two(2) years

Resources

b. Prepare and submit program

TBD

review and technical assistance

reports to local agencies

monitored within 60 days of the

last date of program review

c. Analyze, and summarize, in

TBD

report format the FFY 2008 local

agency review

Reduction in repeat corrective actions

Improved local agency program review outcomes

Program Review Summary Report will reflect an improvement in the number and type of corrective actions received by each local agency reviewed

To reduced the amount of corrective actions received and reduction in repeat revisit to districts/local agencies

47

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Monitoring and Audits
Goal 8: Administer and evaluate processes for continual on-site programmatic management review of district and local agency activities to monitor compliance with program regulations, policies and procedures.
Objective 8.1: Monitor ten (10) districts/local agencies and newly established clinics to ensure programmatic compliance with Federal and State Regulations.
Objective 8.2: To evaluate, analyze and improve our capacity to provide technical assistance to our districts and local agencies Objective 8.3: To update the Georgia Monitoring Tool for VENA compliance by 2010

Objective Strategies/Activities

8.1

d. Close all FFY 2008 district/local agency

Program Reviews

e. Conduct initial on-site visits and program reviews of new clinics and contact Covansys to assign a unique clinic number

Base line TBD
TBD

Indicators

Long Term Outcome

Timely receipt of all documentation as reflected by the clinic flow sheet

To close all FFY 2008 district/local agency Program Reviews within the prescribed timeframe

100% regulatory compliance for monitoring and opening new WIC clinic site Receipt of a new clinic number from Covansys

An increase in clinics located in areas that are easily access to WIC clients

Resources

8.2

f. Evaluate and modify the current process for TBD Program review report responses To provide state sponsored TA

technical assistance (TA)

indicating local technical

to all districts/local agencies on

assistance provided

a yearly basis

Documentation of TA provided in

the field on program reports

g. Draft for an additional WIC Operation

TBD

Specialist position to provide full time TA as

a critical job function

Documentation provided from the Increased staff capacity to

evaluation of the current process provide Technical Assistance to

for Technical Assistance

more clinics yearly

48

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Monitoring and Audits
Goal 8: Administer and evaluate processes for continual on-site programmatic management review of district and local agency activities to monitor compliance with program regulations, policies and procedures.
Objective 8.1: Monitor ten (10) districts/local agencies and newly established clinics to ensure programmatic compliance with Federal and State Regulations.
Objective 8.2: To evaluate, analyze and improve our capacity to provide technical assistance to our districts and local agencies Objective 8.3: To update the Georgia Monitoring Tool for VENA compliance by 2010

Objective

Strategies/Activities

8.3

h. Policy Section and VENA Monitoring Tool Committee will meet to

evaluate the current tool, draft a new tool, pilot and train on the

new tool by 2010

Baseline TBD

Indicators
VENA Monitoring Tool Work Plan Drafts of tool Feedback from staff Results of tool pilot

Long Term Outcome
A Vena compliant Georgia Monitoring Tool

Resources

49

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Civil Rights
Goal 9: Establish and administer policies and procedures that assure client-oriented customer friendly service environment for all applicants and participants
Objective 9.1: To ensure each existing or temporary employee in the Local Agency and State is trained in the area of civil rights for FY '08010.
Objective 9.2: Ensure compliance of civil rights requirements in the use of the non-decimation statement in the Local Agency and State. Objective 9.3: Assure that service is provided in compliance with civil rights requirements.

Objective

Strategies/Activities

9.1

a. Design and develop a civil rights training presentation

for use via videoconference and/or face-to-face

b. Include required topics in presentation in addition to EEO awareness, harassment and cultural competencies

Baseline TBD
TBD

Indicators
Each new employee will be given civil rights training as part of new employee orientation Training will meet the HHS/USDA mandate

Timeline October 1, 2007
October 2006

Resources

c. Distribute civil rights training in CD or DVD format for

TBD

statewide distribution

Trainer will develop and distribute DVD for January 1,

each district

2008

d. Implement a one-month time frame for all employees to TBD be trained in the area of civil rights

After 30 days of employment, each

Ongoing

employee will have attended a CR/CS class

50

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Civil Rights
Goal 9: Establish and administer policies and procedures that assure client-oriented customer friendly service environment for all applicants and participants
Objective 9.1: To ensure each existing or temporary employee in the Local Agency and State is trained in the area of civil rights for FY '08010.
Objective 9.2: Ensure compliance of civil rights requirements in the use of the non-decimation statement in the Local Agency and State. Objective 9.3: Assure that service is provided in compliance with civil rights requirements.

Objective Strategies/Activities

9.2

e. Request a copy of all brochures, handbooks, information

handouts and/or other publications for the proper usage of

the non-discrimination statement

Baseline TBD

Indicators
Each brochure and handout will contain the non-discrimination statement

Timeline Ongoing

Resources

f. Review Monitoring reviews to analyze compliance in civil

TBD

Each district having 6 or more

October 1,

rights

complaints will be mandated to have

2007

state sponsored CS/CR training

g. Check State office publications for inclusion of the nondiscrimination statement

TBD

All publications currently contain the

Ongoing

non-discrimination statement

51

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.1

Strategies/Activities
a. Offer trainings for district staff on the Eat Healthy, Be Active curriculum, to address childhood obesity. 1. Assess existing early child care centers for breastfeeding, healthy eating and physical activity interventions/policies 2. Educate early child care providers on how to support breastfeeding mothers. 3. Ensure that young children in day care settings have healthy food choices, daily physical activity and are taught (including parents and caregivers) the benefits of healthy eating and being physically active. 4. Promote the development of policy that incorporates staff breastfeeding education into all early childcare centers and Head Start Programs

Baseline TBD

Indicators # Of trainings and support activities offered.
Partnerships formed
# of new interventions implemented

Lead Position
Program Consultant 2

Timeline June-Sept. 2007
FFY 2007 2008

Resources
Available: Eat Healthy, Be Active Curriculum -Cooperative Extension -Dept. of Early Care and Learning

52

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.1

Strategies/Activities
b. Coordinate with local districts and community partners to develop a framework for addressing obesity in the WIC population.

Baseline TBD

Indicators
District work plans

Lead Position
# of local agencies offering nutrition and physical activity related projects

Timeline
Program Consultant

Resources June 20, 2008
Needed: Best practice, research based curricula

53

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.1

Strategies/Activities
c. Collaborate with WIC and the Epidemiology Branch to monitor and disseminate surveillance data related to Nutrition Section focus areas
d. Collaborate with WIC and the Epidemiology Branch to monitor and disseminate surveillance data related to Nutrition Section focus areas

Baseline WIC--GWIS BMI related data
PedNSS
PNSS
BRFSS
PRAMS

(14.3 % youth obese)

Indicators Information distributed
Resources developed and distributed Information distributed
Resources developed and distributed

YRBSS Survey

WIC--GWIS BMI related data

Lead Position
Program Consultant 2 Program Consultant 2

Timeline
Ongoing--as needed for programming Ongoing--as needed for programming

Resources Available: GWIS data
Nutrition & Physical Activity Grant project
EPI Branch
Data Team Available: GWIS data
Nutrition & Physical Activity Grant project
EPI Branch
Data Team

54

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services

Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective

Strategies/Activities

Baseline

Indicators

Lead Position

Timeline

Resources

10.1

d. Support Georgia's fruit and

TBD

vegetable promotion programs

1. Assess baseline fruit and

vegetable consumption for

WIC children 2-5 years

2. Educate parents on the

availability of healthy choices

and how to make healthy

choices for family meals.

3. Promote the 5 A Day

Program in Head Start/ Day

Care

4. Assess baseline fruit and

vegetable consumption for

WIC children 2-5 years

5. Educate parents on the

availability of healthy choices

and how to make healthy

choices for family meals.

6. Promote the 5 A Day

Program in Head Start/ Day

Care

Distribution of materials to local agencies

Nutrition Program Consultant

# of trainings offered to staff Distribution of materials to local agencies

Ongoing

Available:
Printed fruit and vegetable resources and materials Needed: Designated local agency staff
Best practice--fruit and vegetable educational materials

55

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.1

Strategies/Activities
e. Coordinate with local districts, promotion of fruit and vegetables consumption-- participation in Farmer's Market Nutrition Program

Baseline
Farmer's Market Program

Indicators
# of coupons redeemed by participants

Lead Position
Nutrition Program Consultant

# of educational programs offered to participants

10.1

f. Implement the Fit WIC Program in District 9.2 Waycross

Overweight data in WIC Children 2005 14.3% PedNSS

Program implemented and evaluated. Made appropriate revision and implement statewide by 2012

Nutrition Program Consultant

Timeline Ongoing
Ongoing

Resources Available: WIC Vendors Program
WIC Farmers Markets
FMNP vouchers Needed:
Available: Fit WIC Resources

56

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services

Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective

Strategies/Activities

Baseline

Indicators

Lead Position

Timeline

Resources

10.2 10.2

a. Promote the Loving Support to Manage Peer Counselors breastfeeding campaign

Eight participating public health districts

b. Work with State Division Directors to expand the number of lactation rooms for DHR employees to at least 4 rooms

One lactation
room to date (11th floor)

Training completed

Breastfeeding Coordinator

Plan developed

Campaign completed

Evaluation plan developed

Increased breastfeeding rates
Incorporated into the workplace assessment tool

Breastfeeding Coordinator

September 30, 2008

Available: USDA grant funds
National Loving Support Team: USDA, Best Start, Mississippi
Local BF Coordinators
Georgia BF Coalition Partners/stakeholders Needed:

FFY 2007 2008

Available: FHB Director
Nut. & Phy. Act. Worksite Wellness team

Georgia Building Authority

57

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4 To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.2

Strategies/Activities
c. Work with WIC Branch to create a breastfeeding duration reporting system

Baseline TBD

Indicators
Development of reporting system

Lead Position
Breastfeeding Coordinator

10.2

d. Continue to provide training and support on breastfeeding activities

WIC 101
Lactation Skills Management Workshop

# Of workshops offered
Evaluations from participants

Breastfeeding Coordinator

Timeline September 2008

Resources
Available: GWIS

WIC Branch staff

Ongoing FFY-20072008

2005 PedNSS/PNSS Needed: 2005 WIC breastfeeding characteristics Needed: WIC 101

Level IV: Lactation Management

58

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services

Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective

Strategies/Activities

Baseline

Indicators

Lead Position

Timeline

Resources

10.3 10.3

a. Conduct an assessment to determine the type of staff that is needed at the State and local level
b. Coordinate competencybased trainings in the following subject areas: VENA competencies (Cultural competency, Critical thinking, communication/3-step counseling) -Infant/child nutrition -Clinical skills/ -Lactation management -etc.
c. Provide WIC 101 trainings to new and current local agency staff

TBD Current trainings
Current trainings

Staff assessment tool completed

Program Consultant 2

Oct. 2007- Sept. 2008 Oct. 2007- Sept. 2008

# Of trainings offered

Workshop materials/ resources developed and distributed Staff assessment tool completed # Of workshops offered

Nutrition Program Consultants

Oct. 2007-- Sept. 2008

Nutrition Section staff State and local WIC staff FHB staff Research-based resources/best practices
Available: Nutrition Section staff Needed:

59

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.3

Strategies/Activities
d. Coordinate training opportunities on the healthy eating/5ADay activities

Baseline
11 teleconference s provided each year

Indicators
# Of activities/teleconferences

Lead Position
Nutrition Program Consultant

10.3

e. Ensure that 2 nutritionists per district obtain the ADA certificate of training in childhood and adolescent weight management.
f. Coordinate trainings related to WIC food package activities (i.e. food package changes, computer system updates, selection and evaluation of WIC approved foods).

May 2007 No local staff with an ADA certificate in weight management
WIC 101 trainings and other related trainings offered.
Current vendors and approved foods list

# of local nutritionists with a certification of training in childhood and adolescent weight management. Resources provided to local agencies
Food package changes updated

Nutrition Education Coordinator
Nutrition Program Consultant

Timeline Ongoing--monthly
Oct. 2008 Sept. 2009
Ongoing--every other Year.

Resources Available: 5ADay Coalition
Fruit & Vegetables promotion materials
CDC monthly teleconferences
ADA Weight Management Course Needed: Finds to support travel for the training. Available: WIC Vendor and Systems Sections
Food Package Committee
Formula Committee Needed: Revised USDA Food Package regulations

60

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.3

Strategies/Activities
g. Coordinate trainings related to New VENA risk criteria changes

Baseline
Current trainings offered

Indicators Trainings held

Current risk criteria

Lead Position
Nutrition Program Consultant

10.3

h. Review, update and maintain written protocols, policies, standards, and operational procedures that incorporate VENA guidance

WIC procedure manual
Current policies, Nutrition Risk Handbook

Manuals Updated
Guides developed and/or updated

Nutrition Program Consultants

Revised each FFY

Timeline October 2007September 2008
Ongoing Oct and Apr each FFY

Resources Available: USDA regulations
VENA Guidelines Needed: Program Review results Available: USDA RISC Committee
State and local WIC program staff
VENA Guidance Manual Needed: Revised USDA Guidelines

61

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.3
10.3

Strategies/Activities
i. Coordinate the VENA work group teams to ensure timely implementation of the VENA initiative across the state.

Baseline
Statewide VENA coalition
VENA priority area work group teams

j. Provide research based, reference textbooks and resources to enhance local agency's nutrition education resource library

Current nutrition reference books in local agencies

Indicators
Work team work plans completed
New questionnaire developed, VENA policies written, VENA monitoring tool developed, MIS enhanced Nutrition education resources delivered to the local agencies

Lead Position
Nutrition Program Consultant
Nutrition Program Consultant

Timeline October 2007September 2008
2007-2008

Resources
Available: VENA Guidance manual
VENA priority work teams Needed: Training materials Revised policies Enhanced computer system Available:
ADA resources Breastfeeding materials WIC Works Website
Needed:

62

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.3
10.3

Strategies/Activities
k. Expand the use of new technologies (CD-ROM, distance learning video conferencing, internet) to offer greater flexibility in information delivery, in collaboration with the WIC Branch
l. Review and update written protocols, policies, standards, and operational procedures for the Georgia WIC Program Manual to comply with VENA Guidance

Baseline Current training modalities
FFY 2007 Procedure manual and State plan completed with VENA included.

Indicators New training methods and evaluation tools developed
Manuals Updated and revised each year

Lead Position Nutrition Program Consultant
Nutrition Program Consultant

10.3

m. Review and provide feedback and technical assistance to local agencies on WIC Nutrition and Breastfeeding plans

Receipt of all local agency plans FFY 2007

Review of local agency plans
Updates reviewed and evaluated

Nutrition Program Consultant

Timeline
Oct. 2007September 2008

Resources Available: DHR Training Office
Needed: Emerging technology

Annually

Available:

GA WIC Procedures

Mar - July each FFY Manual and Nutrition

VENA Guidance manual

Annually

Services State Plan Needed: New USDA regulations Available: Local agency plans USDA program guidelines Needed:

63

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.3

Strategies/Activities
n. Establish and maintain written protocols, policies, standards, and operational procedures for the WIC Program Equipment Guide

Baseline
Current protocols and policies regarding anthropometric al equipment

Indicators
CDC Equipment Guide implemented

Lead Position
Nutrition Program Consultant

10.3

o. Make available ADA on-line Currently being Usage rate by

Program Consultant

Nutrition Care Manual for

used--

state and district

nutrition care protocols

staff

10.3

p. Establish and maintain written Current policies Policy changes Nutrition Program

protocols, policies and

and procedures and updates

Consultant

procedures for infant formula

made

and metabolic foods

Signed contract

with Emory

Genetics# of

special formula

orders processed

Timeline Annually

Resources
Available: ADA

Annual subscription

Contract Needed: CDC Anthropometric Equipment Guide ADA membership

Ongoing

On-line Manual subscription
Available: Local agency staff Infant Formula Contract Formula manufacturers Emory Genetics Special Formula order form

64

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.3

Strategies/Activities
q. Increase the number of Registered/Licensed Dietitians in Georgia Division of Public Health

Baseline
Current number of RDs in the state

Indicators RD exam pass rate percentage
# Interns who graduate from the program

Lead Position
Director of the Dietetic Internship

Timeline Annually

10.3

r. Maintain written protocols,

Dietetic

Policy notebook Director of the Dietetic Annually--by

policies, standards, and

Program Self completed

Internship

December of FFY

operational procedures for

Study

the management of the

>85% first time

Dietetic Internship

Participant

pass rate

notebook

FFY 2006 15 completed program

Resources Available: Public Health Dietetic Internship Program
Needed: Qualified applicants for the program Available: Local and State agency preceptors
CADE guidelines
Advisory committee Needed: Qualified applicants

65

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.3
10.4

Strategies/Activities
s. Establish and maintain written protocols, policies, standards, and operational procedures for the nutrition component of Child Health, Women's Health, Adolescent Health manuals pertinent to the WIC audience
a. Partner with interested health districts to implement community- based nutrition interventions

Baseline Current population team program manuals
Partnerships with: DECAL Head Start FHB & Chronic disease programs

Indicators Nutrition information included in all appropriate manuals
# of programs
# of new partnerships
Fit WIC grant project funded
Grant-in-Aid 154 reports

Lead Position Program Consultant 2
Nutrition Section staff

Timeline Ongoing--annually

Resources
Available: ADA Nutrition Care protocols Needed:

Ongoing

Available: WIC local agencies DECAL, Head Start
Needed: FIT WIC resource materials

66

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.4
10.4

Strategies/Activities
b. Coordinate State and district promotion of health awareness months: Breastfeeding, 5ADay, National Nutrition Month

Baseline
Current annual activities

Indicators
# of promotional activities

Lead Position Program Consultant 2

Timeline Ongoing

# of people reached

c. Monitor nutrition component of local agency -programmatic services

Past local agency-program review/ monitoring records

WIC program review reports
Monitoring and follow-up reports

Program Consultant

Ongoing--10-12 health districts reviewed per FFY.

Resources
Available: Resources available Needed: Appropriate health promotion materials
Available: Local agency nutrition and breastfeeding plan activities Needed:

67

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.4

Strategies/Activities
d. Work with FHB Data Section, EPI, and WIC Branch to disseminate surveillance data to districts

Baseline
PedNSS and PNSS data GWIS data

Indicators
Data disseminated

Lead Position Program Consultant

Timeline Ongoing

10.5 10.5

a. Collaborate with FHB staff to develop and implement an anemia prevention framework to prevent recurrent, chronic anemia

% Of WIC clients with low Hemoglobin levels.

Meetings held
Review & revision of nursing protocols

Program Consultant

b. Coordinate with districts to ensure standardized training on lab process for taking blood samples by district staff

WIC 101 Local level trainings Hemocue manufacturer trainings.

# Of policies developed
# Of trainings provided to districts

Program Consultant

FFY 2007-2008 FFY 2007-2008

Resources
Available: FHB Data team
WIC Branch Needed:
Available: WIC policies CDC treatment Protocols Nursing protocols Needed: FHB state and local staff Available: District supervisors District health directors Hemocue training CDs

68

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: Nutrition Services
Goal 10: To improve the nutritional status and overall health of WIC families in Georgia.
Objective 10.1: To decrease from baseline (14.3 %, Youth Risk Behavior Surveillance Surveys (YRBSS) 2005) the proportion of WIC children (2-5 years) who are overweight by 2010.
Objective 10.2: To increase the breastfeeding initiation and duration rates by 2% each year. Objective 10.3: To develop a competent work force through continuous updating of knowledge and skills in nutrition and other relevant topics
by 2008. Objective 10.4: To develop and maintain strong partnerships between the State Nutrition Section, internal and external, federal, state, and
local partners to support emerging public health issues through FFY 2008. Objective 10.5: To decrease from baseline the proportion of children with low hemoglobin/Iron anemia in WIC by 2010.

Objective 10.5

Strategies/Activities
c. Work with Epi and WIC Branch to identify health districts with especially high rates of anemia

Baseline
% of WIC clients with low Hgb. (GWIS data)

Indicators # Meetings held
District Intervention plans developed

Lead Position
Nutrition Program Consultant

# Of policies/trainings developed

Timeline FFY 2007-2008

Resources
Available: WIC policies CDC treatment Protocols Nursing protocols
Local agency staff Needed:

69

FEDERAL FISCAL YEAR 2007

State Plan

Value Enhanced Nutrition Assessment--VENA
The Value Enhanced Nutrition Assessment Initiative aims to offer a more positive, participant centered WIC service. It calls for a comprehensive approach that shifts the nutrition assessment from a deficiency-based process, to a more positive process that focuses on desired health outcomes and in meeting the needs of the participants.
WIC staff will play more of a facilitative role in providing nutrition counseling and education and will be required to demonstrate competencies in rapport building, cultural competency and critical thinking to ensure VENA's successful implementation. VENA will infuse more "quality" into the delivery of WIC services and provide an improved service for participants and more rewarding work for staff.
In Georgia, several priority work teams have been assembled to work specifically in addressing the five priority areas that VENA will impact, namely, nutrition assessment and processes, staff training and competencies, monitoring, policies and MIS. As the VENA principles are in sync with the "customer care" public service initiative currently being pushed by the Governor's office, we have formed a marketing team--to generate creative ideas to market the VENA initiative to internal and external stakeholders.
As the WIC services are very integrated in the state, we look forward to VENA's positive impact, not just on WIC services, but all public health services.

70

FEDERAL FISCAL YEAR 2007

Georgia WIC Program Nutrition Section
Summary Timeline for Key VENA Implementation Activities (October 2006--October 2009)

Key Activities Survey districts--to compile results for state self-assessment report. Statewide committee meeting held to review self-assessment results and formalize report.

State Plan

Start Oct. 2006 Nov. 2006

Complete by Dec. 2006 Dec. 2006

VENA self-assessment report to submitted to USDA. Identify and recruit state and local WIC staff to participate on VENA statewide implementation team First VENA Statewide Implementation team meeting--formation of priority work teams. Identify staff competencies needed and plan statewide trainings through current fiscal year. Revise all currently offered state and local agency trainings--to incorporate VENA guidance recommendations and staff competencies needed. VENA priority work teams organize, meet and develop work plans of implementation activities--to be included in state work plan sent to USDA. Identify and revise WIC program policies, processes, Program Manual and State Plans to be VENA compliant. Monitoring team--to evaluate current monitoring tool to begin to identify and assess qualitative changes needed to support VENA initiative.
Review and evaluate current assessment forms. Begin drafting new assessment form. (Eliminate 24hour food frequency component.) Develop and distribute VENA fact sheet to internal and external partners, as first step to marketing VENA.

Dec. 2006 Dec. 2006 Feb 2007 Feb. 2007 Oct. 2006

Dec. 2006 Ongoing Feb. 2007 October 2007 Ongoing

Feb. 2007 March 2007

March 2007 April 2007 April 2007

October 2009 August 2007
August 2007

April 2007 June 2007

Create a tag line or "marketing" line to link with and market the initiative and obtain statewide feedback. Develop and format final draft of VENA compliant assessment questionnaire. Offer first series of staff regional trainings. Draft policies specific to nutrition assessment processes--including nutrition assessment questionnaire, use of new risk criteria, certification process.

April 2007 June 2007 June 2007 June 2007

Sept. 2007 Sept. 2007 Oct. 2007 Oct. 2007

71

FEDERAL FISCAL YEAR 2008
Key Activities Hire state consultant and district staff to assist in coordination of VENA initiative.

State Plan

Nutrition assessment form--obtain district feedback on final draft and make revisions. Monitoring tool--obtain local agency input and that of other states on development of VENA compliant tool. Marketing--Development and distribution of VENA initiative posters to formally "introduce" the initiative to clients and all public health staff. Create a system for reward and recognition of districts and district staff. Develop and recognize recognition and reward system to help other "marketing" incentives and giveaways. Assessment form--pilot new form in two districts and obtain feedback Plan and coordinate second series of regional trainings for local agency and state staff for current FFY. Research current computer anthropometrics programs and Identify vendors for purchase of a computerized anthropometrics program. Finalize nutrition assessment questionnaire--based on pilot results and feedback form districts. Implement new nutrition assessment questionnaire statewide. Work with MIS to develop electronic version of finalized nutrition assessment questionnaire. MIS--complete editorial rules and system edits. Finalize revisions to program manual and policies. Develop, coordinate and offer trainings on revised policies and program manual updates. Review training evaluations and feedback from processes to continually assess training needs of staff and identify needed improvements.

Start May 2007
Sept. 2007 Sept. 2007 July 2007
Sept. 2007
Jan. 2008 Jan. 2008 June 2007
May 2007 Aug. 2007 Jan 2008 June 2008 April 2008 June 2008 June 2007

Complete by Ongoing (till filled) Dec. 2007 Dec. 2007 October 2007
Sept 2009
June 2008 Oct. 2008 Sept. 2008
Aug.2008 Sept. 2008 Sept. 2008 Sept. 2009 Sept. 2009 Sept. 2009 Ongoing

72

FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: VENA (Nutrition Assessment Processes and Practices)
Goal: Establish a nutrition assessment process that focuses on promotion of positive health outcomes.

Objective Strategies/Activities Baseline

Indicators

Lead Person(s)

By September 2009, the State will develop and finalize a new VENA compliant Nutrition Assessment questionnaire.

Review and evaluate currently used Nutrition Assessment forms from all districts.

23 different nutrition assessment forms

Eliminate 24hr FF questions

Current Nutrition Assessment Forms reviewed
New criteria #401 and # 428 are incorporated in risk code list

Nutrition Assessment committee Nutrition Section

Incorporate new risk codes into assessment questionnaire /positive health outcome focused

Assessment questionnaire supports VENA guidelines

Time Line
April 2007

Resources/Budget Needed Available: Forms form Districts

VENA Guidance Manual

Nutrition Assessment committee
Needed:

Develop & format

N/A

Georgia's VENA

compliant nutrition

assessment

questionnaire.

Obtain feedback from N/A Districts/local agency staff

Final version of nutrition Nutrition Assessment assessment questionnaire committee form developed

Sept. 2007

Communication from Districts

Nutrition Assessment Dec

committee

2007

facilitators/coordinators

Available: VENA committees,
VENA Guidelines
State and Local staff Needed: Available: State and Local staff Needed:

73

FEDERAL FISCAL YEAR 2008

Goal: Implement computerized anthropometrics statewide.

Objective Strategies/ Activities Baseline

Indicators

By Sept '09 the State will develop and finalize a new, standard Nutrition Assessment form.

Pilot paper version of nutrition assessment questionnaire form in at least 2 Districts

Current

Feedback from pilot

assessment forms districts (Cobb &

Waycross)

State Plan

Lead Person(s)
VENA Nutrition Assessment team Nutrition Section staff

Time Line

Resources/Budget Needed

Available: Jan. '08May `08 Newly developed Georgia
Nutrition Assessment form.

Needed: NSA funds

Review/ Assess/ Update and improve N/A system/form

Final draft version of nutrition assessment questionnaire

Implement new form and coordinate training of new staff.
Work with MIS to develop electronic format of new assessment questionnaire

Current electronic Completed form forms

Multiple computer systems

Meetings held
Electronic draft form developed for testing

Nutrition Assessment Committee
WIC Branch Nutrition Section
VENA MIS team

July 2008
Sept. 2008
Oct. 2008Sept. 2009

Available:
State and Local staff
VENA Guidance Manual Needed: Available:
VENA committees (MIS, Staff Competencies and Training)
State and Local staff Needed:

74

FEDERAL FISCAL YEAR 2008

State Plan

Objective

Strategies/Activities

By September '09 Georgia WIC Research current computer will implement computerized anthropometric programs anthropometrics

Research current computer anthropometric programs.
Work with MIS to develop specific requirements of the program.
Pilot use of computer anthropometrics in at least 2 clinics.

Baseline N/A
N/A
N/A Paper Growth charts

Indicators
List of system/program specifications

Lead Person(s)

Time Line

VENA Nutrition Assessment committee

AprilJune 2007

Feedback from the local agencies on computer capabilities.
A computer anthropometric system identified

May June 2007

Nutrition Section WIC Branch VENA Nutrition Assessment team

June 2007

Feedback from other states VENA Nutrition Sept. Assessment team 2007
Policy developed

Feedback/results from staff/local agencies

Nutrition Section Jan District Nutrition 2008 Directors

Resources/Budget Needed
Available: VENA Committees
NSA funds
State and Local agency staff
Needed: Available: Nutrition Section WIC Branch Local agency staff NSA funds Needed: Available: MIS and Nutrition Assessment committee's Needed: Available: District staff Needed:

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FEDERAL FISCAL YEAR 2008

State Plan

Objective

Strategies/Activities Baseline

Indicators

Lead Person(s)

Time Line

Resources/Budget Needed

Identify vendors for purchase of computerized anthropometrics
Consult with federal and other state partners on computerized anthropometric programs

None exist

A computer anthropometric system Nutrition Section

identified

VENA Assessment work

Feedback from other states

group

September 2008

Available: MIS Policy work team

Policy developed on use of the electronic anthropometric chart.

VENA staff competencies and training

January 2009

State and local staff Needed:

Develop Policy on computerized anthropometrics

Train and implement Current staff Staff appropriately using the new Staff Competency and January

policy

trainings

system

Training committee

2009

Available:
State and Local staff Needed:

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FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: VENA - (Policies)
Goal: Establishment of WIC program policies that support the Value Enhanced Nutrition Assessment initiative.

Objective

Strategies/Activities

Baseline

Indicators

Lead Person(s)

Time Line

Resources/Budget Needed

By 2010, develop and establish nutrition related policies that support a positive, health outcomes approach to the nutrition assessment process.

Develop the policy for use of one Currently multiple

statewide nutrition assessment nutrition assessment

questionnaire

forms are being used

Write policies that encourage the currently in the state

purposeful building of rapport (21 forms) and 4

with WIC clients at all points of computer systems.

service.

Obtain feedback from all state and Current WIC Procedure

local stakeholders.

Manual and policies

Remove and /or eliminate previous

policies regarding the nutrition

assessment form that are not in

compliance with the VENA

initiative.

New Policy approved by WIC Director, USDA Regional Office
Approval of questionnaire
Feedback from local agency staff on new policies.

VENA policy October 2010 Available:

team

Assessment Team

September State/Local Staff

WIC Branch 2007.

USDA

September VENA Guidance Manual

2008-October

2009.

Needed:

Enhancements to MIS

systems to go along with

new assessment form.

By 2010, all education and counseling provided will incorporate VENA principles

1. Training and education of all Current trainings

staff will be documented.

offered by state and

local agencies.

2. Collaboration with other health

care providers to insure the

"message" is the same.

3. Require that all trainings (state and local) incorporate VENA components.

4. All VENA and other staff training must be documented

WIC staff will show improved rapport with participants
2. All WIC staff will incorporate VENA principles into the assessment process.
Local agency staff records of VENA trainings completed.

Policy and Training Team

FFY 2007- Available:

2008 and Policy and Training Team

ongoing each State/Local Staff

FFY.

VENA Guidance Manual

Oct. 2006 Needed: Sept. 2007 and ongoing

Oct. 2007-- Sept. 2009 And ongoing

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Program Function Area: VENA (Policies)
Goal : Establish staffing policies that assure quality program delivery

State Plan

Objective
By 2010, establish policy guidelines regarding staffing ratios to assure quality program delivery in local agencies.
.

Strategies/Activities

Baseline

The VENA committee will work along with the statewide-Staffing Revamp committee to develop staffing guidelines and criteria.

1 Nutritionist/1000 high risk consumers

Work with Public Health

administration to increase salaries Varied caseload and

of dietetic professionals to

staffing patterns

encourage recruitment and

throughout the state

retention of credentialed staff

Consult with federal and other state partners on staffing and caseload ratios

Establish a scaled list of required, recommended and best practice standards for this a variety of clinic settings (urban, rural, etc.).

Indicators
The hiring of more nutritionists and dietitians.
Partner with colleges and universities for nutrition interns.
Feedback from other colleagues/states

Lead Person(s)
VENA Policy committee

Time Line

Nutrition Section

Implementation by FFY 2010

Resources/Budget Needed
Available: Work Force Capacity Team Staffing Revamp Committee Needed: Federal/State Staffing Standards
Public Health Administration
Local and state program managers

List of standards for the various clinic settings.

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FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: VENA--(Policies)

Goal:

The program monitoring process will incorporate VENA principles and guidelines.

Objective

Strategies/Activities

Baseline

Indicators

Lead Person(s)

Time Line

1. Establish policy for the 1. Identify VENA activities, Current staff

The State monitoring State WIC

incorporation of VENA which are part of the

approach monitoring tool and team's

Branch

principles in the local survey process.

team reviews the approach will move to a

agency monitoring 2. Write policies to support a district in a punitive more consultative,

process.

more qualitative program fashion.

interactive process.

review process

Implementation by FFY 2010

Resources/Budget Needed
Available:
State Program Review Monitoring Team; VENA Monitoring Work Group; State/Local Staff

Coordinate training for Monitoring team on VENA principles

Present monitoring tool/system

Needed: New policies to support VENA monitoring process

Pre and post test results VENA staff June-August 2009 Available:

of the staff regarding VENA principles as it relates to monitoring

training team WIC Branch

VENA Guidance manual
Needed: Revised Monitoring tool

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FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: VENA (Marketing)

Goal:

To visibly and creatively promote the Value Enhanced Nutrition Assessment initiative as being the best

practice to consistently provide quality nutrition services and continuity of care through out the community.

Objective

Strategies/Activities

Baseline

Indicators

Lead Person(s) Time Line Resources/Budget Needed

By 2009, establish a Retain a graphic designer in

visual VENA

order to solidify a logo.

marketing

campaign.

Former WIC Kangaroo Logo.

New and improved Kangaroo logo to capture the foundation of VENA and the GA WIC program.

VENA Marketing Team

By 2010 effectively 1. Provide a fact sheet of VENA A comprehensive VENA materials/discussion VENA Marketing

communicate the directed to specific internal marketing plan. at District Health Directors Team

importance of VENA and external partners.

Meeting, WIC Coordinators

to all stakeholders.

Meetings.

2.Create a tag

line/advertisement for VENA

Results from the VENA Tag

Line Survey from the

3. Create VENA Introduction

committee members.

Posters.

Mandatory VENA Posters in

every WIC Clinic.

By 2009, create a customer care; benefit based marketing strategy to include all stakeholders.

1.Survey WIC participants to N/A assess their perceived program benefits and needs. 2. Establish a competitive system of rewards to encourage and recognize public health employees who embrace and exhibit VENA goals and objectives.

Client Needs Assessment VENA Marketing Team
2. Recognition system in place, which will include merit pins, district awards, and statewide awards.

July 2007
April-June 2007
July-Sept. 2007
October 2007
Should coincide with regional trainings.
April 2009

Available: NSA funds Needed: Contract with a graphic designer Available: Federal VENA materials WIC Coordinators
Needed: Poster creation supplies and equipment NSA funds
Available: VENA Training Committee
Needed: Tangible VENA awards and gifts.

NSA funds

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FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: VENA (Quality Assurance & Monitoring)
Goal: To design and implement standards and tools for quality assurance monitoring that are VENA compliant.

Objective

Strategies/Activities

Baseline

By 2008, monitoring Distribute VENA

N/A

and review staff will Guidelines and USDA

exhibit knowledge of Guidance to Program

VENA's application to Review state and local

the monitoring

staff

process

Summarize qualitative

(VENA) program changes

needed for inclusion in Current review

new VENA compliant tool/monitoring

monitoring tool.

process

Survey local agencies for

suggestions on

incorporation of VENA

guidelines

Indicators

Lead Person(s) Timeline

Resources/Budget Needed

VENA Guidelines

State WIC

April-June

discussed and reviewed. monitoring team 2007

# Of planning meetings/discussions

VENA Guidance manual
Nutrition Section staff
State and local agency staff

List of new VENA related monitoring processes needed

June-August 2007

Feedback from local agencies on VENA related monitoring ideas

December 2007

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FEDERAL FISCAL YEAR 2008

State Plan

Objective

Strategies/Activities Baseline

Indicators

Lead Person(s) Timeline

Resources/Budget Needed

To develop a VENA compliant Consult with other states Current

Feedback from Monitoring team

Sept. 2007 NSA funds

program monitoring tool by and federal partners on monitoring

other states-- (state and local

2010.

VENA monitoring tool tool/process

Program Reviewers)

VENA Guidance manual

requirements

USDA Regional office staff

Review district surveys

WIC Branch

for input on new VENA

Oct. 2007-- Nutrition Section staff

monitoring tool

Jan 2008

Design draft of new

Survey results

monitoring tool

Local agency from local

Jan-March

Submit final draft of tool review

districts on ideas

2008

for review to key state, processes/self- for new

district and local agency monitoring results monitoring tool

staff.

VENA Guidance manual

Pilot draft Monitoring

Draft of

State and local staff

tool in at least 2 or more

monitoring tool

Nutrition Section

districts.

Sept-Nov Internal & external

Document findings from

2008

stakeholders

pilot.

Revise and update tool,

DHR Public Health

based on feedback

Dec. 2008- Administration

Jan 2009

Submit monitoring tool N/A

Revised tool

Legal office

for final review process

based on--pilot

(Branch Director, DHR

results

Legal, USDA)

USDA Regional office staff

Submit to USDA for final

review

N/A

State and local agency staff

Provide training (train

Jan. '09- WIC Branch

the trainer) on how to

April `09 Nutrition Section

conduct self reviews with

Comments

new VENA compliant

and/or approval

WIC Branch

monitoring tool

from Director, VENA Monitoring team

MIS--state and local support

Current

Legal office and

Work with MIS--to

monitoring

USDA

WIC Branch

develop electronic

tool/process

April '09-- WIC Branch

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FEDERAL FISCAL YEAR 2008

State Plan

Objective

Strategies/Activities
version of monitoring tool

Baseline

Indicators

Lead Person(s)

Timeline

Resources/Budget Needed

June `09 State and local agency staff Nutrition Section

Review current local agency corrective action data from program review summaries

Identify areas for retraining and management review

Current monitoring related trainings

# of trainings on monitoring tool conducted.
Local agency feedback
State Management Information Systems team

Oct. `09 Sept. `10
Oct. 2009 -Sept. 2010

By 2010, Establish system to track corrective action trends to implement changes and identify training needs.

N/A
Corrective action from program review summaries

State WIC Monitoring team

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FEDERAL FISCAL YEAR 2008

State Plan

Program Function Area: VENA (Staff Competencies and Training)
Goal: WIC Staff will demonstrate proficiency in the six competency skill areas for VENA compliance

Objective

Strategies/Activities Baseline

Indicators

By 2010, all WIC staff Coordinate a series of Current nutrition Training schedule

will be trained in the regional trainings on the workshops and

delivery of a positive, key VENA competencies: trainings

Feedback from

health outcome based (critical thinking, building

workshops

nutrition assessment. rapport, cultural

competency, positive

Materials

health outcome

developed/distributed

assessment)

Coordinate trainings

specifically for clerical

support WIC staff

Current state and

local trainings Trainings for Para-

Professional WIC staff

Lead Person(s) Timeline

Resources/Budget Needed

Nutrition Section VENA staff competency and training team

Sept.2006Oct. 2007 Ongoing-- annually (2 topic areas/year)

VENA Guidance Manual
Rochester Institute of Technology training resources

Local agency staff (all disciplines)

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FEDERAL FISCAL YEAR 2008

State Plan

Objective
By 2009, develop a system for ALL WIC staff to foster and maintain nutrition assessment competencies and customer care skills

Strategies/Activities Baseline

Indicators

Lead Person(s) Timeline

Resources/Budget Needed

Maintain a library of

#Reference books and Staff Competency Ongoing each Best-practice, research

current, research based

materials purchased and and Training

FFY

based educational

electronic references at

delivered to district

Workgroup

resources.

each of the district health

offices

offices.

American Dietetic

Develop a list of

Current resources

Association

recommended reading for available at the

all new and veteran WIC state

Training evaluations

WIC Works Website

personnel involved in

Observations of staff

nutrition assessment.

Ongoing

Conduct regular in-service

training to review

Staff feedback & training

standardized

WIC 101

needs assessment

measurement techniques

and procedures.

Identify individual trainingCurrent local Staff in-service training District Nutrition

needs and seek training agency trainings lists.

and Nursing

Ongoing--

and conference events and in-services

Managers

each FFY

addressing those needs.

Conference certificates WIC staff Nutrition

Appropriate-Nutrition MCH

Provide opportunities to Current trainings obtained.

trainings and annual

attend local, state, and

meetings.

national nutrition training

# Of trainings attended

events and conferences

by staff

focusing on maternal and Current staff

child nutrition issues. meetings/local Assessment of staff

Use informal training trainings.

competencies

District Nutrition

opportunities such as

Directors

staff meetings and in- Current nutrition VENA nutrition

Nutrition Section

services to discuss

assessment

assessment guidelines WIC Branch

participant case studies practices

practices and

and reinforce nutrition

incorporated into

assessment skills

nutrition services.

Foster critical thinking

skills in WIC staff.

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FEDERAL FISCAL YEAR 2008

State Plan

Goal: Develop a statewide infrastructure to facilitate trainings and competency assessment

Objective

Strategies/Activities Baseline Indicators Lead Person(s)

Timeline

Resources/Budget Needed

Hire a State Office Nutrition Develop the job-

Vacant Number of State WIC office

June --October State level Nutrition

Program Consultant to

description for the

persons

Nutrition Section

2007

Program Consultant

facilitate the training schedule Nutrition Program

employed

and implementation of VENA Consultant

Staff Competency and

Personnel support

Develop a list of

Training Workgroup

qualifications and

requirements

Identify a district level nutrition Develop the job-

Current Number of Individual district

June

District level consultant

education consultant to serve description for the

staff

persons

Human Resources October 2007 salary

as a nutrition coordinator and Nutrition Education

employed

facilitate VENA training and Consultant

Personnel Support

implementation in their

Develop a list of

Staff Competency and

respective district

qualifications and

Training Workgroup

requirements

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FEDERAL FISCAL YEAR 2008
Georgia WIC VENA Implementation Plan (Supplemental Information)

State Plan

The following provides additional information on Georgia's VENA implementation plan and the work being done in the various priority areas and in response to the feedback provided on our VENA self-assessment report.
Policy
x All policies, Procedure Manuals and State Plans are being reviewed and revised to ensure VENA compliance by October 2010.
x To ensure that participants are aware of the "quality" services they are entitled to and to encourage staff to comply with new VENA guidelines.
x Customer care type posters will be required to be posted in the WIC clinics. These posters will be developed in part by the marketing and policy work teams and will serve to remind participants and staff of the "enhanced quality care we will be offering clients."
Nutrition Assessment
x Local clinics will be encouraged to work with local administration and building authorities, to assess clinic layout and make appropriate changes (where possible) to enhance the flow of clinic services for WIC participants. The goal is to minimize disruptions, that impacts the quality of the service delivered to clients--(e.g. especially long waiting lines--can be divided by type of service the client is in for). In addition, moving chairs along side the CPA's desk, instead of across from it, to encourage rapport building will be encouraged.
x Staff trainings will focus on providing the skill based competencies needed for VENA and to assist in changing personal attitudes and behaviors toward the WIC participants. Through the cultural competency, building rapport and other trainings, staff will be given opportunities to role-play and practice appropriate behaviors.
x Interpreters will continue to assist with certifications and education that needs to be offered in a language other than English.
x A new standard--nutrition assessment questionnaire is being developed and will be piloted in a couple of districts, before full implementation. The form will include appropriate "trigger" questions to foster more
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FEDERAL FISCAL YEAR 2008

State Plan

conversation and exchange between the CPA and the client. It will not include a 24-hour recall or have check list type questions.

x With the inclusion of the new risk codes, training will be provided to staff on their appropriate use in certifying clients and as with all risk codes.

x Continual training and monitoring (by state and local staff) will occur to ensure that staff are applying the risk code appropriately.

x A statewide "Revamp committee" is currently reviewing staffing patterns, staff to participant ratios and caseload and scheduling,--in efforts to strengthen the WIC workforce capacity across the state. Public Health administration is assessing the current staffing patterns in the districts and proposing plans to aggressively recruit more dietetic professionals and increase current salaries.

x All nutrition education provided (including those via video-conferencing), will be revised to be more generalized and "health promoting", rather than being risk-driven. For example, an anemia class, will be entitled "health food choices"--and incorporate the benefits of choosing iron-rich foods.

x The nutrition assessment process and documentation will include a mutual goal setting component to encourage the participant to be more involved in their self-care. This mutual goal-setting component will be included in the electronic version of the form as well.

Staff Competencies/Training
x All trainings (in all nutrition and health related areas) currently offered to WIC staff will incorporate components of the VENA initiative--to more opportunities to practice competencies needed for successful implementation of VENA. For example, a competency-based training on lactation management will include some role-playing to practice use of open-ended questions and rapport building. In addition, all training materials will be reviewed and revised appropriately, to be in compliance with VENA.
x The statewide VENA implementation team is composed of WIC state and local staff from various disciplines, including--managers, nutritionists, nurses and clerical staff. VENA trainings will be offered to all WIC staff (CPAs and non-CPAs) to ensure that everyone understands the initiative and the role they play in ensuring a more enhanced nutrition assessment. Video-conferencing, local trainings and use of the WIC Works website
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FEDERAL FISCAL YEAR 2008

State Plan

modules, will be used to provide education and information to the staff across the state.

x Future training evaluations will incorporate feedback from participants on their "confidence level" to practice the new skills gained from the VENA workshops (e.g. using open-ended questions, critical thinking and rapport building). Local managers will be encouraged to observe staff during certifications, to assess VENA related training needs.

Management Information Systems (MIS)
x The Nutrition Section is working collaboratively with the WIC Branch to implement the VENA initiative in Georgia. Nutrition Section staff are providing guidance on the revisions and enhancements being made to the computer (MIS) system.
x Currently a plan is being developed to make available an electronic copy of the new assessment questionnaire, once it is completed and approved. The "mouse-over" system was suggested as a way to remind the CPAs (nutritionist and nurses) of what all is needed or should be discussed, if the particular topic was introduced. It would not be a "check-list" system. Nutrition counseling will be the greater focus of the training provided to staff and how to apply critical thinking skills to ensure that the needs of the participant are met during the visit.
Quality Assurance and Monitoring
x VENA will be simultaneously rolled-out to the whole state. All districts will be required to make the revisions to policies, protocols and trainings, etc. In addition, there will be given the opportunity (as with the state), to "phase-in" certain aspects of VENA--like making physical infrastructural changes to their environment (when possible) to allow for greater compliance to VENA guidelines.
x The newly developed VENA compliant, nutrition assessment questionnaire form, once completed, will be piloted in a couple of districts, before being made available for statewide use.
x As the MIS systems enhancements are completed and tested, appropriate trainings will be provided to staff to ensure that all are skilled in the electronic version of the assessment form and other VENA related updates.

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FEDERAL FISCAL YEAR 2008

State Plan

CHAPTER 2
PROGRAM FINANCIAL MANAGEMENT
I. Program Financial Status II. Letter of Credit III. Local Level Requirements IV. Property Management and
Procurement V. Case Load Management / Food Cost

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FEDERAL FISCAL YEAR 2008

State Plan

SECTION I - PROGRAM FINANCIAL STATUS
Narrative Descriptions:
A. 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 and manual entries. The process of writing checks, preparing check registers and other mass detail work, is performed by data processing systems. The records kept in the county health departments are subsidiary or supplemental. County departments submit monthly reports to the Office of Financial Services according to prescribed uniform reporting procedures. These reports cover the financial operations that will be reimbursed by the Department of Human Resources. Supporting data for other county department administrative expenditures are not submitted directly to OFS; they are retained in the county department finance offices. County health departments contract with CPA firms to audit their records.
The State of Georgia Department of Audits performs both financial and program audits. State law mandates that the state auditors perform a financial audit of the books and accounts of the Department of Human Resources each fiscal year. The state auditors perform programmatic audits of specific programs as deemed necessary. The WIC Branch Financial Management Section also contracts with outside professional service providers to review 50% of the eighteen (18) health districts and two (2) contracted local agencies annually.
B. Time Reporting
Random Moment Sample Study (RMSS) is a method used by the State of Georgia to measure the proportion of time spent by employees performing work duties within every state program to allocate costs appropriately. This method uses a statistically valid sample to determine the amount of time employees expend on individual programs. The results of the quarterly RMSS are used as a basis to determine the distribution of each quarter's cost. This detailed process is included in Appendix B of the Cost Allocation Plan. A copy of the Cost Allocation Plan can be obtained from the Office of Financial Services.

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FEDERAL FISCAL YEAR 2008

State Plan

C. Cost Allocation Plan
The Department of Human Resources has a federally approved cost allocation plan. Therefore, it does not employ an indirect cost agreement. The revised plan was submitted to the Department of Health and Human Services on June 14, 2000. DHR is currently awaiting comments and approval.

SECTION II - LETTER OF CREDIT
The Director of the Office of Financial Services functions as cash manager of the Department of 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), agreements with the Treasury and other cash management policies and procedures as designated by the Division of Payment Management (DPM) of the United States Department of Health and Human Services (DHHS), the United States Department of Education (USDE), and the United States Department of Agriculture (USDA). Quarterly, cash draws are reconciled and balanced with actual expenditures. Both federal program fiscal officers and the DPM receive reports of expenditures. Each grant award is recorded, balanced, and reported quarterly as designated.
The ratios of the different federal and state funds that comprise each type of expenditure are determined by analyzing the department's annual budget. This is called the funding mix. Disbursements from the operating, grant-in-aid and payroll accounts are entered into a computer program containing the funding mix and the historical check-clearing patterns of these three bank accounts. The computer program adds the total funds eligible for reimbursement from the three bank accounts by day and stores this information in a program ledger. When reimbursement is requested, the draw represents the projected expenditures clearing in those bank accounts from the previous two to three days. Clearing patterns and the funding mix are updated periodically to insure that projections are as accurate as possible. Near or at the end of each month, it will be determined whether conversion authority exists. If conversion authority exists, the administrative expenditures to date will be compared to the amount of availability on the administrative Letter of Credit.
When rebate funds are received from the formula contractor, the cash manager notifies the DHR Office of Financial Services, Public Health WIC Accountant. The cashier

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FEDERAL FISCAL YEAR 2008

State Plan

records the payment against the receivable by customer number and by invoice number. The cash manager takes the amount of the rebate into consideration before making any future draws on the Letter of Credit.

SECTION III - LOCAL LEVEL REQUIREMENTS
The local level requirements are as follows:
A. The Master Agreement for the Division of Public Health requires that local agencies maintain their financial management systems in accordance with 45 CFR Parts 74.60 and 74.61 (Subpart H) and Official Code of Georgia Annotated (OCGA), Section 31-3-8. A copy of the Master Agreement for Public Health may be obtained from the Financial Management Section of the WIC Branch.
The DHR Administrative Policy and Procedures Manual and the DHR Grants to Counties Manual give specific instructions on the operation of a financial management system at the local level.
B. Each month local agencies must submit a Monthly Income and Expenditure Report (MIER) to the Public Health Grant-In-Aid office. WIC Branch staff monitor these reports against approved budgets. During program reviews, equipment and computer inventories are reviewed to ensure program compliance.
C. The Public Health Master Agreement requires an annual audit of all local agencies. The 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 WIC Branch and the WIC Allocation Advisory Committee, with final approval from the Director of the Division of Public Health. Funds available for allocation to local agencies are determined by subtracting the cost of operations of the WIC Branch, the WIC Nutrition Section and the centralized costs for management of the food grant, from the total NSA grant received from USDA. The balance is allocated to local agencies based on participation.

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State Plan

E. The WIC Allocation Advisory Committee is charged with assisting the Program and the Division of Public Health with developing an acceptable methodology for allocating federal grant funds to local agencies. The State of Georgia WIC Branch approved funding formula has been well accepted by local agencies due to its accuracy and fairness. Additionally, the Georgia WIC Allocation Advisory Committee makes recommendations to the WIC Branch concerning caseload management strategies. A district heath director chairs the committee.
F. Operational and administrative funds are distributed to local agencies by contractual agreements. WIC funding to Georgia's eighteen lead counties is part of the 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 contractual amendments.

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 Georgia Department of Administrative Services, Purchasing Division. Consultants and certain other contracts in excess of $250,000 must be approved by the State Office of Planning and Budget with exemptions to this requirement as stated in the Department of Administrative Services (DOAS) Georgia Procurement Manual, Chapter 2, Section 3. A copy can be obtained from the WIC Branch Financial Management Section.

SECTION V CASELOAD MANAGEMENT / FOOD COST
Food Cost may come from three sources. A description of each source is listed below:
1. Convansys (the State's Data Processing and Banking Contractor) complies a monthly Reconciliation Report (EWRR860G) report using a series of four reports: x Monthly Report of Food Expenditures x Bank Exception x Unmatched Redemption x Bank Listing

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FEDERAL FISCAL YEAR 2008

State Plan

This data is based on the redeemed month that includes all of the voucher activity that occurred during the month, regardless of the issue date of the vouchers.
The State's Office of Financial Services enters the information from the Reconciliation Report (EWRR860G) into the state's financial system (People Soft).
2. The Vendor Section authorizes administrative payments to vendors for returned vouchers. Vouchers may be returned for the following reasons: x Post and Stale date x Signature of participant missing x Exceeded maximum amount allowed x Altered vouchers x Missing Vendor stamp
Post and Stale dated vouchers are not approved for payment. Once these vouchers have been individually researched and payment had been authorized, the information is entered into People Soft. The Office of Financial Services will then release payment.
3. Orders from Special Formula are placed by clinics through the State Nutrition Section.
These orders are reviewed for approval prior to the purchase of formula. Once approved, the formula is ordered and the information placed into People Soft for Office of Financial Services to process.
4. Once the Office of Financial Services has received all of the information, the final cost the redeemed month is entered into the FNA-798 Report.

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FEDERAL FISCAL YEAR 2008

State Plan

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 2008

State Plan

SECTION I - RETAIL DELIVERY METHOD
A. For a description of all food delivery systems that the State Plan uses during the year including any special provisions for the homeless or for the delivery of special formulas [7CRF 246.4(a)(14)(i), 246.4(a)(14)(ix)].
See the Food Delivery Section of the Procedures Manual.
B. For a description of any special food delivery procedures in the event of a natural disaster [7CRF 246.4(a)(14)(i)].
See the Disaster Plan in the Procedures Manual.
C. For copies of all food instrument types [7CRF 246.4(a)(14)(v)].
See the Food Package Section of the Procedures Manual.
D. For a description of food instrument security and accountability procedures at the State level [7CRF 246.4(a)(14)(v), 246.12(1)].
See the Food Delivery and Compliance Analysis Sections of the Procedures Manual.
E. For a description of procedures for shipment of food instruments between all points [7CRF 246.4(a)(14)(v), 246.12(1)].
See the Food Delivery Section of the Procedures Manual.
F. The names of companies, excluding retail vendors, under contract to operate or assist the State in operating the food delivery system [7CRF 246.4(a)(14)(vii)] are as follows:
Covansys (d.b.a. PDA, Inc.), Southern National Bank, MEAD Johnson Nutritionals, Mitchell and McCormick, QS (DeKalb System), and Health Net 2 (Athens System).
G. For a description of State procedures for follow-up on reports of lost or stolen food instruments [7CRF 246.4(a)(14)(v)].
See the Compliance Analysis Section of the Procedures Manual.
H. 0A report on the reconciliation rate for the previous year and an assurance that the state agency will fulfill food instrument reconciliation requirements in the

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coming year [CRF 246.12(n)] follows.
The reconciliation rate for FFY 2006 was 99.96%. The current rate for FFY 2007 is 99.97%.

Georgia WIC Branch Reconciliation Rates FFY 2006 and 2007 to date

Month OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP
Average

FFY 2006 99.88% 99.89% 99.95% 99.97% 99.98% 99.99% 99.99% 99.98% 99.99% 99.93% 99.96% 99.97%
99.96%

FFY 2007 99.94% 99.98% 99.98%
99.97%

Reconciliation
The Georgia WIC Program, in conjunction with its automated data processing contractor, Covansys, uses the following monthly reports to completely track every voucher issued.
Bank Transaction Listing provides each voucher cleared by the bank during the processing month by serial number, date cleared, dollar amount, and transaction code.
Bank Exception Report identifies vouchers that cannot be reconciled with the issued records, either because the voucher number is not recognized as currently valid, or because the voucher number has already been placed in final status.
Closeout Reconciliation Report provides a one to one reconciliation report that shows details on each voucher created during the month currently being closed out. Voucher Reject by the Bank lists detailed data on vouchers rejected by the contract bank during the screening and prepayment audit. The report is
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summarized at the county level within each district/unit. The list includes both computer and manual vouchers.
For manual vouchers (including those prepared by clinics using automated systems) there are Unmatched Redemption Reports, including Cumulative Unmatched Redemption (CUR) reports that show vouchers that cannot be matched to an issue record, a valid WIC identification number or a certification period.
Vouchers Paid by Administrative Checks list details on vouchers rejected by the bank for being over the maximum amount, but subsequently approved for payment by the WIC Branch. This combination of reports and microfilm allows the WIC Program to track every voucher and determine its final disposition.
In addition, the WIC Branch receives records for all vouchers processed during the month on CD-ROM. A PC Internet Program, Check Image Viewer (iCIV), provides fast and easy access to all WIC vouchers processed by the bank.
On April 1, 2004, the Georgia WIC Program entered into a new contract with Covansys (d.b.a. PDA, Inc.) for data processing services. The contract may be extended through March 31, 2009.
In addition, Covansys has developed a WIC Banking secure website that allows users to view checks processed by the bank within three (3) days of their submission. The WIC Branch and Covansys control access to the secure site.
I. For a description of the State Plan to monitor local agency compliance with food delivery and accountability requirements [7CRF 246.19(b)], see the Monitoring Section of the Procedures Manual.

SECTION II - VENDOR MANAGEMENT
See the Vendor Management and Compliance Analysis Sections of the Procedures Manual for the descriptions provided for letters A F below.
A. A description of the vendor management (food delivery) system as it operates at the state agency level, including instructions for the local agency [7CRF 246.4(a) 14(i)].
B. A narrative description of vendor selection, including a list of selection criteria, limitation criteria, if applicable and the application form [CRF 246.4(a) 14(ii)].

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C. A copy of the standard written vendor agreement between food vendors and the state (or local) agency [7CRF 246.4(a)(14)(iii)].
D. A description of the procedures designed to control vendor abuse of the program [7CRF 246.12(k)(2)].
E. A description of the system for monitoring food vendors to ensure compliance and prevent fraud, waste and abuse [7CRF 246.4(a)(14)(iv)] including:
1. The functional breakdown between state and local agency responsibilities for vendor management.
2. Monitoring system. 3. High-risk criteria. 4. Investigation system. 5. Sanction system. 6. Vendor/participant complaint system. 7. Cost Containment.
F. Administrative appeal procedures for food vendors (may be placed in fair hearing section of the Procedures Manual) [7CRF 246.4(a)(17)].

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

SECTION IV MANAGEMENT INFORMATION SYSTEMS
A narrative summary of changes made to the WIC Management Information System(s) in the past year are listed below:
A. Health Outcomes and Service Tracking (HOST) and Automated TAD and Voucher System (ATVS)
Aegis has replaced HOST in all but eleven (11) clinics. Only the clinics in D/U 01-1 remain on HOST. Five (5) of that district's clinics are using the Mitchell and McCormick system. Plans are currently being made to convert both D/U 01-1 and 01-2 to the Health Net 2 (Athens) system within the next 12 to 24 months.
In a related move, the Savannah (D/U 09-1) and Brunswick (D/U 09-3) have been combined into one district (09-1). This district is also exploring the

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possibility of converting to the Athens HN2 system within the next 12 to 24 months.
All of the remaining Automated TAD and Voucher System (ATVS) clinics in D/U 03-2; D/U 08-1 and D/U 12-0 have been converted to Aegis. With the closing of ATVS, the entire state will be able to be on full VPOD, which will result in an overall savings of approximately $48,700 per year in printing costs alone.
B. Georgia WIC Information System (GWIS)/GWISnet.
The Georgia WIC Information System (GWIS) became available in February 2003. This system replaced the paper and microfiche reports as well as the state developed, DOS based Automated Reporting and Management Information System (ARMIS). GWIS operates over a secure website with daily updates done electronically. Monthly reports are received in the State and District offices via monthly CD ROM.
In 2004 GWISnet, the State's data processing contractor, Covansys, developed an Internet version of GWIS. In addition to the functions of GWIS, GWISnet also contains a Clinic Feedback section that will allow clinic, district and state staff to view critical errors, batch rejections and acknowledgements in real time. GWISnet is available to all sites with Internet access. Currently there are over 400 users with access to GWISnet.
C. Vendor Integrity Profile System (VIPS)
VIPS will continue as a stand-alone system for the present time. Long-term plans call for the incorporation of VIPS into GWIS and GWISnet. The FFY 2005 requirements for The Integrity Profile report (TIP) have been incorporated into the latest version of VIPS.
D. WIC Banking
Covansys established a secure WIC Banking website in June 2003. The WIC Branch controls access to the system. This website allows users to view check images as early as three (3) days and as late as six (6) months of processing by the bank.
E. Internet Check Image Viewer (ICIV)
All WIC vouchers processed by the bank are imaged onto CD-ROM. Since 1997, WIC Branch staff has been able to retrieve and print electronic images of all

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vouchers in this manner. Recently, Covansys has expanded the old Check Image Viewer (CIV) to include Internet capability. This allows users to access images posted within the last three (3) days via the WIC Banking website.
F. Participant Characteristic Study See Attachment I for the checklist.

SECTION V - FOOD PACKAGE DESIGN
See the Food Package Section of the Procedures Manual for letters A C below.
A. A description of the standard or commonly used food package for each participant category including Food Packages I - VII that the state plans to use during the year including any special provisions for the homeless [7CRF 246.10(c)].
B. A list of all state-approved infant formulas (including the standard contract formulas), exempt infant formulas, special formulas and medical foods [7CRF 246.10(f)].
C. A copy of the current state authorized food list [7CRF 246.10(b)].

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CHAPTER 4
APPLICATION AND DISQUALIFICATION PROCESS FOR
LOCAL AGENCIES
I. Process for Applying to Operate a WIC Clinic
II. Administrative Appeal: Local Agency

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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 WIC regulations as defined in 7CFR246.5(d). The application must demonstrate the agency's ability to operate a WIC Program in accordance with WIC Federal Regulations and state policies.
The Georgia WIC Program operates in all 159 counties within the state by local public health departments and two Atlanta-based contracted agencies (Grady Health System and Southside Medical Center. During FFY 2004, Georgia WIC continued to explore expanding WIC services into non-public health agencies/providers. These new WIC sites may include migrant health centers, health maintenance organizations, community health centers, schools and/or private provider offices.
Applications will be accepted for the purpose of expanding services in a current program area. In considering such an application, the state agency will evaluate the performance of existing programs in the areas in question. An application will be considered for approval if the existing agency/agencies is/are not able to expand the services to the residents/participants of the area. Availability of food/administrative funds will also be considered.
Upon request from a local agency interested in operating a WIC Program, the state agency will supply, within fifteen days of inquiry, a pre-application information package consisting of the following documents:
1. A cover letter explaining, at minimum, the overall application process, time frames involved, criteria for selecting agencies and information concerning the appeal process, in the event that the application is denied.
2. A copy of the WIC Program Regulations, 7 CRF Part 246.
3. A list of basic requirements to be included in the local agency's application to operate a WIC Program including: staffing and equipment requirements, as well as clinical and nutritional regulatory mandates.
4. A listing of state and local agency resources.
5. A copy of the Memorandum of Understanding between the state agency and the local agency, (the Memorandum of Understanding is included in the Administration Section of the Procedures Manual).
6. A copy of the most current State Plan, Procedures Manual and Georgia WIC Information Packet.

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7. Examples of nutrition education materials and participant training tapes.
Selection criteria for local agencies will be consistent with the requirements of 7 CFR 246.5. [CRF 246.7 (M)]. Applications will also be reviewed for assurance that at minimum:
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 training programs.
12. The agency agrees to comply with all USDA and Georgia WIC reporting and documentation requirements.

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13. The agency demonstrates the ability to comply with all WIC Program automated data processing requirements.
14. The agency agrees to make all documents and records available for review and audits.
15. An agency serving homeless participants agrees to ensure that the homeless facility does not: a. Accrue financial or in-kind benefits from a resident's participation in the program.
b. Subsume foods provided by the WIC Program into a communal food service. WIC foods must only be available to the WIC food recipient.
c. Allow the homeless facility to place constraints on the ability of the participant to partake of the supplemental foods and nutritional education available under the Program.
16. The local agency agrees to contact the homeless facility periodically to ensure continued compliance with these conditions.
17. The local agency requires the homeless facility to notify the state or local agency if it ceases to meet any of these conditions.

SECTION II - ADMINISTRATIVE APPEAL: LOCAL AGENCY
A. The state agency must provide full administrative review to local agencies. The local agency has the right to appeal a state agency's decision for the following: 1. Denial of local agency's application. 2. Disqualification of a local agency. 3. Any other adverse action that affects a local agency's caseload.
The state agency must provide written notification of the adverse action, the procedures to follow to obtain an administrative review, and the cause(s) for effective date of the action (See attachments II and III).
Action Not Subject to Administrative Review The state agency may not provide administrative reviews on local agencies that appeal the following: 1. Expiration of the local agency's agreement.

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2. Denial of a local agency's application, if the state agency's local agency selection is subject to the procurement procedures of the Department of 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 and no later than ninety (90) days after the date of the notice of adverse action or, in the case of an adverse action that is subject to administrative review, no later than the date the local agency receives the review decision.
C. Full Administrative Review Procedures
Procedures for a full administrative review of adverse actions are listed below:
The local agency may appeal the state agency's decision when an application to participate in the WIC Program is denied or terminated, or when a decision is made which adversely affects the local agency's participation in the program, such as a reduction in food or administrative funds.
The local agency must request an administrative review from the state agency within thirty (30) days after the action appealed was taken. The hearing must be scheduled no later then thirty (30) days after the request for hearing is received by the state agency. The local agency must be given fifteen (15) days advance notice of the time and place of the hearing. The proposed adverse action must be postponed from the time a hearing is requested until a decision is reached. The local agency may reschedule a hearing date one (1) time upon request. Sixty (60) days advance notice must be provided to a local agency before disqualification from WIC Program participation. The local agency will have many opportunities to present its case at the hearing, including the opportunity to confront and cross-examine adverse witnesses. Counsel may represent the local agency, if desired. The local agency may review the case file before the hearing.
D. Local Agency Hearing Procedures
To request a hearing, the local agency will send a written request to the WIC Branch. Should a hearing be requested before the deadline stated in the disqualification notice, the local agency authorization shall remain unchanged until final resolution has been attained at the administrative level. If a hearing

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request is received after the deadline stated in the disqualification notice, the local agency shall no longer be authorized for WIC Program participation.
Local agencies may appeal decisions of the WIC Branch when an application to participate in the WIC Program is denied, when participation is terminated, or when other actions are taken that adversely affect the local agency's participation in the program.
The local agency must submit a written request for a hearing to the WIC Branch within fifteen (15) days from the date of notification of an adverse action they wish to appeal.
The 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 forty-five (45) days of the hearing request. The local agency will be notified of the time and place fifteen (15) days before the hearing date. All hearings will be held in the county where the local agency is located.
The proposed adverse action must be postponed from the time an administrative hearing is requested until the Administrative Law Judge (ALJ) reaches a decision. The local agency or the WIC Branch may reschedule local agency hearings one (1) time.
The local agency will have an 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 appellant may review the case file before the hearing.
The Administrative Law Judge (ALJ), Office of State Administrative Appeals, is an impartial decision maker with no personal involvement or interest in the outcome of the hearing. The ALJ's decision shall rest solely on the evidence presented at the hearing with the statutory and regulatory provisions governing the program. The basis for the decision shall be stated in writing, although it need not amount to a full opinion or contain formal findings of fact and conclusions of law. The ALJ and the 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.

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The ALJ will explain any additional appeal mechanism upon request, including the right to a judicial review. If the local agency desires to appeal after an administrative hearing decision that has been granted in the state's favor, the local agency must follow the provisions of the Georgia Administrative Procedure Act (Code Section 50-13-16 and 50-13-17).

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CHAPTER 5 SPECIAL PROJECT PROGRAM
I. Introduction II. Overview of Local Agency Special
Project Grant III. Proposal Process IV. Grant Management

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SECTION I - INTRODUCTION
New ideas and concepts that stimulate growth, collaborative partnerships and program effectiveness are the foundational principles that guide the Georgia WIC Special Project Program. In fiscal year 1999, the WIC Branch initiated the special funding program for new program interventions developed by local WIC agencies. The program offers financial support to local agencies desiring to explore non-traditional means of providing WIC benefits to eligible participants. Resources are available to the local agencies in the form of Local Agency Special Project (LASP) grants. When funds are available, the Georgia WIC Program sets aside Nutrition Service Administration funds to distribute as LASP grant awards.
This section of the plan outlines the purpose and processes for local agencies wishing to participate in the Georgia WIC Local Agency Special Project program. In instances where grant processes are linked to routine program procedures, the related procedures are referenced and must be followed.

SECTION II - OVERVIEW OF LOCAL AGENCY SPECIAL PROJECT GRANTS (LASP)
A. Project Purpose and Priority
LASP grants provide financial support to local agencies endeavoring to implement new program enhancements. The primary intent of the special project grant is to support the efforts of local agencies to plan, design and implement innovative initiatives that will improve access to WIC benefits, and ultimately increase statewide participation.
Priority is given to projects proposing new concepts that can be replicated, are sustainable after the initial funding, can be implemented and completed within twelve months, and demonstrate collaborative partnerships. The focus areas for new program enhancements include: 1. Non-traditional service delivery sites and collaborative partnerships. 2. Special outreach to hard to reach clients. 3. Breastfeeding initiation and duration. 4. Linguistically and culturally appropriated nutrition education. 5. Efficiency measures for staff and participants.
B. Project Period
The LASP grant is a twelve-month non-renewable award. Applicants are encouraged to consider the grant period when deciding the complexity and

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scope of the project. Project proposals selected for funding must illustrate the potential to complete implementation within twelve months. LASP grant funds must be expended by September 30 of the federal fiscal year in which grant is awarded. The WIC Branch plans to award grants to selected local agencies by October 1.

SECTION III PROPOSAL PROCESS
All interested local agencies must submit a proposal. Grants are awarded to an individual local agency or to a consortium of local agencies. Local agencies are encouraged to consider collaborating with other WIC agencies on proposals. A local agency may submit only one proposal per fiscal year. If an agency submits a project proposal as part of a consortium of agencies, it may not submit a separate individual application.
A. Request for Proposal
The WIC Branch conducts an annual solicitation for special project proposals to give local agencies the opportunity to propose new program initiatives for the upcoming fiscal year. The request for proposals (RFP) outlining funding requirements and deadlines are distributed to all WIC local agencies in April.
The RFP package includes the following: 1. Application procedures 2. Proposal requirements 3. Project criteria 4. Proposal format 5. Focus areas 6. Proposal evaluation criteria and weights 7. Application checklist
Completed proposals must be received in the WIC Branch by August 1.
B. Proposal Review Process
It is the intent of the WIC Branch to select proposals that offer new and innovative concepts that address one of the focus areas, and have the best chance to continue beyond the initial funding period. Each proposal is reviewed and ranked by a proposal review committee. The committee is comprised of representatives from the WIC Branch, Nutrition Section of the Family Health Branch, district WIC nutrition coordinators who did not submit an application, and a non-WIC public health program.

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After reviewing and ranking proposals, WIC Branch representatives may interview agencies on site before making selection decisions to: a) clarify questionable concerns identified in the application review process, and b) to collect information that validates the agency's capacity to successfully implement the proposed project.
Selected proposals have two funding possibilities: Georgia WIC Special Project funds or USDA Infrastructure Grant funds. The state submits USDA applications in behalf of local agencies. State staff will provide technical assistance to local agencies to enable full development of proposals to meet USDA requirements. Both funding possibilities are subject to the availability of USDA funds.

SECTION IV GRANT MANAGEMENT
The health director of local agencies awarded special project grants must sign the DHR Master Agreement Addendum to Annex H Terms and Conditions with the Director of the WIC Branch agreeing to implement the project and to use the funds as described in the proposal. Special stipulations or instructions are stated in the agreement. The LASP funds will transfer to local agencies as Grant-in-Aid funds. Funds will not be transferred until the agreement has been signed.
A. Reports
General administration of these grants includes quarterly reports of expenditures, performance progress, a final closeout summarizing project outcomes and financial reconciliation. Local agencies are required to submit a quarterly financial status report on Standard Form 269A. The due dates for quarterly reports are as follows:
January 15 May 15 September 15 December 31(Final report)
The final summary of project accomplishments and a final Standard Form 269A must be submitted to the WIC Branch no later than 90 days after the last day of the federal fiscal year to closeout the project. Additionally, grantees are required to submit copies of educational curricula, videos or other tangible products produced with LASP funds with the final report.

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B. Monitoring
The WIC Branch will monitor grantees as specified in the agreement. If program interventions create a new service delivery site, the Policy Management and Consultation Section, Management Evaluation Unit will conduct a monitoring visit. In addition, the Systems Information Section must assign a unique clinic number. Once the grantee receives permission to proceed with operational plans, a monitoring visit will be conducted. Before the monitoring visit, the local agency is required to complete and submit an inventory of the special project purchases.

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GEORGIA DEPARTMENT OF HUMAN RESOURCES
DIVISION OF PUBLIC HEALTH WIC BRANCH
ATTACHMENTS
STATE PLAN FFY 2008

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Attachment I

ATTACHMENTS

PARTICIPANT CHARACTERISTICS MINIMUM DATA SET (MDS)

The Participant Characteristics Minimum Data Set (MDS) contains data items that are reported to FCS electronically by state agencies for one report month on all or a sample of participants. The MDS has required data items that must be collected and reported. The Supplemental Data Set Specifications (SDS) comprised of optional data items that state agencies may collect and report. Please check those data items the state agency currently collects in its Management Information Systems and those data items it is planning to collect within the next two years.

REQUIRED: Participant Characteristics Minimum Data Set

State Agency MIS: Collects

X

State agency ID. A unique number that permits linkage to the WIC state agency where

the participant was certified.

X

Local agency ID. A unique number that permits linkage to the local agency where the participant was certified as eligible for WIC benefits.

X

Service Site ID. A unique number that permits linkage to the service site where certified.

Either local agency ID or service site ID may be reported according to the level the state

agency feels appropriate. At a minimum, state agencies must provide agency names

and addresses for each ID provided on their files.

X

Case ID. A unique record number for each participant that maintains individual privacy

at the national level.

General Instructions: Participant or Case IDs for each participant should continue to maintain individual privacy at the national level. States are requested to generate these IDs in the same manner that was applied for PC92 to allow longitudinal tracking of participant characteristics. This task can be accomplished by applying the PC92 algorithm to construction of PC98 participant IDs.

X

Client Date of Birth: Month, day and year of participant's birth reported in

MMDDYYYY format.

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 (cont'd)

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

X Monitor clients' views of WIC program services

Monitor changes in WIC participant population dietary behavior

Provide WIC health statistics to other health agencies

X

Provide WIC participant population data to other state health agencies

Provide WIC participant population data to Centers for Disease

X

Control

FOOD INSTRUMENT PRODUCTON

Maintain Food Package Database

X

Record list of approved foods and food package data

X

Record food package variations and food instrument types

X

Prorating food quantities for clients with late pick-up

Print Food Instruments on Demand

X

Print regular food instruments for participants on demand

X

Print food instruments for multiple months

Print vendor-specific food instruments

X

Print prorated food instruments

X

Print custom-tailored food instruments

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Attachment I (cont'd)

MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST

Print and Distribute Food Instruments in Advance of Pick-Up

X

Print food instruments in advance of participant pick-up

X

Print food instruments for multiple months

Print vendor-specific food instrument

Monitor Food Instrument Stock

X

Record stock receipt, shipment and usage of food instruments

FOOD INSTRUMENT PAYMENT AND RECONCILIATION

Void Unissued and Unredeemed Food Instruments

X

Void unissued and unredeemed food instruments produced on demand

X

Void unissued and unredeemed food instruments printed in advance

Reconcile Redeemed Food Instruments

X

Process food instruments redeemed by vendors

X

Produce rejection reports for food instruments not paid to vendors

X

Check for valid vendors on redeemed food instruments

X

Check for redeemed but unissued food instruments

Produce Vendor Payment Detail

X

Produce payment detail for checks (where applicable)

X

Produce payment detail for vouchers (where applicable)

CASELOAD MANAGEMENT

Allocate Caseload

Determine maximum state caseload which could be served with

X

available funds

X

Prepare local agency caseload allocation estimates

X

Record caseload allocations assigned to local agencies

Monitor Caseload

X

Track actual participation against caseload levels

X

Produce FNS reports on participation

VENDOR MANAGEMENT

Support vendor authorizations

X

Capture and maintain data on authorized vendors

X

Produce vendor history information on individual vendors

X

Track vendor authorization process

Determine high-risk vendors

X

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

variance, high mean)

Determine high risk vendors by using additional analysis tools

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Attachment I (cont'd)

MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST

Monitor Vendor Education

X

Record vendor education sessions scheduled for each vendor

X

Record attendance at vendor education sessions by vendor

Track Investigations and Routine Monitoring

Capture compliance buys and routine monitoring data performed on

X

vendors

X

Support constructing a sampling of vendors for investigation

Support record audits with data needed to evaluate vendor inventory of

X

WIC foods

Monitor Compliance Cases and Sanctions

Maintain data for in-state vendor investigation cases and sanctions

X

applied

Maintain compliance data for abusive out-of-state vendors

X

Accumulate sanction points for vendor abuse

Coordinate With Food Stamps Program

X

Maintain FSP violation data on WIC vendors

X

Report WIC sanctions to Food 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

Produce client and food instrument activity reports on local agencies and

X

clinics

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

X

Track referrals of WIC participants to other health and social services

FINANCIAL MANAGEMENT

Record Grants and Budgets

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 (cont'd)

MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST

Monitor Expenditure

X

Monitor nutrition services, administration and food obligations and

expenditures

X

Monitor cash flow

X

Produce FNS 498 Report

Process Manufacturer Rebates

X

Estimate total annual rebates

X

Bill manufacturer(s) for rebate

X

Monitor rebate collections from manufacturer(s)

SYSTEM ADMINISTRATION

Maintain System Data Tables

X

Maintain system data tables

Administer System Security

X

Maintain user identification

X

Maintain user capabilities

X

Monitor unauthorized access

Archive System Data

X

Archive and restore historical data

X

Purge unnecessary data

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FEDERAL FISCAL YEAR 2008

Attachment I (cont'd)

MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS
State Agency MIS:
Collects
X Certification category. One of five (5) possible categories--under which a person is certified as eligible for WIC benefits: pregnant woman; breastfeeding woman; postpartum woman (not breastfeeding); infant (under twelve (12) months); or child (12-59 months).
X Expected date of delivery or 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 recent WIC Program certification as of April 1998.
X Participation in TANF/AFDC, Food Stamps, Medicaid. The participant's reported participation in each of these programs at the time of the most recent WIC Program certification as of April 1998.
X Migrant status. Participant migrant status according to the federal WIC Program definition of a migrant farm worker (currently counted in the FNS 498 report).
X Number in family or economic unit. The number of persons in the family or economic unit upon which WIC income eligibility was based.
A self-declared number in the family or economic unit may be reported for participants whose income was not required to be determined as part of the WIC certification process. These participants are adjunctively incomeeligible due to TANF/AFDC, Food Stamp Program, or Medicaid participation or are deemed income eligible under optional procedures available to the state agency in Federal WIC Regulations, Section 246.7(d)(2)(vi-viii). This means tested programs identified by the state for automatic WIC Program income eligibility, such as income eligibility of Indian and instream migrant farm-worker applicants.

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FEDERAL FISCAL YEAR 2008

Attachment I (cont'd)

MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS
State Agency MIS:
Collects
X Family or economic unit income
For persons for whom income is determined during the certification process, the income amount that was determined to qualify them for the WIC Program during the most recent certification as of April 1998.
FNS will convert income expressed in different measures (weekly, monthly, yearly, etc.) to annual amounts.
For descriptive purposes only, participants whose income was not required to be determined as part of the WIC Program certification process use the self-reported income at the time of certification. These participants include adjunctively income-eligible participants and those persons deemed eligible under optional procedures available to the state agency in Federal WIC Regulations, Section 246.7(d)(2)(vi-viii).
Zero should not be used to indicate income values that are missing or not available. Zero should indicate only an actual value of zero.
X Nutritional risks present at certification. The three highest priority nutritional risks present at the WIC Program certification current in April 1998.
X Hemoglobin or hematocrit. That value for the measure of iron status that applies to the WIC Program certification. It is assumed that the measure was collected within sixty (60) days of the certification date.
X Weight. The participant's weight measured according to the CDC nutrition surveillance program standards [nearest one-quarter (1/4) pound]. If weight is not collected in pounds and quarter pounds, weight may be reported in grams.
X Height. The participant's height (or length) measured according to the CDC nutrition surveillance program standards [nearest one-eight (1/8) inch]. If height is not collected in inches and eighth inches, height may be reported in centimeters.
X Date of height and weight measures. The date of the height and weight measures that were used during the most recent WIC Program certification period as of April 2002 in MMDDYYYY format.
X Currently breastfed. For infant participants between the ages of seven and eleven months, whether or not the participant is currently receiving breast milk.
X Ever breastfed. For infants between the ages of seven and eleven months, whether or not the infant was ever breastfed.

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FEDERAL FISCAL YEAR 2008

Attachment I (cont'd)

MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS
State Agency MIS:
Collects
X Length of time breastfed. For infants between the ages of seven and eleven months, the number of weeks the infant received breast milk.
X Date breastfeeding data collected. For infants between the ages of seven and eleven months, the date on which breastfeeding status was reported in MMDDYYY format.
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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FEDERAL FISCAL YEAR 2008

Attachment I (cont'd)

MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS

State Agency Collects

MIS Plans to Collect Supplemental Data Set (OPTIONAL)

X

Date of first WIC certification: Date the participant was first

certified for the WIC Program in MMDDYYYY format. For

pregnant, breastfeeding and postpartum women, this applies to

the current/most recent pregnancy and not to prior

pregnancies.

X

Educational level: For pregnant, breastfeeding and postpartum

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

infants and children, the highest grade or year of school

completed by mother or primary caretaker.

X

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

participant's household receiving WIC benefits.

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

X

Date when prenatal care began: For pregnant, breastfeeding

and postpartum women, the date when prenatal care began for

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 before pregnancy. Pre-

pregnancy weight may be reported either in pounds and

ounces or in grams.

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FEDERAL FISCAL YEAR 2008
MANAGEMENT INFORMATION SYSTEM PARTICIPATION CHARACTERISTICS

Attachment I (cont'd)

State Agency Collects

MIS Plans to Collect

Supplemental Data Set (OPTIONAL)

Weight gain during pregnancy: For breastfeeding and postpartum women, the participants weight gain during pregnancy as taken immediately at or before. Weight gain during pregnancy may be reported in 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.

X

Birth length: For infants and children, the participant's length

measured according to the CDC nutrition surveillance

program standards (1/8 inches). Birth length may be reported

in either inches and eighth inches or in centimeters.

X

Date of last routine check-up or immunization: Month, day,

and year of the last routine check-up or immunization for

infants and children reported in MMDDYYYY format.

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

Individual states may report the following items at their discretion.

Erythrocyte protoporphyrin. That value for the measure of iron status that applies to the WIC Program certification current in April 1998.
Participation in the Food Distribution on Indian Reservations Program. The participant's reported participation in this program at the time of the most recent WIC Program certification as of April 1998.

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FEDERAL FISCAL YEAR 2008

Attachment II

MANAGEMENT INFORMATION SYSTEM WIC SYSTEMS FUNCTIONAL REQUIREMENTS CHECKLIST

The following checklists were taken from the WIC Functional Requirements Document (FRD), which was provided as guidance to state agencies on functions they should consider incorporating in their Management Information Systems. Please check those functions/capabilities, which the state agency system currently performs or plans to perform within the next two years.

State State Agency Agency Performs 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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FEDERAL FISCAL YEAR 2008

Attachment II

Division of Public Health WIC Branch
Two Peachtree Street, NW Atlanta, Georgia 30303
Disqualification/Not Accepting an Application Form

The WIC Branch is disqualifying/not accepting an application from

(Circle one)

Local Agency Name

______________________________ for the following reason(s):

1. __________________________________________________________________________________ __________________________________________________________________________________

2. __________________________________________________________________________________ __________________________________________________________________________________

3. __________________________________________________________________________________ __________________________________________________________________________________

4. __________________________________________________________________________________ __________________________________________________________________________________

______________________________________________ WIC Branch Director's Signature
127

___________________________ Date

FEDERAL FISCAL YEAR 2008

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 WIC Branch regarding the applicant's desire, qualifications and capacity to deliver WIC Program services to eligible clients/patients. Upon review of the completed application, WIC Branch staff will make an initial determination of the agencies suitability for participation in the program. Final determinations will be made pending decisions regarding coordination with existing service providers.
Initial approval will be based on the following factors:
1. The need for WIC services within the service area. 2. An estimate of the number of individuals to be served by the applicant. 3. The capacity of the agency to deliver quality services. 4. The availability of staff required meeting federal guidelines for WIC service
providers.
AGENCY NAME:
ADDRESS:
CITY, STATE &ZIPCODE:
TELEPHONE NUMBER:
CONTACT PERSON:
NAME OF CEO:
128

FEDERAL FISCAL YEAR 2006
LOCAL AGENCY APPLICATION Page 2

Attachment III (cont'd)

Identify whether the agency is nonprofit, federally funded, Physician Sponsor Plan (PSP), HMO, clinic plan, local health department, private practice, community health center, etc.
TYPE OF AGENCY:
AGENCY NAME:
Describe your service area including geographic area (counties), demographics of the population served, and percent of patients on Medicaid:

Number of pregnant women served: Number of hours for obstetric (OB) services: Number of hours for pediatric services: Number of hours for general services:
AGENCY STAFFING Number of physicians by specialty: Do you have a registered dietitian (RD) on staff? Number of hours per week an RD is available: Number of registered dietitians on staff:

__________________ __________________ __________________ __________________
__________________ __________________ __________________ __________________

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FEDERAL FISCAL YEAR 2008
LOCAL AGENCY APPLICATION Page 3

Attachment III (cont'd)

Number of nutritionists with a B.S. in nutrition and/or Dietetic Technician Registered:
Number of registered nurses (RN) on staff:
Number of staff to weigh and measure and perform hemoglobin and hematocrits:

__________________ __________________
__________________

CLINIC/FACILITY CAPACITY

How many clinic locations do you operate?:

__________________

List the name and location of each clinic to provide WIC services:

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

130

FEDERAL FISCAL YEAR 2008
LOCAL AGENCY APPLICATION Page 4

Attachment III (cont'd)

PROPOSED WIC SERVICES AND ESTIMATE OF NEED FOR WIC SERVICES WIC Program eligibility is prescribed in the Code of the Federal Register (CFR) Title 7 Part 246. To be eligible for participation in the WIC Program, clients/patients must meet income and categorical eligibility requirements. Eligible clients include women, infants and children to age five (5) years who are at or below 185% of the federal poverty level and have a medical or nutritional risk. Residents and migrants meeting these requirements can be offered program benefits. How many WIC eligible clients reside in your service area?: Number of WIC eligible clients served by your agency/clinic: Number of pregnant women currently being served: Number of WIC clients you will serve in the first year: Maximum number of persons you can/will serve after the first year:
What is the date and source of the information provided above (census data; actual count, etc.)?
SOURCE AGENCY:
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FEDERAL FISCAL YEAR 2008

Attachment III (cont'd)

LOCAL AGENCY APPLICATION Page 5
CLINIC/FACILITY CAPACITY
How much space do you plan to designate for WIC service delivery in each clinic location?

Can you perform required laboratory procedures at each location?
Do you have equipment available to perform anthropometric (weight, height/length and hematocrit/hemoglobin) measurements?
What other health-related services do you provide at each clinic location?

132

FEDERAL FISCAL YEAR 2008 LOCAL AGENCY APPLICATION Page 6 BUDGET ESTIMATE Number of WIC clients you will serve in the first year. First year costs of serving eligible WIC clients. Monthly per client cost for year two and beyond.

Attachment III (cont'd)

Signature of Chief Executive Officer (CEO) or Contact Person

Date

For additional information, contact Samuel Sims at (404) 657-2900.
Please return completed form with documents required to:
Division of Public Health WIC Branch
Two Peachtree Street, Suite 10- 495 Atlanta, GA 30303-3182

133