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 FEDERAL FISCAL YEAR 2008 State Plan 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 FEDERAL FISCAL YEAR 2008 State Plan Attachments: Attachment I Participant Characteristic Minimum Data Set (MDS) ...........................116 Attachment II Disqualification/Not Accepting an Application Form .........................127 Attachment III Application Form ........................................................................................128 FEDERAL FISCAL YEAR 2008 State Plan 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 1 FEDERAL FISCAL YEAR 2008 State Plan 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 2 FEDERAL FISCAL YEAR 2008 State Plan 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 3 FEDERAL FISCAL YEAR 2008 State Plan CHAPTER 1 GOALS AND OBJECTIVES I. Introduction II. Mission Statements III. Function Area Accomplishments FFY 2006 IV. FFY 2008 Goals and Objectives 4 FEDERAL FISCAL YEAR 2008 State Plan 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 5 FEDERAL FISCAL YEAR 2008 State Plan 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, 6 FEDERAL FISCAL YEAR 2008 State Plan 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. 7 FEDERAL FISCAL YEAR 2008 State Plan 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. 8 FEDERAL FISCAL YEAR 2008 State Plan Caseload Management: The goal of this function is to enable all eligible individuals to achieve maximum requirements by publicizing available program benefits. This goal is addressed by: 1) Targeting benefits to high-risk individuals and populations. 2) Targeting benefits to eligible populations with special health care needs and residents of non-traditional home environments. 3) Monitoring no-show rates. 4) Sustaining an outreach infrastructure to reach eligible participants. 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 9 FEDERAL FISCAL YEAR 2008 State Plan 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 10 FEDERAL FISCAL YEAR 2008 State Plan 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. 11 FEDERAL FISCAL YEAR 2008 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: 12 FEDERAL FISCAL YEAR 2008 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: 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: 13 FEDERAL FISCAL YEAR 2008 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: 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: 14 FEDERAL FISCAL YEAR 2008 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 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: 15 FEDERAL FISCAL YEAR 2008 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 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: 16 FEDERAL FISCAL YEAR 2008 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 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: 17 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 2.1 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: 75 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: 76 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 77 FEDERAL FISCAL YEAR 2008 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. 78 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 79 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 80 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 81 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 82 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 83 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) 84 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. 85 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 86 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 87 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 88 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. 89 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 90 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. 91 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 92 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. 93 FEDERAL FISCAL YEAR 2008 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 94 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. 95 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 96 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 97 FEDERAL FISCAL YEAR 2008 State Plan 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 98 FEDERAL FISCAL YEAR 2008 State Plan summarized at the county level within each district/unit. The list includes both computer and manual vouchers. For manual vouchers (including those prepared by clinics using automated systems) there are Unmatched Redemption Reports, including Cumulative Unmatched Redemption (CUR) reports that show vouchers that cannot be matched to an issue record, a valid WIC identification number or a certification period. Vouchers Paid by Administrative Checks list 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)]. 99 FEDERAL FISCAL YEAR 2008 State Plan C. A copy of the standard written vendor agreement between food vendors and the state (or local) agency [7CRF 246.4(a)(14)(iii)]. D. A description of the procedures designed to control vendor abuse of the program [7CRF 246.12(k)(2)]. E. A description of the system for monitoring food vendors to ensure compliance and prevent fraud, waste and abuse [7CRF 246.4(a)(14)(iv)] including: 1. The functional breakdown between state and local agency responsibilities for vendor management. 2. Monitoring system. 3. High-risk criteria. 4. Investigation system. 5. Sanction system. 6. Vendor/participant complaint system. 7. Cost Containment. F. Administrative appeal procedures for food vendors (may be placed in fair hearing section of the Procedures Manual) [7CRF 246.4(a)(17)]. SECTION III - DIRECT DELIVERY METHOD A. 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 100 FEDERAL FISCAL YEAR 2008 State Plan 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 101 FEDERAL FISCAL YEAR 2008 State Plan 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)]. 102 FEDERAL FISCAL YEAR 2008 State Plan CHAPTER 4 APPLICATION AND DISQUALIFICATION PROCESS FOR LOCAL AGENCIES I. Process for Applying to Operate a WIC Clinic II. Administrative Appeal: Local Agency 103 FEDERAL FISCAL YEAR 2008 State Plan SECTION I - PROCESS FOR APPLYING TO OPERATE A WIC CLINIC Local agencies must be public or private, health or human service agencies, in accordance with WIC regulations as defined in 7CFR246.5(d). The application must demonstrate the agency's ability to operate a WIC Program in accordance with WIC Federal Regulations and state policies. The Georgia WIC Program operates in all 159 counties within the state by local public health departments and two Atlanta-based contracted agencies (Grady Health System and Southside Medical Center. During FFY 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. 104 FEDERAL FISCAL YEAR 2008 State Plan 7. Examples of nutrition education materials and participant training tapes. Selection criteria for local agencies will be consistent with the requirements of 7 CFR 246.5. [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. 105 FEDERAL FISCAL YEAR 2008 State Plan 13. The agency demonstrates the ability to comply with all WIC Program automated data processing requirements. 14. The agency agrees to make all documents and records available for review and audits. 15. An agency serving homeless participants agrees to ensure that the homeless facility does not: a. Accrue financial or in-kind benefits from a resident's participation in the program. b. Subsume foods provided by the WIC Program into a communal food service. WIC foods must only be available to the WIC food recipient. c. Allow the homeless facility to place constraints on the ability of the participant to partake of the supplemental foods and nutritional education available under the Program. 16. The local agency agrees to contact the homeless facility periodically to ensure continued compliance with these conditions. 17. The local agency requires the homeless facility to notify the state or local agency if it ceases to meet any of these conditions. SECTION II - ADMINISTRATIVE APPEAL: LOCAL AGENCY A. The state agency must provide full administrative review to local agencies. The local agency has the right to appeal a state agency's decision for the following: 1. Denial of local agency's application. 2. Disqualification of a local agency. 3. Any other adverse action that affects a local agency's caseload. The state agency must provide written notification of the adverse action, the procedures to follow to obtain an administrative review, and the cause(s) for effective date of the action (See attachments II and III). 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. 106 FEDERAL FISCAL YEAR 2008 State Plan 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 107 FEDERAL FISCAL YEAR 2008 State Plan 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. 108 FEDERAL FISCAL YEAR 2008 State Plan 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). 109 FEDERAL FISCAL YEAR 2008 State Plan CHAPTER 5 SPECIAL PROJECT PROGRAM I. Introduction II. Overview of Local Agency Special Project Grant III. Proposal Process IV. Grant Management 110 FEDERAL FISCAL YEAR 2008 State Plan SECTION I - INTRODUCTION New ideas and concepts that stimulate growth, collaborative partnerships and program effectiveness are the foundational principles that guide the Georgia WIC Special Project Program. In fiscal year 1999, the WIC 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 111 FEDERAL FISCAL YEAR 2008 State Plan 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. 112 FEDERAL FISCAL YEAR 2008 State Plan 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. 113 FEDERAL FISCAL YEAR 2008 State Plan 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. 114 FEDERAL FISCAL YEAR 2008 State Plan GEORGIA DEPARTMENT OF HUMAN RESOURCES DIVISION OF PUBLIC HEALTH WIC BRANCH ATTACHMENTS STATE PLAN FFY 2008 115 FEDERAL FISCAL YEAR 2008 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. 116 FEDERAL FISCAL YEAR 2008 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 117 FEDERAL FISCAL YEAR 2008 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 118 FEDERAL FISCAL YEAR 2008 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 119 FEDERAL FISCAL YEAR 2008 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 120 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. 121 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. 122 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. 123 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. 124 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. 125 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 126 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: __________________ __________________ __________________ __________________ __________________ __________________ __________________ __________________ 129 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: 131 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