Participation Reporting - PowerPoint Presentation

Participation Reporting Presentation to: Nutrition Service Directors Presented by: Julianne Gaston, MPH, RD, LD Date: September 6, 2017

ObjectivesDescribe changes to WIC participation reportsExplain methodology for current and future WIC participation reportsExamine scenarios which affect participant reports Review next steps

Changes in Participation ReportingInitial objectives: All participants less than one (1) year are counted as an infant (USDA) Breastfeeding women and infants feeding type based on the original feeding type for the transition month (USDA) Added objective: To correct flawed methodology

Transition MonthDefinition: An issuance-month food package adjustment which results in food package issuance for two (2) or more of the following: Types/Forms of formula WIC Types Feeding Types All food package changes do not have a transition month Formula changes do not affect participation WIC Type and Feeding Type do affect participation

Transition Month Example With Transition Month Without Transition Month Month 1 Gerber Good Start Gentle (GGSG) (GGSG) Month 2 One voucher for (GGSG) used and one voucher voided and replaced with new formula Voided all of (GGSG) vouchers and replaced with new formula Month 3 All (GGSG) vouchers voided and replaced with new formula Printed vouchers for new formula

Participation Report ErrorFlawed Methodology Intended Methodology June Issuance (June Infant to Child transitions counted as child) May Thirty Day (May Infant to Child transitions counted as child) April Closeout (April Infant to Child transitions counted as child) June Issuance (June Infant to Child transitions counted as child) May Thirty Day (May and June Infant to Child transitions counted as child) April Closeout (April, May, June Infant to Child transitions counted as child) )

Affect of Correction on Participation ReportsNo change to overall participation numbers Estimated shifts in numbers between WIC Types 12,000 increase in infants (23%) 12,000 decrease in children (10%) 8,500 increase in prenatal (53%) 7,000 decrease in postpartum women (28%) 1,000 decrease in breastfeeding women (28%)

Methodology for Participation ReportsParticipation will be based only on issuance data Participant record will no longer be used to verify issuance record WIC Type submitted with voucher request Feeding Type submitted with voucher request Implemented between February 2017 - August 7, 2017

Methodology for Participation Reports (cont.)For transition months: If two (2) WIC Types are reported in the same month, then count participation based on the first WIC Type If two (2) Feeding Types are reported in the same month, then count participation based on the first Feeding Type

Implementation DateOctober 2017 - Closeout in December 2017 will be the first report run with the new methodology Fiscal Year 2018

To Increase participation report accuracyTips for WIC Staff

How to Increase Report AccuracyStaff must: Keep mother/baby dyad in sync, when possibleMinimize the number of participants with a transition month

How to Increase Report Accuracy (cont.)Staff must: Ensure that WIC Type and Feeding Type are correct on voucher issuance screen before requesting vouchers Update Electronic Turnaround Document (ETAD) sent prior to requesting vouchers

Generic Food PackageStaff should pay special attention to food packages that can be issued to more than one (1) WIC Type such as:199 (Formula ordered from Nutrition Unit) 197 (Formula provided from stock on hand) 999 (District created food package using state created voucher codes) For example : A 999 Alimentum Mostly Breastfeeding Package can be issued to a mother with an Infant WIC Type The mother would be counted as an infant.

AbbreviationsEBF = Exclusively BreastfeedingMBF = Mostly BreastfeedingFFF = Fully Formula Fed FP = Food Package VC = Voucher Code P= Prenatal I = Infant C = Child N = Non-Breastfeeding B = Breastfeeding FP = Food Package VC = Voucher code The following slides will use the below abbreviations:

transition months for WIC typeHow to Handle

Infant to ChildAll participants < 12 months currently receive an infant packageBased on the issuance of an infant package, they will be counted as infant All participants > 12 months certified as a child receive a child package Based on the issuance of a child package, they will be counted as a child 12 months

Prenatal to PostpartumMom has Vouchers for Delivery Month Mother Baby Month 1 Original WIC Type P NA Month 2 (baby born) No change to mom’s package * Issue appropriate infant package P I Month 3Void mom’s prenatal vouchersIssue mom postpartum packageIssue appropriate infant package B or N I *Mother and baby WIC and Feeding Type will not be in sync for this month. Staff may void and replace the prenatal vouchers but this is not required.

EBF Conversion Voucher Mother Baby Month 1 Original WIC Type P NA Month 2 (baby born) Print VC A30 for mom * (Prenatal Conversion to EBF Package) Issue appropriate infant package PIMonth 3Void mom’s prenatal vouchersIssue mom postpartum packageIssue appropriate infant packageB or NI *Mother and baby WIC and Feeding Type will not be in sync for this month. Staff may void and replace the prenatal vouchers but this is not required.

Prenatal to PostpartumMom Does Not Have Vouchers for Delivery Month Mother Baby Month 1 Original WIC Type P NA Month 2 (baby born) Issue mom postpartum package Issue appropriate infant package B or N I Month 3Issue mom postpartum packageIssue appropriate infant packageB or N I

Prenatal to PostpartumStaff are not required to void prenatal vouchers for delivery month Mom with vouchers for a prenatal package will be counted as prenatal for delivery month USDA makes allowance for this dyad discrepancy Must void prenatal vouchers for future months and reissue appropriate postpartum package Prenatal Postpartum

Prenatal to Mostly BreastfeedingReplace prenatal vouchers even if the Food Package Code is not changing (i.e. MBF – FP W01) to ensure the correct WIC Type is associated with the package Prenatal W01 MBF W01

transition months for Feeding typeHow to Handle

EBF to MBF Less Than (<) Six Months Mother Baby Month 1 Original Feeding Type EBF EBF Month 2 (small amount of formula requested) No change to mom’s package * Do not void FP E00 (VC 059) for baby to be counted as EBF Print MBF package for baby EBF** EBF*** Month 3 Void mom and baby’s EBF vouchers and issue new packages MBF MBF *Refer to Mother/Baby Policy **Mom counted as EBF as only one package on file ***Baby counted as EBF based on first package issued

EBF to MBF Less Than (<) Six Months (cont.)For the transition month: Do not void mom’s package Do not void FP E00 (VC 059) For future months: Must void mom’s package Must void VC 059 and replace with new package Void even if the physical copy is not available No monetary value Does not process through WIC banking

EBF to MBF Greater Than (>) Six Months Mother Baby Month 1 Original Feeding Type EBF EBF Month 2 (small amount of formula requested) No change to mom’s package * Do not void FP E01 (VC 059) or baby food vouchers for infant to be counted as EBF Print MBF package for infant without baby food selected EBF** EBF*** Month 3 Must void mom and infant EBF vouchers and issue MBF packages MBF MBF *Refer to Mother/Baby Policy **Mom counted as EBF as only one package on file ***Baby counted as EBF based on first package issued

EBF Infant Greater Than (>) Six Month (cont.)For transition month: Do not void mom’s package Do not void baby’s original package For future months: Must void mom and baby vouchers and replace with new packages

MBF to FFF Mother Baby Month 1 Original Feeding Type MBF MBF Month 2 (Additional formula requested) Mom’s package does not change* Do not void original package in order for infant to be counted as MBF Print FP 999 for the additional formula the infant needs MBF** MBF*** Month 3 Void mom and infant MBF vouchers and issue new packages FFF FFF *Refer to Mother/Baby Policy **Mom counted as MBF as only one package on file ***Baby counted as MBF based on first package issued

MBF to FFF (cont.) For transition month: Do not void mom’s package Do not void FP E01 (VC 059 or baby foods) Print MBF package without the baby foods Or Print 999 package for the additional formula with the new feeding type For future months: Must void mom and baby vouchers and replace with new packages

Formula and Feeding Type Change Mother Baby Month 1 Original Feeding Type MBF MBF Month 2 (Additional formula requested) Mom’s package does not change* Void infant food package Print new food package MBF** FFF*** Month 3 Void mom and infant MBF vouchers and issue new packages FFF FFF *Refer to Mother/Baby Policy **Mom counted as MBF as only one package on file *** Baby counted as FFF based on first package on file

Formula and Feeding Type Change (cont.)For transition month: Do not void mom’s package Void infant’s current package Replace infant’s package For future months: Must void mom and baby vouchers and replace with new packages

Next StepsInform staff, as appropriate on participation reporting changesDiscontinue use of Mother/Baby ReportReport created to increase accuracy of participation Last Report to be worked will be September 2017 Still important for participant records be correct

SummaryParticipation reports will be based on issuance recordsTo correct errors and simplify methodologyStaff should check for accuracy of WIC Type and Feeding Type at voucher issuance H andle transition months with care

What Questions Do You Have?

Julianne Gaston MPH, RD, LDNutrition Senior AnalystOffice: (404) 463-0898JulianneGaston@dph.ga.gov