Food Package/Prescription HuBERT Training Module 3
Food Package/Prescription
Module 3
Slide Title
Slide Text
Introduction
This HuBERT on-demand training module is provided by the MN
Department of Health WIC Program.
Overview
In this module, we will review the few risk factors that affect the default
food package, or DFPs, and DFPs when participants breastfeed more than
one infant.
Risk Factors & DFPs
<RF335>
Although risk factors are necessary to create a DFP there are only a
couple of risk factors that directly affect it.
We are going to take a quick look at these risk factors and the DFPs.
Tera is expecting twins. Click on Health Information.
<RF335HI>
We’ve already indicated this by selecting the Expecting Multiple Births
checkbox.
Click the Cancel button.
When that checkbox is selected, the system automatically assigns Risk
Factor 335 – Multifetal Gestation.
<RF335Assigned>
Let’s take a look at the DFP. Click on Food Prescription.
<RF335FP>
If we think back to Module 1, there were 8 different food packages
numbered 1 – 7+.
This is Food Package 7, or FP7.
Most pregnant women receive FP5. The differences being in the 5 extra
quarts of milk, an extra dozen eggs, and the addition of 30 ounces of
canned fish.
By assigning Risk Factor 335, the DFP is automatically FP7 instead of FP5 for
our pregnant woman.
<RF338>
Now let’s take a look at Meg, a pregnant woman, whom we’ve just
VOC’d, or transferred from out-of-state.
The system won’t require us to complete any further information to create
a food package but, in general, we would want to assign any risk factors
we’re aware of and complete the health information as appropriate.
Go ahead and click on the Health Information tab.
<RF338HI>
Meg is currently fully breastfeeding an infant. Click the Currently
Breastfeeding Infant checkbox to indicate this.
<RF338BFAmt>
Select Fully Breastfeeding from the Breastfeeding Amount checkbox,
<RF338FBF>
<no script>
<RF338Highlt>
<no script>
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Food Package/Prescription HuBERT Training Module 3
<RF338BFDate>
We also need to complete the Date BF Verified. Click the drop-down and
click the Today button on the calendar.
<RF338Today>
<no script>
<RF338RFTab>
Although there are other fields we would complete if we were actually
performing this VOC, for our current purposes we are going to move on.
Click the Risk Factors tab and save our changes.
<RF338Save>
<no script>
<RFs>
Notice the system has assigned Risk Factor 338 – Pregnant Woman
Currently Breastfeeding and Meg is now high risk.
Now let’s create her food package. Click the Food Prescription tab.
<RF338Pan>
<panning down>
<RF338Add>
Go ahead and create her DFP.
<RF338DFP>
<no script>
<RF338FP7>
The Pregnant Enhanced is an indicator that informs us that Meg will receive
FP7 instead of FP5.
And we know it’s FP7 because of the 23 quarts of milk, 2 dozen eggs and
canned fish.
So, by assigning Risk Factor 338, the system will automatically provide FP7
instead of FP5 to our pregnant woman.
One other thing about FP7. Notice that the allocated amount of milk
products is 27 quarts.
This includes the 1 lb of cheese, 23 quarts of milk and 1 quart of yogurt.
What if Meg didn’t want the 1 lb. of cheese and wanted more milk
instead? Go ahead and remove the cheese.
<FP7Cheese>
<no script>
<FP7NoCheese>
According to our milk calculator we have only 24 allocated and 3
remaining quarts.
Let’s see what happens when we edit the amount of milk. Go ahead.
<FP7Edit>
<no script>
<FP7Up>
Use the up arrow to increase the quantity.
<FP7UpAgain>
<no script>
<FP7Cheese3>
Why can’t we increase the quantity beyond 24, when we have a 27-quart
maximum?
FP7&Cheese
The cheese in FP7 cannot be substituted for any other milk product.
Although women with FP7 are eligible to receive 27 quarts of milk
products, 3 of those quarts are always dedicated to cheese.
<RF355>
We have one other risk factor that affects the DFP: Risk Factor 355 –
Lactose Intolerance.
Click on Food Prescription.
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Food Package/Prescription HuBERT Training Module 3
<RF355DFP>
The DFP if a participant is assigned risk factor 355 provides only lactose-free
milk; neither the cheese nor yogurt is automatically included.
<RF801>
Another food option that we need to be aware of is the HOMELESS option
for milk and juice.
Bubba has been assigned Risk Factor 801 - Homelessness.
<RF801Demo>
<no script>
<RF801FdRx>
Click on Food Prescription.
<RF801Same>
The DFP for a participant with Risk Factor 801 is the same as any other.
However, we can tailor the food package to provide a homeless milk and
juice option.
We are going to edit the 8/18/2015 food package. Go ahead and get us
started.
<RF801Edit>
<no script>
<RF801Add>
Click the Add Food Item button.
<RF801Select>
Click the drop-down and select the MILK category.
<RF801Milk>
<no script>
<RF801MilkHighlt>
<no script>
<RF801Homeless>
The HOMELESS ONLY milk option provides the appropriate kinds of milk,
based on the participant’s age, in quarts since storage may be an issue.
Unlike other milk options, this milk option has a maximum of only 2 quarts
that will print on each benefit.
We aren’t actually going to add these food items at this time, so let’s take
a look at the JUICE option. Click the drop-down again and select JUICE.
<RF801Juice>
<no script>
<RF801JuiceHighlt>
<no script>
<RF801JuiceOpt>
Neither of these HOMELESS ONLY juice options provide the full nutritional
benefit allowed for juice.
However, the 6-pack of cans provides the most.
That’s it. MILK and JUICE are the only items that have separate HOMELESS
options.
Breastfeeding Multiple Infants
<BFMultiples>
Now let’s take a look at the DFPs for women who are breastfeeding
multiple infants.
We just VOC’d Joy who is a breastfeeding mother of twins and we’ve
already completed her Health Information. Go ahead and click on that
tab.
<HI>
Click on the Infant(s) Born from This Pregnancy button.
<HIInfantsBorn>
Here we can see that Joy has been linked to both her infants and that she
is fully breastfeeding them.
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Food Package/Prescription HuBERT Training Module 3
Click the Close button.
<HI1>
Let’s go add her DFP. You know what to do.
<FPWait>
<no script>
<FPPan>
<no script>
<FPAdd>
<no script>
<BFDefault>
<no script>
<BFDFP>
<Pause for text animation – 6 seconds> The food package indicator reads
Fully Breastfeeding Multiples and informs us that this participant’s DFP will
be FP7+.
Notice that the cheese, whole grains and juice food items include half
quantities.
Since the system cannot issue half quantities, it alternates a smaller and
larger amount each month in order to provide the full food benefit over
the participant’s entire certification period.
We can see how the highlighted food item will be distributed by clicking
the Show Details button. Go ahead.
<Distribution>
Since the cheese was highlighted, the Food Item Distribution shows us how
cheese will be issued on the benefits starting with the first month of the
participant’s current certification period.
If interested, go ahead and read the highlighted informative statement,
which further explains the distribution, then click the x to exit.
<DFP7+Save>
Let’s save this DFP as is. Click OK.
<FP7+FPtab>
FP7+ is only provided to women fully breastfeeding more than one infant
and is the same regardless of the number of infants (twins, triplets, etc.)
So what happens if one of Joy’s infants receives a small amount of formula
from WIC whereby Joy would be considered fully breastfeeding one infant
while mostly-breastfeeding the other?
Let’s take a look at that scenario next.
An infant’s breastfeeding status can be changed in either the mom’s or
the infant’s records since they should always be linked.
Since were in mom’s record…click on the Health Information tab.
<FP7Infants>
We can update the infant’s breastfeeding status in the Infant(s) Born from
This Pregnancy screen. Click that button.
<FP7Edit>
Let’s edit the first infant’s record since it is already highlighted. Click the
Edit button.
<FP7BFAmt>
We are going to change Faith to a Mostly-Breastfeeding infant. Go
ahead and change the Breastfeeding Amount.
<FP7MBF>
<no script>
<MBFHighlt>
<no script>
<DateSuppBegan>
Since Faith is no longer fully breastfeeding, HuBERT will require us to
complete the Date Supplemental Feeding Began.
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Food Package/Prescription HuBERT Training Module 3
We’ve ascertained from our discussion with Joy that she began
supplementing formula on August 1st…
...keeping in mind that it is important to complete all of these
breastfeeding fields as accurately as possible since they are used to
provide breastfeeding data for the WIC Program.
Go ahead and select August 1 from the Date Supplemental Feeding
Began drop-down calendar.
<SelectDate>
<no script>
<MBFSave>
Save our changes by clicking the OK button.
<BFChangeMsg>
HuBERT keeps the food packages for breastfeeding moms and infants in
sync based on the infant’s breastfeeding amounts.
Since we’ve changed Faith’s breastfeeding amount, this message displays
to inform us that the food prescription will be changed as a result of the
change in breastfeeding status.
Click Yes because we want to continue with our change.
<MBFFormula>
Since we are now providing formula for Faith, the Select Formula screen
opens.
We are going to stick with Similac Advance powder so click the OK
button.
<MBFSaveAgain>
Click OK again.
<MBFMsgNewDFP>
This time, the message is letting us know that a new DFP was created for
mom.
And that Faith will also have a new DFP containing formula. Click OK.
<MBFUpdated>
Notice that our Breastfeeding Amount has been updated and click Close.
<MBFHI>
So, go ahead and check out mom’s new DFP.
<MBFNewDFP>
HuBERT has automatically changed Joy’s food package to FP7.
<FP7Pan>
<no script>
<FP7Date>
If we were to edit this food package...go ahead...
<FP7Edit>
<no script>
<PartiallyBF>
...we would see that the indicator now reads Partially Breastfeeding
Multiples.
<DFPsBFAmt>
When it comes to DFPs and moms who are breastfeeding multiple infants,
the rule HuBERT follows is that the DFP is based on the infant who is
breastfeeding the most.
Click Continue to finish this module.
End Slide
We appreciate you taking the time to review this HuBERT on-demand
training module presented by the MN Department of Health WIC Program.
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