Food Package/Prescription HuBERT Training Module 1
Food Package/Prescription
Module 1
Slide Title
Slide Text
Introduction
This HuBERT on-demand training module is provided by the MN Department
of Health WIC Program.
It provides a first look at the MN WIC food package.
Overview
In this module, we will review the food items provided by MN WIC, default
food packages auto-generated by HuBERT, and how to tailor, edit, add
and delete food packages.
MN WIC Foods
DairySoy
The MN WIC food package, or food prescription, provides variable
combinations and quantities of the following food items:
Dairy products that include milk, cheese, yogurt, and eggs;
soy products as alternatives to dairy like soy beverages and tofu;
GrainProtein
Whole grains such as brown rice, oatmeal, whole wheat and corn tortillas,
whole wheat or whole grain bread and whole wheat pasta;
Protein sources of dry beans, peas, lentils, canned beans, and peanut
butter;
CerealJuice
a wide variety of hot and cold cereals, along with bottled, refrigerated,
and frozen 100% juice;
CerealJuice
Cash-value benefits for purchasing fresh, frozen and canned fruits and
vegetables;
And canned fish, which is included in food package 7 (we’ll explain what
that is in a couple of minutes).
InfantsFish
Lastly, infants can receive infant cereal, bananas and jarred baby fruits
and vegetables. Infants who are fully breastfeeding receive jarred baby
meats as well. WIC also provides supplemental formula.
FoodLists
For reference, the MN WIC Shopping Guide, available online, is a
comprehensive list of all WIC-allowed food items.
We also have a food finder app for mobile phones that allows participants
to scan PLUs and UPCs of food items while shopping. The app indicates
whether the scanned item is WIC-allowed or not.
Default Food Packages
DFPIntro
So, how do we create a participant’s food package in HuBERT?
HuBERT auto-generates default food packages (or DFPs) based on food
maximums defined by the Federal Regulations for WIC Type, age and
breastfeeding amount.
Each food package is assigned a number.
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Food Package/Prescription HuBERT Training Module 1
DFP1-3
Food package 1 is for infants 0 through 5 months old; infants 6 through 11
months old receive FP 2; 3 is for women, infants and child with qualifying
conditions;
DFP4-6
4 is for children 1 through 4 years old, FP 5 is for pregnant and mostlybreastfeeding women; while some-breastfeeding and non-breastfeeding
women receive FP 6.
DFP7s
FP 7 is provided to a slew of different women. This includes, fullybreastfeeding women, women mostly-breastfeeding multiple infants,
women breastfeeding multiple infants where one is fully-breastfed and the
other is either mostly or some-breastfed, women pregnant with multiple
fetuses, and pregnant women who are either fully or mostly-breastfeeding.
The last food package is FP 7+ and this is provided to women who are fully
breastfeeding multiple infants.
DFP1
DFPs are a shortcut that save us time because we don’t have to create a
food prescription, one food item at a time, from scratch.
The quantities and kinds of food provided in the DFP are dependent on
HuBERT knowing the following four things: the participant’s WIC Type, age,
breastfeeding amount, and assigned risk factors.
And where multiple options may occur, such as an option between dry
beans, canned beans or peanut butter, the State has created DFPs that
provide the most commonly requested options.
Let’s take a look at creating the WIC Food Package.
<NoDFP1>
Mack is being certified for the first time and today is 7/21/2015.
Let’s click on the Food Prescription link before we do anything else in the
Certification Guided Script, or CGS.
If the system doesn’t have the information it needs to create the DFP, it will
display the following message:
<no caption> “There are no risk factors on which to base a default food
prescription. The defaulting feature will not be functional.”
In other words, HuBERT will not be able to create a DFP, which means we
would have to create the food prescription from scratch, selecting each
food item individually and editing the quantities when necessary.
Although this is something we certainly could do, it’s not a good use of the
limited amount of time we have to spend with a participant.
<Later>
So now it’s later in Mack’s cert and we have completed the sections that
allow HuBERT to create the DFP.
Let’s click the Food Prescription link again.
<DFPsCreated>
This time, HuBERT created two DFPs.
The first DFP listed has an Effective Date of 5/20/2016, which is Mack’s third
birthday (he was born on 5/20/2013).
HuBERT has multiple age categories for children, including: 1-2, 2-3 and 3-5.
AgeCats
In order to issue benefits, children must have a food prescription created
for the appropriate age category.
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Food Package/Prescription HuBERT Training Module 1
In the Certification Guided Script, HuBERT automatically creates a DFP for a
child’s second or third birthday as long as that birthday falls within their
new certification period.
<Thirdbday>
Since Mack’s new certification period begins today and ends in one year,
his third birthdate will fall between those dates, so HuBERT created a DFP
for the 3-5 year age category.
Tailoring/Editing
<EnableEdit>
As we stated before, the DFP has the most commonly requested food
items.
It will always have to be tailored based on the participant’s preferences.
Tailoring the food package requires us to edit the DFP.
We can edit or delete food packages with today’s date or any date in the
future; food packages with dates in the past cannot be edited or deleted.
Right now, our Edit and Delete buttons are disabled.
In order to enable them, we need to click the date of the food package
we want to edit or delete so that it is highlighted.
Since we want to edit the food package with today’s date, let’s click on
7/21/2015.
<ClickEdit>
The buttons are now enabled so let’s click on Edit.
<EffDate>
Since we are editing the food package, the Effective Date, or the date the
food package will start being issued on the benefits, is disabled.
The UOM is the Unit of Measure and indicates how the food item is
distributed.
For example, peanut butter is distributed by the jar, eggs by the dozen, milk
by the quart, and fruits/vegetables by the cent.
The Quantity is based on the UOM and is the maximum amount allowed for
that DFP.
How the quantity, UOM, and food item display on this grid may be different
from what actually prints on the benefits.
Print
For instance, milk is issued on benefits with a UOM of gallons, half-gallons
and quarts while fruits and vegetables are issued as a dollar amount.
<Calculator>
The Milk Products calculator assists us when adding alternative milk items.
It informs us of the maximum allowed, in quarts, for our specific participant.
It also indicates the number of quarts already existing in the food package,
or the Allocated amount.
This includes the 12 quarts of milk, 1 quart of yogurt and the 1 lb. of cheese,
which is equivalent to 3 quarts of milk.
The equivalencies for non-milk food items are displayed in parentheses.
We’ll take a look at the milk calculator in action once we actually start to
tailor Mack’s food package.
<DFP2to5>
This is the DFP for a child 2 to 5 years old.
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Food Package/Prescription HuBERT Training Module 1
The DFP evolves so it may not be the exact same as the current DFP in
options or quantities but it’s probably pretty close.
Notice that for milk, it specifically states “Fat Free/Skim or 1% Milk”.
If Mack were between 1 and 2 years of age…
<DFP1to2>
The milk option would include “Whole, 2%, 1% or Fat Free/Skim milk”.
<LowfatMilk>
Women and children 2 to 5 years old can only buy lower fat milk with their
WIC benefits.
However, during our discussion with Mack’s mom she informed us that they
follow some vegetarian practices so she would prefer soy beverage and
tofu instead of the milk but is OK with the cheese, yogurt, and eggs.
She would also prefer to receive peanut butter and canned beans every
other month.
Let’s tailor Mack’s DFP to reflect mom’s preferences.
First, let’s add the soy beverage.
Which button do you think we are going to click on? Go ahead.
<FoodCat>
Next, we need to select from the Food Category drop-down. Click the
drop-down.
<MilkCat>
In which category should we find soy beverage? Select it from the list.
<SelectMilk>
<no script>
<HalfGallon>
On a quick side note, take a second to read through the list and notice
that the “Whole, 2%...” option isn’t even listed.
OK. So we have two options for the Soy Beverage: 1/2 gallons or quarts.
In general, we want to keep our food costs down in order to serve more
participants so we should provide the half gallons, which tend to be less
expensive than quarts.
Click on the half-gallon option.
<Bummer>
Although tofu is also listed under MILK, we can’t multi-select from this list
and can only select one item at a time.
Click OK.
<SoyBevAdded>
The soy beverage was added to the bottom of the DFP and provides the
maximum amount allowed.
Notice that the milk calculator has been adjusted to reflect the addition of
the 16 quarts of soy beverage.
Our maximum doesn’t change at 16 but the allocated is now 32 and the
remaining is negative 16, which means we need to remove 16 quarts to be
able to save the food package.
What would happen if we were to try to save our food package right now?
Click the OK button.
<MilkValidation>
This very long-looking message is just letting us know that the quantity of the
milk products in our food package is too high.
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Food Package/Prescription HuBERT Training Module 1
HuBERT has validations like this for all food categories in order to ensure that
we don’t accidentally issue more than the maximum amount allowed.
Click the OK button.
<AddTofu>
Mom also wanted some tofu. So let’s add that too – think you can do it on
your own?
<FoodCat1>
<no script>
<MilkCat1>
<no script>
<SelectMilk1>
<no script>
<SelectTofu>
<no script>
<ClickTofuOK>
<no script>
<TofuAdded>
<pause for animation>Although the maximum amount of tofu allowed is 16
pounds, the default quantity is 2.
We now have 34 quarts allocated and negative 18 remaining, which
means we need to remove a total of 18 quarts from Mack’s food package.
Currently, we have milk, soy beverage, tofu, yogurt, and cheese all
contributing to our milk allotment.
Mom doesn’t want any milk so let’s delete this first. Click on the milk in the
list and click the Delete Food Item button.
<DeleteMilk>
<no script>
<DeleteMilkYes>
<no script>
<EditTofu>
That looks better. Now we just have 6 quarts too many.
Next, we need to edit the quantities of the soy beverage and tofu.
During our discussion with mom, we determined that she would like 4
pounds of tofu and the remaining to be soy beverage.
We can edit these items in whatever order we want so let’s start by
increasing the amount of tofu. Click on tofu.
<ClickEditTofu>
Click the Edit Food Item button.
<ArrowUp1>
We can type our new quantity over the existing quantity or use the
increase/decrease arrows to change it incrementally.
Go ahead and click the up arrow to increase the quantity to 4.
<ArrowUp2>
<no script>
<SaveQuantity>
Click OK to save our new quantity.
<ModifySoyBev>
Notice now that we’ve increased our tofu to 4, the equivalency has also
been adjusted.
And we now have 8 quarts that we have to remove.
The last amount we have to modify is for Soy Beverage. Can you get us to
the Edit screen?
<ClickEditSoy>
<no script>
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Food Package/Prescription HuBERT Training Module 1
<Quantity8>
<pause for happy face>This time, we have to decrease our quantity by 8
so let’s just type that directly into the field.
<AddAltPB>
Our maximum and allocated quantities now match and we have 0
remaining. We are good to go.
Before we can move on though, we have one more edit to make.
Mom said she also wanted peanut butter and canned beans to alternate
each month.
The DFP provides peanut butter every month. Do you think you can finish
tailoring Mack’s food package on your own?
<DeletePBFirst>
<AddAltFirst>
<no script>
<DeletePBYes>
<SelectLegumes1>
<no script>
<PBClickAdd>
<HighltLegumes1>
<no script>
<PBFoodCat>
<SelectAlt1>
<no script>
<SelectLegumes>
<SaveAlt1>
<no script>
<SelectPBSecond>
<no script>
<SelectAlt>
<DeletePBSecond>
<no script>
<SaveAlt>
<DeletePBYes1>
<no script>
<Awesome>
<pause for text animation> We have one more thing we need to do.
Since we are providing soy products to a child, we must complete the
required documentation.
SoyDoc1
Soy documentation is required for the following:
Children when receiving any quantity of either soy beverage or tofu; fullybreastfeeding women if receiving more than 6 lbs. of tofu; and all other
women if receiving more than 4 lbs. of tofu.
SoyDoc2
CPAs are responsible for conducting the individual nutrition assessment of
need and documenting that reason in the participant record.
Eligibility criteria for soy foods include: milk allergy, lactose intolerance,
vegan/vegetarian diet, cultural/lifestyle practice and religious observance.
The reason why soy is being provided can be documented in either a
General note or a SOAP note, depending on Local Agency practice.
More information about providing soy foods can be found on the MDH
WIC website in the Medical Documentation Changes for Soy Foods Memo.
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Food Package/Prescription HuBERT Training Module 1
<OpenNote>
We can add a General Note directly from this screen or we can remember
to add it to our SOAP Note later.
Let’s document it now. Click the Add General Note button.
<NoteSubject>
We always need to select a Subject so click on the Subject drop-down.
<Subject>
Many of these subjects may be appropriate.
However, topics are available that specifically address soy food
documentation.
To see these, we have to scroll to the bottom of the list.
Click on the scroll bar…
<Drag>
…and we’ll drag it down.
<5Topics>
There are 5 different topics based on the eligibility criteria we just reviewed.
Remember, Mack’s mom told us that their family follows some vegetarian
practices, which is why she requested soy beverage and tofu instead of
milk.
Go ahead and select the note subject that best applies.
<SubjectHighlt>
<no script>
<Note>
Click inside the text box and we will quickly type the note.
<TypeNote>
Done. We’ve completed our required documentation so go ahead and
click the OK button.
<DoneTailoring>
We have also completed tailoring Mack’s food package.
Click OK to save his revised food package.
<ExpandFP>
Notice that Mack’s 3-year food package does not have any of the
changes we just made.
When it comes time to issue that food package, we will need to check in
with mom to see how we should tailor it.
Let’s take a look at Mack’s new food package.
Clicking either the plus next to the date or double-clicking the date
expands the food package for viewing.
Double-click on 7/21/15.
<NextTime>
Looks good.
Adding & Deleting
Now what if mom were to say that next time, she would like the rice/oats
option instead of the bread/tortilla/pasta option?
Whether we create the new food package now, while in the CGS, or in the
Participant Folder the next time she comes to WIC to pick-up benefits, is up
to us.
And we should note that the process is the same regardless of whether we
are in the CGS or the Participant Folder.
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Food Package/Prescription HuBERT Training Module 1
Let’s just see what we would have to do if we were to create another food
package for Mack right now.
To add a new food package, we would click what button? Go ahead.
<AddFP>
We want to create a new food prescription for Mack that starts the next
time he comes to WIC for a nutrition visit and receives benefits.
The Use Default button generates a DFP that is appropriate for our
participant.
However, first we need to set the Effective Date, which has defaulted to
today’s date and can be changed to a future date.
But, what date do we use?
Since Mack is being certified today and he doesn’t have anyone else in his
household to sync to, his benefit issuance cycle will start on the 21st of
each month.
Assuming he gets benefits for the next three months today, the next time
he’ll come to WIC for benefits will be in October.
Go ahead and enter 10/21/15 into the Effective Date of Food Prescription
field, then click the Use Default button.
<NewDFP>
Notice that the DFP does not have any of the changes we incorporated
into the 7/21/15 food package.
The DFP doesn’t change. HuBERT does not adjust it based on the
participant’s previous preferences; it always starts over after it has assessed
for type, age, breastfeeding and risk factors.
However, we can view Mack’s previous food package by simply clicking
on the title bar and dragging the window over to view the screen behind
it.
Let’s try it. Click the title bar and we’ll drag the screen to the right.
<MoveRight>
<no script>
<Handy>
This can come in handy when we have a new DFP that we need to tailor
and mom says she “wants the same foods that they always get”.
Click on the title bar again and we’ll drag the screen back to center.
<MoveLeft>
<no script>
<CancelFP>
We aren’t actually going to make all those changes again but let’s save
the food package as is. Click OK.
<DeleteFP>
The new food package is added chronologically.
What if we wanted to delete the 10/21/2015 food package?
<ClickDelete>
<no script>
<DeleteYes>
<no script>
<CloseFP>
<pause for text animation>
One last thing… Click the Close button.
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Food Package/Prescription HuBERT Training Module 1
<ViewNote>
Remember the note we wrote? Let’s just take a look at it. Click the
Manage Notes icon.
<Note>
And here is the General Note we created on 7/21/15 with the subject of
Soy Food - Vegan/Vegetarian while in the Food Prescription screen.
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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