MN WIC Advisory Group Meeting January 25, 2016 Notes Advisory Group (AG) Members Participating: Jessica Allred (Winona County); Wendy Bauman (Dakota County); Deb Boe (Dakota County); Julie Carroll (Brown County); Kari Carlson (Mille Lacs Band); Amber Converse (Dodge County); Maggie Domski (Washington County); Jenifer Drill (Morrison County); Rebecca Gruenes (Blue Earth County); Kris Klopp, AG Chair (Mille Lacs County); Amy Lueck (Southwest HHS CHB); Renee Lukkason (Cass County); Stephanie Olson (Polk County); Mary Peick (Ramsey County); Liz Short (Aitkin County); Kimberly Vickberg (Anoka County). AG Member Absent: Jill Bruns (Renville County); Shari Nelson (Crow Wing County); and Heather Thissen (Kandiyohi County). MDH Staff in Attendance: Rick Chiat, Food Delivery Unit Supervisor; Pat Faulkner, Nutrition Unit Supervisor; Kate Franken, Program Unit Supervisor; Carol Rowe, Operation Unit Supervisor; and Rekha Dixit, Financial Analyst. Welcome & Introductions Kris Klopp, AG Chair, welcomed everyone and asked that each person introduce themselves, say what agency they are from, and what group they represent. We had 8 new members at the meeting, due to the restructuring of the state from 5 regions to 8, and the new representatives replacing those whose terms ended December 2015. People also shared with the group, how long they had worked in WIC: among the group, the range is 1½ years to over 30! WIC Everyday Heroes The Everyday Hero Award was developed by the AG to be given to local agency staff chosen by their colleagues to acknowledge staff’s great work, service, and attitude. The first awards were given out in August 2015. AG members involved in the process last summer learned a lot and shared some of the challenges they faced, at the October 2015 AG meeting, at which time the group decided to form an ad hoc workgroup to address and resolve these issues. Maggie Domski (Washington Co.), Deb Boe (Dakota Co.), and Liz Short (Aitkin Co.) volunteered to work on this and report back to the AG at the April 2016 meeting. The next awards will be given out in August 2016. Imagining the Possibilities for Nutrition Services This discussion was a continuation of the discussion that began at the October 2015 meeting. At that time, many AG members wanted to get input from their staff, as well as from the agencies they represent. Similar issues, interests, comments as in October: Relationships are key: face-to-face is important, but when there’s not a need to be in clinic (e.g., for secondary ed), having more flexibility & options might benefit both participants & LAs. “Meeting participants where they’re at” geographically, technologically, developmentally (category), and in interests (lots of interest in recipes). Potential options to meet different needs: written materials such as NE cards and/or newsletters; video-clips; podcasts; by phone and/or Skype/Face Time; online education (e.g., wichealth.org, others?); Technology: apps (participants love the Food Finder app); social media; “virtual” connections (e.g., skype or FaceTime); kiosks in clinic; texting (pushing educational messages out); tweeting; o Not everyone has a smart phone or computer access; o Not everywhere is there adequate connectivity; Issues to be addressed/considered: security of equipment; data privacy; meeting the Federal Regulations regarding what constitutes “NE”; documentation in HuBERT; food benefit issuance – do participants need to be present? (mailing vouchers or with e-WIC loading food packages remotely). Pat mentioned that the state agency is planning to do a pilot using tablets in clinic, that would facilitate showing video-clips to participants to enhance the education. The state staff is also looking into Skype or FaceTime as an alternative to education by phone in very rural areas. Mary (Ramsey Co.) mentioned the CA WIC Assoc. Newsletter, which highlighted some proposals included in the Child Nutrition Reauthorization (CNR) bill, including: serving children not yet in full-day kindergarten until their 6th birthday; certifying infants to 2 years of age; and authorization to conduct pilot projects 'to test alternative certification, food delivery procedures, service delivery methods, and mechanisms for providing additional food assistance’. The Senate Agriculture committee is discussing the bill this month. Marketing WIC to County Boards Interest in how local agencies “marketed” WIC to their county boards came up at the October 2015 AG meeting, when Renee (Cass Co.) shared with the group how news of the Everyday Hero Award presented to one of her staff was shared with the PH Director, who shared it with the PH Advisory Group, and eventually the county Board – who were very interested, invited Renee and her staff person to a board meeting where they presented her with a certificate of their own. Most connections with County Boards occur through the local PH Director. Many PH Directors report regularly (e.g., monthly, quarterly, or annually) to their local PH Advisory Group, often including information about WIC. Often the PH Director will request information from the WIC Coordinator or ask the Coordinator to present. It’s essential that whoever is the conduit between PH and the Board, understand WIC. Board compositions vary – some are more open to hearing & learning about PH & WIC. When possible, find a “WIC or PH champion” on the board. AG members know that there are often misunderstandings by people of the WIC Program - presuming it is like SNAP, and not understanding the focus on nutrition and breastfeeding; not knowing that children are eligible to age 5. Information AG members suggested be shared w/ County Boards: broadly how WIC services benefit their community; number of participants being served, and % babies-born in their county/area participating in WIC; income guidelines (demonstrating that WIC serves both low-income and working families); the value of vouchers redeemed in their area; dollar value of the food package; number of WIC authorized stores in their area; information on cost/benefit (or Return on Investment) of WIC – money spent in WIC results in health care cost savings. Some provide WIC Facts Sheets and/or “the Word on WIC”. And stories – make it personal and emotion-based. Activities shared: • Some PH Directors do an annual update for their county Boards & include information on WIC. • Anoka: annually gets a proclamation issued for National Nutrition Month, which is presented to the Board; • Inviting Board members to a WIC open house (e.g., when opening a new clinic) 2 • Brown County WIC: The PH Director has an annual agency meeting with PH staff and • Preparing a WIC information packet or “WIC Newsletter” for the board each year, w/ information listed above; Aitkin: WIC staff participate in “lunch & learns” for hospital staff, chamber of commerce; Blue Earth: the county commissioners “walk through” WIC, annually • • County Board members. WIC information was presented this past year, followed by PH staff and Board members going to a grocery store to find the foods on WIC vouchers. UPDATES WIC Budget: • Final FFY15 funding letters were sent the week of January 19th and funds were to be transferred the week of January 25th. Because Management Team has increased funding to LAs during the year (through the increase in per participants rate and the availability of training funds), there as somewhat less NSA remaining to cover LA expenses that exceeded their grant. However, the total amount of money going to LAs in FFY15 is approximately the same as in FFY14. • Because state agency has not yet received the FFY16 budget from USDA, we are considering only essential requests for increases in administrative funds and not making any decision about the availability of training funds. • Management Team will be looking at our funding “formula” to consider changes that might more effectively support smaller agencies that lack “economies of scale”. Federal ME: We received the letter from USDA summarizing our Federal ME, which Management Team shared. • Noteworthy acknowledgements: security training for state & local staff; state agency’s use of WIC data to identify & address health disparities; our Food Finder App.; program integrity activities in the area of vouchers used inappropriately; and our breastfeeding promotion and support activities. • Findings: processing standards (not meeting the 10/20 day processing standards and/or lacking adequate documentation to verify that the standards are being met); data privacy (related to instances of LAs providing WIC participant data to CT&C without obtaining the required Release of Information); Separation of Duties (related to a more stringent interpretation of federal regulations by USDA); protection/security of voucher stock. • Recommendations: rights & responsibilities (ensuring participants have adequate time to read the R & R before signing); local agency MEs (recommendations to the state staff regarding our standards and tracking); goal-setting with participants in nutrition education. e-WIC: Rick and Carol reiterated that MAXIMUS, our planning contractor, has recommended we use the online (mag-stripe) technology (rather than off-line/CHIP), and has estimated that e-WIC will cost the state ~$500,000 more per year (regardless of the technology used). Carol & Rick described the next steps in the process: completing a number of required planning documents for USDA, and developing a RFP for procuring the services of an e-WIC processor. As we did when we rolled out HuBERT, we will convene a “LA clinic readiness” workgroup. Vendor Rule Revision: Rick noted that the impetus for revising the vendor rules is to add necessary provisions related to the implementation of e-WIC; however, in opening up the rules for review, other parts of the vendor rules will be considered (e.g., changes to minimum stock). The process takes about 12-18 months, and involves getting input from many stakeholders, including stores, LAs, and others. LAs will be notified through the Wednesday Update, of the opportunity to comment. 3 April 25th Meeting - Proposed agenda: • WIC budget update • Everyday Hero – Report from Ad Hoc workgroup • Federal ME Update: responses from MWRO, next steps • E-WIC Update • Update on training resources 4
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