Kylia Crane, RDN, LD Nutrition Coordinator Georgia Chapter- American Academy of Pediatrics WIC and Georgia Chapter of the American Academy of Pediatrics Collaborations

Promotion & Education Physician Education  WIC Physician Outreach Pilot 1. Needs Assessment 2. What is WIC? 3. WIC Approved Formula & Medical Foods 4. Referrals 5. Resources in the community

Purpose of Physician Outreach Campaign Assist physicians and office staff in understanding public health programs and services for women, infants and children Identify the benefits of these programs Encourage referrals by physicians to appropriate public health programs and services

2002 Pilot of Physician Outreach Campaign Goals Increase WIC participation rates Increase breastfeeding rates Address childhood obesity Increase physician awareness of Children 1 st, services related to Georgia’s Newborn Screening for Metabolic and Sickle Cell Disorders and Universal Newborn Hearing Screening and Intervention

Pilot Site Selection The State WIC Office & MCH selected the following as pilot sites: Dublin- FY 03 Waycross- FY 04 Macon- FY 05 Valdosta- FY 06 Augusta- FY 07 Coastal- FY 08 Technical Assistance Project- FY 09 Columbus- FY 10 Clayton- FY 11 Rome- FY 12

WIC & Nutrition Topics Presented What is WIC? WIC services Qualifications/Eligibility Referrals WIC Formula Contract/ Medical Documentation Breastfeeding support EPIC Breastfeeding Program Feeding Practices Childhood obesity- Expert Committee Recommendations Utilizing Local Resources

Birth- 5 Topics Presented Children 1 st - single point of entry Universal Newborn Hearing Screening & Intervention Metabolic screening Babies Can’t Wait Childrens Medical Services High Risk Infant Follow Up GA HealthCheck Requirements

Public Health District’s Role Creation of Physician Listing in District- Pediatricians, Family Physicians, & OB-Gyns Districts selected outreach method- Lunch workshops, office visit, educational toolkit, regional Meetings, grand rounds Strongly encouraged District/County staff would attend scheduled office visits District Tailored Outreach Materials

Educational Toolkit Pediatric & Family Practice WICChildren 1 st  Georgia WIC Program Fact Sheet- Physician Reference  WIC Clinic List- Columbus District  GAWIC Formula Guide  New GA WIC Food Package Flyer  GA WIC Medical Documentation Forms 1 & 2  Breastfeeding Education Sheet  AAP Breastfeeding Coding Fact Sheet  EPIC Breastfeeding Flyer  CDC Criteria for Anemia Flyer  Expert Committee Guidelines on Prevention, Assessment & Treatment of Childhood Obesity  AAP Obesity Coding Fact Sheet Additional Materials:  WIC Partnering with Medical Community CD  Breastfeeding and Mothers’ Milk- Thomas Hale, PhD  Body Mass Index (BMI) Wheels  Food and Fitness Matter: Raising Healthy, Active Kids DVD  Physicians Guide to Coastal Public Health Programs and Services  Children Special Services Brochures  Children 1 st Screening and Referral Form  Newborn Metabolic Screening Follow-up Brochure  Universal Newborn Hearing Screening & Intervention Brochure  Universal Newborn Hearing Screening & Intervention Flow Chart  AAP Coding Fact Sheet on Developmental Screening  EPIC Immunization Brochure Additional Materials:  Autism Tool Kit  Bright Futures Tool Kit Information

Educational Toolkit OB/GYN Practice WICChildren 1 st  Georgia WIC Program Fact Sheet- Physician Reference  WIC Clinic List- Columbus District  New GA WIC Food Package Flyer  GA WIC Medical Documentation Forms 1 & 2  Breastfeeding Education Sheet  AAP Breastfeeding Coding Fact Sheet  EPIC Breastfeeding Flyer  CDC Criteria for Anemia Flyer Additional Materials:  WIC Partnering with Medical Community CD  Breastfeeding and Mothers’ Milk- Thomas Hale, PhD  Physicians Guide to Coastal Public Health Programs and Services  Children Special Services Brochures  Children 1 st Screening & Referral Form  Newborn Metabolic Screening Follow- up Brochure  Universal Newborn Hearing Screening & Intervention Brochure  Universal Newborn Hearing Screening & Intervention Flow Chart  EPIC Immunization Brochure

Georgia AAP’s Role Create an outreach toolkit that included Pediatrician Guide to Public Health Programs and Services as a core piece Lunch and Learn Workshops to Physicians & Practice Staff Identify benefits of these programs for physicians and their patients Provided referral & resource materials Answer questions/concerns about WIC

Challenges in Provider Outreach Limited face time with physician staff Large practices may having “rolling” lunch break Bias or negative perception of public health Bias or negative perceptions of physicians & staff

Physician Feedback Need guidance on Medical Documentation Need guidance on Special Formulas & Appropriate Usage Physicians concern over language used to discuss WIC Medical Prescriptions ex. This formula is approved with prescription. Preferred- This formula is approved if patient has appropriate diagnosis indicated for that formula.

Post Campaign Activities General Physician Education throughout state Development of Special Formula Infant Formula Algorithm- Stan Cohen, MD Trainings on Infant Formula Technical assistance with Medical Documentation- Special Formulas & Medical Foods WIC Advocate Survey Dissemination EPIC Breastfeeding Program

Things to Come… Developing Referral & Networking Plan Special Infant Formula Algorithm Evaluation of effectiveness Update algorithm & resource information Developing policies for issuance of Child Special Formula Nutritionals

Things to Come… 2 Presentations at WIC Conference in August High Risk Infant-Special Formulas Premature Infant Nutrition- Treatment Guidelines Technical assistance with physicians- Medical Documentation- Special Formula Issuance Blast-communications Newsletter Articles

Technical Assistance Protocol Please have District contact me after an attempt has been made to resolve issue with physician practice. During contact please provide: 1. Patient Name, DOB, parent/guardian name 2. Physician/or Practice Staff Name, number 3. Diagnosis- any necessary documented information 4. Name of WIC Clinic, Nutritionist who contacted Physician/Practice Staff

Technical Assistance Physician Office will be contacted State Office & District Staff will receive communication on status of issue If issue not resolved via phone- possible lunch and learn workshop may be approved. Lunch and learn workshop- I will schedule and invite District/and or County staff to attend at physician practice. I will assist District/County staff in sharing of information for workshop.

Questions ???