1. Georgia WIC Program Management Evaluation Training Nutrition Services Directors Meeting Sonia Jackson March 22, 2016

2. VISION STATEMENT A leader in promoting healthy behaviors that improve lives. MISSION STATEMENT The mission of Georgia Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Program is to improve health outcomes and quality of life for eligible women, infants, and children by providing nutritious food, nutrition education, including breastfeeding promotion and support, and referrals to health and other services.

3. Explain the Management Evaluation (ME) process to the Nutrition Service Directors of the Georgia WIC Program Examine potential findings from current program reviews Discuss tips for a successful review OBJECTIVE

4. WHAT IS A ME A ME is an official audit conducted by the United States Department of Agriculture (USDA), Food and Nutrition Services (FNS), to evaluate total operations of the program. The rules for a Management Evaluation (ME) is found in the Code of Federal Regulations, CFR 7 Section 246.19 or on the web at https://www.federalregister.gov/select- citation/2013/02/28/7-CFR-246.19https://www.federalregister.gov/select- citation/2013/02/28/7-CFR-246.19

5. WHAT IS AN ME CONT’D A ME is conducted every two years or more A programmatic, vendor, and financial review may all be conducted in the same year Scheduling of ME: USDA contacts State WIC Dates are decided A calendar is developed Districts are informed USDA will inform the State Office of the type of audit (vendor, financial, programmatic) that will be performed

6. AREAS OF FOCUS FOR THE ME FOR THIS YEAR The management evaluation (ME) will consist of the following components at the State and District/Clinic levels: Certification and Eligibility Food Delivery Civil Rights Vendor Nutrition-VENA/Motivational Interviewing Participant Observations

7. USDA Submits pre-review questions to the state Schedules the date and time of the visit Specify locations of the local agency visits Select time of the Entrance conference Submit names of the staff that will be conducting the review

8. STATE WIC OFFICE TEAM LEADER RESPONSIBLITIES Receives pre-review information. These questions will encompass the areas of focus Distributes questions to various departments Send Responses to USDA The team leader will: –Inform staff of date & time of entrance conference –Send out invites to key staff for entrance conference –Schedule conference room for entrance and use during audit (SWO) –Request key staff (state and local) not to take annual leave during the audit –Coordinate with NSD of chosen districts to schedule conference rooms during the local agency review

9. LOCAL AGENCY PROGRAMATIC REVIEW Conduct an entrance and exit conference with state and local staff Request a list of participant records from GWIS of the selected clinics prior to the review Request a list of files from the clinic staff Submit a list to request information/documents from the local agency Perform Observations Note: Usually the programmatic review will last for a week. The time of the entrance is given to the State staff by USDA

10. Local Agency Exit Conference When the review of the local clinic has been completed, what occurs next? An Exit conference is given by USDA to the State and Local Agency staff (the time of the exit is given to the State staff) The conference consists of USDA staff informing State and Local Agency of their findings or corrective actions

11. What is a Finding or Corrective Action? A Finding is the noncompliance of the state agency with the federal regulations of the SERO WIC program A Corrective Action is the response to the findings Note: Noncompliance from the local agency will be considered state Findings/Corrective Actions

12. AREAS OF REVIEW AND POTENTIAL FINDINGS Certification and Eligibility Greeting of participants Program requirements explained Income requirements Race/ethnicity determination Adjunctive eligibility requirements Miscalculating household size and income Explanation of What is WIC and other program services Participant privacy/confidentiality Physical Presence requirements and exceptions Separation of Duties Thirty Day

13. AREAS OF REVIEW AND POTENTIAL FINDINGS Certification and Eligibility: Cont’d Proper techniques used for anthropometrics (height, weight, bloodwork) Clarify diet assessment with participant Nutrition risk eligibility explained to participant, documentation Nutrition education relevant to nutrition risk Nutrition goal developed with participant Nutrition Education Material provided Qualified staff providing nutrition assessment and education Appropriate referrals provided to participants High Risk follow up provided and documented Participant centered interviewing/VENA Qualified staff providing breastfeeding information Breastfeeding encouragement/ referrals Breastfeeding education tailored to participant’s needs Breastfeeding Education Material provided Appropriate staff discusses food package selection Participants asked if changes are needed to their food package Information provided on how to use WIC vouchers WIC authorized food list provided/explained Use of Breast Pump Policy

14. AREAS OF REVIEW AND POTENTIAL FINDINGS FOOD DELIVERY How to use WIC Vouchers Use of Authorized Vendors only Accountability and Security of Food Instruments Alternates and Proxy Procedures Issuance Procedures Receipt of Vouchers Explanation of Food Delivery System

15. AREAS OF REVIEW AND POTENTIAL FINDINGS CIVIL RIGHTS Posters Prominently Displayed (Justice for All, Interpretation, No Smoking, How to File a Complaint, and No Charge For Services) Civil Rights Complaint Handling Procedures (Oral and Written) Non-Discrimination Policy consistently provided Use of Non-Discrimination Statement on Materials Disability Act Participant greeted by staff/receptionist Explanation of all paperwork to participants Participants notified of expected wait time Clinic Flow (Service and Wait Times) Voter Registration Rights and Obligations English as a Second Language

16. AREAS OF REVIEW AND POTENTIAL FINDINGS VENDOR MANAGEMENT Application Selection Authorization Process High Risk Vendors Inventory Audits & Sanctions Application Process & Training VIPS Other

17. State WIC Office Response How does the State respond to an ME? The state agency will submit a plan to address any regulations that are found to be out of compliance sixty (60) days from receipt of the report. USDA will monitor the plan to ensure that the state agency is in compliance and submit a response to the state within sixty days Each state office is responsible for addressing their designated area by the assigned date (Local Agency may be contacted for needed information from their site visit)

18. Summary of ME Tips: Never give more information than is needed to answer the question Take advantage of the opportunity to seek assistance when needed prior to the audit Choose knowledgeable staff who will assist in the ME to provide assistance to the review team Ensure key staff members are available for the entire review period Explain the process of the Management Evaluation to the outside team members (DHD, Program Manager, Clinical Nurse Supervisor) by e-mail or a meeting prior to the review Be flexible (an auditor may change the schedule at any time)

19. Summary of ME Tips cont’d Be prepared to provide documents three years plus current Begin preparing documents that may be requested by the review team (inventory logs, training files, copies of NE materials, etc.) If an auditor ask you for something and you can’t find it right away, be honest about it Be prepared for USDA to ask to use GWISNET, Internet, etc. Be prepared to answer questions on the spot Never use state or county funds to feed auditors

20. LOCAL AGENCIES CHOOSEN Glynn County- Coastal Health District June 6-10, 2016 Macon/Bibb County-North Central Health District June 20-24, 2016

21. QUESTIONS AND COMMENTS