1.  Coming January 5, 2015 Idaho WIC Program:

2.  Session Objectives:  By the end of the session you will be able to… o Define one year certification and which participants are eligible o Identify the time frame for one year certification, health screen and nutrition education contacts o Identify the steps to complete a health screen o Complete practice scenarios

3.  Expanded to include children  Applies to any category (catg) that is certified one year  Continues to apply to infants and breastfeeding women (regardless of % BF)  Includes a Health Screen mid-year  Local Agencies were asked to start alerting participants about the upcoming changes (August/September 2014)

4. What are the advantages of one year certification for participants and staff?

5.  Documents required only once every 12 months o Income, identification, and residency  Less o Items to bring to appointment o Temporary certifications  Mid-year ‘Health Screen’ appointment o Allows more time for assessment and nutrition education o Assigns new risks, identifies areas of concern

6.  Required for all catgs certified for one year: o Children, infants, breastfeeding women  Appointment occurs 5 to 7 months into the certification o Allows flexibility mid year  HS is similar to a certification o Eligibility portion is omitted

7.  Click on ‘Health Screen’ link (appears when HS due) o Left hand navigation  A screen will appear similar to certification o New income, identification, residency will not be required Note: QRC’s available for reference or training

8.  All catg at 5-7 months into the certification o ‘Health Screen Due’ prompt: Appears on the left navigation o ‘Edit Health Screen’ function: Appears for 24 hours after HS completed o Prompt disappears when HS completed Won’t show when certification is due in 3 months or less  VOC (transfers) o Prompt to complete a HS if participant comes to Idaho less than 5 calendar months into their certification  Prompt doesn’t prevent ability to print checks

10.  There is not a ‘Run Health Screen Check’ function  WISPr automatically registers data entered in each area required for Health Screen completion o Sections completed will get the green check mark o Areas needing to be updated will have the “Update” button and messages like on certification o Omitted the extra step (run HS check function) since HS is less complex than a Certification  When all required sections are complete, a button displays at the bottom of the page ‘Complete Health Screen’

12.  Complete assessment o Height/weight, hemoglobin (if applicable), immunizations (if applicable), feeding tab (if applicable), assessment interview  Add any new nutrition risks  Follow-up on previous goal(s)  Follow-up on referrals; add any new ones  Nutrition education  New goal (if applicable)  Write care plan o Will see prompt ‘Do not forget to create Care Plan’

13.  Referrals o Enter follow-up info and any new referrals if applicable o MA, SNAP, TANF, SA are not required at HS o Immunization referral when applicable Shows as required (left hand navigation) if “no” or “forgot records” selected o High risk referrals for RD Referral and RD Route/Review will be automated for new risks only; staff need to review past RD care plan for the plan for risks that were assigned at certification o A participant with newly assigned high-risk codes will be included on the 575 High Risk Participants report

14.  Physical presence is required  Measurements/hemoglobin accepted if < 60 days old  View the summary of the HS on the Participant at bottom of ‘Cert summary’ page  An automated note will display in the staff notes area for HS completion

15.  Risk Code Assignment o Risks are assigned at Certification (system and manually) ‘Certification risk’ is any risk assigned at certification o Additional risks may be added during HS (system and manually) ‘Additional’ risks are any new risks assigned during the health screen o If an edit occurs within 24 hrs the changes will take effect o Anytime an edit occurs outside the 24 hrs edit period that changes the assessment, staff should document to account for the change(s)

16.  Why is it important to have a health screen appointment during the middle of a certification?

17.  Identifies new nutrition/health concerns o New assessment; new nutrition risks can be added  Reveals progress or barriers towards goal(s) o New goal can be added  Past referrals are followed-up on o New referrals can be added  Allows more time for o Participant centered interaction o Providing and exploring nutrition education information

18.  Minimum of 4 education contacts required yearly: o 1 at certification; 1 in between; 1 at HS; 1 prior to next certification  Education consists of o Individual education, group classes and quick/mini WIC as appropriate by catg and risk level ( high or low risk)  Nutrition Education Contact by Certification Length: o < 6 months (at least 1 NEC) o 6 months (at least 2 NEC) o 7-11 months (at least 3 NEC) o 12 months (at least 4 NEC) o

19.  Documentation: o Document each nutrition education contact in participant’s record o Combined educations with other family members should be relevant to each participant o Keep a record of any missed apts., no-shows, etc. that resulted in the participant missing their HS or NE o While checks cannot be held if the HS isn't complete, a HS is federally required along with nutrition education

20.  Care Plans –Updates: o Care plan ‘type’ Required field Select from drop down Ex. Certification, Health screen, RD, Catg change etc. o Will have a section for Health Screen Assessment information Initial risks and newly assigned risks

22.  Care Plans –Updates: o “Topics” will now say “Education Topics” Meant to be topics discussed during education; any discussion during the nutrition interview would not be appropriate here o Will have a section to list education handouts 3 open fields to list handouts Staff should limit to using 1-2 education handouts May have other handouts to document such as Substance Abuse o Goal line will only have 2 lines (3 rd line omitted) Focus on one of two measureable goals at a time

24.  Why is documentation (assessment information and care plan) an important part of the Health Screen?

25.  Identifies changes since the last certification and/or appointment  Allows the next staff person to continue ‘where you left off’  Identifies current participant interests, concerns, questions  Lists relevant nutrition risks/referrals  Identifies nutrition/breastfeeding education discussed  States the participant’s next steps (a goal if one was set)  Allows the next staff to follow-up on progress/barriers regarding goals, referrals  Is federally required by USDA; reviewed during audits  Serves as a legal document that may be used in court

26.  Now it is your turn to practice!  See ‘HS Practice Activity ‘ for further guidance  You will need the list of available WISPr participants o Provided to each Local Agency Coordinator

27.  Talk with your Local Agency RD/Coordinator  Contact the State office: Michele Faiella, 334-5919 faiellam@dhw.idaho.gov Marie Collier, 334-5953 collierm@dhw.idaho.gov  Thank you for your participation!