WIC’s New Choices for WIC’s New Choices for Participants with Participants with

Special NeedsSpecial Needs

Barbara Longo, MS, RD and Karla Magie, MPH, RDBarbara Longo, MS, RD and Karla Magie, MPH, RDCalifornia WIC ProgramCalifornia WIC Program

Program Evaluation and Policy BranchProgram Evaluation and Policy BranchApril 28, 2009April 28, 2009

What are your thoughts about What are your thoughts about therapeutic formulas?therapeutic formulas?

How important are therapeutic How important are therapeutic formulas?formulas?

Together we will explore …Together we will explore …

I. New WIC food choices and procedures for participants with special needs:+ Food Package III+ Food Package IV

II. Coordination with medical providers

The Big PictureThe Big Picture

1)1) Medically fragile WIC participants may Medically fragile WIC participants may receive all WIC foods receive all WIC foods if prescribed. if prescribed.

2)2) Children may receiveChildren may receive

soy beverage and tofu soy beverage and tofu with with medical documentation.medical documentation.

WPM 390-10 Policy ChangesWPM 390-10 Policy Changes

Obtain medical documentation before issuing:Obtain medical documentation before issuing:

• Therapeutic formula, a medical food, or Therapeutic formula, a medical food, or any any WIC foodsWIC foods

• Additional formula instead of food for infants Additional formula instead of food for infants 6 to 11 months of age6 to 11 months of age

• Soy-based beverage or tofu to a childSoy-based beverage or tofu to a child

Medical Documentation for Package IIIMedical Documentation for Package III

Overview of ISIS Changes Related to the New Food PackageOverview of ISIS Changes Related to the New Food Package

WIC Foods for Participants WIC Foods for Participants Prescribed Therapeutic Formula Prescribed Therapeutic Formula

NowNow

October 1, 2009October 1, 2009

New WIC Pediatric Referral FormNew WIC Pediatric Referral Form

New ISIS Question for New ISIS Question for Package IIIPackage III

“Are there restrictions on any WIC foods?”

Case Study #1Case Study #1 Mom’s 2 yr/o toddler was just diagnosed Mom’s 2 yr/o toddler was just diagnosed

with severe cow’s milk, soy, and egg with severe cow’s milk, soy, and egg allergies and brings a prescription for allergies and brings a prescription for Pregestimil to WIC. Her son has Molina Pregestimil to WIC. Her son has Molina Medi-Cal managed care health insurance.Medi-Cal managed care health insurance.

1.1. Which food package?Which food package?

2.2. Which WIC foods?Which WIC foods?

3.3. Does WIC provide Pregestimil?Does WIC provide Pregestimil?

Soy – Child Soy – Child (Food Package IV )(Food Package IV )

Overview of ISIS Changes Related to the New Food PackageOverview of ISIS Changes Related to the New Food Package

Soy Food Package Policy

• Soy beverage and tofu issuance to a child Soy beverage and tofu issuance to a child requires medical documentation. requires medical documentation.

• Soy documentation from a health professional Soy documentation from a health professional with prescriptive authority only needs to be with prescriptive authority only needs to be requested once.requested once.

• Soy documentation is not required for women.Soy documentation is not required for women.

Case Study #2Case Study #2A vegan mother wants her 14 mo/o baby boyA vegan mother wants her 14 mo/o baby boyto receive soy milk. There is NO medicalto receive soy milk. There is NO medicalCondition and the family has Kaiser privateCondition and the family has Kaiser privateInsurance.Insurance.

1.1. Which food package?Which food package?2.2. Is a Rx required?Is a Rx required?

Questions?Questions?

WIC Coordination WIC Coordination with the Health Care Communitywith the Health Care Community

Step #1: Announce the new WIC changes . . . Step #1: Announce the new WIC changes . . .

1.1. WebEx conferencesWebEx conferences

2.2. Physician meetings and correspondencePhysician meetings and correspondence

3.3. ArticlesArticles

4.4. Joint program lettersJoint program letters

5.5. PresentationsPresentations

6.6. CA WIC web pages for physiciansCA WIC web pages for physicians

WIC Web Pages for Health Professionals

WIC Collaboration WIC Collaboration with the Health Care Communitywith the Health Care Community

Step #2: Train the trainer model . . .Step #2: Train the trainer model . . .

• Health plansHealth plans

• PhysiciansPhysicians

• NursesNurses

• CWA webinars in August 2009 CWA webinars in August 2009

MD - WIC Collaborative

• Breastfeeding promotionBreastfeeding promotion• Childhood obesity preventionChildhood obesity prevention• Healthy habits Healthy habits • Early intervention and access to careEarly intervention and access to care

Local Agencies Coordinates with Local Agencies Coordinates with the Health Care Communitythe Health Care Community

Did you know….Did you know….

……medical certification program for physicians medical certification program for physicians promotes and supports breastfeeding in promotes and supports breastfeeding in physician offices in Riverside County...physician offices in Riverside County...

……physicians teach WIC participants about physicians teach WIC participants about breastfeeding and good nutrition in Glenn breastfeeding and good nutrition in Glenn CountyCounty

Who takes the child by the hand…Who takes the child by the hand…

……takes the mother by the takes the mother by the heart.heart.