Adidja Amani, Lod Hambanou,

Julie Jabaley, Rose Kattakayam, Emma

Konan

History and Legislation

Child Nutrition Action of 1972 (PL 92-433) began as 2-year pilot

administered by USDA/FNS at federal level

evidence of importance of maternal nutrition for pregnancy outcomes

potential for permanent physical damage to malnourished infants

By1975… became permanent program

nutrition education mandated

programmatic changes

By 1978 income eligibility guidelines set

funding formulas for states

Healthy Meals for Healthy Americans Act of 1994 Special Supplemental Nutrition Program for Women, Infants, and Children

Organizational Structure

Private Contract Agency n1 Contract Agency n2

State Government

Department of Human Resources (DPH) WIC Branch

Federal Government

Food and Nutrition Services

WIC Branch FlowchartPolicy Mgmt & Consultation

Vendor Management

Systems Information

Planning and Resources

Compliance AnalysisClerical Support Unit

Branch Director

Financial Management

Georgia WIC

Functions

1-Nutrition education and

health surveillance

2-Vendor and case load

management

3-Food instrument production4-Food

instrument payment and reconciliation

5-Monitoring and audit

6-System administration

Georgia WIC Partnerships

American Association of Pediatricians

Wellstar Hospital and the Timber

Ridge Conference Center

Emory

Non-WIC food programs

Outcome Goal

Improve health status and

reduce infant mortality by

nutrition and health services

for women, infants and

children.

Who?

Pregnant

Breastfeeding women

Non-breastfeeding postpartum women

Infants

Children

Eligibility Criteria

Resident or receiving healthcare

Family income at or below 185% of

federal poverty income guidelines

Persons receiving other services –

Medicaid, TANF, Food Stamps

Documented nutritional risk

What is done?

Nutritional assessment

health screening

medical history

body measurement

hemoglobin check

Vouchers for food supplements

Immunization assessment

Referrals

Voter registration

Nutritional Risk Assessment

VENA (Value Enhanced Nutrition

Assessment)

Inadequate dietary intake

Abnormal hematological

measurements

Documented nutritional or medical

needs

Predisposition

milk, cheese, iron-fortified formula

eggs, dried beans, tuna

carrots, fruit juice

dried cereal

Food Voucher Progression

Local Agencies

Participants

Grocery Stores

Nutritional Education

For whom? adult participants

parents

guardians of infant and child participants

By whom?local agencies

Content?information and education materials

Breastfeeding Support & Education

By whom?

Local agency

Breastfeeding coordinator

Content?

Preferred method

Encouragement

Support

Budget and Resources

No independent budget for WIC

Problems with projected states’ revenues in recent years

States agencies required to reduce budget of 6% -10% for FY- 2009 & 2010

Suspension of certain activities to reduce expenditures• Recruitment of additional personnel

• Travel and participation in conferences

• Vehicle purchases

Down to the Nitty Gritty…R

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15 Infant & Child Health Promotion - Laboratory Supplies

325,000 9,736,316 5.37% Savings from closing GPHL on Saturdays including testing kits $275,000 and utilities $50,000

16 Infant & Child Health Promotion -Contract Elimination

140,000 140,000 9,876,316

5.44% YMCA Fit for Life $100,000; Safe House Outreach $40,000

17 Infant & Child Essential Health-Contract Reduction

Infant & Child Essential Health-Contract 582,000

10,458,316 5.76% Reduce Hemophilia of Georgia $382,000 (20%); Tertiary Care Centers $200,000 (10%)

Georgia Budget & Resources

FFY 2005 WIC Expenditures in

Georgia

Total: $ 230,465,330

WIC FFY 2005 Funding Sources

Federal (Food + NSA) $159,952,282

Formula Rebate $70,513,048

Total $230,465,330

Budget & Resources

Food costs: $ 188,552,366

Federal food:63%

Formula Rebate:37%

Budget & Sources: Expenditures

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

Total federal

Local Match

Food: $1,309,243

Administrative: $290,572

The BIG Picture

ecological, upstream intervention

step toward Healthy People

2010 goals

example of evidence-based

programming that works

Some Granularity

$22K/lb versus $40/lb

WIC Mothershave longer pregnancies

get earlier prenatal care/better nutrition

have greater breastfeeding initiation rates

breastfeed babies10-25% more frequently than non-WIC babies

WIC Childrendemonstrate better academic performance

have greater assurance of normal growth

access regular healthcare/vaccines more

More Granularity

GA WIC serves monthly…

81K infants

145K children

24K pregnant mothers

21K BF mothers

33K PP mothers

GA WIC contributes $301million to

economy

Strengths, Weaknesses & Opportunities

Cost

Smoking intervention concurrent

w/nutrition interventions/education

Improve breastfeeding rates

ReferencesAhluwalia, I.B., Tessaro, I., Grummer-Strawn, L.M., MacGowan, C. & Benton-Davis, S. (2000, June). Georgia's

breastfeeding promotion program for low-income women [Electronic version]. Pediatrics, 105(6).

Delahanty, J.C., DiClemente, C.C., Havas, S., & Langenberg, P. (2008). Smoking status and stages of change for

dietary behaviors among WIC women [Electronic version]. American Journal of Health Behavior, 32(6), 583-593.

Georgia Department of Human Resources. (2008, August). Department of Human Resources board meeting August

2008. Retrieved on November 26, 2008, from http://health.state.ga.us/phchanges/pdfs/ DHR_Board-

Budget%20Reduction%20Presentation_08-20-2008.pdf

Georgia Department of Human Resources. (n.d.). 2008 Georgia WIC procedures manual & Georgia state plan.

Retrieved on November 8, 2008, from http://health.state.ga.us/pdfs/wic/2008_Georgia_WIC_Procedures_

Manual.pdf

Georgia Department of Human Resources. Division of Public Health. (2006, May). Georgia WIC facts and figures FFY

2005. Retrieved on November 26, 2008, from http://health.state.ga.us/pdfs/wic/wic.Facts%20and%20Figures%

20Report%20FFY%202005.pdf

Georgia Department of Human Resources. Division of Public Health. (n.d.). Supplemental nutrition program for women,

infants & children (WIC). Retrieved November 8, 2008, from http://health.state.ga.us/programs/wic

Georgia Department of Human Resources. Division of Public Health. (n.d.). WIC fact sheet. Retrieved November 8,

2008, from http://health.state.ga.us/ pdfs/wic/wic.faq.pdf

United States Department of Agriculture, Food and Nutrition Service. Program data. (n.d.). Retrieved November 27,

2008 from http://www.fns.usda.gov/pd/wicmain.htm

United States Department of Health and Human Services. Healthy people 2010: Understanding and improving health

[Electronic version]. (2nd ed). Washington, DC: U.S. Government Printing Office, November 2000.

United States Government Accountability Office. (2006, February). Breastfeeding. Retrieved November 8,2008, from

http://www.gao.gov/new.items/d06282.pdf

United States General Accounting Office. (2001, December). Food assistance. Retrieved November 8,2008,

http://www.gao.gov/new.items/d02142.pdf