CONNECTICUT DEPARTMENT OF PUBLIC HEALTH PUBLIC HEALTH INITIATIVES BRANCH

Transcription

CONNECTICUT DEPARTMENT OF PUBLIC HEALTH
PUBLIC HEALTH INITIATIVES BRANCH
COMMUNITY HEALTH AND PREVENTION SECTION
Connecticut State Plan for Program Operation
of the Special Supplemental Nutrition Program
For
WOMEN, INFANTS, AND CHILDREN (WIC)
Federal Fiscal Year 2013
(October 1, 2012 – September 30, 2013)
Submitted in accordance with USDA
Food and Nutrition Service
Federal Regulations 246.4(A) - State Plan
August 10, 2012
CT WIC State Plan FY2013
TABLE OF CONTENTS
PART I
A.
Introduction………………………………………………………………………………………….1
B.
Mission Statements……………………………………………………………………………….2
C.
State Agency Organization…………………………………………………………………….3
D.
Local Agency Organization…………………………………………………………………….8
E.
PROGRESS FFY 2012 Goals and Objectives ………………………….……………10
F.
FFY 2013 Goals and Objectives……………………………………………………………45
A.
INTRODUCTION
The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is implemented by the United
States Department of Agriculture (USDA-FNS) under public law 95-627, Section 17 of the Child Nutrition Act of 1966;
final regulations were issued January 2002. Funds for Food and Administrative costs are transferred from USDA – FNS
to the Connecticut Department of Public Health, Public Health Initiatives Branch, Community Health and Prevention
Section.
The State Plan for Connecticut’s Women, Infants and Children (WIC) Program is the governing document that provides
guidance and direction for the state and local agencies administering the program. In compliance with Federal
regulations and State regulations and requirements, the plan is updated annually to ensure the inclusion of new and
revised federal and state requirements, miscellaneous rules etc. Although the Plan is primarily based on Federal
regulations, it is includes requirements and guiding principles for best practices from the state perspective and that of
the nation’s public health framework.
Although the State WIC Plan references a single document, it has 3 major components. Part I of the plan contains the
State goals and objectives FFY2013 and the evaluation FFY2012. To the extent possible, the goals address the core
functional areas of the WIC Program. These functional areas are: management and organization, nutrition services and
breastfeeding support and promotion, food delivery and food instrument accountability, vendor management,
management information systems, caseload management and outreach, coordination of services, civil rights,
certification and eligibility, monitoring and QA, fiscal management and data quality, analysis and reporting. The goals
and objectives are State-specific and function as a guide for enhancing both State and local program operations
effectiveness and efficiency.
The remaining VENA Implementation Plan tasks are 90% completed. Those remaining tasks will be integrated into
relevant functional areas to ensure the sustainability of the VENA concept.
Approximately $52 million is allocated to CT WIC for Food and Administration and an additional $12 million rebated by
Mead Johnson Nutrition, through a cost savings measure as part of the infant formula rebate program.
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B.
MISSION STATEMENTS
DPH Mission:
To protect and improve the health and safety of the people of Connecticut by:
• Assuring the conditions in which people can be healthy;
• Promoting physical and mental health, and
• Preventing disease, injury, and disability.
DPH Vision Statement:
Healthy People in Healthy Connecticut Communities.
CHAPS Section Mission:
Community Health and Prevention section is a positive and productive section of the CT Department of Public Health
that creates and achieves optimal public health outcomes through strong, consistent, proactive and ethical leadership; a
positive and productive workplace environment; results-based accountability, and premier customer friendly service to
the public by valued employees through technical assistance, best-practice and research-based expertise, and clear and
accurate communication.
WIC Program Mission:
The Connecticut WIC Program is committed to improving the health of eligible pregnant women, new mothers, and
children by providing nutrition education, breastfeeding support, healthy foods, and referrals to health and social
programs during the critical stages of fetal and early childhood development. We do that by giving our most vulnerable
children the best possible start by providing optimal nutrition during the critical stages of fetal and early childhood
development phases.
Breastfeeding Statement:
The Connecticut WIC Program endorses the American Academy of Pediatrics' Policy Statement on “Breastfeeding and
the Use of Human Milk” (2005), which states, “Exclusive breastfeeding is the reference or normative model against
which all alternative feeding methods must be measured with regard to growth, health, development, and all other
short-and long-term outcomes.” Connecticut Special Supplemental Nutrition Program for Women, Infants and Children
(WIC) promotes exclusive breastfeeding as the normal infant feeding method through the first year of life and beyond,
with the addition of appropriate complementary foods when the infant is developmentally ready, usually around six
months of age. All WIC staff have a role in promoting and providing support for the successful initiation and
continuation of breastfeeding.
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C.
STATE AGENCY ORGANIZATION
Public Health Initiatives Branch
Community Health and Prevention Section
Special Supplemental Nutrition Program for
Woman, Infants and Children (WIC)
Administrative Organization Chart
John Frassinelli
State WIC Director
Vacant
Associate Accountant
Stacy Nelson
Secretary 1
Kimberly Boulette
Health Program Associate
Kevin Krusz
Health Program Assistant 2
Olga Jimenez
Processing Technician
Antonia DiGrazia
Marjorie Chambers
Nutrition Consultant 2
Carol Castro
Maureen Wojtczak
Marangelie Ortiz
Health Services Worker
Marilyn Lonczak
Steven Hotchkiss
Hea;th Program Assistant 1
Amanda Moore
Elsa Arce
Health Service Worker
Caroline Cooke
Barbara Quiros
Health Service Worker
Luis Maldonado
Office Assistant
INFORMATION
TECHNOLOGY
FINANCIAL
MANAGEMENT
(Operations Branch )
(Administrative Branch)
Thomas Young
Technical
Analyst 2
Daniel Fuller
Technical
Analyst 2
Kirk Whalley
Technical
Analyst 2
CHAPS EPI Unit
(PHI Branch)
Minerva Sisco
Fiscal
Administrative
Officer
Justin Peng
EPI - 4
Mary Funari
Associate
Accountant
Susan Hewes
EPI - 3
3
D. STATE
AGENCY ORGANIZATION
STAFF M EM B ER
P RI M ARY R ESP ONSI BI LI TES
John Frassinelli, MS, RD
State WIC Director
T: (860) 509-7836
F: (860) 509-8391
E-mail: [email protected]
Federal grants management
Contracts and budgets
WIC program policy
Program planning and evaluation
Program management & administration
Certification and eligibility
Nutrition Services
MIS & Fiscal units oversight
Amanda Moore, RD
T: (860) 509-8055
F: (860) 509-8391
Nutrition Services and Certification Reviews
Issue written reports/respond to corrective
action
Provide technical assistance
Update/provide input on Local Agency plan and
State Plan Polices
Marilyn Lonczak, MEd, RD
Special Projects
T: (860) 509-8261
F: (860) 509-8391
Breastfeeding Promotion and Support
State Plan
Local staff training and technical assistance
Ensure quality breastfeeding and nutrition
services
Nutrition Risk Criteria (back-up) on RISC
Caroline Cooke, RD, CLC
Nutrition Consultant I
T: (860) 509-7138
F: (860) 509-8391
Breastfeeding Promotion and Support
Breastfeeding councils and coalitions
Breastfeeding program planning and evaluation
Local staff training and technical assistance
Marjorie Chambers, MS, RD
Nutrition Services Monitor
T: (860) 509-8101
F: (860) 509-8391
Review Program Monitors written reports and
response to corrective action
Lead Liaison for Local WIC Agencies
Conduct grant management activities such as
the development of request for proposals (RFP)
Update/provide input on Local Agency plan and
State Plan Polices
Develop new food packages
Maureen Wojtczak, MS, RD
Nutrition Education Specialist
T: (860) 509-8091
F: (860) 509-8391
Nutrition Risk Criteria
LA Technical Assistance
Nutrition education
Formula issuance
Antonia DiGrazia, BA
Program Monitor
T: (860) 509-7684
F: (860) 509-8391
Management Evaluation Reviews
Caseload management
Complaints/customer service
Civil rights
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STATE AGENCY ORGANIZATION cont’d
Carol Castro
T: (860) 509-7187
F: (860) 509-8391
Web content
State Plan update
WIC Materials management
Contract liaison
Training Evaluation
Complaints/customer service
Special Formula Reconciliation
Marangelie Ortiz
T: (860) 509-8084
F: (860) 509-8391
Field work
Steven Hotchkiss
T: (860) 509-8084
F: (860) 509-8391
Vendor monitoring
Program services
Elsa Arce
T: (860) 509-7814
F: (860) 509-8391
Check reimbursements
Special Formula orders
Vendor Customer Service
Barbara Quiros
T: (860) 509-8084
F: (860) 509-8391
Field Work
Kimberly Boulette
Vendor Specialist
T: (860) 509-7845
F: (860) 509-8391
Food package implementation lead
Vendor compliance investigations
Development & maintenance of Food list
The Integrity Profile Report
Vendor Advisory Council lead
Administrative Review Process
Kevin Krusz
Vendor Monitor
T: (860) 509-8090
F: (860) 509-8391
Vendor Monitoring
Vendor training
Wholesale/Distributor liaison
Coordination of formula availability in stores
Mariano Ortiz
Vendor Monitor
T: (860) 509-8090
F: (860) 509-8391
Vendor Monitoring
Track review process
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Claudio Santoro
Vendor Monitor
T: (860) 509-8090
F: (860) 509-8391
Vendor Monitoring
Above 50% store determinations/reporting
Inventory Audits
Follow up on lost and stolen checks
Olga Jimenez
Processing Technician
T: (860) 509-8072
F: (860) 509-8391
Vendor application processing
Price Stock Survey updates
Vendor correspondence/notification
Susan Hewes
Epidemiologist
T: (860) 509-7795
F: (860) 509-8391
Outcome objective analysis
Program Data analysis
Produce results for quarterly objectives
Internal/External data requests
Stacy Nelson
Secretary
T: (860) 509-7841
F: (860) 509-8391
State staff support
Customer Service
Order and maintain supplies
Timekeeper
Meeting minutes
Luis Maldonado
Office Assistant
T: (860) 509-7755
F: (860) 509-8391
Purchase requisitions
Price Stock Survey
Clerical Support
Thomas Young
Technical Analyst
T: (860) 509-7841
F: (860) 509-8391
Systems development lead
SWIS maintenance and enhancements
Local Agency technical support
SWIS data requests
Daniel Fuller
Technical Analyst
T: (860) 509-7841
F: (860) 509-8391
Help Desk/Technical Support
Equipment Prep/Deployment/Inventory
Hardware Maintenance/SWIS update
Hardware/Software Purchase
Kirk Whalley
Technical Analyst
T: (860) 509-7841
F: (860) 509-8391
Mainframe Lead:
Development & maintenance
Cost containment & monitoring
Security & Disaster recovery
FoxPro developer backup
Help Desk
6
Mary K. Funari
Associate Accountant
T: (860) 509-7763
F: (860) 509-7227
Financial Management of WIC grant
Food Cost Estimation
Review and monitor funding levels
Organize and maintain Budget
Project expenditures for budgets and reporting
purposes
Work with other agencies to ensure accuracy of
our transactions
Work with auditors and program to ensure
information reported is correct
Monthly 798 report for USDA
Reconcile bank and treasurer accounts
Monitor Local Agency cash flow and
disbursements
Monitor Local Agency expenses for accuracy and
compliance
Minerva Sisco
Fiscal Administrative Officer
T: (860) 509-7713
F: (860) 509-8391
Bank reconciliation & Treasury Report
Beechnut & Mead Johnson rebates
Local agencies and Breastfeeding
EBT report 425
7
D.
Local Agency Organization
LOCAL AGEN CY
P ROGRAM
COOR DI NATOR
P ROGRAM
NUTRI TI ONI ST
The Access Agency, Inc. WIC Program
1315 Main Street, Suite 2
Willimantic, CT 06226
(860) 450-7405
[email protected]
Karen Lechene
Patricia Gaenzler
Optimus Health Care Bridgeport WIC
Program
1450 Barnum Avenue
Bridgeport, CT 06610
(203) 333-9200
[email protected]
Bristol Hospital WIC Program
9 Prospect Street
Bristol, CT 06010
(860) 585-3280
[email protected]
Verletha Santiago
Marla Cofrancesco
Melissa Dickau
Pamela Beaulieu
Danbury Health Department WIC
Program
13 Main Street
Danbury, CT 06810
(203) 797-4629
[email protected]
Patricia Mascoli
Ann Marie Evans
East Hartford Health Department WIC
Program
754 Main Street
East Hartford, CT 06108
(860) 291-7323
[email protected]
Family Strides, Inc. WIC Program
350 Main Street, Suite C
Torrington, CT 06790
(860) 489-1138
[email protected]
Kathy Minicucci
Bina Patel
Nicole Laracuente (Acting)
Kristen Vilardi
Hartford Health Department WIC
Program
131 Coventry Street
Hartford, CT 06112
(860) 757-4780
[email protected]
Devone Edwards
Danielle Smiley
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Local Agency Organization cont’d
Meriden Health Department WIC Program
165 Miller Street
Meriden, CT 06450
(203) 630-4245
[email protected]
Patricia Sullivan
Shelley Carpenter
New Haven WIC Program
Hospital of Saint Raphael
1401 Chapel Street
New Haven, CT 06511
(203) 789-3563
[email protected]
Mary Chervenak
Jennifer Gemmell
Stamford Health Department WIC
Program
888 Washington Boulevard
Stamford, CT 06904
(203) 977-4385
[email protected]
Rona Marotta
Gloria Kelley
Thames Valley Council for Community
Action (TVCCA) WIC Program
83 Huntington Street
New London, CT 06320
(860) 425-6620
[email protected]
Sarah Drake
Amy Botello
Waterbury Health Department
WIC Program
1 Jefferson Square, 1st Floor
Waterbury, CT 06706
(203) 574-6785
[email protected]
Kara Vendetti
Michael Dessalines
9
PROGRESS ON
FFY 2012
GOALS AND
OBJECTIVES
Program Functional Area 1: Management and Organization
Goal 1: Ensure program integrity, cost-effectiveness, quality of services and accountability in the delivery of nutrition services in the
provision of food benefits.
Objective 1.1: Implement a Memorandum of Understanding (MOU) with the State Department of Social Services (DSS) and
Medicaid/Managed Care Providers to provide cross referrals and seamless and consistent services to WIC clients.
Objective 1.2: Implement a Memorandum of Understanding (MOU) with the State Department of Children and Families (DCF) that
addresses sharing of information between agencies.
Objective 1.3: Refine and modify the CT WIC Annual Report by March 30, 2012.
Objective 1.4: Provide a 1-2 day leadership and management workshop for LA Coordinators/Program Nutritionists/SA staff.
Objective 1.5: Review, update and enhance WIC Continuity of Operations/Disaster Preparedness Plan
Objective
1.1
Implement a Memorandum
of Understanding (MOU)
with the State Department
of Social Services (DSS) and
Medicaid/Managed Care
Providers to provide cross
referrals and seamless and
consistent services to WIC
clients.
Strategies/Activities
Develop priorities and strategize multi-prong
approach regarding WIC business case.
• Attend face-to-face meetings.
• Identify specific liaisons from Connecticut’s
Medicaid Program HUSKY and WIC
• Develop a customized information packet.
• Identify best practice collaborations at local
agencies
• Evaluate cross referral process and
1.2
Implement a Memorandum
of Understanding (MOU)
with the State Department
of Children and Families
(DCF) that addresses
sharing of information
between agencies.
• Establish workgroup of agency representatives.
• Develop an understanding of each agency’s
requirements.
• Develop MOU language and execute the
agreements.
• Provide training to State and local agency
staff.
Baseline
N/A
Indicators
Executed MOU and
evidence of enhanced cross
referral between WIC and
HUSKY
Progress
An amendment to the
Department’s standing MOU
with DSS has been transmitted
to DSS liaison, appending WIC’s
request for Medicaid data to
help facilitate the cross-referral
of clients for co-enrollment.
Currently pending DSS
response.
Study carried out linking birthMedicaid-WIC records to determine baseline co-enrollment;
results presented to colleagues,
Local Agency staff and the Department’s Commissioners.
N/A
Executed MOU
Local and State Agency
understanding of
procedures
In process. Management staff
continues to meet with DCF to
clarify language for MOU. In FY
2013, necessary training and
technical assistance will be
provided to the local agencies.
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1.3
Refine and modify the CT
WIC Annual Report by
March 30, 2012.
Coordinate end of the year reports with local
agency outcomes measures for FFY2011
• Report enhanced data on statewide
measures
• Share human interest stories highlighting
how WIC benefits participants
• Incorporate operational information on WIC
to outside entities
• Produce, distribute & post on WIC website.
N/A
Annual report is published
and distributed.
Not accomplished. Due to
shifts in program priorities
based on funding levels, this
report was not a focus of State
staff this year. However,
moving forward we recognize
that a summary of WIC’s
contributions and
accomplishments will be very
important to justify and secure
limited Federal funds. Overall,
the report format and data
tables are in process. Data for
the program’s 5 process &
outcome objectives has been
analyzed and graphed;
corresponding narrative
sections are partially drafted.
1.4
Provide a 1-2 day leadership and management
workshop for Local Agency
Coordinators/Program
Nutritionists/SA staff.
Secure facilitator, date, content and location
(retreat location).
• By end of 2nd quarter, develop and finalize
contract
• Attend logistics meetings.
• Conduct meeting.
• Evaluate and plan for future/ongoing
training.
N/A
Workshop offered.
Evaluation drives
improvements in program
operations
Due to the reduced budget, this
meeting was not accomplished.
However, provided updates at
Program Coordinators’ meetings
on Local agency plan and
Developed framework for local
agency technical assistanceSee Functional Area 2 for
details. As funds become
available, plan follow-up
retreat.
1.5
Review, update and
enhance WIC Continuity of
Operations/Disaster
Preparedness Plan.
Review and incorporate CT DPH COOP plan
N/A
Updated Plan
Not accomplished. Will move
this objective to 2013.
Incorporate Disaster Preparedness Data
Recovery (DPH IT) Plan components
Provide training to State and Local Agency
staff
11
Program Functional Area 2: Nutrition Services and Breastfeeding Support & Promotion
Goal 2: Improve the nutritional and overall health of WIC families in Connecticut and to increase the proportion of WIC-enrolled
infants who are breastfed exclusively for at least 6 months.
Objective: 2.1 At least 70% of pregnant women participating in the WIC Program for a minimum of 6 months gain appropriate weight.
Objective: 2.2 The incidence of low birth weight (LBW) among infants whose mothers were on the WIC Program for at least six months
during pregnancy does not exceed 6%.
Objective: 2.3 The prevalence of anemia among children enrolled in the WIC Program for at least one year does not exceed 7.5%.
Objective: 2.4 a. The prevalence rate of BMI > 85th percentile to < 95th percentile for children 2-5 years does not exceed 15%.
b. The prevalence rate of BMI > 95th percentile for children 2-5 years of age does not exceed 25%.
Objective: 2.5 At least 60% of infants enrolled in the WIC Program initiate breastfeeding.
Objective: 2.6 At least 25% of infants enrolled in the WIC Program breastfeed for 6 months or more.
Objective: 2.7 Increase percentage of blood work results obtained and recorded in SWIS for postpartum women (result of deficient PC
2010 data findings)
Objective: 2.8 Conduct a workshop for local agencies on development of core nutrition education lesson plans by September 30, 2012.
Objective
2.1
At least 70% of pregnant
women participating in
the WIC Program for a
minimum of 6 months
gain appropriate weight.
Continue to monitor trends
and assess local agency staff
skills in identifying women at
risk for poor weight gain
during pregnancy, and the
effectiveness of education
efforts on:
• Weight gain during pregnancy
• Nutrition during pregnancy
• Smoking, ETOH/drug dangers
• Referrals
Expert speaker on domestic
violence to speak at
Statewide meeting. Develop
content sheet specific to
weight gain during
pregnancy. Continue to
monitor remaining local
agencies for implementation
of revised IOM pregnancy
weight gain guidelines
(NRC#10)
Baseline
2012 WIC Goal: ≥70%
FFY 2007: 66.9%
Range: 56.2% - 82.4%
FFY 2008: 65.7%
Range: 57.3% - 78.4%
FFY 2009: 67.2%
Range: 57.9% - 76.5%
FFY 2010: 66.4%
Range: 42.3% - 81.3%
FFY 2011: 68.8%
Range: 59.0% - 81.1%
FFY 2012: 72.2%*
Range: 48.9% - 85.4%
(* 9-month average)
Source: CT SWIS, Outcome
Objective #1 – Weight Gain
during Pregnancy; quarterly
reports, by federal fiscal year
Indicators
SWIS quarterly and
annual reports.
Referral & counter-referral
reports.
Results of monitoring
show local agencies are
using effective
educational methods and
appropriate education
materials.
Change in trend data over
time for low performing
agencies.
Progress
Chart audits and observations during
monitoring (4 agencies) indicate that
approximately 85% of local agency staff
adequately addressed weight gain during
pregnancy during education of pregnant
clients. In process. Potential speaker to
meet with state staff in FY 2012 to discuss
content.
Guidance document planned to be
completed by September 30. Identified
specific educational materials and/or
lesson plans may be limited, depending
on funding or availability of revised Tips
for Pregnancy/My Plate are available. The
four (4) agencies monitored to date;
Optimus, Hartford, East Hartford and New
Haven have implemented the revised IOM
pregnancy weight gain guidelines.
Accomplished. All local agency plans
were reviewed by state staff and feedback
provided to the agencies.
12
Con’t
2.1
minimum of 6 months
Review action steps of all
local agency plans on
maternal weight gain.
Developed framework for local agency
technical assistance. Attached to State
Plan submission. Each Nutrition Unit staff
member without monitoring duties will be
assigned to 3 local agencies as a Local
Agency Liaison. These staff are
responsible for following up on ME
findings, CAP, LAP development and areas
of low performance. Initial technical
assistance visits to be completed by
September 30, 2012.
• FFY 2012 Target: ≥ 70%
• Statewide average (based on 9-mos of
FY data): 72.2% (R = 48.9% - 85.4%)
• Identify lowest performers: objective
met.
- Waterbury/Naugatuck: 66.0%
- Hartford: 67.3%
- New Haven: 68.3%
• Identify best performers: objective met.
- Norwich/New London: 80.8%
- Danbury: 77.6%
- Torrington: 77.4%
to the two (2) lowest
performing local agencies
identified for this objective.
See Functional Area 12, Data
Quality, Analysis and
Reporting for information on
these activities.
2.2
The incidence of low birth
weight (LBW) among
infants whose mothers
were on the WIC Program
for at least six months
during pregnancy does
not exceed 6%.
Continue to monitor trends
and improve weight gain
during pregnancy. During
observations monitor for
nutritionist identification and
discussion of contributing
factors for this risk
• History of LBW or pre-term
delivery;
• Mother’s age, etc.
Review action steps of all
local agency plans for LBW.
to the two (2) lowest
performing agencies for this
objective. See Functional Area
12, Data Quality, Analysis and
these activities.
2012 WIC Goal: ≤ 6%
FFY 2007: 5.9%
Range: 1.5% - 9.4%
FFY 2008: 5.9%
Range: 3.6% - 9.5%
FFY 2009: 5.8%
Range: 2.6% - 9.1%
FFY 2010: 5.8%
Range: 1.8% - 10.0%
FFY 2011: 6.1%
Range: 3.5% - 8.5%
FFY 2012: 6.0%*
Range: 2.1% - 8.7%
(* 9-month average)
Objective #2 – LBW Incidence; quarterly reports, by
federal fiscal year.
SWIS quarterly and
annual reports
Reduce health disparities.
using effective
materials.
agencies.
During observations, 90% of Nutritionists
identify and discuss the contributing
factors for LBW with clients.
Accomplished. All local agency plans
were reviewed by state staff and feedback
provided to the agencies.
• FFY 2012 Target: ≤ 6.0%
FY data): 6.0% (R = 2.1% - 8.7%)
met.
- Windham/Putnam: 7.4%
- New Haven: 7.1%
- Danbury: 3.6%
- Torrington: 3.7%
- Meriden/Middletown: 4.0%
13
2.3
The prevalence of anemia
among children enrolled
in the WIC Program for at
least one year does not
exceed 7.5%.
Monitor trends and assess
local agency staff skills in
identifying children at risk for
anemia and effectiveness of
education efforts on:
• Iron-rich food sources,
explanation of anemia/
risks, importance of timely
blood work, appropriate
iron supplementation and
low-iron’s connection with
risk for lead poisoning.
• Making appropriate
referrals and follow-up.
Monitor for local agency
incorporation of anemia
content sheet messages into
individual education sessions
2.4
a. The prevalence of BMI
> 85%ile to < 95%ile
for children 2-5 years
of age does not exceed
15%.
b. The prevalence of BMI
> 95%ile for children
2-5 years of age does
not exceed 25%.
Work with IT staff to
incorporate BMI as a new
quarterly outcome objective
for FFY 2012, and to generate
the needed data by local
agency, age group,
race/ethnicity and town of
residence.
incorporation of content
sheets targeted to prevent
obesity- fruit and vegetable
intake, physical activity and
introduction to solids
IT and Epi specific activities
related to this objective.
2012 WIC Goal: ≤ 7.5%
FFY 2007: 8.1%
Range:
2.7% - 12.5%
FFY 2008: 7.9%
Range:
3.4% - 10.4%
FFY 2009: 7.6%
Range:
3.9% - 10.5%
FFY 2010: 6.8%
Range:
2.4% - 10.6%
FFY 2011: 6.8%
Range:
4.1% - 8.8%
FFY 2012: 7.7%*
Range: 4.4% - 10.3%
SWIS quarterly and
annual reports
using effective
materials
agencies
(* 9-month average)
Objective #4 – Anemia Rate;
quarterly reports, by federal
fiscal year.
WIC 2012 Goal: N/A
CT WIC Program Data:
BMI ≥ 85 & < 95%ile:
FFY 2007: 9.7%
Range:
9.2% - 10.2%
FFY 2008: 9.5%
Range:
9.1% - 9.8%
FFY 2009: 9.7%
Range:
9.5% - 10.0%
FFY 2010: 9.3%
Range:
9.0% - 9.5%
FFY 2011: 9.8%
Range:
9.4% - 10.1%
FFY 2012: 9.8% *
Range:
9.6% - 10.0%
During observations, 90% Nutritionists
are using effective education methods and
appropriate educational materials.
• FFY 2012 Target: ≤ 7.5%
FY data): 7.7% (R = 4.4% - 10.3%)
met.
- Hartford: 9.9%
& Bridgeport: 9.4%
- Bristol/New Britain: 8.4%
& Meriden/Middletown: 8.4%
- Danbury: 5.7%
& New Haven: 5.7%
- Torrington: 6.1%
SWIS quarterly and
annual reports
See Certification Section for information
on updated Nutrition Risk criteria.
Childhood BMI or obesity
Outcome Objective is
included in FY 2013 State
Plan.
Accomplished. SWIS quarterly report will
be generated beginning October 1, 2012.
Included revised overweight and obesity
targets into Local Agency Plan
performance standards and nutrition
outcome objectives.
(* 7-month average)
BMI ≥ 95%ile:
FFY 2011: 11.0%
Range:
10.6% - 11.4%
FFY 2012: 10.93% *
Range:
10.8% - 11.0%
(* 7-month average)
CDC/PedNSS Data:
BMI:
85<95
CY 1985: 11.0%
≥95
6.7%
14
Con’t
2.4
15%.
CY
CY
CY
CY
CY
CY
CY
CY
CY
CY
not exceed 25%.
2.5
At least 60% of infants
enrolled in the WIC
Program initiate
breastfeeding.
1990:
1995:
2000:
2005:
2006:
2007:
2008:
2009:
2010:
2011:
14.5%
15.0%
17.9%
16.3%
16.5%
16.0%
15.7%
15.4%
14.9%
15.3%
11.0%
13.2%
16.6%
16.6%
16.2%
16.2%
15.5%
16.0%
15.8%
15.9%
Source: CDC, Pediatric
Nutrition Surveillance System. Connecticut (calendar
year); Table 12C.
Coordinate statewide WIC
breastfeeding promotion and
support activities. WIC BF Committee meeting and
activities.
- Meet quarterly in person
and/or via conference call
- Using LS Grow and Glow
curriculum, develop consistent
content for breastfeeding
group education.
-Revise, as needed Connecticut
Breastfeeding Guidelines,
provide training to local staff
and incorporate updates into
State Plan-Provide technical
assistance to LAs in
implementing WIC BF
guidelines and annual BF
promotion plans.
- Conduct three (3)
breastfeeding focused site
reviews in FY 2012. (Schedule
reviews by end of first
quarter)
-Continue to monitor
implementation of four (4)
breastfeeding content sheets.
WIC 2012 Goal: ≥ 60%
FFY 2006: 57.2%
Range: 43.5% - 88.4%
FFY 2007: 59.1%
Range: 45.0% - 87.6%
FFY 2008: 61.3%
Range: 49.3% - 89.0%
FFY 2009: 63.7%
Range: 52.1% - 88.9%
FFY 2010: 65.8%
Range: 53.9% - 91.2%
FFY 2011: 65.0%
Range: 49.8% - 88.4%
FFY 2012: 68.7%*
Range: 48.5% - 91.4%
(* 9-month average)
Objective #3a – BF Initiation
Rate; quarterly reports by
federal fiscal year.
Documentation of
improved compliance with
guidelines per technical
assistance reviews and
monitoring reports. More
than half of agencies
visited will meet or exceed
performance standards.
Record of meetings and
joint tasks or activities
accomplished from CBC,
CT Chapter of the
American Academy of
Pediatrics (CT-AAP) and
other groups.
Completed 3 BF coordinator meetingsOctober, January and April. Last 2012
meeting scheduled for July. Agendas
attached. Revised Food Package section
of CT Breastfeeding Guidelines to focus on
appropriate formula supplementation for
mom who both BF and give formula.
Reviewed tips to incorporated
Breastfeeding: You Can Do it! DVD in
group and individual education. Focus on
FAQ section and facilitated discussion.
Completed 7 BF technical assistance
reviews- Waterbury and Bristol, New
Haven WIC = St. Raphael’s, Yale New
Haven, Hill Health Center sites, East
Hartford and Hartford. Additional TA Visits
planned for Fair Haven site on 7-18-12
Meriden on 7-20-12 and Torrington in
August. Staff use of BF content sheets
monitored during TA visits. Provided
several sites with suggestions for staff
self-directed learning and enrichment.
Main areas for improvement in those local
agencies reviewed are staff education and
learning environment.
• FFY 2012 Target: ≥ 60%
FY data): 68.7% (R = 48.5% - 91.4%)
met.
- Torrington: 53.2%
15
Con’t
2.5
enrolled in the WIC
Program initiate
breastfeeding.
2.6
enrolled in the WIC
Program breastfeed for 6
months or more.
Manage WIC Breastfeeding
Peer Counseling Programs.
• Monitor performance of
Hartford and New Haven
programs. Submit reports
to USDA.
• Continue to implement
pilots and refine protocols.
-Begin to analyze data for
pilot sites.
Follow-up on implementation
of USDA’s Loving Support:
Building Breastfeeding
Competencies initiative.
• Incorporate portions of the
Grow & Glow modules into
bi-annual State
orientations.
Follow-up on sustainability of
Connecticut Breastfeeding
Initiative with DPH partners.
Provide support as needed to
NAPO.
Coordinate at least one (1)
Breastfeeding-focused CTAAP teleconference in FY
2012.
Actively participate in the CT
Breastfeeding Coalition (CBC).
With Epi and IT Units, review
calculation of breastfeeding
duration, and make any
necessary adjustments.
WIC 2012 Goal: N/A
HP 2010 Goal: 25%
WIC Program Data:
FFY 2006: 7.0%
Range: 0.2% - 22.7%
FFY 2007: 7.8%
Range: 0.5% - 18.9%
FFY 2008: 8.0%
Range: 2.9% - 16.0%
FFY 2009: 9.4%
Range: 2.8% - 15.7%
FFY 2010: 7.0%
Range: 1.1% - 17.2%
FFY 2011: .%
Range: .% - .%
FFY 2012: .%
Range: .% - .%
Objective #3b - BF Duration;
quarterly reports, by federal
fiscal year.
CDC/PedNSS Data:
By Calendar Year:
CY 1985: 7.2%
CY 1990: 8.3%
CY 1995: 11.3%
CY 2000: 15.8%
CY 2002: 23.8%
CY 2004: 22.9%
CY 2006: 24.6%
CY 2008: 24.4%
CY 2010: 27.0%
By Race/Eth. & Year:
Hispanic, by Year
CY 2001: 24.6%
CY 2003: 26.6%
CY 2005: 26.1%
CY 2007: 27.6%
CY 2009: 29.9%
CY 2010: 29.4%
NH Black, by Year
CDC’s Pediatric Nutrition
Surveillance System
(PedNSS) reports
[Connecticut reports are derived
entirely from CT’s Statewide WIC
Information System – SWIS].
technical assistance
provided to local
agencies, local agency BF
coordinators and CT
Breastfeeding Coalition
Quarterly activity and
expenditure reports from
contractors, including # of
women enrolled and
duration rates.
- Hartford: 53.4%
- Bristol/New Britain: 63.1%
- Danbury: 90.0%
- Stamford/Norwalk: 78.5%
- New Haven: 74.4%
Performance of Hispanic Health Council
(HHC) and Yale New Haven Hospital
(YNHH) Breastfeeding Heritage and Pride
(BHP) programs are tracked quarterly.
Contract extension for YNHH program is
at AG’s office. Revisions to WIC Clinic Peer
Counseling Pilot forms and protocols are
in process. Contract with consultant to
organize and analyze available data from
pilot sites. Peer Counselor training update
held on 10-27-12 for 3 peers. Planned
and facilitated monthly training
conference calls for 3 pilot sites and
peers. Breastfeeding portion of bi-annual
WIC Program Orientation revised 2011.
Additional revisions to include facilitated
discussion to model technique to new
staff to be incorporated by August 2012.
Attached presentation. Reviewed and
provided extensive comments on CBI
evaluation report from Professional Data
Analysts Inc., (PDA). Provided information
on CBI project as requested by Centers
for Disease, Control and Prevention (CDC)
to assist in the development of the BestFed beginnings project by NICHQ. Plan to
submit manuscript on CBI to American
Journal of Public Health for publication.
CT-AAP/DPH joint teleconference
scheduled for 4-24-12 Pediatricians’ Role
in the BFHI. Secured speaker and
consulted on announcement and learning
objectives. Will assist physicians in CT in
getting 1 hour of required education as
for BFHI designation.
Board member of CBC. Attend quarterly
meetings. Legislation for postponement of
16
Con’t
2.6
enrolled in the WIC
Program breastfeed for 6
months or more.
2.7
Increase percentage of
bloodwork results
obtained and recorded in
SWIS for postpartum
women (result of
deficient PC 2010 data
findings).
2.8
Conduct workshop for
local agencies on
development of core
nutrition education lesson
plans by September 30,
2012.
IT and Epi specific activities
related to this objective.
CY
CY
CY
CY
CY
CY
2001:
2003:
2005:
2007:
2009:
2010:
23.1%
20.5%
17.8%
21.7%
23.6%
25.5%
CY
CY
CY
CY
CY
CY
2001:
2003:
2005:
2007:
2009:
2010:
20.2%
18.1%
21.7%
19.5%
23.1%
23.1%
Jury duty for breastfeeding mothers
passed. Link to law: Contributed to
development of DPH Nursing Mothers’
Policy, employee orientation packet and
supervisory training materials. Joint
venture with AAO and HR.
NH White, by Year
Source: CDC, Pediatric
Nutrition Surveillance System. Connecticut, 2010
(calendar year); Table 13C.
Continue to identify local
agency with issues obtaining
current bloodwork for
postpartum participants.
Develop solutions to improve
access for postpartum women
to obtain bloodwork. Monitor
10 additional postpartum files
targeting bloodwork data.
Using nutrition education
guidance content sheets
developed in 2011, plan and
present Statewide workshop
for local agency nutrition staff
on development of core
plans. After workshop, state
staff will review draft lesson
plans from each workgroup
and finalize for statewide use.
Concurrently, local agencies
will determine which of the 5
core lesson plans they will use
and how they will implement
in their agencies by Sept. 30,
2012.
PC error reports data?
PC 2012 Data,
Surveillance System
(PedNSS) reports
Chart audit results
In the four (4) agencies monitored, blood
work was documented in 97% of the
post-partum charts audited.
FY 2011 nutrition
education guidance
content sheets
• Anemia
• Smoking and
pregnancy
• Introduction to
solids
• Vegetable and fruit
consumption
• Physical activity
Local agency plans and
objectives.
Five (5) core lesson plans
are developed and
finalized. Local agencies
implement at least one
(1) core lesson plan in
nutrition services
provision in FY 2012.
Accomplished. Workshop provided to all
nutritionists on March 9, 2012 and draft
nutrition education lesson plans
developed. In process, plans for final
drafts by June 30, 2012. Partially
accomplished. A mandatory nutrition
objective specific to nutrition education
lesson plans was added for fiscal year
2012 for all local agencies. A follow up
status report will be requested of all
agencies to be submitted to the State WIC
Office before the end of the fiscal year as
part of their local agency plan progress
report.
17
Program Functional Area 3: FOOD DELIVERY AND FOOD INSTRUMENT ACCOUNTABILITY
Goal 3: To improve food delivery operations at the state and local agency level.
Objective:
Objective:
Objective:
Objective:
3.1
3.2
3.3
3.4
Increase to 90% timely local agency submission of unused check stock inventory reports.
Decrease the number of rejected checks for selected rejection reasons by 10%.
Make changes to food packages and eligible foods in response to Final Rule for Revisions in the WIC Food Packages.
Improve access to special formulas at retail stores.
Objective
3.1
Increase to 90%
timely local agency
submission of
unused check
stock inventory
reports.
An e-mail reminder will be sent to the
LAs if the report is not received by the
middle of the month. A telephone call
reminder will be made to Las if the
report is not received by the last week
of the month.
Non-compliant local agencies will
continue to be cited and monitored for
future compliance during
management evaluations.
Baseline
Currently an average of
87% compliance
Indicators
Compliance of local agency
reports. Decreased finding of
non-compliance in
management evaluation
reports.
N/A
Monitoring report findings.
Results of the unused check
stock inventory report
spreadsheet.
3.2
Decrease the
number of rejected
checks for selected
rejection reasons
by 10%.
Provide written policy to LAs on
handling voided in-hand checks and
the immediate detection of misnumbered checks that lead to
rejections. Follow up on agencies
based on reports.
586 rejected checks
due to distribution of
checks that were
voided-in-hand or misnumbered
Reduction in the number of
checks rejected due to misnumbering and checks
voided-in-hand, but
distributed to participants.
Try to amend the Banking Services
contract to allow vendors to place the
vendor stamp in the endorsement
area of the back of the WIC check as
well as the required placement on the
front of the check.
5384 rejected checks
due to illegible vendor
stamp
checks rejected due to the
bank’s inability to read the
stamped vendor numbers.
Store implementation of new
endorsement rule.
Progress
The average % compliance for
the first 5 months of the FY is
89%. The average %
compliance for the last 3
completed months of the FY is
92%.
Accomplished. During FFY2012
all local agencies were in
compliance with this mandate.
A numbered memo to provide
written policy to LAs will be
completed and distributed
during Q3 2012.
Vendor bulletin was sent in
November 2011 as to how
stores can prevent rejected
checks.
Request was made in Q1 for
Office of the Treasurer to
reword banking contract to
include this language, but as of
7/25/12, the RFP has not been
released.
18
3.3
Make changes to
food packages and
eligible foods in
response to Final
Rule for Revisions
in the WIC Food
Packages.
Changes to food list, minimum
inventory, pricing and monitoring
reports will be needed. Review the
influx of submissions from
manufacturers and distributors on
product nutrition labels, statewide
availability and retail costs
Revise the CT WIC approved food list,
the maximum monthly quantities in
food packages and forms to be used
in food delivery at the local agency
(e.g. medical documentation). Secure
and adapt education materials.
If needed, finalize the vendor and
farmer agreements to update the
minimum inventory requirements and
the procedures for processing the fruit
& vegetable check.
If needed, provide bulletin for training
on new regulations or procedures
Final rule expected in
December 2011.
Emails and information
submitted to the State WIC
Office for approval in
Connecticut.
As of 7/25/12, Final rule has not
been released, so any necessary
changes are unknown and
project is delayed.
2nd Quarter of FY12
New Food List is printed.
project is delayed.
2nd Quarter of FY12
New Agreements are printed
and executed.
project is delayed.
2nd Quarter of FY12
Bulletins sent to all WIC
authorized vendors and
farmers.
project is delayed.
If needed, communicate necessary
SWIS changes in food packages to IT
2nd Quarter of FY12
Changes have been tested.
project is delayed.
If needed, provide updates to local
agencies regarding any new policies,
educational materials, and changes to
the usage of the fruit & vegetable
check.
If needed, notify wholesale
distributors of updates to food
packages, new food items, and
minimum inventory requirements.
Issuance of all CT WIC checks
reflecting full implementation of the
new food package changes for all
categories of WIC participants.
2nd Quarter of FY12
Numbered memo sent.
project is delayed.
2nd Quarter of FY12
Mailing list.
2nd Quarter of FY12
Issued check files.
project is delayed.
project is delayed.
New peer group maximums
are sent to the bank.
19
3.4
Improve access to
special formulas at
retail stores.
Develop a document utilizing our
spreadsheet of all CT WIC-approved
formulas and medical foods for
participant/local agencies to order
formula at authorized WIC vendor
locations.
1st Quarter of FY12
Facilitate WIC participants’
obtaining products that are
printed on their WIC checks
in a timely manner.
Distribute document to local agencies
for participant use, as well as
authorized vendors and their
corporate offices.
Include the document in printed
annual training materials and
interactive training presentations.
1st Quarter of FY12
Vendors are able to better
serve WIC customers
needing formulas and
medical foods.
Make vendors aware that the
tool exists to help serve WIC
customers’ needs.
2nd – 4th Quarters of
FY12
Document needs major
revisions due to recent changes
in formula names and package
sizes. Ordering codes are
needed from formula
distributors. Postponed to
2013.
Postponed to 2013.
Postponed to 2013.
20
Program Functional Area 4: Vendor Management
Goal 4: To improve communication and effectiveness in Vendor Management.
Objective:
Objective:
Objective:
Objective:
Objective:
4.1
4.2
4.3
4.4
4.5
Enhance the WIC website and email usage to provide important vendor-related information.
Implement a pilot for open enrollment of stores to become WIC authorized vendors.
Increase from 10% to 50% the number of compliance investigations that are initiated and completed within FY 2012.
Utilize a Microsoft Access database to improve the tracking of application/authorization processes.
Investigate and determine the process for changing State Regulations.
Objective
4.1
Enhance the WIC
website and email
usage to provide
important vendorrelated information.
Maintain links to federal
regulations, vendor authorization
process, vendor agreement and a
monthly list of currently
authorized vendors and farmers’
markets.
Baseline
2011 information
Indicators
Changes are needed for
updated information.
Progress
Link to federal regulations has been
maintained, WIC Vendor Agreement
and updated food list was posted in
Q1. Website utilized for open
enrollment in Q2 and email system
utilized for responses to open
enrollment make up training.
Website wording updated and the
authorized vendor list is posted
monthly. Pending: update map of
Local Agency sites on website,
following conclusion of RFP process
& award of new contracts. Add &
maintain map locating currently
authorized vendors.
Include our email address on all
correspondence to vendors to
encourage submission of
information and questions to the
program.
10% of vendors in
FY11
An increase in the number of
emails received from vendors.
Email system being utilized for
notification of open enrollment
opportunity, price updates from
WIC vendors, requests for
additional food lists and authorized
vendor list.
Monitor vendors’ usage of email
as a first point of contact and
notify vendors of the need for
each vendor ownership, to have
an email address by October 1,
2012.
Currently only
prospective
vendors are using
email to respond to
needs assessment
postings because
it’s required.
Increased utilization of the
website by vendors to obtain
relevant information.
Reduction in calls for
information that is provided
on the website.
Majority of vendors are still calling
WIC staff with questions, however
food lists and the list of authorized
vendors has been requested
electronically. Communication on
WIC requiring an email address is
planned for August of Q4.
21
Con’t
4.1
Enhance the WIC
website and email
usage to provide
important vendorrelated information.
4.2
Implement a pilot for
open enrollment of
stores to become WIC
authorized vendors.
Utilize distribution list of vendors’
email addresses to improve
communications and encourage
website usage.
Only used email for
communications
from the State WIC
Office to farmers in
FY10.
Increased communications to
vendors via email.
Evaluate effectiveness of the
website content and revise
according to the needs of both
the state and vendors, if deemed
appropriate for publication.
Website’s potential
is only partially
realized.
Updates to website
information based on vendor
feedback/questions.
Reduction in calls received for
routine information.
Increased number of state
staff referrals to the website
for information.
In January 2012, post on the
website, the statewide
opportunity for stores to apply to
become authorized to accept WIC
checks.
Periodic needs
assessments and
postings for specific
locations have been
used for the last 5
years.
Limiting the number of
authorized vendors has
caused a sense of unfairness
in the vendor community,
staff time has been consumed
with questions, and we have
not been able to authorize
large independently owned
supermarkets.
Utilized distribution list of past
potential applicants to inform
vendors of open enrollment
opportunity posted on website.
Continued usage of email
notifications to WIC Vendor
Advisory Council members
regarding vendor bulletins and Price
Stock Survey (PSS) due dates.
Notification of August PSS due date
and bulletins will be sent via email
using distribution list of authorized
vendors in Q4.
Referrals to the WIC Vendor
Agreement on website made in
response to callers’ questions.
Accomplished. Posting was made, 230
stores registered for training through
Survey Monkey indicating that they are
interested in applying for WIC
authorization and posting removed on
January 31st.
22
Con’t
4.2
Implement a pilot for
open enrollment of
stores to become WIC
authorized vendors.
4.3
Increase from 10% to
50% the number of
compliance investigations that are initiated
and completed within
FY 12.
In February 2012, training will be
conducted and applications will
be reviewed.
2nd quarter of
FY12
Review responses to posting and
supply applications to stores that
are eligible to apply.
In February and March, 12 training
sessions total were held in Bridgeport,
Waterbury, East Hartford, Norwich,
Windsor and Hamden in English and
Spanish. 185 stores attended and
were trained while WIC staff reviewed
all applications on site. 9 stores were
not trained because they did not have
an application package, 58 application
packages were incomplete and
returned to the stores, 127
application packages were complete
and accepted.
In March and early April 2012,
monitoring visits will be
conducted and determinations
made for the stores that will be
authorized.
Late 2nd and 3rd
quarter of FY12
The submission of a complete
application package and the
passing of an onsite monitoring
visit.
In late April and May, non-select
stores who do not meet all
selection criteria and provide
stamp and an executed
agreement to stores that may be
authorized.
3rd quarter of FY12
Check stores against all selection
criteria (application requirements
met, minimum inventory met,
etc.)
During the first quarter, select
stores to be investigated, have
contractor perform initial
compliance buys and DPH to
review compliance buy reports.
10%
As of October 1, 2011, 5% of
the authorized vendors are
investigated early in the fiscal
year.
Monitoring visits were conducted,
stamps were ordered and
authorizations occurred for stores that
met all selection criteria. As of
7/25/12, over 100 stores were
authorized.
Process was expected to be
completed by May 1st, but has been
delayed to May 30th. No action is
being taken on 5 stores due to not
submitting an application and 58
stores have received non selection
letters.
From the FY11 TIP report, 53 ongoing
investigations have been identified
that must be closed this year. Most
new investigations will be initiated in
FY13.
During the second quarter, send
sanction letters and confirm
receipt of notice of violations if
applicable.
N/A
Results of the compliance buy
that identifies if violations
occurred which may necessitate
a sanction letter.
Sanction letters were sent for
violations identified during compliance
buys done in FY11.
23
Con’t
4.3
50% the number of
compliance investigations that are initiated
and completed within
FY 12.
4.4
Utilize a Microsoft
Access database to
improve the tracking
of application/
authorization
processes.
During the third quarter, have
contractor perform follow up
compliance buys as needed.
N/A
Additional compliance buys
performed on vendors that
would have received warnings.
Compliance buys are being planned
for July for ongoing investigations, as
well as initial buys for newly opened
investigations on additional stores.
During the fourth quarter, send
additional sanction letters if
applicable.
N/A
At least 50% of investigations
are deemed to be complete.
It is expected that by August, half of
the ongoing investigations will be
closed with the rest being closed by
the end of the 4th quarter. Follow up
buys will be performed in Q4 and
sanction letters will be sent after
closing the investigations, along with
new buys that will carry over into
FY13.
Develop forms that feed data into
the Vendor Management
database.
Database is
developed and
currently in use as
a table only.
Standardized queries and reports
developed to meet VM staff
needs.
In January 2012, forms were
developed that link to the All Vendors
database to feed the Vendor
Management database to track
application status, monitoring visits
and stamp requisitions.
Obtain pertinent training for all
vendor management staff
Minimal knowledge
of and experience
with MS Access
software
“How-To” fact sheets and other
resources developed and shared
with Vendor Management staff.
Expansion of staff knowledge
base.
In Q1, the office assistant took Access
training and set up the database with
forms for data entry. In Q2,
monitoring staff were trained in how
to use them and additional staff is
being encouraged to attend Access
training currently being offered.
Query the database for vendors
included in each aspect of the
application process (e.g.
renewals, new stores under the
same ownership, stores in the
enrollment process, etc.).
Vendor application
information is in an
Excel documents.
Vendor database tracks and
reports out vendor management
activities by phase, and
increases the efficiency and
accuracy of the vendor
application, selection and
authorization process, from a
store’s initial request, through
training, and determination of
authorization.
The database was used in Q2 for
tracking open enrollment and multiple
stores under the same ownership
applications. Beginning in June, it
was utilized to track monitoring visits
for the renewal process of vendors
whose agreements are expiring at the
end of FY12.
24
Con’t
4.4
Utilize a Microsoft
Access database to
improve the tracking
of application/
authorization
processes.
4.5 Investigate and
determine the process
for changing State
Regulations.
Utilize queries to track progress
and determine if internal
deadlines will be met or need to
be adjusted.
Currently tracked
through multiple
Excel spreadsheets.
Increased efficiency in managing
yearly application/authorization
tasks.
Will be done in Q4 to assess if all
stores who meet the selection criteria
get authorized and non select those
stores who do not meet the criteria.
Utilize database to facilitate
updating information and
preparing the annual TIP report
(The Integrity Profile).
Currently tracked
through the Access
table and Excel
spreadsheets.
Decrease in time to complete the
TIP report.
Being used to determine newly
authorized stores since October 1,
2011 and information being entered
into the FY12 TIP report.
Review Federal Regulations and
current State regulations to
identify areas that are
inconsistent
Current state
regulations have
been in effect since
June 1998.
Vendor Management policies are
compliant with federal
regulations, but have changed
since state regulations were last
updated.
Not accomplished. Planned for FY
2013.
Identify and document the
expedited process for changing
certain regulations and determine
when it is (for what changes)
appropriate to use this process.
Explore the regular process for
changing regulations and
determine which required
changes can be completed using
this process.
2013.
2013.
25
Program Functional Area 5: Management Information Systems
Goal 5: To maintain and enhance the WIC IT infrastructure.
Objective:
Objective:
Objective:
Objective:
Objective:
Objective:
Objective:
Objective:
Objective
Objective:
5.1 Implement solutions or new technologies to address changes in USDA regulations and/or state policy.
5.2 Establish a structured approach to Release Management and Helpdesk Support
5.3 Establish a master schedule for all WIC IT projects
5.4 Continue the mainframe cost containment initiative.
5.5 Procure an MIS and EBT solution for Connecticut.
5.6 Move towards a self service reporting environment for regular WIC information needs
5.7 Prepare for data migration and conversion to new MIS
5.8 Repair or replace broken or outdated equipment as part of IT life cycle plan.
5.9 Increase staff knowledge and utilization of current IT languages, tools and techniques
5.10 Implement new technologies to enhance productivity or system security.
Objective
5.1
Implement solutions or
new technologies to
address changes in
USDA regulations
and/or state policy.
Re-program SWIS as required to
accommodate changes in
regulations and/or policy.
Deploy new technologies as
required by changes in USDA
and/or DoIT policies.
Baseline
NewSWIS version
1.61
Indicators
Progress
SWIS has been updated to support
new growth charts. Additional
updates have been made to ensure
system is always backed up locally
and at the state offices in the event
of a failure.
5.2
Establish a structured
approach to Release
Management and
Helpdesk Support.
Establish a formal process for
enhancements and helpdesk
support.
Enable web access to self service
helpdesk system.
No current
consistency
Process created and
followed
Increased use of TrackIt
Reduced administration
time for helpdesk staff.
Process has been created. An email
connection to TrackIt has been
implemented rather than require
users to learn this system.
5.3
Establish a master
schedule of all WIC IT
projects.
Create and maintain a master
schedule of IT activities.
All projects
independent
Master calendar created
and maintained.
Staffing and budget cuts have
deferred this initiative.
5.4
Continue the
mainframe cost
containment initiative.
Monitor various processes for
usage, printing, disk and tape
storage costs. Move certain
processes from mainframe to
server. Remove obsolete report
processes.
Mainframe costs
from prior year for
given month
Maintain MF cost in
report of MIS Cost
Survey Feb 2010.
Mainframe costs stayed static for this
year.
26
5.5
Procure an MIS and
EBT solution for
Connecticut.
5.6
Move towards a self
service reporting
environment for
regular WIC
information needs.
5.7
Prepare for data
migration and
conversion to new MIS.
5.8
Repair or replace
broken or outdated
equipment as part of IT
life cycle plan.
5.9
Increase staff
knowledge and
utilization of current
Programming
languages, tools and
techniques.
Complete BEST required
documents for system selection.
Complete IAPD.
Issue RFP.
Award RFP.
Identify standard reports for
automatic creation.
Look at intranet or report server
options for distribution.
Look at adhoc reporting
capabilities for common
requests.
Updating SWIS technical
documentation.
Create data dictionary.
Purging old data.
Data scrubbing.
Manual cleanup by Las.
Conversion strategy for phased
rollout.
Maintain operational status of IT
infrastructure by providing timely
service or replacement of
defective equipment.
Maintain inventory of IT
equipment and implement.
Replacement plans as dictated
by resources and budget.
Create upgrade/refresh schedule
for next 18 months.
Include professional
development as part of annual
review criteria.
Lunch and learn sessions to
share knowledge.
WIKI or sharepoint sites for all
system.
Feasibility Study and
related documents
BEST Approval.
USDA Approval.
RFPs Issued.
RFPS Awarded.
Budget cuts have delayed project.
Feasibility Studies and IAPD have
been completed. Currently awaiting
USDA approval.
As defined by CDC,
USDA, program
requirements and
epidemiologist work
Standard report list with
creation calendar.
Pilot intranet or report
server.
Pilot Adhoc reporting
capability.
Initiative was put on hold because of
budget cuts.
System documentation.
Data dictionary.
Old data purged.
Data scrubbed.
Conversion strategy
document.
Documentation has been started, but
not completed because of budget
cuts.
Current IT
infrastructure
LAs are able to provide
adequate services to
participants during
equipment downtime.
End of Life determined
for all key IT assets.
Publically available
upgrade/refresh
schedule for next 18
months.
Obsolescence plan created, but
funding is not available to
implement. Older high use servers
are being swapped out with newer
machines where possible, but
otherwise machines are only being
replaced at failure.
Current knowledge
and tools
Increased professional
development.
Lunch and learn
sessions.
Build out of WIKI or
SharePoint sites for all
systems.
Planned but not implemented based
on staffing reductions.
27
5.10
Implement new
technologies to
enhance productivity or
system security.
Deploy new technologies to
enhance productivity or system
security. Larger or dual
monitors. Intranet or Sharepoint
for organizing information.
Implement LINC (MS
Communicator) for interagency
communication. New switches
for remote site admin.
Current IT
infrastructure
New switches purchased.
Installations expected to be
completed by July 1. Larger
monitors are replacing smaller
monitors when they fail based on
budget issues. Intranet, Sharepoint
and LINC deferred based on budget
cuts.
28
Program Functional Area 6: Caseload Management/Outreach
Goal 6: Effectively reach all eligible individuals as resources allow, and achieve the maximum caseload capacity to serve the greatest
number of women, infants and children.
Objective 6.1:
Objective 6.2:
By September 30, 2012, increase by 2% enrollment of high-risk applicants by evaluating local agency targeted
outreach activities for these populations.
By September 30, 2012, decrease the no-show rate by 5% using baseline established by each local agency as reference
point.
Objective
6.1
By September 30,
2012, increase by 2%
enrollment of highrisk applicants by
evaluating local
agency targeted
outreach activities for
these populations.
1st trimester enrollment of
pregnant women is greater or
equal to 50%. Determine
feasibility of tracking early
enrollment of infants within first
six weeks of life. If feasible,
develop report to provide data to
local agencies for program
evaluation and planning. Review
all local agency plans for
evaluation of outcomes of prior
year’s outreach activities and
changes that were incorporated for
future outreach activities based on
reported results. During
monitoring and for those agencies
that are conducting the selfassessments, review current
outreach strategies with local staff
to ensure outreach plan remains
relevant. Provide on-site technical
assistance as needed.
Baseline
2012 WIC Goal: ≥ 50%
FY 2006: 49.5%
Range:
16.4-74.9%
FY 2007: 47.9%
Range:
19.4-62.2%
FY 2008: 48.2%
Range:
25.6-57.6%
FY 2009: 50.3%
Range:
26.2-66.3%
FY 2010: 50.9%
Range: 30.7% - 67.4%
FY 2011: 53.6%
Range: 40.8% - 66.2%
FFY 2012: 53.5%*
Range: 39.9% - 71.5%
(* 9-month average)
Source: CT SWIS, Process
Objective 1 – 1st Trimester
Entry into WIC, quarterly
report
Indicators
SWIS Process Objective
Report (FY 2012 Range
should be 39.3%-71.5%)
Baseline or indicator to be
established.
Data points of infant’s birth
date and certification date
can be use to generate
report.
Quantitative assessment of
each Outreach Activity
carried out reported in local
agency plan.
Progress
1st trimester enrollment remained
stable. Continue to strive to
increase enrollment for pregnant
women.
• FFY 2012 Target: ≥ 50%
• Statewide average (based on 9mos of FY data): 53.5% (R =
39.9% - 71.5%)
• Identify lowest performers:
objective met.
- Danbury: 41.7%
- E Hartford: 48.2%
• Identify best performers:
objective met.
- Stamford/Norwalk: 63.6%
- Meriden/Middletown: 59.3%
- Hartford: 57.0%
Accomplished. All local agency
plans were reviewed by state
staff and feedback provided to
the agencies. Partially
Accomplished: Development of
Local Agency Quantitative
Assessment method is in progress
by each local agency.
Recommendations made by Local
Program Operations Monitors in
order to evaluate effectiveness of
Outreach activities.
29
6.2
By September 30,
2012, decrease the
no-show rate by 5%
using established local
agency baseline.
Ensure continued effective
implementation of daily
appointment reminder calls.
Develop an automated,
standardized report for tracking
no-show rate.
Identify lowest performing local
agency and provide targeted
technical assistance to improve
outcomes. E.g. sharing of
successful strategies from other
agencies.
TBD
Verification that all local
agencies are rate tracking,
analyzing and implementing
and effective strategies to
reduce no-show rate.
Verified in FFY2012 Local
Agency Plans and during
Administrative Monitoring
Reviews during FFY2011.
Partially Accomplished: Local
agencies have developed a
system to track the no-show rate,
established a baseline and have
identified this area as one in need
of improvement in their FFY2012
Local Agency Plan.
An automated report for tracking
no-show rates was not
developed. In FY 2013, a state
standardized method for tracking
no-show rate will be provided to
local agencies based on the best
methods developed by locals.
30
Program Functional Area 7: Coordination of Services
Goal 7: Strengthen coordination of information and resources with other Connecticut State Agencies to respond to the needs of the
WIC clients.
Objective: 7.1 Maintain active coordination with at least 75% of identified key partners
Objective: 7.2 In 90% of reviewed charts/clinic observations during monitoring visits appropriate mandated and targeted referrals
were made.
Objective
7.1
Maintain coordination
with at least 75% of
identified key partners.
Continue to actively participate in
State level MCH Task Forces, Head
Start, Oral Health, Lead
Prevention/Immunization
programs, HUSKY (Medicaid
Managed Care) and DSS. Continue
to coordinate with DPH Food
Protection Program, Consumer
Protection Agency, and DPH
Environmental Epidemiology.
Connecticut was awarded a FY
2011 USDA WIC Special Project
Concept Paper Development Grant
to develop a full-grant proposal for
the Connecticut WIC and Head
Baseline
Letters of
agreement or
MOU’s with
Medicaid Managed
Care (HUSKY),
Immunization,
SNAP-Ed, Child
Enforcement
Agency and TANF.
Indicators
Improvement of service
delivery to mutual clients
Policy and
procedures on
formula safety and
recall
Final WIC SPG Full grant is
submitted and funded.
Grant proposal is included in the
State Plan submission. Continue
SNAP Ed/WIC Program LYF/FYF
Collaborative Initiative:
•
Coordinate with SNAP Ed as
needed with local agency
workshop/display plans
•
Incorporate routine use of
SNAP Ed recipes in WIC
education/resources used
•
Incorporate USDA core
messages in WIC nutrition
education where indicated.
MOA with UCONN
for full grant
development
Start Cross-Program Collaboration
Project.
Ensure safety of food/formula
provided to WIC participants.
Current
recommendations/guidelines
relevant to WIC participants
are sent to local WIC
agencies.
Successful SNAP Ed
workshops/displays at local
agencies based on
evaluations and feedback
from SNAP Ed/local
agencies/students
SNAP-Ed Recipes utilized at
local WIC agencies
FNS Core Messages
incorporated into WIC
Nutrition Education lesson
plans and/or other education
materials
Progress
Ongoing. Oral Health staff will be
conducting survey of WIC staff at the
September 2012 Statewide meeting
to assess the oral health knowledge
base and practices of WIC staff.
Accomplished and Ongoing.
Coordinated with DPH environmental
Epidemiology regarding sushi
consumption inquiry in pregnant and
breastfeeding women resulting in
guidance added to DPH fish advisory
information. Ongoing communication
regarding new BPA law and
data/research/impact on WIC.
Coordination of current investigation
by FPP, DCP, and FDA of WIC
participant formula quality complaints
on Nutramigen liquid conc and two
other formulas. Several updates to
local agencies regarding various food
and formula recalls, items in the news
etc. Per USDA Memo on 2012 WIC
Special Projects Grant concept paper
awardees: multi-purpose funds are
not available due to their use to
support caseload. No RFP was
released. Full grant proposal has
been drafted and will be submitted in
2013 if funds are available. Other
options for smaller pilot are being
explored in addition to sustaining and
31
Objective
Con’t
7.1
Identify other State partners
serving similar populations to
improve coordination of services.
7.2
In 90% of reviewed
charts/observations
during monitoring
visits appropriate
mandated and targeted
referrals were made.
During reviews, assess local
agency utilization of revised
referral codes and referral policy
and procedures.
• Update revised
policies/procedures if indicated.
• Provide review of updated
policies and procedures at
Statewide Meetings as needed.
Last year’s 7.3 not accomplished.
Deferred until roll-out of new IS.
See 7.2 FY 2011 Progress for
details. Monitoring staff to
continue to track during site
reviews. More emphasis placed on
referral and outreach goals and
outcomes in local agency planning
process.
Baseline
N/A
Indicators
Improved local level
coordination with staff
regarding referrals.
All local agencies will utilize a
Local Community Resource
Guide on a regular basis.
Improved documentation on
provision of referrals and
follow up. Improved
consistency of use of referral
codes by LA’s.
LA’s develop internal process
for tracking referrals
(providing and following up).
Reduction in review findings
related to referrals.
Progress
strengthening collaboration with State
level Head Start office. In process.
SNAP Ed Loving Your Family Feeding
Their Future group classes/displays
collaboration continues on a limited
basis due to funding. FY 2011 results
and 2012 planned were shared at the
December 2012 Statewide meeting.
Displays had better return for
investment than classes so more
displays will be done this time around
Accomplished. SNAP Ed recipes, with
the My Plate logo, were requested
and provided to all local WIC
agencies. Spanish recipes developed
by SNAP Ed and reviewed by WIC
local agency translation team., and
supplies distributed to local agencies.
In process/ongoing. Core messages
included in SNAP Ed recipes/SNAP Ed
workshops/displays. Plan to
incorporate messages/concept into
guidelines/materials as appropriate.
The 90% targeted goal for referrals
was not reached in the four (4)
agencies monitored to date.
Documentation of referrals in SWIS,
utilizing the referral codes continues
to be an issue. Documentation of
targeted referrals ranged from 10%
to 30% in the four (4) agencies
monitored. Follow-up to referrals
were not documented in any of the
agencies.
32
Program Functional Area 8: Civil Rights
Goal 8: Establish and administer policies and procedures that ensure client-oriented customer friendly service environment for all
applicants and participants and comply with Racial/Ethnic Federal mandate to ensure uniformity and comparability in the
collection and use of data as required by OMB standards.
Objective: 8.1
Objective: 8.2
Verify 100% of local agencies are in compliance with use of non-discrimination statement requirements and OMB
racial/ethnic data collection standards.
Conduct annual civil rights training for local agency staff
Objective
8.1
Verify 100% of local agencies
are in compliance with use of
non-discrimination statement
requirements and OMB
racial/ethnic data collection
standards.
8.2
Conduct annual civil rights
training for local agency staff.
Request copies of LA developed
brochures, handbooks, and/or other
publications and review for proper
usage of the non-discrimination
statement.
Monitor to verify that Racial/Ethnic
Data Collection procedures followed
at local agencies during FY 2012
reviews.
Update and train all State and local
staff on revised discrimination
complaint procedures.
Explore a web-based, interactive
module for annual civil rights
training.
• Review existing options
• Recommendations to
management by second
quarter
• Implement new training
model in third or forth
quarter of 2012.
Baseline
Ongoing
Indicators
Each brochure and
handout will contain
the non-discrimination
statement.
Progress
Accomplished. During FY2011
95% of all local agencies have
been in compliance with this
mandate.
Regulatory compliance
as evidenced in
monitoring reports.
Web-based or some
type of interactive
training is
implemented at local
agencies.
Accomplished. During FFY2011,
State Program Operations
Monitor researched and
developed a Civil Rights Power
Point Presentation, revised for
updates by DPH - EEO Manager
– Training was conducted during
Statewide Meeting in September
2011 to all local and State
agency staff. State Program
Operations Monitor researched
and developed language for
Discrimination Complaint
Procedures/Discrimination
Complaint Form and Fair Hearing
Procedures included in State
Plan and revised for updates by
DPH-EEO Manager.
33
Program Functional Area 9: Certification & Eligibility
Goal 9: Improve and maintain program integrity in the areas of certification and eligibility.
Objective: 9.1 90% of special formula procedures observed in reviews were accurate and complete.
Objective: 9.2 Monitor local agency implementation of WPM Nutrition Risk Criteria Revision 10 (See Objective: 2.1)
Objective: 9.3 Implement updated risk criteria by October 1, 2012
Objective
9.1
90% of special
formula procedures
during monitoring
were accurate and
complete.
Continue to evaluate local
compliance with special formula
procedures during nutrition
services monitoring
• Review special formula log
during reviews for accuracy
and to determine frequency
of insufficient “medical
rationale”
• Work with support units to
obtain list of participants
receiving special formulas
and verify proper procedures
were followed. Ten (10)
participants at a minimum.
• Based monitoring results,
determine areas of
improvement in the training
of staff, and clarify WIC
formula policies and
procedures as needed.
Continue to update formula
resource tables, issue timely
WIC numbered memos, provide
in-service training and develop
user-friendly formula resources
for Nutritionists.
Employ multi-level approach to
improve local staff and medical
community knowledge in area
of formula issuance.
Baseline
June 2012 report:
Exempt infant
formulas
Range-7.72-17.52%
Average- 10.31%
Updated information
will be provided midOct.
Indicators
Local agencies will
demonstrate proficiency with:
• Following formula policies
and procedures
• Appropriate rational for
ordering a special formula.
Local agency report of
improved knowledge base and
comfort-level in interactions
with HCP’s.
health care provider phone
calls related to confusion re:
WIC special formula issuance
SWIS Infant Formula Monthly
Reports
Progress
The review of special formula logs
during local agency monitoring
indicates that formula procedures
are being followed. Ongoing.
Developed guidance and transmitted
multiple numbered memos and email communications and technical
assistance for local agency staff on
formula related topics and formulary
changes. State Plan Policy and
Procedure Manual Food Delivery
section (400) revised. Ongoing.
Considering development of a WIC
Nutrition Advisory committee which
would include key stakeholders i.e.
physician, clinical dietitians,
pediatricians, public health nursing
to discuss WIC nutrition policies and
solicit feedback on current WIC
nutrition issues to enhance
consistent messages to participants
and understanding of WIC policies
and stakeholder needs. Provided
training on WIC Program in general
and addressed WIC formula policies
for 10 Connecticut Breastfeeding
Initiative (CBI) hospitals during one
CBI networking conference call.
Provided same training during
January CBC meeting to educate
staff from maternity care facilities on
WIC breastfeeding support and
clarify formula issuance policies.
34
Objective
Con’t
9.1
90% of special
formula procedures
during monitoring
were accurate and
complete.
9.2
Monitor local agency
implementation of
WPM Nutrition Risk
Criteria Revision 10.
9.3
Implement updated
by October 1, 2012.
• Respond to/solicit feedback
from WIC medical advisor,
key stakeholders
Develop and provide two (2)
in-service trainings to
identified maternity care
facilities regarding WIC
formula policies and
procedures by September 30,
2012.
During FY 2012 chart audits
target IOM weight gain grids
and assignment of associated
risks (USDA Risks 101, 111,131,
133 and 335) for accuracy.
During observations local
agency staff accurately
incorporates revisions to USDA
risks 411, 425 and 427 in risk
assessment and counseling.
Nutrition staff provide timely
technical assistance or
clarification when deficiencies
are identified.
By end of first quarter, review
updated criteria, develop
training plan and submit IT
request to perform needed
modifications to SWIS.
Determine timeframe for
system upgrades. Plan to train
appropriate WIC staff on
updated risks at March
Statewide meeting. Develop
mechanism to get feedback
from locals on implementation
of revised/new risk criteria
(WHO growth charts). Provide
tools for local agencies to
educate key providers on WHO
Baseline
Indicators
Progress
Program Monitoring
SWIS Nutrition Risk
report
Clinic observations, chart
audits, Management
evaluation results
SWIS Report
Chart Audits conducted during
monitoring has identified plotting of
the weight gain grid at certification
and more so at follow-up visit was
not done in approximately 50% of
the pregnant woman’s charts in one
local agency. During observations,
about 85% of local staff accurately
incorporated the USDA risks
revisions in risk assessment and
counseling. Staff has been providing
technical assistance to local agencies
when a need is identified or
requested. See Functional Area 2 for
explanation of Local agency liaison
role.
N/A
IT report submitted
Training scheduled for local
agencies.
Completed 4-2-2012. IT request
developed and submitted January
2012. Changes to SWIS
implemented 4-2-2012. At March
2012 Statewide meeting trained
nutrition staff on revised and new
criteria and system upgrades for
implementation. Provided needed
policy and procedure updates to
NERO for review and approval. In
process of planning for Sept. CTAAP/DPH joint teleconference to
review WHO growth standards
and WIC’s use of growth charts.
35
Objective
Con’t
9.3
Implement updated
by October 1, 2012.
growth standards. As needed,
provide targeted education to
health care providers i.e. CTAAP teleconference on
adaptation of WHO growth
standards.
Baseline
Indicators
Progress
36
Program Functional Area 10: Monitoring & QA
Goal 10: Conduct on-site programmatic management and nutrition services reviews of local agencies to ensure compliance with
Federal and State Regulations.
Objective: 10.1 Monitor six (6) service regions including satellites.
Objective: 10.2 Continue to evaluate applications of VENA principles in local operations and identify training and technical assistance
needs.
Objective: 10.3 Improve local agency compliance with monitoring findings (nutrition services and program operations) outcomes.
Objective: 10.4 By September 30, 2012, implement a system to track, quantify and resolve vendor and participant complaints received
by the State Office.
Objective: 10.5 Implement off-year Local Agency Self-Assessments.
Objective
10.1
Monitor six (6)
service regions
including satellites.
• By end of 1st quarter, develop
FY2012 monitoring schedule.
• Conduct monitoring visits and exit
conference within one (1) week of
completion of fieldwork.
• Prepare and submit program review
reports to local agencies within
thirty (30) calendar days of the last
date of the program review.
• Synthesize common review findings
and responses to CAP in both
nutrition services and program
operations to update FFY13 Goals
and Objectives, training and
technical assistance plans.
Baseline
FFY11 LA monitoring
schedule (See
Objective 10.3)
Indicators
FY2012 Monitoring and
review schedule
tracking sheet.
Number of visits and
reports completed
within timeframe
indicated.
Progress
The FY2012 monitoring schedule
was developed. Seven (7) local
agencies were scheduled to be
monitored this year. Four (4)
have been monitored through
June 2012. Exit conferences
were not completed within 1
week due to local agency and
State office scheduling conflicts
and priorities, but were
conducted at the first available
opportunity. Monitoring reports
for the Certification, Nutrition
Services and Administrative
components have been submitted
to Management within the
designated time frame.
37
10.2
Continue to evaluate
applications of VENA
principles in local
operations and
identify training and
technical assistance
needs.
• Use revised monitoring tools to
assess/report local agency staff
progress in three (3) VENA
competency areas to establish
individual baselines for self
improvement.
• Summarize collected VENA best
practices in areas of nutrition
services and program operations,
provide to all local agencies by Sept
30 each year. Provide time at State
wide meetings to highlight best
practices.
• Continue convene the “VENA
committee” monthly to address
local agency training and technical
assistance needs.
-Subcommittee work to continue
and evolve in FY 2012.
Baselines from local
agency reviews
Ongoing process/tool
evaluation and
feedback from local
agencies
Evidence of LA
application of VENA
principles is reflected in
monitoring reports.
visits are incorporated
into technical
assistance and training
plans.
VENA committee
deliverables
The VENA committee was
renamed the ReNEW 2.0
committee to reflect the focus on
quality services and expectations
for nutrition services. Results of
agencies monitored showed 90%
of the staff from the
demonstrated competency in the
VENA skill of rapport building.
About 75% of the staff
demonstrated the VENA skill of
critical thinking. However, 95%
of staff from all of the agencies
need work on developing
competency in Positive Health
Outcomes, specifically; allowing
clients to set goal and the
summarization of those goals.
Best practice highlights will occur
December 2012 as the June 2012
was cancelled due to funding
cuts. Nutrition education
subcommittee. See Nutrition
Objective 2.8. re: development of
lesson plans and Coordination of
Services 7.1 re: SNAP Ed.
collaboration. Translation to
Spanish of Want a healthy baby?
What you Need to Know about
Cigarette Smoking Even if you
Don’t Smoke into was completed.
Scheduling subcommittee is in the
process of working on updated
language for WIC Public web site
based on positive health
outcomes. Documentation
subcommittee: Completed work
on 2 policies- Wait List and Foster
Care. Also began work on
statewide initiative to “PAUSE” to
respond to monitoring funding re:
positive health outcomes.
38
10.3
Continue to improve
local agency
compliance with
monitoring findings
(nutrition services
and program
operations)
outcomes.
Provide targeted technical assistance
interventions and training
opportunities based on identified
deficiencies. Continue to use timely
distribution of FAQ’s after Statewide
trainings to clarify nutrition services
and program operations questions.
As warranted, incorporate FAQ’s into
Local Agency Policy and Procedure
Manual
TBD Review prior
monitoring reports
(See Objective 10.1)
Reductions of repeat
findings and
observations in areas of
nutrition services and
program operations.
Meetings are scheduled after
each program review to connect
the appropriate staff Nutritionist
to provide technical assistance in
the areas that were identified
during the review. See Nutrition
2.0 for a description of the Local
Agency Liaison process than
began this fiscal year. Scheduling
subcommittee tasks not
accomplished this year included a
series of “boosters” on policies
that need clarification. First
booster originally set for April on
Alternate/Caretaker Policy, was
moved back to August.
39
10.4
By September 30,
2012, implement a
system to track,
quantify and resolve
vendor and
participant
complaints received
Review existing complain tracking
procedures. Based on review, refine or
develop a centralized system and train
appropriate State staff on how to
record and track both vendor and
participant complaints received by the
State Office. Update State office
procedures for taking, documenting
and resolving vendor complaints re:
participants and participant complaints
re: local agencies or vendors. During
monitoring, review local agency
compliance with providing required
information re: WIC check use at
orientation, certification and re certifications. Topics covered by local
staff should include:
a) Food List/WIC approved foods
b) Check Redemption procedures
c) Consequences of Participant abuse
As needed, work with Vendor Unit to
incorporate any feedback into vendor
training.
Establish baseline.
10.5
Implement off-year
Local Agency Self
Assessments.
Provide technical assistance to the five
(5) local agencies that will implement
the off-year Self-Assessment. Tools
and guidance available in Policy and
Procedure Manual.
N/A
Tally number of
complaints
received/documented
at State office
Decreased number of
documented complaints
at the State Office
Documentation of
acceptable resolution of
complaint(s)
Baseline and indicators
TBD. All local agencies
in off-year review cycle
should include one (1)
page summary from
Self-Assessment in FY
2013 Local Agency Plan
Vendors are reporting that
participants are having difficulty
with least expensive brand policy.
Plan update to WIC Orientation
Policy and Food Delivery Policy to
address training issues.
Documentation of all complaints
from vendors against WIC
participants received by the Local
Program Operations Monitor has
been kept on file for future
reference. Resolution of all
complaints was reached with the
assistance and guidance of the
Local Program Operations
Monitors. During Administrative
Reviews, the Program Monitor
ensures all Local Agency
Coordinators review a),b) & c)
with staff and appropriate
suggestions or recommendations
made and documented in
Administrative Review Reports.
These three areas are also
emphasized during State
Orientation Training to new local
agency staff.
Off-year self assessments to
began in 2012.
40
Program Functional Area 11: Fiscal Management
Goal 11: Maximize the utilization of WIC food funds.
Objective: 11.1 By September 30, 2012, expand the usage to 97% of all food dollars.
Objective: 11.2 By September 30, 2012, revise Local Agency forms for required monthly reporting and required budgets and
amendments.
Objective: 11.3 By September 30, 2012, incorporate financial data into data quality activities to provide trend analysis on Connecticut
WIC
Objective
11.1
By September 30,
2012, expand the
usage to 97% of all
food dollars.
Track LA expenditures monthly.
• Meet with program directors.
• Monitor food costs using the
current CPI cost indicators.
Baseline
Budget/expenditure
reconciliation.
Indicators
100% of food dollars are
accounted for.
Progress
Completed. Anticipate
use of 97% of funds
Maintained monthly
meetings with local
agency directors and
provided training on
expenditures.
11.2
By September 30,
2012, revise Local
Agency forms for
required monthly
reporting and required
budgets and
amendments.
Update current forms.
• Change current format to Excel.
• Join worksheets to eliminate
repetitive information.
Worksheets with instructions
for Local Agency use with
less errors.
Less time to fill out forms
and cut down on errors.
Completed. Forms
standardized and
created in electronic
format for all local
agency expenditures,
budget revisions and
amendment requests.
State agency staff
(former local agency
director) provided onsite training for new LA
directors on reports.
11.3
By September 30,
2012, incorporate
financial data into
data quality activities
to provide trend
analysis on
Connecticut WIC.
Utilize financial data in trend analysis
N/A
Utilize financial trend data
to drive program decisions
Financial Management
Completed. Monthly
reports include trend
analyses in state
agency and local
agency expenditures
and food costs.
41
Program Functional Area 12: Data Quality, Analysis & Reporting
Goal 12: Strengthen data outputs for improved program planning, monitoring, evaluation and administration.
Objective 12.1:
Objective 12.2:
Improve access to, and the utility and application of, WIC Program data:
a. Build on current reports to provide enhanced, more accessible, data resources;
b. Expand research/data analysis and reporting initiatives;
c. Provide support in meeting other Program-related data needs.
Contribute data inputs to help maximize strategic program coverage and effectiveness:
a. Strengthen appropriate access to and delivery of program services;
b. Ensure adequate access to vendor services, and vendor capacity to meet demand.
Objective
12.1
Improve access to, and
the utility and
application of, WIC
Program data:
a. Build on current
reports to provide
enhanced, more
accessible, data
resources;
1. Prepare summary data tables, graphs
to illustrate trends, and maps to compare distribution of selected variables;
2. CDC’s PNSS/PedNSS reports: post
national, state and county data files
to DPH/WIC website; share local-level
files with field staff;
Baseline
- Monthly SWIS
reports
- Annual PNSS/
PedNSS reports
- Biannual PC
studies

3. USDA’s Program & Participant Characteristics: summarize and share pertinent information;
Indicators
Enhanced analysis and data
presentations better meet
USDA, state & local WIC agency
needs for information on:
WIC participation and
caseload;
Risk factors and referrals;
Process and outcome
objectives;
Check issuance and
redemption;
Authorized vendors.
4. Censor data as appropriate in keeping
with confidentiality regulations prior
to sharing outside of WIC Program;

5. Post results or otherwise share selected data tables, graphs, trend reports
and/or maps.
Data tables, graphs and maps
facilitate comparison of participant characteristics, risk factors,
outcomes, etc.;

Summary reports and improved
data access result in less staff
time invested in responding to
routine requests.
6. Provide WIC Director with monthly
summary stats covering participation,
caseload, check issuance & redemption, program costs, and vendors,
plus national WIC data and state
population figures.
Progress
N/A
42
b. Expand
research/data analysis and reporting
initiatives;
1. Link WIC data file with the State’s
birth file & Medicaid records: determine dual enrollment WIC/Medicaid;
Prior studies
2. Project caseload, participation and
program costs based on historical
data and methodologies currently in
use in other state WIC programs;

More in-depth analyses help
inform program decisions in
support of key interventions and
resource allocation;

Local-level disparities are identified based on 2010 Census
data, to better target program
services & resources.

Timely response to internal and
external data requests;

Surveys and presentations developed and/or technical assistance provided;

Committees successfully complete assigned tasks.
N/A
3. Update estimate of WIC eligibles,
using most recent Census, birth and
other data sources;
4. Map selected health, demographic
and socioeconomic Census variables
at the local level; compare results
with current program coverage;
5. Identify and track risk factors contributing to poor program outcomes;
6. Evaluate associations between WIC
participation and risk factors for poor
birth outcomes.
c. Provide support in
meeting other
Program-related data
and reporting needs.
1. Respond to internal and external data
requests;
2. Identify/develop relevant reference &
training resources;
Draft presentations for WIC
Director, Nutrition staff, etc.
Provide survey design, analysis,
reporting, or technical assistance.
Current SWIS reports
Ongoing collaboration
N/A
3. Collaborate in initiatives that benefit
the State’s MCH population:
Serve as the State’s PNSS/PedNSS Coordinator;
Participate on DPH committees
(MCH Block Grant, RFP and Publication Review Committees, etc.).
43
12.2
Contribute data inputs to
help maximize strategic
program coverage and
effectiveness:
a. Strengthen
appropriate access to
and delivery of program services;
1. Monitor program services to help inform program planning and implementation efforts:
Identify service gaps, priorities
and opportunities;
Track program outcomes and
evaluate changes;
Target resources to improve outcomes for those at highest risk.
Current program
services and resources

Decisions to increase/decrease
program services and resources
are based on objective inputs;

Risk factors and other variables
associated with a given outcome
or result are identified, providing
enhanced criteria for targeting
program interventions.
N/A
2. Provide data/mapping inputs to help:
(Re)locate clinic and vendor resources;
Identify specific populations to
target for outreach/promotional
efforts and program services.
b. Ensure adequate access to vendor services, and vendor capacity to meet demand.
1. Database development:
Investigate need for data input
form(s) to help facilitate data entry, increase efficiency & reduce
error rates;
Continue to identify priority data
needs; build standardized queries
to meet those needs;
Provide monthly updates on authorized vendors to WIC Director
and Vendor Management Unit.
Current vendor
database
Currently authorized
vendors
WIC participation
Vendor services and resources meet
participant and program needs.
2. Vendor selection:
Review the results of upcoming
policy change in vendor selection
from quarterly needs assessment
to open enrollment, to determine
effectiveness in meeting participant and program needs.
44
FFY 2013
GOALS AND
OBJECTIVES
Program Functional Area 1: Management and Organization
Goal 1: Ensure program integrity, cost-effectiveness, quality of services and accountability in the delivery of nutrition services in the
provision of food benefits.
Objective 1.1: Implement a Memorandum of Understanding (MOU) with the State Department of Social Services (DSS) and
Medicaid/Managed Care Providers to provide cross referrals and seamless and consistent services to WIC clients.
Objective 1.2: Implement a Memorandum of Understanding (MOU) with the State Department of Children and Families (DCF) that
addresses sharing of information between agencies.
Objective 1.3: Refine and modify the CT WIC Annual Report by March 30, 2012.
Objective 1.4: Provide a 1-2 day leadership and management workshop for LA Coordinators/Program Nutritionists/SA staff.
Objective 1.5: Review, update and enhance WIC Continuity of Operations/Disaster Preparedness Plan
Objective 1.6: Implement a Memorandum of Understanding (MOU) with the State Department of Social Services (DSS) to provide
direct access to State agency WIC to obtain information.
Objective
1.1
Implement a Memorandum of
Understanding (MOU) with the
State Department of Social
Services (DSS) and
Medicaid/Managed Care Providers
to provide cross referrals and
seamless and consistent services
to WIC clients.
1.2
State Department of Children and
Families (DCF) that addresses
sharing of information between
agencies.
Develop priorities and strategize multiprong approach regarding WIC business
case.
• Attend face-to-face meetings.
• Identify specific liaisons from
Connecticut’s Medicaid Program HUSKY
and WIC
• Develop a customized information
packet.
• Identify best practice collaborations at
local agencies
• Evaluate cross referral process and
• Continue meeting with workgroup of
agency representatives including the
DPH Hearing Office
• Develop an understanding of each
agency’s requirements.
• Develop MOU language and execute the
agreements
• Provide training to State and local
agency staff.
Baseline
N/A
Indicators
Executed MOU and evidence of
enhanced cross referral between
WIC and HUSKY
N/A
Executed MOU
Local and State Agency
understanding of procedures
Staff
Director
Nutrition Unit
Director
Nutrition Unit
45
1.3
Refine and modify the CT WIC
Annual Report by March 30,
2013.
1.4
Provide a 1-2 day leadership
and management workshop for
Local Agency
Coordinators/Program
Nutritionists/SA staff.
Coordinate end of the year reports with local
agency outcomes measures for FFY2012
• Report enhanced data on statewide
measures
• Share human interest stories
to highlight how WIC benefits participants
• Incorporate operational information on
• WIC to outside entities. Produce,
distribute & post on WIC website.
Secure facilitator, date, content and location
(retreat location).
• By end of 2nd quarter, develop and
finalize
contract
• Attend logistics meetings.
• Conduct meeting.
• Evaluate and plan for future/ongoing
training.
N/A
Annual report is published and
distributed.
Director
Nutrition Unit
Epidemiologist
Special Projects
N/A
Workshop offered.
Evaluation drives improvements
in program operations
Director
Nutrition Unit
Epidemiologist
1.5
Review, update and enhance
WIC Continuity of
Operations/Disaster
Preparedness Plan.
• Review and incorporate CT DPH COOP
plan
• Incorporate Disaster Preparedness Data
Recovery (DPH IT) Plan components
• Provide training to State and Local Agency
staff
N/A
Updated Plan
Director
Nutrition Unit
Vendor Unit
IT Unit
1.6
State Department of Social
Services (DSS) to provide direct
access for the State agency
WIC to obtain information.
Develop MOU language and execute the
agreement.
N/A
Executed MOU
Reduction in the time spent to
obtain information from DSS
Nutrition Unit
Identify a State Department of Social
Services (DSS) liaison to provide guidance
and support to SA WIC Staff.
Streamline DSS policies that
affect WIC participants
Establish a method of communication that
will provide timely response to inquiry.
46
Program Functional Area 2: Nutrition Services and Breastfeeding Support & Promotion
Goal 2: Improve the nutritional and overall health of WIC families in Connecticut and to increase the proportion of WIC-enrolled
infants who are breastfed exclusively for at least 6 months.
Objective: 2.1 At least 70% of pregnant women participating in the WIC Program for a minimum of 6 months gain appropriate weight.
Objective: 2.2 The incidence of low birth weight (LBW) among infants whose mothers were on the WIC Program for at least six months
during pregnancy does not exceed 6%.
Objective: 2.3 The prevalence of anemia among children enrolled in the WIC Program for at least one year does not exceed 7.5%.
Objective: 2.4 a. The prevalence rate of BMI > 85th percentile to < 95th percentile for children 2-5 years does not exceed 10%.
b. The prevalence rate of BMI > 95th percentile for children 2-5 years of age does not exceed 15%.
Objective: 2.5 At least 65% of infants enrolled in the WIC Program (have mothers who) initiate breastfeeding.
Objective: 2.6 At least 10% of infants enrolled in the WIC Program are breastfed for 6 months or more.
Objective: 2.7a Increase percentage of blood work results obtained and recorded in SWIS for postpartum women (result of deficient
PC 2010 data findings)
Objective: 2.7b Increase the percentage of bloodwork results obtained and recorded in SWIS for 18 month old children.
Objective: 2.8 By FY 2014, all local agencies will use their outcome data to develop and implement targeted nutrition education lesson
plans.
Objective
2.1
minimum of 6 months
Continue to monitor trends and
assess local agency staff skills in
identifying women at risk for
poor weight gain during
pregnancy, and the effectiveness
of education efforts on:
• Weight gain during pregnancy
• Nutrition during pregnancy
• Smoking, ETOH/drug dangers
• Referrals
Expert speaker on domestic
violence to speak at Statewide
meeting. Develop content sheet
specific to weight gain during
pregnancy. Continue to monitor
remaining local agencies for
implementation of revised IOM
pregnancy weight gain guidelines
(NRC#10).
Baseline
2013 WIC Goal: ≥70%
FFY 2007: 66.9%
Range: 56.2% - 82.4%
FFY 2008: 65.7%
Range: 57.3% - 78.4%
FFY 2009: 67.2%
Range: 57.9% - 76.5%
FFY 2010: 66.4%
Range: 42.3% - 81.3%
FFY 2011: 68.8%
Range: 59.0% - 81.1%
FFY 2012: 72.2%*
Range: 48.9% - 85.4%
(* 9-month average)
Objective #1 – Weight Gain
during Pregnancy; quarterly
reports, by federal fiscal year
Indicators
SWIS quarterly and annual
reports. Referral & counterreferral reports. Results of
monitoring show local agencies:
Provide appropriate frequency of
visit to monitor weight gain.
Use effective educational
methods and appropriate
education materials. Change in
trend data over time for low
performing agencies. Once
released, new My Plate materials
and Tips for Pregnant Women
will be utilized by local agencies
for participant education and
verified through monitoring and
technical assistance visits.
Staff assigned
Nutrition Monitor
Epidemiologist
Nutrition Unit
47
Con’t
2.1
minimum of 6 months
2.2
The incidence of low birth
weight (LBW) among
infants whose mothers
were on the WIC Program
for at least six months
during pregnancy does
not exceed 6%.
2.3
exceed 7.5%.
Orient local staff to new My Plate
tips for Pregnant women. Review
action steps of all local agency
plans on maternal weight gain.
(through Local agency Liaison)
to the two (2) lowest performing
local agencies identified for this
objective. See Functional Area
12, Data Quality, Analysis and
these activities.
Continue to monitor trends and
improve weight gain during
pregnancy. During observations
monitor for nutritionist
identification and discussion of
contributing factors for this risk
• History of LBW or pre-term
delivery;
• Mother’s age, etc.
Review action steps of all local
agency plans for LBW. Provide
technical assistance to (through
Local agency Liaison) the two (2)
lowest performing agencies for
this objective. See Functional
Area 12, Data Quality, Analysis
and Reporting for information on
these activities.
Monitor trends and assess local
agency staff skills in identifying
children at risk for anemia and
effectiveness of education efforts
on:
• Iron-rich food sources,
explanation of anemia/ risks,
importance of timely blood
work, appropriate iron
supplementation and lowiron’s connection with risk for
2013 WIC Goal: ≤ 6%
FFY 2007: 5.9%
Range:
1.5% - 9.4%
FFY 2008: 5.9%
Range:
3.6% - 9.5%
FFY 2009: 5.8%
Range:
2.6% - 9.1%
FFY 2010: 5.8%
Range:
1.8% - 10.0%
FFY 2011: 6.1%
Range:
3.5% - 8.5%
FFY 2012: 6.0%*
Range:
2.1% - 8.7%
(* 9-month average)
reports
Reduce health disparities.
Nutrition Monitoring staff
Epidemiologist
Nutrition Unit
Results of monitoring show local
agencies are using effective
appropriate education materials.
Change in trend data over time
for low performing agencies.
Objective #2 – LBW Incidence;
quarterly reports, by federal fiscal
year.
2013 WIC Goal: ≤ 7.5%
FFY 2007: 8.1%
Range:
2.7% - 12.5%
FFY 2008: 7.9%
Range:
3.4% - 10.4%
FFY 2009: 7.6%
Range:
3.9% - 10.5%
FFY 2010: 6.8%
Range:
2.4% - 10.6%
reports
Results of monitoring show local
agencies are using effective
appropriate education materials
Nutrition monitoring staff
Epidemiologist
Nutrition Unit
FFY 2011: 6.8%
Range:
4.1% - 8.8%
FFY 2012: 7.7%*
Range: 4.4% - 10.3%
Change in trend data over time
for low performing agencies
48
Con’t
2.3
exceed 7.5%.
2.4
10%.
not exceed 15%.
lead poisoning.
• Making appropriate referrals
and follow-up.
incorporation of anemia content
Sheet messages into individual
education sessions.
Work with IT staff to incorporate
BMI as a new quarterly outcome
objective for FFY 2012, and to
generate the needed data by
local agency, age group,
race/ethnicity and town of
residence.
incorporation of content sheets
targeted to prevent obesity- fruit
and vegetable intake, physical
activity and introduction to
solids.
Orient local agencies to the
revised My Plate tips for toddlers
brochure/concepts
Quality, Analysis and Reporting
for information on IT and Epi
specific activities related to this
objective.
Monitor for local agencies
inclusion of new nutrition
outcome objectives in local
agency plans.
Provide training and guidance to
local agencies on incorporating
measurable strategies into their
plans.
(* 9-month average)
Objective #4 – Anemia Rate;
year.
WIC 2013 Goals:
reports
CT WIC Program Data:
BMI ≥ 85 & < 95%ile:
Childhood BMI or obesity
Outcome Objective is included in
FY 2013 State Plan and is
included in all local agency
plans.
< 10% 85-95th%ile
> 15% 95th %ile
FFY 2007: 9.7%
Range:
9.2% - 10.2%
FFY 2008: 9.5%
Range:
9.1% - 9.8%
FFY 2009: 9.7%
Range:
9.5% - 10.0%
FFY 2010: 9.3%
Range:
9.0% - 9.5%
FFY 2011: 9.8%
Range:
9.4% - 10.1%
Nutrition monitoring staff
Epidemiologist
IT staff
Nutrition Unit
Once released, new My Plate
materials and Tips for Toddlers
will be utilized by local agencies
for participant education and
verified through monitoring and
technical assistance visits.
FFY 2012: 9.8% *
Range:
9.6% - 10.0%
(* 7-month average)
CDC/PedNSS Data:
BMI:
85<95 ≥95
CY 1985: 11.0%
6.7%
CY 1990: 14.5% 11.0%
CY 1995: 15.0% 13.2%
CY 2000: 17.9% 16.6%
CY 2005: 16.3% 16.6%
CY 2006: 16.5% 16.2%
CY 2007: 16.0% 16.2%
CY 2008: 15.7% 15.5%
CY 2009: 15.4% 16.0%
CY 2010: 14.9% 15.8%
Source: CDC, Pediatric Nutrition
Surveillance System.
Connecticut, 2010 (calendar
year); Table 12C.
49
2.5
enrolled in the WIC
Program (have mothers
who) initiate
breastfeeding.
2.6
At least 10% infants
enrolled in the WIC
Program are breastfed for
6 months or more.
Coordinate Statewide WIC
breastfeeding promotion and
support activities. WIC BF
Committee meeting and activities.
- Meet quarterly in person and/or
via conference call
- Using LS Grow and Glow
curriculum, develop consistent
content for breastfeeding group
education.
-Revise, as needed Connecticut
Breastfeeding Guidelines and
provide training to local staff and
incorporate updates into State
Plan. Include requirement for
annual breast pump
demonstration training for all local
staff that issue breast pumps.
Provide technical assistance to
LAs in implementing WIC BF
guidelines and annual BF
promotion plans.
- Conduct three (3) breastfeeding
focused site reviews in FY 2012.
(Schedule reviews by end of first
quarter). Continue to monitor
implementation of four (4)
breastfeeding content sheets.
Revise content sheet focused on
pumping for workplace based on
recent LLL conference content.
Monitor for incorporation of
strategies to increase
breastfeeding duration in local
agency plans. Include revised
measure as part of LAP
performance measures.
-Address data quality issue re;
duration
WIC 2013 Goal: ≥ 65%
HP 2020: 81.9%
FFY 2006: 57.2%
Range: 43.5% - 88.4%
FFY 2007: 59.1%
Range: 45.0% - 87.6%
FFY 2008: 61.3%
Range: 49.3% - 89.0%
FFY 2009: 63.7%
Range: 52.1% - 88.9%
FFY 2011: 65.0%
Range: 49.8% - 88.4%
FFY 2012: 68.7%*
Range: 48.5% - 91.4%
Documentation of improved
compliance with guidelines per
technical assistance reviews and
monitoring reports. More than
half of agencies visited will meet
or exceed performance
standards.
Breastfeeding Unit
Epidemiologist and IT staff
Record of meetings and joint
tasks or activities accomplished
from CBC, CT Chapter of the
American Academy of Pediatrics
(CT-AAP) and other groups.
(* 9-month average)
Objective #3a – BF Initiation
Rate; quarterly reports by federal
fiscal year.
CT State BF Initiation:
Birth year 2000: 86.4%
Source: CDC. Provisional Data,
National Immunization Survey,
2005 Births. 2008. (Note: NIS
covers the general population,
while PedNSS includes only lowincome population in federally
funded programs.)
WIC 2013 Goal: 10%
HP 2020 Goal: 60.9%
WIC Program Data:
FFY 2006: 7.0%
Range: 0.2% - 22.7%
FFY 2007: 7.8%
Range: 0.5% - 18.9%
FFY 2008: 8.0%
Range: 2.9% - 16.0%
FFY 2009: 9.4%
Surveillance System (PedNSS)
reports [Connecticut reports are
Breastfeeding Unit
Epidemiologist
derived entirely from CT’s Statewide WIC
Information System – SWIS].
technical assistance provided to
local agencies, local agency
50
Con’t
2.6
enrolled in the WIC
6 months or more.
Manage WIC Breastfeeding Peer
Counseling Programs.
• Monitor performance of
Hartford and New Haven
programs. Submit reports to
USDA.
• Continue to implement pilots
and refine protocols.
-Begin to analyze data for
pilot sites.
Follow-up on implementation of
USDA’s Loving Support: Building
Breastfeeding Competencies
initiative.
• Test revised portions of the
Grow & Glow modules into biannual State orientations.
Continue to lead sustainability of
Connecticut Breastfeeding
Initiative with DPH partners.
Convene 4 meetings of the DPH
internal breastfeeding committee
in FY 2013. -Update day care
breastfeeding training
Coordinate at least one (1)
Breastfeeding-focused CT-AAP
teleconference in FY 2012.
Actively participate in the CT
Breastfeeding Coalition (CBC).
With Epi and IT Units, review
calculation of breastfeeding
duration, and make any
necessary adjustments.
Quality, Analysis and Reporting
for information on IT and Epi
specific activities related to this
objective.
Range: 2.8% - 15.7%
FFY 2010: 7.0%
Range: 1.1% - 17.2%
Objective #3b - BF Duration;
year.
NIS Study Data:
State 6-mos BF Duration:
BF coordinators and CT
Breastfeeding Coalition
Quarterly activity and
expenditure reports from
contractors, including # of
women enrolled and duration
rates.
Source: CDC. Provisional Data,
National Immunization Survey,
2005 Births. 2008. (Note: NIS
covers the general population,
while PedNSS includes only lowincome population.)
CDC/PedNSS Data:
By Calendar Year:
CY 1985: 7.2%
CY 1990: 8.3%
CY 1995: 11.3%
CY 2000: 15.8%
CY 2002: 23.8%
CY 2004: 22.9%
CY 2006: 24.6%
CY 2008: 24.4%
CY 2010: 27.0%
By Race/Eth. & Year:
Hispanic, by Year
CY 2001: 24.6%
CY 2003: 26.6%
CY 2005: 26.1%
CY 2007: 27.6%
CY 2009: 29.9%
CY 2010: 29.4%
NH Black, by Year
CY
CY
CY
CY
CY
2001:
2003:
2005:
2007:
2009:
23.1%
20.5%
17.8%
21.7%
23.6%
51
Con’t
2.6
enrolled in the WIC
6 months or more.
2.7 a
bloodwork results
SWIS for postpartum
women (result of
deficient PC 2010 data
findings).
2.7 b
bloodwork results
SWIS for 18 month old
children.
2.8
By FY 2014, all local
agencies will use outcome
data to develop targeted
nutrition education
lessons plans.
CY 2010: 25.5%
NH White, by Year
CY
CY
CY
CY
CY
CY
2001:
2003:
2005:
2007:
2009:
2010:
20.2%
18.1%
21.7%
19.5%
23.1%
23.1%
Source: CDC, Pediatric Nutrition
Surveillance System. CT, 2010
(calendar year); Table 13C.
Continue to identify local agency
with issues obtaining current
bloodwork for postpartum
participants. Develop solutions to
improve access for postpartum
women to obtain bloodwork.
Monitor 10 additional postpartum
files targeting bloodwork data.
Continue to identify local
agencies with issues obtaining
15-18 month bloodwork results
for 18 month old children.
Identify Health Care Providers
(HCP) not in compliance with the
ESPDT periodicity schedule.
Work with DSS liaison and HCP’s
to resolve.
Develop workshop and train local
agency staff on how to use local
agency outcome data and ad hoc
SWIS reports to drive provision
of nutrition education and
development of lesson plans.
State staff will review FY 2013
local agency plans for
objectives/strategies that
utilize one or more core
plans developed in 2012.
During technical assistance visits
and routine monitoring assess
PC error reports data?
PC 2012 Data,
Surveillance System (PedNSS)
reports
Chart audit results
Monitoring staff
Epidemiologist
Nutrition Unit
Increase the percentage of
bloodwork results obtained
Decrease in the number of
reported cases of HCP’s
noncompliance
Quarterly outcome reports
and SWIS reports
2012 and 2013 Local
agency plans
Local agencies report on
implementation of at least one
lesson plan in 2012 (using one
of 5 core lesson plans). Local
agencies will incorporate
strategies in LAP to fully
implement local agency
customized nutrition education
by 2014.
Nutrition Education
subcommittee
Nutrition Unit
Nutrition Monitoring staff
52
Con’t
2.8
By FY 2014, all local
agencies will use outcome
data to develop targeted
nutrition education
lessons plans.
proficiency in local agency
nutrition staff’s ability to
develop targeted lesson plans
using outcome data
Monitor for implementation of
one of the five core lesson plans.
Twice a year, discuss successes
and/or challenges with local
agency implementation lesson
plans as result of technical
assistance and monitoring visits,
to troubleshoot and identify best
practices for replication.
53
Program Functional Area 3: FOOD DELIVERY AND FOOD INSTRUMENT ACCOUNTABILITY
Goal 3: To improve food delivery operations at the state and local agency level.
Objective:
Objective:
Objective:
Objective:
Objective:
3.1
3.2
3.3
3.4
3.5
Increase to 100% timely monthly receipt of local agency unused check stock inventory reports.
Decrease the number of rejected checks for selected rejection reasons by 10%.
Make changes to food packages and eligible foods in response to Final Rule for Revisions in the WIC Food Packages.
Improve access to special formulas at retail stores.
Complete transition of previous Food Delivery Coordinator duties among remaining Food Delivery/Vendor Management
Staff.
Objective
3.1
Increase to 100%
timely monthly receipt
of local agency unused
check stock inventory
reports.
3.2
Decrease the number of
rejected checks for
selected rejection
reasons by 10%.
An appointment was sent in FY12 to
each Coordinator’s Outlook calendars
that the report is due on the 15th of
every month with a reminder 3 days
before. An email will be sent to LA if the
report is not received by the middle of
the month.
Non-compliant local agencies will
continue to be cited and monitored for
future compliance during management
evaluations.
Baseline
Currently an average
of 92% compliance
Indicators
Compliance of local agency reports.
Decreased finding of noncompliance in management
evaluation reports.
Staff assigned
Food Delivery Unit
N/A
Monitoring report findings. Results
of the unused check stock inventory
report spreadsheet.
Program Monitor
Provide written policy to LAs on handling
voided in-hand checks and the
immediate detection of mis-numbered
checks that lead to rejections. Follow up
on agencies based on reports.
Rejected checks due
to distribution of
checks that were
voided-in-hand or
mis-numbered
Reduction in the number of checks
rejected due to mis-numbering and
checks voided-in-hand, but
distributed to participants.
Food Delivery Unit
Amendments to the State’s banking
contract were provided in FY11.
Included was a request to allow vendors
to place the vendor stamp in the
endorsement area of the back of the
WIC check as well as the required
placement on the front of the check.
Rejected checks due
to illegible vendor
stamp
Reduction in the number of checks
rejected due to the bank’s inability
to read the stamped vendor
numbers.
Store adherence of endorsement
rule.
Vendor Unit
54
3.3
Make changes to food
packages and eligible
foods in response to
Final Rule for Revisions
in the WIC Food
Packages.
Changes to food list, minimum inventory,
pricing and monitoring reports will be
needed.
Final rule delayed in
2011; expected in
FY13.
Emails and information submitted to
the State WIC Office for approval in
Connecticut.
2nd Quarter of FY13
New Food List is printed.
2nd Quarter of FY13
New Agreements are printed and
executed.
If needed, provide bulletin for training on
new regulations or procedures.
2nd Quarter of FY13
Bulletins sent to all WIC authorized
vendors and farmers.
If needed, communicate necessary SWIS
changes in food packages to IT.
2nd Quarter of FY13
Changes have been tested.
If needed, provide updates to local
agencies regarding any new policies,
educational materials, and changes to
the usage of the fruit & vegetable check.
If needed, notify wholesale distributors
of updates to food packages, new food
items, and minimum inventory
requirements.
Issuance of all Connecticut WIC checks
reflecting full implementation of the new
food package changes for all categories
of WIC participants.
2nd Quarter of FY13
Numbered memo sent.
2nd Quarter of FY13
Mailing list.
2nd Quarter of FY13
Issued check files.
New peer group maximums are
sent to the bank.
Review the influx of submissions from
manufacturers and distributors on
product nutrition labels, statewide
availability and retail costs
Revise the Connecticut WIC approved
food list, the maximum monthly
quantities in food packages and forms to
be used in food delivery at the local
agency (e.g. medical documentation).
Secure and adapt education materials.
If needed, finalize the vendor and farmer
agreements to update the minimum
inventory requirements and the
procedures for processing the fruit &
vegetable check.
Food Delivery Unit
Vendor Unit
Nutrition Unit
55
3.4
Improve access to
special formulas at
retail stores.
3.5
Complete transition of
previous Food Delivery
Coordinator duties
among remaining Food
Delivery/Vendor
Management staff.
3.6
Measure program
integrity through
investigation of the sale
of food benefits and
formula.
3.7
Improve program
integrity through
sanctions for the sale of
food benefits and
formula.
Revise draft document to update names
and sizes of all CT approved formulas
and medical foods for participant/local
agencies to order formula at authorized
WIC vendor locations.
Distribute document to local agencies for
participant use, as well as authorized
vendors and their corporate offices.
1st Quarter of FY13
Facilitate WIC participants’
obtaining products that are printed
on their WIC checks in a timely
manner.
1st Quarter of FY13
Vendors are able to better serve
WIC customers needing formulas
and medical foods.
Include the document in printed annual
training materials and interactive training
presentations.
2nd – 4th Quarters of
FY13
Make vendors aware that the tool
exists to help serve WIC customers’
needs.
Duties of the WIC Vendor Specialist will
be dispersed among vendor
management staff that includes tracking
the review process, distribution of
monthly authorized vendor list to local
agencies and website, and revisions to
the WIC Approved Food List.
1st Quarter of FY13
Vendor management lead is
attending reviews and acting as
technical advisor to the review
officer, authorization status of
vendors change on a monthly basis
and supply of current food list is
running low.
Lead in food delivery/vendor
management will oversee unused check
stock inventory and check deliveries on
an ongoing basis
1st Quarter of FY13
Above 50 percent determinations,
average prices paid to all vendors, and
management of not-to-exceed prices for
A50 stores
Monitor for and respond to ads offering
commonly issued food benefits and/or
formula.
1st Quarter of FY13
Unused check stock inventory
reports are received each month
from local agencies, usage is
tracked and additional check stock
is ordered every 2 months
Test of means report, 4th Quarter
report due to USDA by February 1,
2013.
Comply with sanction and claims
requirements for participants that have
offered for sale/sold or improperly
disposed of food benefits and/or formula
Food Delivery Unit
Vendor Unit
Food Delivery Unit
Vendor Unit
Currently this activity
is performed three
times per week
Documentation of the number of
the incidences of WIC Participant
involvement and the number of ads
responded to will measure the
degree of participant involvement.
Food Delivery Unit
Vendor Unit
Currently this activity
is performed each
time there is
sufficient
documentation of
participant
involvement.
Frequency of participant sanctions
and claims issued for this violation
will temporarily increase.
Food Delivery Unit
Vendor Unit
56
Program Functional Area 4: Vendor Management
Goal 4: To improve communication and effectiveness in Vendor Management.
Objective:
Objective:
Objective:
Objective:
4.1
4.2
4.3
4.4
Enhance the WIC website and email usage to provide important vendor-related information.
Increase from 10% to 50% the number of compliance investigations that are initiated and completed within FY 2013.
Utilize a Microsoft Access database to improve the tracking of application/authorization processes.
Investigate and determine the process for changing State Regulations.
Objective
4.1
Enhance the WIC website
and email usage to
provide important vendorrelated information.
Indicators
Maintain links to federal
regulations, vendor authorization
process, vendor agreement and
a monthly list of currently
authorized vendors.
2012 information
Changes are needed for updated
information.
Email address is now part of our
letterhead to encourage
submission of information and
questions to the program.
Monitor vendors’ usage of email
as a first point of contact and
monitor compliance for each
vendor ownership having an
email address.
15% of vendors in FY12
An increase in the number of emails
received from vendors.
Only applicant vendors are
required to use email to
respond to open enrollment
postings. 33% of
authorized stores provide
an email address.
Email usage for bulletins/
communications were
mostly to corporations and
farmers in FY12.
Website’s potential is only
partially realized.
Increased utilization of the website by
vendors to obtain relevant information.
Reduction in calls for information that is
provided on the website.
Utilize distribution list of vendors’
email addresses to improve
communications and encourage
website usage.
Evaluate effectiveness of the
website content and revise
according to the needs of both
the state and vendors, if deemed
appropriate for publication.
Baseline
Staff
assigned
Vendor Unit
Increased communications to all vendors
via email.
Updates to website information based on
vendor feedback/questions. Reduction in
calls received for routine information.
Increased number of state staff referrals
to the website for information.
57
4.2
50% the number of
compliance investigations
that are initiated and
completed within FY 13.
4.3
Expand Access databases
to improve the tracking of
application/authorization
processes.
During the first quarter, select
stores to be investigated, have
contractor perform initial
compliance buys and DPH to
review compliance buy reports.
During the second quarter, send
sanction letters and confirm
receipt of notice of violations if
applicable.
During the third quarter, have
contractor perform follow up
compliance buys as needed.
During the fourth quarter, send
additional sanction letters if
applicable.
Develop additional forms that
feed data into a vendor
management database.
Obtain pertinent training for all
vendor management staff
through in-service classes.
10%
As of October 1, 2012, 5% of the
authorized vendors are investigated early
in the fiscal year.
N/A
Results of the compliance buy that
identifies if violations occurred which may
necessitate a sanction letter.
N/A
Additional compliance buys performed on
vendors that would have received
warnings.
At least 50% of investigations are
deemed to be complete.
N/A
2 databases being used,
one as a table and source
document and one as a
form for data entry for
monitoring, tracking of
applications and stamps.
Minimal knowledge of and
experience with Microsoft
Access
Query the database for vendors
included in each aspect of the
application process (e.g.
renewals, new stores under the
same ownership, stores in the
authorization process, etc.).
Vendor application
information is in an Excel
documents.
Utilize queries to track progress
and determine if internal
deadlines will be met or need to
be adjusted.
Some currently tracked
through multiple Excel
spreadsheets, others
through Access database.
Standardized queries and reports
developed to meet VM staff needs.
Vendor Unit
Vendor Unit
“How-To” fact sheets and other resources
developed and shared with Vendor
Management staff. Expansion of staff
knowledge base.
Vendor database tracks and reports out
vendor management activities by phase,
and increases the efficiency and accuracy
of the vendor application, selection and
authorization process, from a store’s
initial request, through training, and
determination of authorization.
Increased efficiency in managing yearly
application/authorization tasks.
58
Con’t
4.3
Expand Access databases
to improve the tracking of
application/authorization
processes.
Utilize database to facilitate
updating information and
preparing the annual TIP report
(The Integrity Profile).
Currently tracked through
the Access table and Excel
spreadsheets.
Decrease in time to complete the TIP
report.
4.4 Investigate and
determine the process for
changing State
Regulations.
Review Federal Regulations and
current State regulations to
identify areas that are
inconsistent.
Identify and document the
expedited process for changing
certain regulations and
determine when it is (for what
changes) appropriate to use this
process.
Explore the regular process for
changing regulations and
determine which required
changes can be completed using
this process.
Vendor monitors will perform
inspections and complete a
written inspection report for
authorized vendors.
Current state regulations
have been in effect since
June 1998.
Vendor Management policies are
compliant with federal regulations, but
have changed since state regulations
were last updated.
Vendor Unit
56%
Baseline percentage will increase to 85%
Vendor Unit
Currently, vendors receive a
follow up monitoring visit
after documentation of
state agency sanctions
when time and staff
resources allow.
Any vendor that fails to meet the
minimum inventory requirements during a
routine monitoring visit will meet
minimum the minimum inventory
requirements during a follow up
inspection prior to the end of that fiscal
year.
Vendor Unit
4.5
85% the number of
Authorized Vendors that
receive on site monitoring
visits in FY13.
4.6
Improve vendor
compliance with minimum
inventory requirements
through follow up
inspections.
Any vendor that fails to meet the
minimum inventory requirements
during a routine monitoring visit
shall receive a follow up
monitoring visit after
documentation of state agency
sanctions.
59
Program Functional Area 5: Management Information Systems
Goal 5: To maintain and enhance the WIC IT infrastructure.
Objective:
Objective:
Objective:
Objective:
Objective:
Objective:
Objective:
Objective
Objective:
5.1
5.2
5.3
5.4
5.5
5.6
5.7
5.8
5.9
Implement solutions or new technologies to address changes in USDA regulations and/or state policy.
Establish a master schedule for all WIC IT projects
Continue the mainframe cost containment initiative.
Procure an MIS and EBT solution for Connecticut.
Move towards a self service reporting environment for regular WIC information needs
Prepare for data migration and conversion to new MIS
Develop a new MIS equipment obsolescence plan.
Increase staff knowledge and utilization of current IT languages, tools and techniques
Implement new technologies to enhance productivity or system security.
Objective
5.1
Implement solutions or new
technologies to address
changes in USDA regulations
and/or state policy.
5.2
Establish a master schedule
of all WIC IT projects.
Re-program SWIS as required to
accommodate changes in regulations
and/or policy.
Deploy new technologies as required
by changes in USDA and/or DoIT
policies.
Create and maintain a master schedule
of IT activities.
Baseline
NewSWIS version 1.61
Indicators
Staff Assigned
IT Section Chief
IT Supervisor
All projects independent
Master calendar created
and maintained.
IT Section Chief
IT Supervisor
5.3
Continue the mainframe cost
containment initiative.
Monitor various processes for usage,
printing, disk and tape storage costs.
Move certain processes from
mainframe to server. Remove obsolete
report processes.
Mainframe costs from
prior year for given
month
Maintain MF cost in report
of MIS Cost Survey Feb
2010.
Technical Analyst II
5.4
Procure an MIS and EBT
solution for Connecticut.
Complete BEST required documents
for system selection. Complete IAPD.
Issue RFP. Award RFP.
Feasibility Study and
related documents
BEST Approval. USDA
Approval.
RFPs Issued. RFPS
Awarded.
Director
IT Section Chief
IT Supervisor
60
5.5
Move towards a self service
reporting environment for
regular WIC information
needs.
Identify standard reports for automatic
creation. Look at intranet or report
server options for distribution. Look at
adhoc reporting capabilities for
common requests.
5.6
Prepare for data migration
and conversion to new MIS.
Updating SWIS technical
documentation. Create data dictionary.
Purging old data.
Data scrubbing. Manual cleanup by
Las. Conversion strategy for phased
rollout.
Maintain operational status of IT
infrastructure by providing timely
service or replacement of defective
equipment. Maintain inventory of IT
equipment and implement.
Replacement plans as dictated by
resources and budget. Create
upgrade/refresh schedule for next 18
months.
Include professional development as
part of annual review criteria.
Lunch and learn sessions to share
knowledge. WIKI or sharepoint sites
for all system.
5.7
Develop a new MIS
equipment obsolescence
plan.
5.8
Increase staff knowledge and
utilization of current
Programming languages,
tools and techniques.
5.9
Implement new technologies
to enhance productivity or
system security.
Deploy new technologies to enhance
productivity or system security.
Larger or dual monitors. Intranet or
Sharepoint for organizing information.
Implement LINC (MS Communicator)
for interagency communication. New
switches for remote site admin.
As defined by CDC,
USDA, program
requirements and
epidemiologist work.
Current IT infrastructure
Current knowledge and
tools
Current IT infrastructure
Standard report list with
creation calendar. Pilot
intranet or report server.
Pilot Adhoc reporting
capability.
IT Section Chief
IT Supervisor
System documentation.
Data dictionary. Old data
purged. Data scrubbed.
Conversion strategy
document.
LAs are able to provide
adequate services to
participants during
equipment downtime.
End of Life determined
for all key IT assets.
Publically available
upgrade/refresh schedule
for next 18 months.
Increased professional
development.
Lunch and learn sessions.
Build out of WIKI or
SharePoint sites for all
systems.
New switches
IT Section Chief
IT Supervisor
IT Section Chief
IT Supervisor
61
Program Functional Area 6: Caseload Management/Outreach
Goal 6: Effectively reach all eligible individuals as resources allow, and achieve the maximum caseload capacity to serve the greatest
number of women, infants and children.
Objective 6.1:
Objective 6.2:
By September 30, 2013, increase by 2% enrollment of high-risk applicants by evaluating local agency targeted
outreach activities for these populations.
By September 30, 2013, decrease the no-show rate by 5% using baseline established by each local agency as reference
point.
Objective
6.1
By September 30, 2012,
increase by 2%
enrollment of high-risk
applicants by evaluating
local agency targeted
these populations.
1st trimester enrollment of
pregnant women is greater or
equal to 50%.
Determine feasibility of tracking
early enrollment of infants
within first six weeks of life. If
feasible, develop report to
provide data to local agencies
for program evaluation and
planning.
Baseline
2013 WIC Goal: 50%
FY 2006: 49.5%
Range:
16.4-74.9%
FY 2007: 47.9%
Range:
19.4-62.2%
FY 2008: 48.2%
Range:
25.6-57.6%
FY 2009: 50.3%
Range:
26.2-66.3%
Indicators
SWIS Process Objective Report (FY
2012 Range should be 39.3%71.5%)
Staff assigned
Program Monitor
Baseline or indicator to be
established.
Data points of infant’s birth date
and certification date can be use
to generate report
FY 2010: 50.9%
Range: 30.7% - 67.4%
FY 2011: 53.6%
Range: 40.8% - 66.2%
FFY 2012: 53.5%*
Range: 39.9% - 71.5%
(* 9-month average)
Source: CT SWIS, Process
Objective 1 – 1st Trimester Entry
into WIC, quarterly report
62
Con’t
6.1
increase by 2%
enrollment of high-risk
applicants by evaluating
local agency targeted
these populations.
6.2
decrease the no-show
rate by 5% using
established local agency
baseline.
Review all local agency plans
for evaluation of outcomes of
prior year’s outreach activities
and changes that were
incorporated for future
outreach activities based on
reported results.
Quantitative assessment of each
Outreach Activity carried out
reported in local agency plan.
Program Monitor
Nutrition Monitor
Verification that all local agencies
are rate tracking, analyzing and
implementing and effective
strategies to reduce no-show rate.
Program Monitor
During monitoring and for those
agencies that are conducting
Self-assessments, review
current outreach strategies with
local staff to ensure outreach
plan remains relevant. Provide
on-site technical assistance as
needed.
Ensure continued effective
implementation of daily
appointment reminder calls.
Develop an automated,
standardized report for tracking
no-show rate.
TBD
Identify lowest performing local
agency and provide targeted
technical assistance (in
coordination with Local agency
Liaison) to improve outcomes.
E.g. sharing of successful
strategies from other agencies.
63
Program Functional Area 7: Coordination of Services
Goal 7: Strengthen coordination of information and resources with other Connecticut State Agencies to respond to the needs of the
WIC clients.
Objective: 7.1 Maintain active coordination with at least 75% of identified key partners
Objective: 7.2 In 90% of reviewed charts/clinic observations during monitoring visits appropriate mandated and targeted referrals
were made.
Objective 7.3 Determine the effectiveness of current satellite sites.
Objective
7.1
Continue to actively participate in State level
MCH Task Forces, Head Start, Oral Health,
Lead Prevention/Immunization programs,
HUSKY (Medicaid Managed Care) and DSS.
Continue to coordinate with DPH Food
Protection Program, Consumer Protection
Agency, and DPH Environmental
Epidemiology. CT was awarded a FY 2011
USDA WIC Special Project Concept Paper
Development Grant to develop a full-grant
proposal for the Connecticut WIC and Head
Start Cross-Program Collaboration Project. A
courtesy copy of the final Full Grant proposal
will be sent to NERO upon submission for the
FY 2013 SPG Full Grant award. In the
interim, UCONN and State staff are
investigating other funding sources for a
scaled back version of project to increase
chances of funding in 2013 or 2014.
Continue SNAP Ed/WIC Program LYF/FYF
Collaborative Initiative: Coordinate with
SNAP Ed as needed with local agency
workshop/display plans. Incorporate routine
use of SNAP Ed recipes in WIC
education/resources used. Incorporate USDA
core messages in WIC nutrition education
where indicated. Identify other State
partners serving similar populations to
improve coordination of services.
Baseline
Letters of agreement or
MOU’s with Medicaid
Managed Care (HUSKY),
Immunization, SNAP-Ed,
Child Enforcement Agency
and TANF.
Policy and procedures on
formula safety and recall
MOA with UCONN for full
grant development
Indicators
Improvement of service
delivery to mutual clients
Staff assigned
Nutrition Unit
Program Operations
Ensure safety of
food/formula provided to
WIC participants. Current
recommendations or
guidelines relevant to WIC
participants are sent to local
WIC agencies.
Final WIC SPG Full grant is
submitted and funded.
Successful SNAP Ed
workshops/displays at local
agencies based on
evaluations and feedback
from SNAP Ed/local
agencies/students
SNAP-Ed Recipes utilized at
local WIC agencies. FNS
Core Messages incorporated
into WIC Nutrition Education
lesson plans and/or other
education materials
64
Objective
7.2
In 90% of reviewed
charts/observations
during monitoring
visits appropriate
mandated and targeted
referrals were made.
During reviews, assess local agency
utilization of revised referral codes and
referral policy and procedures.
• Update revised policies/procedures if
indicated.
• Provide review of updated policies and
procedures at Statewide Meetings as
needed.
Monitoring staff to continue to track during
site reviews. More emphasis placed on
referral and outreach goals and outcomes in
local agency planning process.
7.3
Determine the
effectiveness of current
satellite sites.
Collect data on satellite site operations
• Location of satellite sites
• Number of clients served
• Hours of operation
Baseline
N/A
Indicators
Improved local level
coordination with staff
regarding referrals.
All local agencies will utilize
a Local Community Resource
Guide on a regular basis.
Improved documentation on
provision of referrals and
follow up. Improved
consistency of use of referral
codes by LA’s.
LA’s develop internal process
for tracking referrals
(providing and following up).
Reduction in review findings
related to referrals.
Staff assigned
Monitoring Unit
Nutrition Monitor
Nutrition Monitor
Local agency Liaison
65
Program Functional Area 8: Civil Rights
Goal 8: Establish and administer policies and procedures that ensure client-oriented customer friendly service environment for all
applicants and participants and comply with Racial/Ethnic Federal mandate to ensure uniformity and comparability in the
collection and use of data as required by OMB standards.
Objective: 8.1
Objective: 8.2
Objective: 8.3
Verify 100% of local agencies are in compliance with use of non-discrimination statement requirements and OMB
racial/ethnic data collection standards.
Ensure annual civil rights training for state and local agency staff
By 2014, implement web-based Civil Rights Training for State and Local agency staff.
Objective
8.1
Verify 100% of local agencies
are in compliance with use of
non-discrimination statement
requirements and OMB
racial/ethnic data collection
standards.
Request copies of LA developed
brochures, handbooks, and/or other
publications and review for proper usage
of the non-discrimination statement.
Baseline
Ongoing
Indicators
Each brochure and handout will
contain the non-discrimination
statement.
Staff assigned
Monitoring Unit
Monitor to verify that Racial/Ethnic Data
Collection procedures followed at local
agencies during FY 2012 reviews.
Regulatory compliance as
evidenced in monitoring reports.
8.2
Conduct annual civil rights
training for local agency staff.
Update and train all State and local staff
on revised discrimination complaint
procedures.
Web-based or some type of
interactive training is implemented
at local agencies.
Monitoring Unit
State and Local Agency staff will
be issued a certificate upon
completion of Civil Rights Training
Monitoring Unit
Explore a web-based, interactive module
for annual civil rights training.
• Review existing options
• Recommendations to
management by second quarter
• Implement new training model
in third or forth quarter of 2012.
8.3
Implement web-based Civil
Rights Training for State and
Local agency staff.
Review California Webinar and adapt to
Connecticut.
66
Program Functional Area 9: Certification & Eligibility
Goal 9: Improve and maintain program integrity in the areas of certification and eligibility.
Objective:
Objective:
Objective:
Objective:
9.1 90% of special formula procedures observed in reviews were accurate and complete.
9.2 Monitor local agency implementation updated risk criteria.
9.3 100% of participants (children, postpartum and breastfeeding women) receive targeted exit counseling.
9.4 Implement and track 1- year certification for children.
Objective
9.1
90% of special
formula procedures
during monitoring
were accurate and
complete.
Continue to evaluate local compliance with special
formula procedures during nutrition services
monitoring
• Review special formula log during reviews for
accuracy and to determine frequency of
insufficient “medical rationale”
• Review WIC infant formula report on a monthly
or quarterly basis to determine local agency
usage of special or exempt formulas.
• Work with support units to obtain list of
participants receiving special formulas and verify
proper procedures were followed. Ten (10)
participants at a minimum.
• Based monitoring results, determine areas of
improvement in the training of staff, and clarify
WIC formula policies and procedures as needed.
Continue to update formula resource tables, issue
timely WIC numbered memos, provide in-service
training and develop user-friendly formula resources
for Nutritionists.
Employ multi-level approach to improve local staff
and medical community knowledge in area of
formula issuance.
• Respond to/solicit feedback from WIC medical
advisor, key stakeholders
• Provide two (2) in-service trainings to identified
maternity care facilities and NICU regarding WIC
formula policies and procedures by September
30, 2013. Assist local agencies in providing inservice presentations as appropriate.
Baseline
June 2012 report:
Exempt infant
formulas
Range-%
Average- %
Indicators
Local agencies will demonstrate
proficiency with:
Staff assigned
Nutrition Monitor
Nutrition Unit
Following formula policies and
procedures. Appropriate rational
for ordering a special formula.
Local agency report of improved
knowledge base and comfortlevel in interactions with HCP’s.
health care provider phone calls
related to confusion re: WIC
special formula issuance
SWIS Infant Formula Monthly
Reports
67
Objective
9.2
Monitor
implementation
updated Nutrition Risk
Criteria.
By end of first quarter, review updated criteria,
develop training plan and submit IT request to
perform needed modifications to SWIS.
Baseline
Indicators
IT report submitted
Training scheduled for local
agencies.
Staff assigned
Nutrition Unit
Monitoring Unit
Breastfeeding Unit
IT Unit
Monitoring results
During routine monitoring local
agency staff will show
proficiency with providing
appropriate exit counseling to
participants.
Nutrition Unit
Monitoring Unit
Breastfeeding Unit
IT Unit
N/A
During routine monitoring local
agency staff will show
proficiency with implementing 1
year certification procedures.
Nutrition Unit
Program Monitor
Breastfeeding Unit
IT Unit
N/A
Monitor system upgrades via local agency feedback.
Determine timeframe for system upgrades.
Through routine monitoring determine if local staff
completed required training. Plan to train
appropriate WIC staff on updated risks at March
Statewide meeting.
Develop WIC HC Provider Fact Sheet on WHO
growth standards.
9.3
100% of participants
(children, postpartum
and breastfeeding
women) receive
targeted exit
counseling.
9.4
Implement 1-year
certification for
children.
Provide tools for local agencies to educate key
providers on WHO growth standards. As needed,
provide targeted education to HCPs i.e. CT-AAP
teleconference on adaptation of WHO growth
standards.
Review and update existing exit counseling policies
in Local agency Policy and Procedure Manual
Train local agency staff on any updated policies.
Continue with implementation plan for 1 year
certification for children.
• Necessary changes to SWIS are completed
by October 1, 2012
• Develop policy including mid-certification
requirements.
• At September statewide meeting, train local
agency staff on 1 year certification policies
and procedures
68
Program Functional Area 10: Monitoring & QA
Goal 10: Conduct on-site programmatic management and nutrition services reviews of local agencies to ensure compliance with
Federal and State Regulations.
Objective: 10.1 Monitor six (6) service regions including satellites.
Objective: 10.2 Continue to evaluate applications of VENA principles in local operations and identify training and technical assistance
needs.
Objective: 10.3 Improve local agency compliance with monitoring findings (nutrition services and program operations) outcomes.
Objective: 10.4 By September 30, 2013, implement a system to track, quantify and resolve vendor and participant complaints received
Objective: 10.5 Continue implementation of off-year Local Agency Self-Assessments.
Objective
10.1
Monitor six (6) service
regions including
satellites.
• By end of 1st quarter, develop
FY2013 monitoring schedule.
• Conduct monitoring visits and exit
conference within one (1) week of
completion of fieldwork.
• Prepare and submit program review
reports to local agencies within thirty
(30) calendar days of the last date of
the program review/exit conference.
• Synthesize common review findings
and responses to CAP in both
operations to update FFY13 Goals
and Objectives, training and
technical assistance plans.
Baseline
FFY12 LA monitoring
schedule (See
Objective 10.3)
Indicators
FY2012 Monitoring and review
schedule tracking sheet.
Staff assigned
Nutrition Monitor
Program Monitor
Number of visits and reports
completed within timeframe
indicated.
69
10.2
Continue to evaluate
applications of VENA
principles in local
operations and identify
training and technical
assistance needs.
10.3
Continue to improve
local agency compliance
with monitoring
findings (nutrition
services and program
operations) outcomes.
• Use revised monitoring tools to
assess/report local agency staff
progress in three (3) VENA
competency areas to establish
individual baselines for self
improvement.
• Summarize collected VENA best
practices in areas of nutrition
services and program operations,
provide to all local agencies by Sept
30 each year. Provide time at State
wide meetings to highlight best
practices.
• Continue convene the “ReNEW 2.0
committee” as needed (every other
month or quarterly) to address local
agency training and technical
assistance needs.
-Subcommittee work to continue and
evolve in FY 2013.
Baselines from local
agency reviews
Provide targeted technical assistance
interventions and training opportunities
based on identified deficiencies. See
attached outline of Local Agency Liaison
from Nutrition Services Functional Area.
Continue to use timely distribution of
FAQ’s after Statewide trainings to clarify
operations questions.
TBD Review prior
monitoring reports
(See Objective 10.1)
Ongoing process/tool evaluation
and feedback from local
agencies
Nutrition Unit
Breastfeeding Unit
Monitoring Unit
Evidence of LA application of
VENA principles is reflected in
monitoring reports.
Results of monitoring visits are
incorporated into technical
assistance and training plans.
ReNEW 2.0 committee
deliverables
Reductions of repeat findings
and observations in areas of
operations.
Nutrition Unit
Breastfeeding Unit
Monitoring Unit
As warranted, incorporate FAQ’s into
Local Agency Policy and Procedure
Manual
70
10.4
implement a system to
track, quantify and
resolve vendor and
participant complaints
received by the State
Office.
Review existing complain tracking
procedures
Based on review, refine or develop a
centralized system and train
appropriate State staff on how to
record and track both vendor and
participant complaints received by the
State Office.
Establish baseline.
Tally number of
complaints
received/documented
at State office
Decreased number of
documented complaints at the
State Office
Monitoring Unit
Vendor Monitor
Documentation of acceptable
resolution of complaint(s)
Update State office procedures for
taking, documenting and resolving
vendor complaints re: participants and
participant complaints re: local agencies
or vendors.
During monitoring, review local agency
compliance with providing required
information re: WIC check use at
orientation, certification and re certifications.
Topics covered by local staff should
include:
a) Food List/WIC approved foods
b) Check Redemption procedures
c) Consequences of Participant abuse
As needed, work with Vendor Unit to
incorporate any feedback into vendor
training.
10.5
Continue with
implementation of offyear Local Agency Self
Assessments.
Provide technical assistance to the five
(5) local agencies that will implement
the off-year Self-Assessment. Tools
and guidance available in Policy and
Procedure Manual.
N/A
Baseline and indicators TBD.
All local agencies in off-year
review cycle should include one
(1) page summary from SelfAssessment in FY 2014 Local
Agency Plan.
Nutrition Unit
Breastfeeding Unit
Monitoring Unit
71
Program Functional Area 11: Fiscal Management
Goal 11: Maximize the utilization of WIC food funds.
Objective: 11.1 By September 30, 2013, expand the usage to 97% of all food dollars.
Objective: 11.2 By September 30, 2013, revise Local Agency forms for required monthly reporting and required budgets and local
agency amendments.
Objective: 11.3 By September 30, 2013, incorporate financial data into data quality activities to provide trend analysis on Connecticut
WIC
Objective
11.1
expand the usage to 97%
of all food dollars.
Track LA expenditures monthly.
• Meet with program directors.
• Monitor food costs using the
current CPI cost indicators.
Baseline
Budget/expenditure
reconciliation.
Indicators
100% of food dollars are
accounted for.
Staff
Fiscal Unit
11.2
revise Local Agency forms
for required monthly
reporting and required
budgets and amendments.
Update current forms.
• Change current format to
Excel.
• Join worksheets to eliminate
repetitive information.
Worksheets with instructions
for Local Agency use with
fewer errors.
Less time to fill out forms and cut
down on errors.
Fiscal Unit
11.3
incorporate financial data
into data quality activities
to provide trend analysis
on Connecticut WIC.
Utilize financial data in trend
analysis
N/A
Utilize financial trend data to
drive program decisions
Fiscal Unit
72
Program Functional Area 12: Data Quality, Analysis & Reporting
Goal 12: Strengthen data outputs for improved program planning, monitoring, evaluation and administration.
Objective 12.1 Improve access to, and the utility and application of, WIC Program data:
a. Build on current reports to provide enhanced, more accessible, data resources;
b. Expand research/data analysis and reporting initiatives;
c. Provide support in meeting other Program-related data needs.
Objective 12.2 Contribute data inputs to help maximize strategic program coverage and effectiveness:
a. Strengthen appropriate access to and delivery of program services;
b .Ensure adequate access to vendor services, and vendor capacity to meet demand.
Objective
12.1
Improve access to, and
the utility and
application of, WIC
Program data:
a. Build on current
reports to provide
enhanced, more
accessible, data resources;
Prepare summary data tables, graphs to illustrate
trends, and maps to compare distribution of
selected variables;
CDC’s PNSS/PedNSS reports: post national, state
and county data files to DPH/WIC website; share
local-level files with field staff;
USDA’s Program & Participant Characteristics:
summarize and share pertinent information;
Censor data as appropriate in keeping with
confidentiality regulations prior to sharing outside
of WIC Program;
Post results or otherwise share selected data
tables, graphs, trend reports and/or maps.
Provide WIC Director with monthly summary stats
covering participation, caseload, check issuance &
redemption, program costs, and vendors, plus
national WIC data and state population figures.
Baseline
- Monthly SWIS
reports
- Annual PNSS/
PedNSS reports
- Biannual PC
studies
Indicators
Enhanced analysis and data
presentations better meet
USDA, state & local WIC
agency needs for information
on:
- WIC participation and
caseload;
- Risk factors and referrals;
- Process and outcome
objectives;
- Check issuance and
redemption;
- Authorized vendors.
 Data tables, graphs and
maps facilitate
comparison of participant
characteristics, risk factors, outcomes, etc.;
 Summary reports and
improved data access
result in less staff time
invested in responding to
routine requests.
Staff
Epidemiologist
IT staff
Nutrition unit
73
b. Expand
research/data analysis
and reporting
initiatives;
Link WIC data file with the State’s birth file &
Medicaid records: determine dual enrollment
WIC/Medicaid;
Prior studies
Project caseload, participation and program
costs based on historical data and
methodologies currently in use in other state
WIC programs;

More in-depth analyses
help inform program
decisions in support of
key interventions and
resource allocation;

Local-level disparities are
identified based on 2010
Census data, to better
target program services &
resources.

Timely response to
internal and external data
requests;

Surveys and presentations developed
and/or technical assistance provided;

Committees successfully
complete assigned tasks.
Update estimate of WIC eligible’s, using most
recent Census, birth and other data sources;
Epidemiologist
Nutrition unit
Map selected health, demographic and
socioeconomic Census variables at the local
level; compare results with current program
coverage;
Identify and track risk factors contributing to
poor program outcomes;
Evaluate associations between WIC
participation and risk factors for poor birth
outcomes.
c. Provide support in
meeting other Programrelated data and reporting needs.
Respond to internal and external data
requests;
Identify/develop relevant reference & training
resources;
Draft presentations for WIC Director,
Nutrition staff, etc.
Provide survey design, analysis, reporting,
or technical assistance.
Collaborate in initiatives that benefit the
State’s MCH population:
Serve as the State’s PNSS/PedNSS Coordinator;
Participate on DPH committees (MCH
Block Grant, RFP and Publication Review
Committees, etc.).
Current SWIS
reports
Ongoing collaboration
Epidemiologist
74
12.2
Contribute data inputs
to help maximize
strategic program
coverage and
effectiveness:
a. Strengthen
appropriate access to
and delivery of program
services;
b. Ensure adequate access to vendor services,
and vendor capacity to
meet demand.
Monitor program services to help inform program
planning and implementation efforts:
- Identify service gaps, priorities and opportunities;
- Track program outcomes and evaluate changes;
- Target resources to improve outcomes for those
at highest risk.
- Provide data/mapping inputs to help: (Re)locate
clinic and vendor resources; Identify specific
populations to target for outreach/promotional
efforts and program services.
Database development:
- Investigate need for data input form(s) to help
facilitate data entry, increase efficiency &
reduce error rates;
- Continue to identify priority data needs; build
standardized queries to meet those needs;
- Provide monthly updates on authorized vendors
to WIC Director and Vendor Management Unit.
Current program
services and
resources

Decisions to
increase/decrease program services and
resources are based on
objective inputs;
Risk factors and other
variables associated with
a given outcome or result
are identified, providing
enhanced criteria for
targeting program interventions.
Vendor services and
resources meet participant
and program needs.
Epidemiologist
Nutrition unit

Current vendor
database
Currently authorized
vendors
Epidemiologist
Vendor Unit
WIC participation
Vendor selection:
- Review the results of upcoming policy change in
vendor selection from quarterly needs
assessment to open enrollment, to determine
effectiveness in meeting participant and
program needs.
75

CONNECTICUT DEPARTMENT OF PUBLIC HEALTH PUBLIC HEALTH INITIATIVES BRANCH

Transcription

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