Kylia Crane, RDN, LD

1
WIC and Georgia Chapter of theAmerican Academy
of PediatricsCollaborations

• Kylia Crane, RDN, LD
• Nutrition Coordinator
• Georgia Chapter- American Academy of Pediatrics
• kcrane_at_gaaap.org
• 404-881-5093

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Promotion Education

• 2001- 2012 Physician Education
• WIC Physician Outreach Pilot
• Needs Assessment
• What is WIC?
• WIC Approved Formula Medical Foods
• Referrals
• Resources in the community

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Purpose of Physician Outreach Campaign

• Assist physicians and office staff in
  understanding public health programs and services
  for women, infants and children
• Identify the benefits of these programs
• Encourage referrals by physicians to appropriate
  public health programs and services

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2002 Pilot of Physician Outreach Campaign

• Goals
• Increase WIC participation rates
• Increase breastfeeding rates
• Address childhood obesity
• Increase physician awareness of Children 1st ,
  services related to Georgias Newborn Screening
  for Metabolic and Sickle Cell Disorders and
  Universal Newborn Hearing Screening and
  Intervention

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Pilot Site Selection

• The State WIC Office MCH selected the following
  as pilot sites
• Dublin- FY 03
• Waycross- FY 04
• Macon- FY 05
• Valdosta- FY 06
• Augusta- FY 07
• Coastal- FY 08
• Technical Assistance Project- FY 09
• Columbus- FY 10
• Clayton- FY 11
• Rome- FY 12

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WIC Nutrition Topics Presented

• What is WIC?
• WIC services
• Qualifications/Eligibility
• Referrals
• WIC Formula Contract/ Medical Documentation
• Breastfeeding support
• EPIC Breastfeeding Program
• Feeding Practices
• Childhood obesity- Expert Committee
  Recommendations
• Utilizing Local Resources

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Birth- 5 Topics Presented

• Children 1st- single point of entry
• Universal Newborn Hearing Screening
  Intervention
• Metabolic screening
• Babies Cant Wait
• Childrens Medical Services
• High Risk Infant Follow Up
• GA HealthCheck Requirements

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Public Health Districts Role

• Creation of Physician Listing in District-
• Pediatricians, Family Physicians, OB-Gyns
• Districts selected outreach method-
• Lunch workshops, office visit, educational
  toolkit, regional
• Meetings, grand rounds
• Strongly encouraged District/County staff would
  attend scheduled office visits
• District Tailored Outreach Materials

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Educational Toolkit
Pediatric Family Practice Pediatric Family Practice
WIC Children 1st
Georgia WIC Program Fact Sheet- Physician Reference WIC Clinic List- Columbus District GAWIC Formula Guide New GA WIC Food Package Flyer GA WIC Medical Documentation Forms 1 2 Breastfeeding Education Sheet AAP Breastfeeding Coding Fact Sheet EPIC Breastfeeding Flyer CDC Criteria for Anemia Flyer Expert Committee Guidelines on Prevention, Assessment Treatment of Childhood Obesity AAP Obesity Coding Fact Sheet   Additional Materials WIC Partnering with Medical Community CD Breastfeeding and Mothers Milk- Thomas Hale, PhD Body Mass Index (BMI) Wheels Food and Fitness Matter Raising Healthy, Active Kids DVD   Physicians Guide to Coastal Public Health Programs and Services Children Special Services Brochures Children 1st Screening and Referral Form Newborn Metabolic Screening Follow-up Brochure Universal Newborn Hearing Screening Intervention Brochure Universal Newborn Hearing Screening Intervention Flow Chart AAP Coding Fact Sheet on Developmental Screening EPIC Immunization Brochure   Additional Materials Autism Tool Kit Bright Futures Tool Kit Information  
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Educational Toolkit
OB/GYN Practice OB/GYN Practice
WIC Children 1st
Georgia WIC Program Fact Sheet- Physician Reference WIC Clinic List- Columbus District New GA WIC Food Package Flyer GA WIC Medical Documentation Forms 1 2 Breastfeeding Education Sheet AAP Breastfeeding Coding Fact Sheet EPIC Breastfeeding Flyer CDC Criteria for Anemia Flyer   Additional Materials WIC Partnering with Medical Community CD Breastfeeding and Mothers Milk- Thomas Hale, PhD     Physicians Guide to Coastal Public Health Programs and Services Children Special Services Brochures Children 1st Screening Referral Form Newborn Metabolic Screening Follow-up Brochure Universal Newborn Hearing Screening Intervention Brochure Universal Newborn Hearing Screening Intervention Flow Chart EPIC Immunization Brochure
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Georgia AAPs Role

• Create an outreach toolkit that included
  Pediatrician Guide to Public Health Programs and
  Services as a core piece
• Lunch and Learn Workshops to Physicians
  Practice Staff
• Identify benefits of these programs for
  physicians and their patients
• Provided referral resource materials
• Answer questions/concerns about WIC

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Challenges in Provider Outreach

• Limited face time with physician staff
• Large practices may having rolling lunch break
• Bias or negative perception of public health
• Bias or negative perceptions of physicians
  staff

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Physician Feedback

• Need guidance on Medical Documentation
• Need guidance on Special Formulas Appropriate
  Usage
• Physicians concern over language used to discuss
  WIC Medical Prescriptions
• ex. This formula is approved with prescription.
• Preferred- This formula is approved if patient
  has appropriate diagnosis indicated for that
  formula.

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Post Campaign Activities 2012-2015

• General Physician Education throughout state
• Development of Special Formula Infant Formula
  Algorithm- Stan Cohen, MD
• Trainings on Infant Formula
• Technical assistance with Medical Documentation-
  Special Formulas Medical Foods
• WIC Advocate Survey Dissemination
• EPIC Breastfeeding Program

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Things to Come

• Developing Referral Networking Plan
• Special Infant Formula Algorithm
• Evaluation of effectiveness
• Update algorithm resource information
• Developing policies for issuance of Child Special
  Formula Nutritionals

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Things to Come

• 2 Presentations at WIC Conference in August
• High Risk Infant-Special Formulas
• Premature Infant Nutrition- Treatment Guidelines
• Technical assistance with physicians- Medical
  Documentation- Special Formula Issuance
• Blast-communications
• Newsletter Articles

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Technical Assistance

• Protocol
• Please have District contact me after an attempt
  has been made to resolve issue with physician
  practice.
• During contact please provide
• Patient Name, DOB, parent/guardian name
• Physician/or Practice Staff Name, number
• Diagnosis- any necessary documented information
• Name of WIC Clinic, Nutritionist who contacted
  Physician/Practice Staff

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Technical Assistance

• Physician Office will be contacted
• State Office District Staff will receive
  communication on status of issue
• If issue not resolved via phone- possible lunch
  and learn workshop may be approved.
• Lunch and learn workshop- I will schedule and
  invite District/and or County staff to attend at
  physician practice. I will assist District/County
  staff in sharing of information for workshop.

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• Questions
• ???