Service Area Strategic Plan
11/23/2009   4:32 am
Department of Health (601)
Biennium: 2008-10
Service Area 1 of 1
Local Nutrition Services (601 440 18)
Description

The purpose of the service area is to assure healthy diets for mothers during pregnancy and breast-feeding and for their children ages 0 to five who might otherwise not be able to afford to eat properly. The service is offered for families with income under 185% of the federal poverty level.

Virginia’s Special Supplemental Nutrition Program for Women, Infants and Children operates pursuant to United States Department of Agriculture regulations in response to increasing scientific evidence that children’s ability to learn and excel in school is directly related to the quality of nutrition received during the critical period of prenatal and early childhood brain development. Women, Infants and Children differs from the Food Stamp program by covering only these high risk population groups, providing only specified high nutrition food items and requiring nutritional assessment and education for the participants.

The provision of vouchers to purchase a package of specifically prescribed high nutrient foods at local groceries is coupled with education for the mothers and/or primary care-givers about healthy eating. Increasing attention is being paid to educating families about ways to avoid the risks of childhood obesity while assuring proper nutrition. Breastfeeding is promoted while regular and specially prescribed formulas are provided for infants who are not breastfed. Offering the services of this program though local health departments allows linkage and referrals to be made assuring that the low-income recipients obtain primary health care services and specific preventive services such as childhood immunizations and lead-screening.
Background Information
Mission Alignment and Authority
  • Describe how this service supports the agency mission
    This service area directly aligns to the mission of the Virginia Department of Health to protect and promote the health of Virginians. It accomplishes this by providing information and specific resources for lower income families to assure optimal nutrition during the times of greatest brain development and growth of Virginia’s future citizens.
  • Describe the Statutory Authority of this Service
    The Federal Child Nutrition Act of 1966, Section 17 [42 U.S.C. 1786] established the Special Supplemental Nutrition Program for Women, Infants and children to provide supplemental foods and nutrition. Women, Infants and Children Regulations are found in the Code of Federal Regulations, 7 C.F.R. Part 246.

    Public Law 102-314 established the Women, Infants and children Farmers’ Market Nutrition Program (Code of Federal Regulations, 7 C.F.R. Part 248).

    • Code of Virginia Section 32.1-351.2 established the Children’s Health Insurance Program Family Access to Medical Insurance Security Plan). A mandated agreement with Department of Medical Assistance Services requires Virginia Department of Health to identify children who are eligible for Women, Infant and Children to expedite their eligibility for Family Access to Medical Insurance Security Plan.
Customers
Agency Customer Group Customer Customers served annually Potential annual customers
WIC Participants - Children 66,222 125,521
WIC Participants - Infants 35,615 35,415
WIC Participants - Women 35,122 52,190

Anticipated Changes To Agency Customer Base
Successful attempts to add more of the higher priority customer base (pregnant and breastfeeding
women) to the program may result in fewer children being served because the federal funds to purchase
food are limited.

Changes in the cultural view low-income women have of child-bearing and breastfeeding may either
increase or decrease the percentage of such women who actually participate depending on how their views
conform to the expectations of the program.

The perception by the families as well as by community informants such as physicians, friends, and
relatives of the “trouble” to participate as compared to the perceived benefit of the “free food” will impact
the number of actual eligible persons who will enroll and continue to participate.

Federal guidelines are expected to change the composition of the food package, and possibly other
matters, based on a report expected soon from an Institute of Medicine review. These changes may increase
or decrease the eligible populations, change the priorities for service among customer groups or change the
acceptability to different groups of the foods offered.

An increase or decrease in the number of families below the qualifying Federal poverty levels is possible
based on local economic conditions.

An increase in the number of women of child-bearing age may increase the number of eligible pregnant
and breastfeeding women.

A decreasing birthrate may decrease the number of women eligible for Women, Infant and Children.

Changes in access to other feeding programs (Food Stamps, charitable feeding programs, etc.) will raise or
lower the percentage of eligible persons who enroll and participate in this program, especially if they
believe that “free food and formula” is the only benefit of participating because they do not value the
provision of nutrition education.
Partners
Partner Description
[None entered]
Products and Services
  • Factors Impacting the Products and/or Services:
    Changes in federal regulations may serve to add to or limit the kinds or extent of service provided, either
    by specific direction or by reducing the resources supporting those services.

    Decreases in the availability of appropriately-credentialed employees may reduce the extent and/or
    quality of the services provided.

    Potential decreases in the level of training required of certain Women, Infant and Children employees with the substitution of algorithms for individual professional determination, may limit the ability of the program to fully meet or satisfy the unique requirements of some customers.

    Technological changes (e.g. automated telephone appointment reminders and computer-based health
    education for clients, etc.) may enhance client participation and understanding of the importance of good
    nutrition, allow faster and easier communication between staff and customers, and streamline the record
    keeping process, among many other potential benefits. However, more technology may deter some clients
    from enrolling or participating as desired.
  • Anticipated Changes to the Products and/or Services
    Increasing use of automated methods for delivering health education to clients in group and individual
    sessions

    Increasing use of automated methods to record information and track program measurements.

    Increased use of para-professional level personnel and algorithms to reduce program cost.
  • Listing of Products and/or Services
    • Information and support services for breastfeeding
    • Weight and height measurement
    • Testing for anemia
    • Blood lead risk information and referral (testing may be provided with non-Women, Infant and Children resources)
    • Individual and group education about nutritional needs and how to best meet them
    • Individual nutritional counseling for certain special health needs
    • Infant formulas provided including many as a result of physician prescription
    • Vouchers to purchase packages of specified high nutrition foods
    • Referrals to other primary and preventive health services
    • Immunization screening under age two and referral as indicated; immunizations often provided with other Health Department resources
    • Multi-vitamins and iron supplements provided with non-Women, Infant and Children funds to some participants under local medical protocols
Finance
  • Financial Overview
    Federal funds from the United States Department of Agriculture support a grant to Virginia to operate the Women, Infant and Children program. This service area includes the funds from the state grant that the state Women, Infant and Children office allocates to support local operation of the Women, Infant and Children program. No state or local matching funds are imposed by Virginia's acceptance of this grant.

    These funds represent 59 percent of the funds United States Department of Agriculture allocates to Virginia to administer the Women, Infant and Children program. Localhealth departments' funding levels are determined by a formula primarily based on client caseload. Funds received by local health departments are split among three activities with 24% allotted to nutrition education and breastfeeding services and 76% allotted to administrative costs.

    Local health departments use these funds almost exclusively for salaries and benefits for the nutritionists and other staff who enroll client in the program and provide services to those eligible individuals who participate in the Women, Infant and Children program. To varying degrees, most local health departments provide in-kind contributions such as office space and telephones for the Women, Infant and Children staff. As needed, many local health departments must also use staff paid by the cooperative budget in order to comply with United States Department of Agriculture program and record keeping requirements and to maintain current services. This staff time is indeterminate and varies considerably depending on such factors as the number of delivery sites, staff turnover, and increasing salaries. The cooperative budget staff time spent delivering Women, Infant and Children services is not usually reimbursed by the grant. Federal Women, Infant and Children funds coming to Virginia are likely to remain at a level that will require local health departments to continue in-kind and direct support of the program as needed.

    Virginia's Women, Infant and Children grant funds that support the purchase of food packages and infant formula as well as state office services and administration of the program are reflected in the Women, Infant and Children and Community Nutrition Service Area.
  • Financial Breakdown
    FY 2009    FY 2010
      General Fund     Nongeneral Fund        General Fund     Nongeneral Fund  
    Base Budget $0 $17,486,579    $0 $17,486,579
    Change To Base $0 $-191,521    $0 $-209,612
               
    Service Area Total   $0  $17,295,058     $0  $17,276,967 
Human Resources
  • Human Resources Overview
    [Nothing entered]
  • Human Resource Levels
    Effective Date      
    Total Authorized Position level Ø    
    Vacant Positions Ø    
    Current Employment Level 0.0    
    Non-Classified (Filled)    
    Full-Time Classified (Filled)    breakout of Current Employment Level
    Part-Time Classified (Filled)    
    Faculty (Filled)    
    Wage    
    Contract Employees    
    Total Human Resource Level 0.0   = Current Employment Level + Wage and Contract Employees
  • Factors Impacting HR
    [Nothing entered]
  • Anticipated HR Changes
    [Nothing entered]
Service Area Objectives
 
  • Provide low-income families with knowledge and resources to support healthy diets during pregnancy, breastfeeding and early childhood.
    Objective Description
    The right intake of nutrients by the pregnant woman and during early life has been repeatedly shown to be one of the most powerful ways to optimize the development of the young brain and place the child on the right road for development and learning in later years. Opportunities that are lost by inadequate nutrition during these critical periods cannot be recovered later in life.
    Objective Strategies
    • Local Health Departments will individually assess enrollees and provide them with nutrition education services as well as information about how to use the food vouchers and other requirements of the WIC program. These services will include offering related preventive health services and referrals. Local Health Departments will send reminders, make phone calls and take other steps to assure that enrollees continue to participate in the program by picking up and using food vouchers and returning for required re-certification and additional nutrition education sessions. Local Health departments, supported by the state WIC program, will survey clients and use other means to determine preferences and use the information to develop and implement improved means for delivering nutrition education that is practical and useful for clients over their life-time. Local Health Departments will reach out to find members of the priority risk groups and other potentially eligible individuals to enroll them in the WIC program. This strategy will involve use of media, partnering with health care providers and other community groups and offering accessible service times to enroll new customers.
    Objective Measures
    • Percentage of potentially-eligible pregnant women enrolled in the WIC program
      Measure Class:
      Other
      Measure Type:
      Output
      Measure Frequency:
      Annual
      Preferred Trend:
      Up
      Measure Baseline Value:
      69
      Date:
      9/30/2004

      Measure Baseline Description: Percent

      Measure Target Value:
      85
      Date:
      6/30/2010

      Measure Target Description: Percent

      Data Source and Calculation: The WIC-Net data system is the source of the persons enrolled. The number of persons estimated to be in each risk group was developed from state demographic and family income data by a contracted organization in 2003 and is updated as new birth and family income data is available.


Back to the Strategic Planning Page
http://www.vaperforms.virgina.gov