CERTIFICATION WPPM #220-20 Subject: Telehealth WIC Services Item: Virtual Breastfeeding Support and Telelactation

PURPOSE: To ensure that local agencies (LAs) perform breastfeeding support services in accordance to WIC program requirements when using telehealth technology (phone and/or videoconferencing) as a mode of service delivery. POLICY: I. LAs must comply with WIC program requirements for breastfeeding support and promotion regardless of whether breastfeeding services are provided in person or via telehealth. LA staff must: A. Maintain the same responsibilities of ensuring the privacy of health information, promoting breastfeeding as the norm for infants, and any other duties related to breastfeeding support. B. Work within their existing scope of practice when providing virtual breastfeeding support or telelactation services. C. Use CDPH/WIC approved platforms. Refer to WPPM 220-10. D. Make reasonable accommodations for participants, family representatives, and caretakers with disabilities. PROCEDURE(S): I. Pre-Approval for Conducting Telehealth Services A. The LA must submit a written proposal or plan to their Nutrition Consultant (NC) prior to performing breastfeeding support services using telehealth technology. Refer to WWPM 220-10. II. Obtaining and Documenting Consent for Virtual Breastfeeding Support/Telelactation A. LA staff must: 1. Obtain consent (verbal, written, or text message) from the family representative/caretaker prior to initiating telehealth as a mode of service delivery for WIC breastfeeding support or telelactation services. 2. Document the consent in the Comments field of the Contacts grid in the WIC Web Information System Exchange (WIC WISE). The Contacts grid is available on either the “Screening” screen or the “Family Information” screen.

California WIC Policy and Procedure Manual Page 1 of 3 May 18, 2021

CERTIFICATION WPPM #220-20 Subject: Telehealth WIC Services Item: Virtual Breastfeeding Support and Telelactation

California WIC Policy and Procedure Manual Page 2 of 3 May 18, 2021

3. Verify that consent has been documented in the WIC WISE family record prior to beginning a video conference appointment. If consent is missing, obtain and document consent before proceeding. 4. Inform the family representative/caretaker of all the individuals (e.g., interpreter, other pertinent staff members) who may be present to view the screen and/or hear the audio. B. Breastfeeding Peer Counselor (BFPC) staff must also document consent in the BFPC Database in addition to WIC WISE. III. Maintaining Privacy and Confidentiality A. LA staff must: 1. Provide all breastfeeding support and telelactation services in a secure and confidential manner. Refer to WPPM 220-30. 2. Conduct all telehealth services requiring breastfeeding or breast observations and/or pumping observations in a private space, free from intrusion by others, with only pertinent staff involved in the care of the participant present and able to view the video screen and/or hear the audio. 3. Not photograph or record (audio or video) a breastfeeding participant or infant for any purpose unless written consent has been obtained. IV. Scope of Practice A. LA staff must work within their scope of practice when providing breastfeeding support and telelactation services. B. LA staff must refer participants with issues beyond their scope of practice to the appropriate next level for additional support (e.g., BFPC refers to DBE or IBCLC; IBCLC to health care provider). V. Documentation of Virtual Breastfeeding Support and Telelactation Services A. BFPCs must document all contacts in the BFPC Data Base, and when applicable, document in WIC WISE per LA protocol. B. IBCLCs providing breastfeeding services to participants enrolled in the BFPC program must document care plans in the BFPC Data Base, and when applicable, document in WIC WISE per LA protocol. C. IBCLCs providing services to participants not enrolled in the BFPC program must document contacts and notes per LA protocol. When applicable, IBCLCs must

CERTIFICATION WPPM #220-20 Subject: Telehealth WIC Services Item: Virtual Breastfeeding Support and Telelactation

California WIC Policy and Procedure Manual Page 3 of 3 May 18, 2021

document this information in WIC WISE using the Contact History and Breastfeeding Notes grids in the Breastfeeding Support and Notes screen. D. LA staff providing breastfeeding support services (e.g., WNA, CLE/CLC, RD, DBE, etc.) must document all phone and/or video contacts in WIC WISE using the Contact History and Breastfeeding Notes grids in the “Breastfeeding Support and Notes” screen. AUTHORITY: 7 CFR §246.7 7 CFR §246.26 RESOURCE: Photo Notice and Release Form CROSS REFERENCE: WPPM 220-30 Telehealth Privacy and Confidentiality