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Local Staffing

Policy: Local WIC programs are required to have specific staff to carry out identified program functions and roles to ensure that local agencies are able to meet all program requirements and functions defined by federal regulations and state policy.

Regulation: CFR 246.11 c (7) (ii), CFR 246.2, CFR 246.6 b (2), USDA FNS WIC Nutrition Services Standards, FNS WIC Breastfeeding Curriculum: Peer Counselor Management

Procedure/Additional Guidance Staffing for the local WIC clinic includes the following positions/roles. Some staff may be in more than one position/role. ● Local Agency WIC Director ● Regional WIC Local Agency Director ● WIC High Risk Counselor (RD/RN) ● WIC Educator ● Local Agency Retail Coordinator ● Local Agency Outreach Coordinator ● Local Agency Breastfeeding Coordinator ● Lactation Management Specialist ● Educator WIC Lactation Specialist/Educator Advanced Lactation Credentials ● High Risk Counselor WIC Lactation Specialist/High Risk Counselor Advanced Lactation ● Designated Breastfeeding Expert ● Designated Breastfeeding Expert IBCLC ● Breastfeeding Peer Counselor Program Coordinator ● Breastfeeding Peer Counselor ● Breastfeeding Peer Counselor Lactation Management Specialist ● Non-WIC Staff with WIC Duties ● Volunteers

Local Agency WIC Director Local Agency (LA) WIC Director performs professional administrative and supervisory work in the planning, development, implementation and evaluation of the WIC Program. Oversees and coordinates the WIC activities of all clinic sites to ensure compliance with federal and state regulations. In large agencies, many of the duties described in this role may be delegated to other staff members. However, the ultimate responsibility for each duty falls on the WIC Director. In small agencies, the WIC Director and the WIC High Risk Counselor may be the same individual. The LA WIC Director works under the supervision of the agency's health officer or a designated high-level administrator. The LA WIC Director has line authority over subordinate professional and paraprofessional staff involved in the WIC Program.

Best practice is a dedicated 0.8 to 1.0 full-time equivalent (FTE) for this role.

Qualifications ● Education and Registration/License: The WIC Director must be a Registered Dietitian (RD) with the Commission on Dietetic Registration, a Registered Nurse (RN with a Bachelor’s Degree) licensed to practice in the State of Colorado, or a Medical Doctor (MD). Because WIC is a nutrition program, the position of WIC Director is ideally held by a Registered Dietitian. Note: In addition to the licensure requirements, a Bachelor’s Degree is the minimum education level required for this position. Preference is given to those who have a Master of Science (MS) or Master of Public Health (MPH) degree. ● Experience: Experience in public health or ambulatory care settings is preferred. A minimum of one-year experience in a public health setting or one year in a hospital setting is acceptable for consideration.

Knowledge, Skills and Abilities

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A fully functioning WIC Director should possess the knowledge, skills, and abilities listed below. In hiring for this position, supervisors should look for persons who possess most of these skills: ● Knowledge of human nutrition in health and nutrition needs for disease and its application to public health practices. Knowledge of nutrition needs for infants, children and women during the prenatal, postpartum, and breastfeeding stages. ● Knowledge of training, supervision, counseling, and educational concepts and methods. ● Ability to communicate effectively orally and in writing. ● Ability to manage Program operations and carry out Program planning functions; ability to formulate plans, policies, and procedures. ● Ability to organize, prepare, and analyze reports. ● Ability to establish and maintain effective working relationships. ● Ability to promote breastfeeding as the optimal infant feeding choice while allowing participant choice. ● Ability to supervise and direct professional and paraprofessional staff. ● Ability to develop forms and educational materials.

Responsibilities/Duties ● Completes the Colorado WIC New Employee Training program within the timelines defined. Manages overall WIC clinic operations: ● Formulates plans (including nutrition education plans), policies, standards, and procedures for the operation of the agency WIC Program within state and federal guidelines. ● Understands state and federal rules and regulations and follows up on agency deficiencies. ● Interprets and makes arrangements for implementation of federal and state regulations and policies. ● Evaluates implementation of new policies. ● Manages caseload and spending levels to meet appropriations by the State Office. ● Develops and makes recommendations for WIC budget proposals. Contacts State WIC fiscal officer and/or nutrition consultant regarding fiscal concerns/issues. ● Oversees, coordinates, and manages prescreening and waiting lists. ● Completes all forms/reports as requested by State WIC staff for monitoring and site visits; attends monitoring and site visit sessions; follows up on all monitoring findings and submits a timely response to the State Office. ● Ensures required retail monitoring and vendor training is done and that retailer monitoring reports are completed; works with retailers to prevent or correct problems. Ensures retailer contacts are documented in retailer files, and retailer misuse is documented in participant electronic charts. Ensures the State Retailer Coordinator is contacted with vendor problems/issues. ● Evaluates services to participants including clinic flow, use of staff time, clinic access, phone coverage, clinic space, and community needs. ● Provides the State Office with immediate feedback on adverse consequences of State policies or if policies are not understood. ● Ensures consistency among clinics in technical procedures and use of forms. Makes regular visits to all decentralized clinics to oversee operations. ● Oversees maintenance of equipment and testing for accuracy at all clinic sites. ● Maintains participant confidentiality and ensures that participants are treated equally and with respect, compassion, and empathy. ● Informs the State Office of major changes (i.e., staff, address, telephone, clinic hours which affect services). ● Participates in continuing education activities; attends meetings, conferences, and workshops; keeps abreast of current nutrition research as it relates to the WIC Program and participants. Registered dietitians must maintain registration with the required 75 credit hours per five-year period. ● Runs appropriate reports to verify food benefit issuance and redemption, processing standards, caseload management, etc. ● Contacts nutrition consultant with questions concerning caseload, management reports, clinic flow, State policies, equipment needs, nutrition education, staffing, and monitoring visits. ● Maintains a basic working knowledge regarding the Compass computer system and how it operates. ● Complies with the state WIC office regarding security, operations and functions of the Compass system. ● Ensures that administration areas of Compass are updated: referrals, pamphlets, Master Schedule, etc. ● Acts as LA Breastfeeding Coordinator (unless other staff is appointed).

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● Completes the WIC Lactation Specialist (WLS) Training to become WLS certified during the next WLS certification window ● Oversees breast pump loan program. ● Oversees Breastfeeding Peer Counseling (BFPC) Program (if applicable). ● Ensures staff is well trained. o Recruits, interviews, and recommends individuals for hire. o Oversees or conducts the orientation, training, and evaluation of newly hired WIC personnel. ✔ Ensures new staff complete Level I, II and III of the Colorado WIC New Employee Training Program as outlined by the state office. ✔ Observes staff interaction during appointments, including performing thorough nutrition assessments and providing nutrition information and counseling participants. o Defines staff roles and responsibilities, evaluates participant/staff ratios and staff needs. o Supervises WIC staff including annual performance evaluations, ongoing coaching and feedback. o Ensures continuing education opportunities for staff, including at least two sessions per year devoted to nutrition education. o Holds regular staff meetings to provide and enhance communication, to provide updates on policy and procedures, and provide staff training. Monthly staff meetings are optimal; however, small agencies may need bi-monthly or quarterly meetings. o Ensures quality nutrition education services to participants. o Develops or adapts and implements protocols of nutrition care. o Ensures staff members are trained in protocols. o Ensures that a WIC High Risk Counselor is available and trained to provide high risk education contacts. o Defines high risk for the agency (ensuring the State defined minimum definitions of high risk are covered); ensures WIC Educators know how to make appropriate referrals of high risk participants to the WIC High Risk Counselor. o Observes counseling skills of all staff members to ensure that accurate and appropriate information is being disseminated and that counseling skills are adequate. Trains staff in areas where improvement is needed. o Ensures that the documentation in participant electronic chart meets the required criteria listed in the WIC Program Manual. o Reviews, selects, or develops nutrition education materials as needed. o Attends and ensures that all staff members attend State sponsored WIC training. Attends and ensures that all staff members attend required State sponsored WIC trainings. o Recommends and registers staff for the WLS training (including suggesting staff take training as a refresher if staff completed the WLS training more than 5 years prior). o Oversees the implementation of Program nutrition objectives, participates in the nutrition education planning process via State Office guidance, and ensures that nutrition education and data collection conforms to standardized and accepted practices. ● Coordinates activities with other community services. o Arranges outreach and publicity for the agency WIC Program. o Develops formal referral relationships with pediatric and obstetric health caregivers. o Acts as a liaison to the community regarding WIC services, policies, and/or nutrition issues (e.g., informing and updating health care providers, social service agencies, assessing community needs). o Coordinates and assists staff to be familiar with community resources and services when referring WIC participants.

Partnership WIC Local Agency Director Partnership WIC Local Agency Director (PWLAD) performs professional administrative and supervisory work in the planning, development, implementation and elevation of the WIC program. Oversees and coordinates the WIC activities of multiple agencies/counties and clinic “satellite” sites to ensure compliance with federal and state regulations. The PWLAD may delegate some of the duties described in this role; however, the ultimate responsibility for each duty and all contract requirements falls on the PWLAD. The PWLAD works under supervision of the agency’s health officer or a designated high-level administrator and has line authority over subordinate professional and paraprofessional staff involved in the WIC program at all sites in the region. Roles related to the human resource management of staff at satellite agencies may remain a responsibility of that agency, depending on the structure and agreement between agencies and approved by the state authority.

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Best practice is a dedicated 0.8 to 1.0 full-time equivalent (FTE) for this role.

Qualifications ● Education and Registration/License: The WIC Director must be a Registered Dietitian (RD) with the Commission on Dietetic Registration, a Registered Nurse (RN with a Bachelor’s Degree) licensed to practice in the State of Colorado, or a Medical Doctor (MD). Because WIC is a nutrition program, the position of WIC Director is ideally held by a Registered Dietitian. Note: In addition to the licensure requirements, a Bachelor’s Degree is the minimum education level required for this position. Preference is given to those who have a Master of Science (MS) or Master of Public Health (MPH) degree. ● Experience: Minimum of five years’ experience in a public health setting is preferred. Minimum of two years’ WIC experience is required.

Knowledge, Skills, Abilities All knowledge, skills, and abilities included in the LA WIC Director description, plus: Ability to manage multi- agency agreements, training, staffing, and resource management.

Responsibilities/Duties All Responsibilities/Duties included in the LA WIC Director description and all agreed upon duties in the MOU between partnership agencies, plus:

WIC High Risk Counselors (RD/RN) The WIC High Risk Counselor performs professional and supervisory public health nutrition activities by delivering direct care participant services as well as participating in program planning and evaluation as assigned. In small agencies, this professional may be the same individual as the WIC Director. The WIC High Risk Counselor works under the supervision of the LA WIC Director and may supervise the WIC Educator and/or other WIC High Risk Counselors as assigned.

Best practice is a ratio of approximately 1 full-time equivalent HRC to 1500-1850 clients for this role, depending on other duties (supervision, clinic oversight, etc.).

Possible Titles: ● Nutritionist ● Registered and/or Licensed Dietitian ● Community High Risk Counselor ● Public Health High Risk Counselor ● Community Nurse ● Public Health Nurse ● WIC High Risk Counselor

Qualifications ● Education and Registration/License: The WIC High Risk Counselor must be a Registered Dietitian (RD) with the Commission on Dietetic Registration, a Registered Nurse (RN with a Bachelor’s Degree) licensed to practice in the State of Colorado, Medical Doctor (MD), or Physician Assistant (PA). Because WIC is a nutrition program, the position of WIC Director is ideally held by a Registered Dietitian. Note: In addition to the licensure requirements, a Bachelor’s Degree is the minimum education level required for this position. Preference is given to those who have a Master of Science (MS) or Master of Public Health (MPH) degree. o RD eligible allowed for a maximum of 6 months post hire date. ● Experience: Experience in ambulatory care, public health, or clinical setting.

Knowledge, Skills and Abilities A fully functioning WIC High Risk Counselor will need the knowledge, skills, and abilities listed below. In hiring for this position, a supervisor should look for persons possessing the majority of these skills:

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● Knowledge of human nutrition in health and disease and its application to public health practices. ● Knowledge of nutrition needs for infants and children and women during the prenatal, postpartum, and breastfeeding stages. ● Knowledge of effective counseling and educational concepts and methods. ● Ability to communicate effectively orally and in writing. ● Ability to establish and maintain effective working relationships. ● Ability to develop and carry out ongoing plans for nutrition education. ● Ability to interpret scientific information for lay audiences. ● Knowledge and understanding of the high risk functions related to the Compass computer system. ● Ability to assess nutritional status, design nutritional care plans, and counsel participants toward improved diets with behavior change. ● Ability to promote breastfeeding as the optimal infant feeding choice while allowing participant choice. ● Ability to be understanding and empathetic when dealing with participants. ● Ability to prepare educational materials and prepare and deliver in service trainings. ● Ability to supervise paraprofessional/professional staff as needed to assist the WIC Director/Coordinator.

Responsibilities/Duties ● Completes the Colorado WIC New Employee Training program within the timelines defined. ● Interviews participants and makes thorough nutrition assessments by interpreting anthropometrics and laboratory data, health histories, medical diagnoses, physician's orders, eating habits and nutrition practices, diet assessments, and other related factors. ● Develops, implements, evaluates, and follows up on participant care plans. Counsels participants and families on nutritional needs with consideration of income, cultural and religious food patterns, home facilities, educational level, and other psychosocial factors. ● Maintains participant confidentiality and ensures that participants are treated equally with respect, compassion, and empathy. ● Consults with health care providers on participants’ nutritional needs, formula requiring prescription, and health concerns; makes appropriate referrals and follow up. ● Provides appropriate documentation in participant electronic charts, including participant concerns, nutrition assessment, and materials provided, nutrition education, referrals, and progress toward attaining new behavior change nutrition goals, and follow up plans. ● Counsels all high risk participants at least once during a certification period and within the required time frame. ● Determines follow up care for as long as the participant is considered high risk. ● Completes the WIC Lactation Specialist (WLS) Training to become WLS certified during the next WLS certification window. ● Provides information on the benefits of breastfeeding, aids in breastfeeding promotion in the clinic, offers praise for breastfeeding, and refers staff to IBCLCs as necessary. ● Assesses need and issues breast pumps, instructs on pump use and milk collection/storage, as needed. ● Assesses and provides counseling on common and complex breastfeeding problems, including WIC breastfeeding risk factors and provides high risk follow up, as necessary. ● Authorizes the use of exempt infant formulas, WIC-eligible medical foods, and individual needs for certain tailoring of WIC food packages. ● Reviews and signs as the authorized certifying professional for WIC Educators who have not completed Level I of the Colorado WIC New Employee Training Program. ● Provides nutrition education through individual and/or group instruction to participants, professionals, and community groups. ● Helps orient, train, supervise, and evaluate WIC paraprofessionals, volunteers, and clerical staff as assigned. ● Conducts and/or assists with in service education for staff and professional groups. ● Reviews, evaluates, and/or develops nutrition education materials. ● Participates in Program planning development and evaluation; works on assigned nutrition projects. ● Acts as a resource person for nutrition information. ● Assists with outreach and public relation activities. ● Participates in monitoring electronic charts, paper files, clinic activities, nutrition education, and counseling.

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● Participates in continuing education activities; attends meetings, conferences, and workshops; keeps abreast of current nutrition research as it relates to the WIC Program and participants. ● Participates in staff conferences, meetings, in service training, and State meetings.

WIC Educator The WIC Educator delivers WIC services to participants by determining and documenting eligibility, issuing food benefits, maintaining participant and Program electronic records and paper files related to participant certification, interviewing, providing nutrition education with behavior change goals, and developing individual care plans based on a sound understanding of nutritional concepts.

The WIC Educator develops proficiency in providing the full range of WIC services to participants. Titles of these individuals might include Lead WIC Educator, Administrative WIC Educator, WIC Receptionist, WIC Technician, WIC Clerk, or WIC Program Assistant. Lead WIC Educators are typically assigned higher-level duties such as training and supervising other staff.

The WIC Educator is expected to work under minimal supervision and to exercise independent judgment and a high degree of initiative within established procedures. The Educator works under the supervision of the WIC Director, WIC High Risk Counselor or designated WIC Supervisor.

Best practice is a ratio of approximately 1 full-time equivalent Educator to 400-500 clients for this role, depending on other duties.

Qualifications ● Because WIC is a nutrition program, the job of WIC Educator is ideally held by a Diet Technician (someone who has a two-year degree in nutrition science). Also highly desirable in this position is a Licensed Practical Nurse (LPN). All persons hired as a WIC Educator must complete the Colorado WIC New Employee Training Program modules within defined timelines. ● Education: Minimum high school diploma or GED. ● Experience: Previous work experience with the public. WIC and/or public health experience and experience with low income participants is preferred. ● Special Qualifications: Bilingual (Spanish) desirable.

Knowledge, Skills and Abilities A fully functioning WIC Educator will need all of the knowledge, skills, and abilities listed here. In hiring for the position, a supervisor should look for the first ten skills. The last six can be learned on the job. ● Knowledge of business English, spelling, and math. ● Knowledge of standard office practices and procedures. ● Knowledge of socio economic conditions of local community and social agencies. ● Ability to operate standard office equipment, including a computer. ● Ability to read and interpret a variety of complex rules, regulations, and other materials. ● Ability to prepare and maintain accurate and neat records. ● Ability to provide participant services to assigned caseload and complete paperwork within time limits. ● Ability to establish and maintain effective working relationships. ● Ability to communicate effectively orally and in writing. ● Ability to work with minimal supervision; ability to work as a team member. ● Ability to pass the Colorado WIC New Employee Training Program with the required passing scores for Level I II and III. ● Ability to work with height/length, weight, and measuring devices. ● Ability to perform finger stick blood tests to determine hematocrit or hemoglobin levels. ● Knowledge of effective interviewing and counseling techniques. ● Knowledge of nutrition and nutritional concepts. ● Ability to promote breastfeeding as the optimal infant feeding choice while allowing participant choice.

Responsibilities/Duties ● Completes the Colorado WIC New Employee Training program within the timelines defined.

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● Explains the Program to prospective participants; takes applications over the phone and in person; maintains waiting lists by priority and prescreening list, when necessary. ● Provides assistance in completing the certification process for people who have difficulty in speaking or writing. ● Schedules appointments with participants and follows up on participants who miss their appointments. ● Takes accurate health assessments at specified intervals involving heights, lengths, weights, and hematocrit or hemoglobin measurements; accurately enters this information into the Compass computer system and/or routes to appropriate person. ● Collects comprehensive diet information with a participant centered positive approach. ● Determines and documents complete Program eligibility; identifies all relevant risk factors; enrolls participants; reevaluates participants for continued Program eligibility. ● Determines and tailors food packages to individual needs; documents tailoring; and issues food benefits. ● Provides full explanation of the Program to participants to prevent and help resolve participant misuse; explains purpose of the WIC food package and the nutrients provided. ● Educates participants on the Colorado WIC Program Food List & Shopping Guide. ● Assesses need for and refers participants to appropriate health care and social service programs; makes individual referrals to health/social professionals and follows up referrals. ● Assists participants with individual nutrition education plans; dialogues with participants to identify appropriate behavior change goals; makes appropriate referrals; follows up and documents progress toward goals; reevaluates and establishes new goals; follows protocols. ● Identifies high risk participants according to the definition and makes appropriate referrals to the WIC High Risk Counselor. ● Provides information on the benefits of breastfeeding, aids in breastfeeding promotion in the clinic, offers praise for breastfeeding, conducts breastfeeding education classes and support groups (as able/necessary) and refers to WIC High Risk Counselor, DBE, Educator Advanced Lactation Credentials, or Educator WIC Lactation Specialist (WLS). ● Maintains confidentiality of participants and ensures that participants are treated equally with respect, compassion, and empathy. ● Understands retailer requirements; documents participant and retailer requests or problems and resolves simple problems; refers more complex or repeated problems for resolution. ● Ensures all equipment is clean and maintained in working order and tested for accuracy at regular intervals. ● Orders and maintains adequate inventory of office supplies, clinical supplies, forms, educational pamphlets, eWIC card stock, and other materials for the clinic site. ● Participates in on-going training on the Compass computer system. ● Highly encouraged to attend the WIC Lactation Specialist Training to become a WLS.

Local Agency Retailer Coordinator (LARC) WIC contact person for the state office and for the WIC vendors regarding food delivery topics. Communicate with local vendors regarding current WIC policy and procedures. Complete retailer monitoring visits and reports. Follow-up with participants and store complaints and concerns. The Local Agency Retailer Coordinator (LARC) works under the supervision of the WIC Director, WIC High Risk Counselor or designated WIC Supervisor.

Best practice staffing is equal to 26 hours per year + (3 hours x # of stores = total hours) = total # of hours needed.

Qualifications ● Education: Minimum high school diploma or GED. ● Experience: Previous work experience with the public. WIC and/or public health experience and experience with low-income participants is preferred. Experience with retail stores and/or cashier experience is helpful.

Knowledge, Skills and Abilities (See the complete listing of skills for the WIC Educator position) ● Ability to read and interpret the WIC retailer rules and regulations. ● Ability to prepare and maintain accurate and neat records. ● Ability to communicate effectively orally and in writing. ● Ability to assist with conflict resolution and confidentiality issues.

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● Knowledge of effective counseling and education concepts and methods. ● Ability to establish and maintain effective working relationships. ● Ability to deliver orientation/training/monitoring sessions to various levels of store staff.

Responsibilities/Duties ● Sets up a process so that any staff member can record comments or problems. Keeping detailed, precise records is the key to effective coordination between the State, Local Agency and stores. ● Conducts pre-authorization visits. ● Collects and maintains vendor reports from State WIC staff detailing WIC food benefit redemption, inventory and/or volume history. Assists with training and problem resolution, as needed, for the store. ● Completes training and orientation visit for all new WIC vendors, including shelf surveys. ● Conducts informal site visits ● Conducts routine retailer monitoring visits using the Retailer Monitoring Report form within the agreed upon monitoring schedule. Submits Retailer Routine Monitoring Reports to State Office within 3 days of visit. Follows-up on findings and violations found during the visit. o Reviews WIC policy and procedures such as redeeming food benefits, the Colorado WIC Food List & Shopping Guide, stocking requirements, with the local agency, stores, and participants as appropriate. o Develops processes for tracking and resolving vendor and participant complaints and/or problems. o Participates in the LARC Quarterly Calls. o Completes LARC 101 Training Module every three years (October-December). o Provides written documentation supporting sanctions/disqualifications of participants and/or vendors if needed, including testifying at Fair Hearing Procedures. o Provide vendor coordination guidance to local agency staff.

Local Agency Outreach Coordinator Publicizes the availability of the WIC Program, builds an outreach network, informs organizations in the outreach network about the WIC Program, and coordinates with other community resources to increase the WIC caseload. Outreach Coordinator works under the supervision of the WIC Director, WIC High Risk Counselor or designated WIC Supervisor.

Qualifications ● Education: (See the education and qualifications listed for all of the WIC positions) ● Experience: Previous work experience with the public. WIC and/or public health experience and experience with low-income participants is preferred. Experience with other community programs and agencies plus work with various media is helpful.

Knowledge, Skills and Abilities (See the complete listing of skills for the WIC Educator, WIC High Risk Counselor.) ● Ability to coordinate and chair a committee. ● Ability to evaluate all possible outreach approaches and possible audiences. ● Ability to work with a variety of media. ● Ability to communicate effectively orally and in writing.

Responsibilities/Duties ● Coordinates outreach planning with the WIC Director, the WIC staff, an outreach committee or task force. ● Publicizes the availability of the WIC Program. ● Establishes an outreach network with community agencies/programs serving similar populations. ● Educates the agencies/organizations about the WIC Program and how possible participants can apply. ● Documents outreach activities, agencies contacted and the date of completion. ● Assists the LA WIC Director with updating the referral list in Compass. ● Under the direction of the LA WIC Director, performs duties associated with the WIC Referral System (WRS).

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Local Agency Breastfeeding Coordinator Every WIC agency in Colorado has a designated LA Breastfeeding Coordinator, although larger agencies may have a designated coordinator at each clinic. The Breastfeeding Coordinator is responsible for coordinating breastfeeding promotion and support activities for the agency or clinic in collaboration with the agency’s WIC Director. The LA Breastfeeding Coordinator works under the supervision of the WIC Director, WIC High Risk Counselor or designated WIC Supervisor.

Best practice is based on the number of staff supported by this role, depending on other duties (0.25 FTE: 1-10 staff; 0.25 - 1.0 FTE: 11-25staff; 1.0+ FTE: >25 staff).

Qualifications ● Education/Training: Minimum high school diploma or GED; a four-year degree from an accredited university/college is preferred, ideally a degree in nutrition science or other health science field. Additionally, has received at least 20 hours of advanced training in breastfeeding promotion and support beyond the Colorado WIC New Employee Training Program (e.g., breastfeeding workshops; WIC breastfeeding training, State WIC Meetings, WLS, CLC, CLE, or IBCLC). ● Experience: Must meet all requirements for a WIC Educator. Previous work experience with the public and/or community programs. Breastfeeding experience is desirable, but not required.

Knowledge, Skills and Abilities (See complete listing of skills for the WIC Educator position.) ● Ability to disseminate and implement appropriate policies and guidelines that support and promote breastfeeding as the preferred method of infant feeding. ● Ability to collaborate with prenatal, well child, and family planning programs, hospitals, and/or other community health care providers to coordinate breastfeeding promotion and support activities. ● Ability to prepare and maintain accurate and neat records, and submit reports to the State Office in a timely manner. ● Ability to communicate effectively orally and in writing.

Responsibilities/Duties ● Completes the WIC Lactation Specialist (WLS) Training to become WLS certified during the next WLS certification window. ● The clinic/agency environment is breastfeeding-friendly by implementing the following requirements: o Portray breastfeeding as the preferred infant-feeding method in a culturally and aesthetically appropriate manner. o Establish a positive attitude toward breastfeeding by clinic and agency staff. o Avoid use of printed and audiovisual materials and office supplies developed by formula manufacturers in any WIC clinic. o Store infant formula in areas not visible to the WIC participant. o Provide a supportive clinic environment in which women feel comfortable breastfeeding their infant. o Incorporate positive peer influence into the prenatal period through use of peer counselors, bulletin boards that display successful breastfeeding mothers and infants, or hosting sessions where pregnant women can talk with breastfeeding women, and/or scheduling pregnant and breastfeeding women at the same time. o Include participants’ family and friends in breastfeeding education sessions. o Issue a formula package consistent with the mother’s breastfeeding goals and the infant’s nutritional needs. ● Systems/programs are in place to provide timely support services to breastfeeding women and infants. Activities may include: o Create procedures to ensure breastfeeding women and infants are certified within 7 to 10 days of delivery. o Coordinate in-services on assessing the breastfeeding dyad. o Collaborate with community programs/organizations to identify or develop systems of support (e.g., La Leche League, local hospital lactation programs, home visitation program, public health nursing). o Coordinate a telephone follow-up program. o Regularly assess agency needs for breast pumps and supplies and, in collaboration with WIC Director, completes breast pump and supply order form.

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o Review policies and procedures for issuing breast pumps and supplies with all staff periodically. o Use breastfeeding reports to identify common reasons women cease breastfeeding and develop strategies to address barriers. o Track breastfeeding rates for the agency/clinic. o Participate in Breastfeeding Coordinator conference calls, meetings, and other activities with the state breastfeeding coordinator. ● Ensures all staff members are competent in providing breastfeeding education and support. Activities may include: o Orient new employees on the agency’s breastfeeding activities and services, WIC policies and procedures, and the Program’s breastfeeding goals. o Assess staff training needs and coordinate training opportunities as appropriate, including referring staff to complete the WLS training program. o Plan and implement breastfeeding continuing education for staff annually. o Review participant breastfeeding education materials and staff training materials annually to ensure they are up-to-date and accessible to staff. o Apprise staff of changes in WIC breastfeeding policies, procedures, or recommendations. Review tailoring of the breastfeeding infant food package with staff on a regular basis. o Work with the LA Director to include questions in the interview process for prospective employee’s ability to provide breastfeeding education as well as in the annual evaluation process of the employee. o Serve as a breastfeeding resource person for staff (e.g., is well versed in Colorado WIC breastfeeding policies and procedures, maintains local agency/clinic breastfeeding library [books and videos], and materials needed to complete the Breastfeeding Module). o Coach staff to build their skills in providing breastfeeding education and support. ● The clinic/agency staff actively promotes and supports breastfeeding to the WIC population and community. Activities may include: o Coordinate activities to celebrate WIC National Breastfeeding Week. o Present to local organizations and health care programs on the services provided by WIC emphasizing breastfeeding education and support services. o Participate in the local breastfeeding task force or possibly initiate the development of a task force if one does not exist. o Submit breastfeeding articles and public service announcements to local media.

Educator WIC Lactation Specialist (Educator WLS)/Educator Advanced Lactation Credentials This is an enhanced role for a WIC Educator who has received higher-level breastfeeding education through the Colorado WIC Lactation Specialist (WLS) training and/or advanced lactation credentials (CLC, CLE or IBCLC) and has developed their expertise. The following roles and responsibilities are within the scope of practice for an Educator WLS and/or Educator Advanced Lactation Credentials:

Qualifications ● Meets qualifications of a WIC Educator. ● Education: o Educator WLS - Minimally, has participated in the Colorado WLS training. o Educator Advanced Lactation Credentials - Minimally, has obtained advanced lactation credential (CLC, CLE, or IBCLC) from an accredited program including completing course work, passing an exam and maintaining the credential as required by the accrediting body (e.g., continuing education credits, fees). ● Experience: Previous work experience with the public and/or community programs.

Knowledge, Skills and Abilities (see WIC Educator role for complete listing) ● Ability to disseminate and implement appropriate policies and guidelines that support and promote breastfeeding as the preferred method of infant feeding. ● Ability to review evidence-based literature and apply to practice. ● Ability to pass the WLS or CLC, CLE, or IBCLC exam at the completion of the training [and pass two required WLS observations (unless already CLC, CLE or IBCLC certified)].

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Responsibilities/Duties ● Assesses and provides counseling on common and complex breastfeeding problems. ● Performs the counseling expectations described in the “Breastfeeding Complications or Potential Complications (602/603)” content in the High and Low Risk Protocol policy. ● Provides prenatal anticipatory guidance [responding to concerns and issues about breastfeeding; such as, reinforcing that it takes about a month to establish milk supply; no formula first month; what to request in the hospital (Baby-Friendly Hospital Initiative’s Ten Steps to Successful Breastfeeding), issues returning to work or school; hand expression; breastfeeding resources in community]. ● Responds to participant breastfeeding questions, providing information on the benefits of breastfeeding, offering praise for breastfeeding, and aids in breastfeeding promotion activities in the clinic. ● Assesses need, coordinates and loans/issues breast pumps and supplies, instructs on pump use and milk collection/storage.

Optional Functions ● Teaching participant breastfeeding classes and/or leading breastfeeding support groups. ● Providing support calls to mothers prenatally or early postpartum to offer encouragement and respond to questions, including after pump issuance. ● Recommending breast shells, breast pads, and other breastfeeding aids.

High Risk Counselor WIC Lactation Specialist (WLS)/High Risk Counselor Advanced Lactation Credentials All High Risk Counselors are required to participate in a training to be able to function as a WIC Lactation Specialist (WLS). High Risk Counselors may also obtain advanced lactation credentials (CLC, CLE, IBCLC) to further their expertise and support for participants. The following roles and responsibilities are within the scope of practice for High Risk Counselor WLS and/or High Risk Counselor Advanced Lactation Credentials.

Qualifications ● Meets qualifications of High Risk Counselor. ● Education: o High Risk Counselor WLS: Minimally, has participated in the Colorado WIC WLS training. o High Risk Counselor Advanced Lactation Credentials - Minimally, has obtained advanced lactation credential from an accredited program (CLC, CLE, IBCLC) including completing course work, passing an exam and maintaining the credential as required by the accrediting body (e.g., continuing education credits, fees). ● Experience: Previous work experience with the public and/or community programs.

Knowledge, Skills and Abilities In addition to the following, see complete listing for High Risk Counselors and Educators in Local Staffing section, respectively. ● Ability to disseminate and implement appropriate policies and guidelines that support and promote breastfeeding as the preferred method of infant feeding. ● Ability to review evidence based literature and apply to practice. ● High Risk Counselor WLS - Ability to pass the WLS exam at the completion of the training course. High Risk Counselor Advanced Lactation Credentials - Ability to pass the CLC, CLE, and/or IBCLC exam at the completion of the training course(s) and any required observations.

Responsibilities/Duties ● Mentors Educator WLS and BFPC WLS. ● Performs the counseling expectations described in the “Breastfeeding Complications or Potential Complications (602/603)” content in the High and Low Risk Protocols policy. ● Provides high risk follow-up to a mother and infant within two weeks of risk assignment of NRF 602/603 if initial 24-hour high risk counseling was provided by an Educator WLS. ● Provides prenatal anticipatory guidance (responding to concerns and issues about breastfeeding; reinforces that it takes about a month to establish milk supply; no formula first month; what to request in the hospital; issues for returning to work or school; hand expression; breastfeeding resources in community).

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● Assesses need, coordinates and loans/issues breast pumps and supplies. Can delegate to Educator WLS or Educator Advanced Lactation Credentials. ● Makes referrals to health care providers, IBCLC or hospital lactation staff. ● Contacts participant’s health care provider to discuss concerns (e.g. medications and breast milk; formula supplementation prescriptions). ● Responds to participant breastfeeding questions. ● Recommends breast shells, breast pads, and other breastfeeding aids. ● Troubleshoots breastfeeding concerns such as inadequate milk supply (perceived or real) and solutions for engorgement.

Optional Functions ● Teaching breastfeeding classes and/or leading support groups. ● Providing support calls to mothers prenatally or early postpartum to offer encouragement and respond to questions.

Designated Breastfeeding Expert The Designated Breastfeeding Expert (DBE) has special training and experience helping mothers with complex breastfeeding problems that are outside the scope of practice of BFPCs and other WIC staff. The DBE operates within the policies and procedures of the WIC program and within the context of WIC’s role for breastfeeding support. Each LA operating a BFPC program is required to have access to a DBE to assist WIC participants with complex breastfeeding challenges in a timely manner. This role is typically fulfilled by the LA BFPC Coordinator.

Qualifications ● Education: Is a Registered Dietitian, Nutritionist or health care provider (Master's or Bachelor’s degree in Nutritional Sciences, Community Nutrition, Clinical Nutrition, Dietetics, Public Health Nutrition or Home Economics with emphasis in Nutrition), IBCLC, Registered Nurse, Physician’s Assistant certified by the National Committee on Certification of Physician’s Assistants or has completed a minimum of 8 college courses from an Accredited Institution in the Health Sciences (suggested coursework includes, but is not limited to the following areas: Human Anatomy, Human Physiology, Biology, Infant Growth and Development, Nutrition, Counseling Skills, Sociology, Introduction to Clinical Research, etc.). ● Training: Successful completion of the FNS competency-based training for WIC Breastfeeding Curriculum (levels 1-4) or completion of a State-approved competency-based breastfeeding training that is consistent with the FNS WIC Breastfeeding Curriculum. ● Experience: o Experience working with low-income breastfeeding mothers and infants who experience complex breastfeeding challenges. o Minimum of one year of experience in counseling breastfeeding mother/infant dyads. o Experience providing breastfeeding training/education.

Knowledge, Skills and Abilities A fully functioning DBE will have the following skills or be able to learn them on the job. ● Knowledge of socio-economic conditions of the local community. ● Critical thinking and problem solving. ● Breastfeeding Assessment and Care Plan Development. ● Ability to clearly communicate complex care plans to the WIC breastfeeding team, as appropriate.

Responsibilities/Duties The WIC DBE duties include, but are not limited to: ● Acts on referrals from BFPCs regarding complex breastfeeding challenges beyond their scope of practice. ● Assesses, contributes towards the development of a care plan and counsels the mother/infant dyad with complex breastfeeding challenges. ● Performing the counseling expectations described in the “Breastfeeding Complications or Potential Complications (602/603)” content in the High and Low Risk Protocols policy. ● Communicates care plan to the rest of the WIC breastfeeding team, as appropriate. ● Refers participants to health care providers for further assessment and medical care when needed.

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● Refers to hospital lactation staff and community breastfeeding support resources, as necessary. ● Assesses need, coordinating and loaning/issuing breast pumps and supplies. Can delegate to Educators or High Risk Counselors who are WLSs or have advanced lactation credentials. ● Recommending breast shells, breast pads, and other breastfeeding aids and administering/overseeing supplemental nursing systems (SNS) as necessary. ● Mentors all other WIC staff, specifically Educator WLS, BFPC WLS and High Risk Counselor WLS. ● Maintains lactation credentials and certifications.

Optional Functions ● Teaching breastfeeding classes and/or leading support groups. ● Providing breastfeeding trainings for WIC staff and serving as a resource and mentor. ● Promoting breastfeeding within the community.

Designated Breastfeeding Expert IBCLC The Designated Breastfeeding Expert IBCLC (WIC DBE-IBCLC) has special training and expertise assisting participants with complex breastfeeding problems. This position requires completion of both DBE requirements and IBCLC credential. This position is optional and can be combined with other WIC staffing roles, or as its own position within the LA.

Qualifications ● Meets qualifications of WIC DBE. ● Education: o Minimally, has obtained and maintained the International Board Certified Lactation Consultant (IBCLC) credential as provided by and verified by the International Board of Lactation Consultant Examiners (IBLCE). o Successful completion of the FNS competency-based training for WIC Breastfeeding Curriculum (levels 1- 4) or completion of a State-approved competency-based breastfeeding training that is consistent with the FNS WIC Breastfeeding Curriculum. o Maintains consistent continuing education credits and stays up to date on best practices related to lactation. ● Experience: o Advanced experience assisting families with complex breastfeeding challenges. o Experience working with low-income breastfeeding mothers and infants who experience complex breastfeeding challenges. o Minimum of one year of experience in counseling breastfeeding mother/infant dyads. o Experience providing breastfeeding training/education to colleagues, health care professionals, and the general public.

Knowledge, Skills and Abilities A fully functioning WIC DBE-IBCLC will have the following skills or be able to learn them on the job. ● Knowledge of socio-economic conditions of the local community. ● Critical thinking and problem solving. ● Breastfeeding Assessment and Care Plan Development. ● Ability to clearly communicate complex care plans to the WIC breastfeeding team, as appropriate.

Responsibilities/Duties The WIC DBE-IBCLC duties include, but are not limited to: ● Acts as the breastfeeding expert for the agency, responding to referrals from WIC staff and BFPCs regarding complex breastfeeding challenges beyond their scope of practice. ● Troubleshoots breastfeeding concerns such as inadequate milk supply (perceived or real) and solutions for engorgement. ● Assesses, contributes towards the development of a care plan and counsels the mother/infant dyad with complex breastfeeding challenges. ● Performs the counseling expectations described in the “Breastfeeding Complications or Potential Complications (602/603)” content in the High and Low Risk Protocols policy. ● Communicates care plan to the rest of the WIC breastfeeding team, as appropriate.

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● Contacts participant’s health care provider to discuss concerns (e.g. medications and breast milk; formula supplementation prescriptions). ● Refers to hospital lactation staff and community breastfeeding support resources, as necessary. ● Provides prenatal support and guidance (responds to advanced concerns and issues about breastfeeding; addresses potential physiological challenges that would inhibit/limit breastfeeding; sets expectations for birth and early postpartum, including support to request at the hospital). ● Assesses need, coordinates and loans/issues breast pumps and supplies. Can delegate to Educator/High Risk Counselor WLS. ● Recommends breast shells, breast pads, and other breastfeeding aids and administers/oversees supplemental nursing systems (SNS) as necessary. ● Mentors all other WIC staff, specifically Educator WLS, BFPC WLS and High Risk Counselor WLS. ● Maintains IBCLC credentials and obtains appropriate continuing education credits through training opportunities annually.

Optional Functions ● Teaching breastfeeding classes and/or leading support groups. ● Providing breastfeeding trainings for WIC staff. ● Promoting breastfeeding within the community, especially outreach with health care providers. ● Providing support calls to mothers prenatally or early postpartum to offer encouragement and respond to questions.

Breastfeeding Peer Counselor Program Coordinator The WIC Breastfeeding Peer Counseling (BFPC) Program Coordinator manages the BFPC Program at the local agency level and works under the direction of the LA WIC Director.

Qualifications ● Education: o Minimum high school diploma or GED and advanced lactation credentials, such as Certified Lactation Counselor (CLC) or Certified Lactation Educator (CLE). IBCLC preferred. ● Experience: o Previous work experience with the public. WIC and/or public health experience and experience with low- income participants is preferred. o Has a minimum of one-year experience counseling breastfeeding women. o Has experience in program management. o Has demonstrated experience in supervision. o Has demonstrated expertise in breastfeeding management and promotion.

Knowledge, Skills and Abilities A fully functioning breastfeeding peer counselor program supervisor/coordinator will have the following skills or be able to learn them on the job. ● Completes the WIC Lactation Specialist (WLS) Training to become WLS certified during the next WLS certification window ● Successful completion of the FNS competency-based training for WIC Breastfeeding Curriculum (levels 1-4) or completion of a State-approved competency-based breastfeeding training that is consistent with the FNS WIC Breastfeeding Curriculum. ● Successful completion of the FNS WIC Breastfeeding Curriculum: Peer Counseling Management training. ● Knowledge of socio-economic conditions of the local community. ● Ability to read and interpret a variety of materials. ● Ability to prepare and maintain accurate, neat records. ● Abilities to provide services to the assigned caseload and complete paperwork within time limits. ● Ability to establish and maintain effective working relationships. ● Ability to communicate effectively orally and in brief writing. ● Ability to work as a team member. ● Ability to complete WIC and breastfeeding information modules.

Responsibilities/Duties

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The LA BFPC Coordinator duties include, but are not limited to: ● Assists in establishing program goals and objectives. ● Assists in establishing BFPC program protocols and policies. ● Assures that the BFPC program follows the FNS WIC Breastfeeding Model Components for Peer Counseling. ● Determines BFPC program staffing needs. ● Recruits and interviews potential BFPCs in alignment with program policies and standards. ● Arranges training of BFPCs. ● Mentor new BFPCs during the first three months and provide ongoing supervision ● Holds monthly meetings with BFPCs. ● Reviews documentation records and data as appropriate. ● Monitors the program, including conducting spot checks. ● Routinely reports on the program to supervisor and State BFPC Program Coordinator. ● Works with other BFPC supervisors (if available) to assess for ongoing improvements to the program that may be needed. ● Arranges for availability of WIC Designated Breastfeeding Expert (DBE) for managing complex breastfeeding problems beyond the scope of the peer counselor. (Note: May also serve as the LA’s DBE.)

Breastfeeding Peer Counselor The WIC Breastfeeding Peer Counselor (BFPC) is a paraprofessional support person who provides basic breastfeeding information and encouragement to pregnant and breastfeeding WIC participants who are pregnant or breastfeeding. The BFPC is required to document contacts and make referrals to lactation experts when concerns are beyond their scope of practice.

Note: New hires should not have professional training in health, nutrition, or the clinical management of breastfeeding (e.g. CLC, CLE or IBCLC).

Supervision WIC BFPCs work under the supervision of the LA BFPC Program Coordinator or WIC Director.

Qualifications To ensure that the BFPC relates with a WIC mother, the position qualifications are: ● Has breastfed at least one child (does not have to be currently breastfeeding). Ideally, candidates should have breastfed for 6 months or more, but candidates with less than 6 months of experience who can demonstrate a strong understanding of breastfeeding practices and challenges may also be considered. ● Is enthusiastic about breastfeeding, and wants to help other mothers enjoy a positive experience. ● Bilingual (Spanish/English) preferred but not required. ● Can work a set number of hours a week (as established by the local agency) and is available to WIC participants outside usual clinic hours. ● Completes the FNS WIC Breastfeeding Curriculum training for BFPCs and all required orientation activities.

Knowledge, Skill and Abilities A fully functioning BFPC already has the following skills and/or learns them on the job. ● Knowledge of socio-economic conditions of the local community. ● Ability to read and interpret a variety of materials. ● Ability to prepare and maintain accurate, neat records. ● Abilities to provide services to the assigned caseload and complete paperwork within time limits. ● Ability to establish and maintain effective working relationships. ● Ability to communicate effectively orally and in writing. ● Ability to work as a team member. ● Ability to complete WIC and breastfeeding information modules.

Responsibilities/Duties ● Counsels pregnant and breastfeeding WIC participants through phone calls, text messaging, clinic visits, home visits, and/or hospital visits at scheduled intervals determined by the LA. ● Receives a caseload of pregnant and breastfeeding WIC participants and makes routine periodic contacts.

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● Provides basic breastfeeding information and support to new mothers, including telling them about the benefits of breastfeeding, overcoming common barriers, and getting a good start with breastfeeding. Helps mothers prevent and handle common breastfeeding concerns. ● May be available outside usual 8 to 5 working hours to new mothers who are having breastfeeding problems. ● Maintains confidentiality. ● Keeps accurate records of all contacts made with WIC participants. ● Refers mothers, according to clinic-established protocols, to appropriate resources: o WIC BFPC Coordinator, DBE, High Risk Counselor, Educator Advanced Lactation Credentials, or Educator WLS. o Lactation consultant. o Health care providers. o Public health programs in the community. o Social service agencies. ● Attends and assists with prenatal classes and breastfeeding support groups. ● Attends monthly staff meetings and breastfeeding conferences/workshops as appropriate. ● Reads assigned books and materials on breastfeeding that are provided by the supervisor. ● May assist WIC staff in promoting the BFPC program through special projects and duties as assigned.

Breastfeeding Peer Counselor WIC Lactation Specialist (BFPC WLS) This is an enhanced role for Breastfeeding Peer Counselors (BFPCs) who have expertise in breastfeeding counseling and management through previous experience as a BFPC and additional lactation training (e.g. Colorado WLS training) and who can maintain their role as a peer connecting with a peer. This enhanced role is not necessarily available to any peer who has attended the WLS training. Supervisors must consider each BFPC individually (knowledge, skill, desire, etc.) to assess if they fit the criteria and can continue to be a BFPC while having this additional knowledge.

Note: ● BFPCs must have at least 12 months of work experience in the role in order to attend the WLS training. This requirement can be flexed per the discretion of the LA BFPC Coordinator. ● BFPCs should not be in the role of educator or teacher. BFPCs should be considered part of the team for the care of the mother/baby and should know when to yield to the WIC BFPC Coordinator, DBE, High Risk Counselor, Educator Advanced Lactation Credentials, or Educator WLS.

Qualifications ● Meets qualifications of a WIC BFPC. ● Has completed the WIC Lactation Specialist (WLS) Training to become WLS certified.

Knowledge, Skills and Abilities In addition to the following, see complete listing for BFPC. ● Ability to pass the WLS exam at the completion of the training and pass two required WLS observations.

Responsibilities/Duties ● Provides prenatal anticipatory guidance [responding to concerns and issues about breastfeeding; such as, reinforcing that it takes about a month to establish milk supply; no formula first month; what to request in the hospital (Baby-Friendly Hospital Initiative’s Ten Steps to Successful Breastfeeding), issues returning to work or school; hand expression; breastfeeding resources in community]. ● Provides support calls to mothers prenatally or early postpartum to offer encouragement and respond to questions. ● Responds to participant breastfeeding questions. ● Troubleshoots breastfeeding concerns such as inadequate milk supply (perceived or real) and solutions for engorgement.

Optional Functions ● Assessing need, coordinating and loaning/issuing breast pumps and supplies, instructing on pump use and milk collection/storage for BFPC participants.

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● Perform required follow-up 24-72 hours after a breast pump has been issued to a BFPC client. Follow-up must be documented in the clients’ Participant Care Plan. ● Leading breastfeeding support groups and classes. (Note: BFPC funds are to support programs beyond current operations and breastfeeding classes are considered current operations. If a BFPC WLS leads a breastfeeding class, the funds should come from the WIC budget rather than the BFPC budget. As support groups are not considered current operations, BFPC funds can be used to pay for the BFPC’s time to lead these groups.) ● Depending on level of skill and knowledge of supervision, could serve as the LA BFPC Coordinator.

NOTE: Out of Scope for all Colorado WIC Program Staff ● Recommending use of a galactagogue – should refer to the mother's health care provider, hospital lactation or IBCLC in the community. ● Recommending treatment for or diagnosing breast yeast or bacterial infection or breastfeeding or breast milk jaundice – should refer to a health care provider. ● Fitting and placement of nipple shields – should refer to hospital lactation or IBCLC in the community. ● Diagnosing based on infant test weights done in the WIC clinic. ● Recommending a specialized infant formula when supplementation is medically warranted. Staff should refer the mother back to the health care provider.

Non-WIC Staff with WIC Program Duties LA WIC Directors may assign WIC duties to agency staff not considered WIC employees. For example, a non-WIC staff may be assigned to obtain heights, weights, and hemoglobin/hematocrit measurements. Most often, these staff persons have limited access to Compass. To ensure these individuals are adequately trained, the WIC Director develops a training plan to provide the individual with the skills and knowledge needed to perform her/his work. Civil Rights Training is required for all regardless of job duties.State Office Nutrition Consultants are available to assist with help in developing a training plan.

The supervisor is required to document the training that was provided for the individual including the topics, method of training, test scores, and dates of completion. This information must be kept in the employee’s file and electronically entered into Compass, Staff Competencies. Should the non-WIC staff not have Compass access, maintain documentation of provided training in a separate file.

Standards for Use of Volunteers in WIC Clinics WIC clinics are continually challenged with the problem of how to improve quality services with limited financial resources. One of the creative solutions to this problem has been the use of volunteers in the clinic. One concern when using volunteers is to see that they receive quality training and appropriate supervision. This is necessary to ensure participants receive a high level of care and WIC protocols and procedures are maintained.

LAs may have a volunteer coordinator and established policies for using volunteers. It is recommended that LAs coordinate WIC volunteer services within the agency policies. The following standards must be followed when beginning a volunteer program for WIC:

● LAs will discuss the plan for use of volunteers with the State Office assigned nutrition consultant. ● Program administrators will check LA policies regarding insurance, legal liability, and confidentiality concerning the use of volunteers in the agency setting. ● All volunteers will receive an orientation to the overall WIC Program and to the specific LA. Which might be hard to do since interns may rotate with ● All volunteers will receive direct supervision from a WIC administrative professional and/or WIC Supervisor. Supervision must include ongoing coaching and feedback and a yearly performance evaluation. Observation of volunteers may be included in state site visits and monitoring visits. ● Volunteers are used in different capacities based on their interests and skills and the agency’s needs. Some of the activities that volunteers have been used for include intake eligibility work (e.g., helps participants with completion of forms); clerical work (e.g., filing, typing, answering the phone, folding pamphlets, organizing pamphlets); and height and weight screening (e.g., takes heights and weights). ● Volunteers must not determine nutrition risk, nutrition eligibility, or issue, WIC food benefits.

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An appropriate training plan must be developed based on assigned duties. The training plan should be developed based on the tasks the individual is responsible for in the WIC clinic. The supervisor is required to document the training that was provided for the individual including the topics, method of training, test scores, and dates of completion. This information should be kept in the volunteer’s file and electronically entered into the Compass computer system, if appropriate.