Colorado WIC Program Policies and Procedures Section 7: Caseload Management Revised: 10/01/2018

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Outreach

Policy: The WIC Program must publicize the availability of the Program at least once per year using outreach techniques believed to be the most effective. Additionally, the State WIC Office must release an annual statewide general press release.

Regulation: CFR 246.4(a)(7), 246.7(a)(9)

Procedure/Additional Guidance The United States Department of Agriculture (USDA) specifies that WIC Programs perform the four following principle activities to assure effective outreach (each discussed in detail below):  Publicize the availability of the WIC Program  Build an outreach network  Inform organizations in the outreach network about the WIC Program  Coordinate with other community resources

Outreach consists of the techniques used to promote and advertise the WIC Program to inform applicants, participants, and potentially-eligible persons of the Program availability, Program participants’ rights and responsibilities, the nondiscrimination policy and the procedure to file a complaint. Should the Colorado WIC Program’s financial resources become limited, participants at the highest nutritional risk must be served. Therefore, an effective outreach program targets those with the highest nutritional risk.

Principle Activities for Effective Outreach  Publicizing the Availability of the WIC Program: Several techniques can be used to publicize the availability of a local WIC Program. Media related activities include news releases, newspaper feature stories, and public service announcements. Other activities include distribution of flyers, pamphlets, and posters.

Public Service Announcements must include the following elements: o Program Availability  Hours of operation  Location of clinics o Complaint Information  How to file a complaint  The WIC Nondiscrimination Statement

 Building an Outreach Network : An effective outreach program includes an established network of community agencies, organizations, and employers who serve the same population. The purpose of this network is to ensure that potentially-eligible clients are referred to the WIC Program. Include community agencies and organizations serving low income pregnant, breastfeeding and postpartum women, infants, and children in the outreach network. Since many working families qualify for the WIC Program, include employers of potentially-eligible clients in the outreach network. Provide to these organizations written materials that describe WIC and how to apply

 Informing Organization in the Outreach Network about the WIC Program o Once the outreach network is established, provide continual updates regarding the WIC Program to the agencies/organizations. This can be accomplished by routinely visiting the agency, through telephone contacts, and/or sending personal update letters or arranging to provide short presentations on the WIC Program at a staff meeting could also be a valuable outreach technique. Minimally, each agency/organization should be contacted at least once a year, and more often if a major change in the Program occurs (i.e., caseload increase or decrease). o Community agencies should maintain a stock of pamphlets describing the WIC Program with the address and telephone number of the nearest WIC office, so they can be distributed to potentially- eligible clients. Also, if the agency permits, a WIC poster should be displayed.

Colorado WIC Program Policies and Procedures Section 7: Caseload Management Revised: 10/01/2018

Page 2 of 6  Coordinate with Community Resources: The local WIC Program’s outreach activities should be coordinated with other community programs.

Targeting Outreach Efforts to Special Populations and High Risk Groups

 Migrant Farm Workers: The migrant population needs outreach even more than the general population because their newness to the area often means they do not know where to obtain WIC services. Outreach is also necessary to overcome their isolation from the general population. Outreach techniques used for migrants may include: o Outreach in migrant camps by bilingual staff members or volunteers. o Special WIC clinics held in the migrant camps. o Inclusion of migrant farm worker organizations in the outreach network.

 Refugee Population: The refugee population also needs outreach more than the general population because of their newness to the area. Outreach techniques that may be useful for the refugee population include: o Notifying agencies that sponsor refugees about the WIC Program. o Making WIC outreach pamphlets available in the appropriate language(s). o Including community organizations that service refugees in the outreach network.

 Infants and Children under the Care of Foster Parents, Protective Services, or Child Welfare Services Infants and children in protective services, placed in a foster home, or under the care of child welfare are considered to be families of one and are, therefore, eligible to participate in WIC when caseload slots are available. Outreach is necessary to let the caregivers of this population know about Program services. This population may be reached by: o Notifying agencies/organizations that work with infants and children placed in protective care or foster homes:  Medicaid Office  Mental Health  TANF Office  Foster Parent Support Groups

 Protective Services Office

o Use public service announcements (PSAs) targeted specifically toward caregivers of these infants and children.  Encourage clients to do outreach. Support groups for foster parents and other caregivers may exist in some communities. These groups could provide a number of referrals and word of mouth is often the most effective means of getting the word out.

Targeting High Priorities Target services to the highest WIC priorities, especially when WIC agencies are at caseload. Targeting WIC services to those who would benefit most from the Program includes priorities 1 and 2 or pregnant/ breastfeeding women and infants, migrants, and homeless individuals. Infants and children under the care of foster parents, protective services, or child welfare authorities, including infants exposed to drugs prenatally should be targeted. Suggested activities for targeting infants and pregnant/breastfeeding women include:

 Enlist the help of people in the community who are well known and respected by the people you are targeting or who care about the people you are targeting. These key people might be popular radio announcers, grocers, doctors, teachers, nurses, 4-H leaders, athletes, and pharmacists. They may be willing to do spot radio announcements or newspaper interviews on nutrition, discuss WIC with people they work with, or be advocates for WIC in other ways.  Contact employers in your community to see if they are willing to display outreach posters or brochures or let you speak at a staff meeting can be very effective at reaching working people who are not using WIC services.

 Form a local task force and work with groups to put together a strategy for publicizing WIC to high priorities within the community. o Other programs within your health department or nursing service. o Church groups. o Boards of Education.

Colorado WIC Program Policies and Procedures Section 7: Caseload Management Revised: 10/01/2018

Page 3 of 6 o Local chapters of the nursing/physician/dietetic organizations. o Mayor or County Commissioners. o Local representatives of elected officials. o School nurses and wellness teams. o Local chapter of March of Dimes. o Medicaid offices. o Temporary Assistance to Needy Families (TANF) offices. o Supplemental Nutrition Assistance Program (SNAP) offices. o Hunger Free Colorado. o La Leche League or local breastfeeding task forces. o Hospitals. o Agriculture extension offices. o Day care facilities. o Provide WIC information (posters, pamphlets, presentations etc.) to all the places in your community that specifically attract infants and pregnant and breastfeeding women (versus attracting children or families in general). Medicaid offices. o Child birth classes. o Summer feeding programs. o La Leche League meetings. o Obstetricians' and pediatricians' offices. o Stores/thrift shops that sell maternity or infant clothes. o Obstetrics wards in hospitals. o Teen mothers' classes or groups. o New parents' classes at the YMCA/YWCA or Red Cross. o Day care centers that serve infants. o Babysitting co-ops. o Diaper services. o Supermarkets – at customer service or next to the baby food, diapers, or formula. o Exercise programs geared for pregnant women. o Infant swim classes. o Birthing clinics. o Offices serving other nutrition assistance programs, e.g., Supplemental Nutrition Assistance Program (SNAP), CSU Extension.

 Encourage clients to help with outreach. Make a poster directed at clients telling clients (especially pregnant and breastfeeding women or infants) about WIC. Or, give incentive prizes to participants for referring applicants. Extra "points" can be given for referring pregnant and breastfeeding women and infants. Try to get a merchant to donate incentive prizes (such as a half price restaurant meal, a movie pass, or a discount haircut). Participant surveys show that word of mouth referrals are by far the most effective outreach mechanism.  Write a newspaper article about good nutrition for pregnancy, breastfeeding, and/or infancy. Use a catchy title that will attract the reader's attention. At the end of the article, describe the WIC Program, and include your local address and phone. Include a "human interest" photo that will attract the readers' attention, (e.g., a pregnant woman being weighed, a mother holding her newborn).  Use public service announcements (PSAs) designed specifically to attract pregnant and breastfeeding women and infants. Consider whether your PSAs need to be done in a second language too, such as Spanish. Target radio and television stations with programming oriented to high-priority populations that may be interested in WIC.  Outreach in small towns throughout the county. These towns may offer a new pool of high priority clients.  Advertise and offer free height and weight screenings for infants. At the screening, let families know about the WIC Program.  Include information about WIC on the county or local health department’s webpage.  Add a link from the county webpage to the Colorado WIC Facebook page. (www.Facebook.com/CDPHE.WIC).  Share posts to the Colorado state WIC Facebook page. This helps cross promote both organizations.  Let participants know about the Colorado WIC Facebook page.

Considerations When Doing Outreach  Avoid jargon in your outreach materials. For example, people may not understand the meaning of a "food package" or "nutrition risk criteria."  Outreach not only to target populations but also to those people who care for them such as grandparents in a local senior citizen group.  Be sensitive to the community's values. For example, do not stress that WIC is a USDA program in a county where USDA may be associated with farm foreclosures.

Colorado WIC Program Policies and Procedures Section 7: Caseload Management Revised: 10/01/2018

Page 4 of 6  Develop an “additional resources” sheet for people who apply for WIC as a result of outreach efforts but do not qualify or are put on a waiting list.

Documenting and Reviewing Effectiveness of Outreach Activities Local agencies are encouraged to develop a documentation mechanism that suits their needs. The State agency reviews outreach efforts during monitoring visits through review of the documentation maintained by the agency.

Local agencies may want to determine if their outreach network is functioning effectively. By reviewing the Referral Summary report, the agency can see who is making referrals to your clinic and those programs where outreach efforts can be enhanced.

Outreach Resources The State Office has outreach pamphlets and posters available in English and Spanish. Agencies can adapt these for local use by including the address and telephone number of the nearest WIC office.

Colorado WIC Program Policies and Procedures Section 7: Caseload Management Revised: 10/01/2018

Page 5 of 6 WIC Outreach Network

Farm Worker Organizations

Education Institutes

Agencies

Child Care Serving

Program Homeless Individuals

Health and Medical Organizations

Community Organizations Serving High-Priority Populations

Local WIC Program

Hospitals, Clinics,

Physicians

Faith-Based Organizations

Employers of Potentially- Eligible Clients

Social Service Agencies

Community Assistance

and Unemployment

Agencies Colorado PEAK

Page 6 of 6 General Agencies or Organizations in the WIC Outreach Network

Specific Examples Employers of Potentially-Eligible Clients Major employers in the community

Factories/warehouses

Fast food restaurants/restaurants

Grocery stores

Retail stores

Health and Medical Organizations Local childbirth associations

Local medical associations

La Leche League

Local dietetic and nursing associations

Hospitals, Clinics and Physicians Local physicians (obstetricians, pediatricians, etc.)

Local hospitals (include Social Service and dietary departments, maternity and pediatric units)

Local health department or nursing services (EPSDT) Health Care Program for Children with Special Needs (HCP) Nurse Family Partnership,

Health maintenance organizations

Family Planning

Community Assistance & Unemployment Agencies Salvation Army

Goodwill

Local Job Training Partnership Act (JTPA)

Local WIN (Work Incentive) Programs

Social Service Agencies Medicaid

Supplemental Nutrition Assistance Program

Temporary Assistance to Needy Families

Foster Care Program Colorado PEAK

Religious Organizations/Advocacy Groups Churches/Synagogues

Colorado Advocates Against Hunger

Bread-For-The-World

Emergency food banks

Housing Authority

Crisis Center

Battered Women Center

Community Action Program

Educational Institutes Adult education programs

High school Teen Parents’ Program

Local colleges and universities

CSU-Extension service SNAP-Ed

Extended Food and Nutrition Education Program (EFNEP)

Agencies Serving Homeless Individuals Homeless Shelters

Food Kitchens

Unemployment Offices

YMCA, YWCA