GEORGIA WIC PROGRAM PROCEDURES MANUAL BF Multi-User Electric Pump Recovery

Policy No. BF-1260.11 Effective date: October 1, 2017

No. of Pages: 2 Revised March 2019

Page 1 of 2

Policy Local Agency Staff, excluding Breastfeeding Peer Counselors, must attempt to recover and track multi-user breast pumps no longer being used, or without successful monthly follow-up contact with the participant. Purpose To minimize costs associated with replacing unreturned pumps. Procedures Local agency staff must:

I. Complete all issuance follow up steps as detailed within Policy 1260.06 Pump Issuance.

II. Mail the Final Request for Return of Medela Symphony® Breast Pump letter to the participant and the alternate contact five to ten calendar days after the deadline outlined in the Multi-User Breast Pump Follow Up letter.

III. Complete the following steps to report retrieval efforts after mailing the Final Request for Return of Medela Symphony Breast Pump letter:

A. Update WIC Breast Pump Inventory Tracking System as “Lost.” B. Complete the Lost or Stolen Multi-User Electric Breast Pump Report. C. Submit copies of the following to the State WIC Office Breastfeeding Unit at Gawic.breastfeeding@dph.ga.gov : 1. Lost or Stolen Multi-User Electric Breast Pump Report 2. Multi-User Electric Breast Pump Loan Agreement 3. Multi-User Breast Pump Follow Up letters to both the participant and alternate 4. Final Request for Return of Medela Symphony® Breast Pump letters to both the participant and alternate 5. Most recently signed copy of the participant’s Rights and Responsibilities 6. Pertinent medical record information that supports local recovery efforts

GEORGIA WIC PROGRAM PROCEDURES MANUAL BF Multi-User Electric Pump Recovery

Policy No. BF-1260.11 Effective date: October 1, 2017

No. of Pages: 2 Revised March 2019

Page 2 of 2

IV. If a pump is reported to have been stolen: A. Request a copy of the police report B. Update WIC Breast Pump Inventory Tracking System as “Lost” C. Complete the Lost or Stolen Multi-User Electric Breast Pump Report D. Submit copies of the following to the State WIC Office Breastfeeding Unit at: Gawic.breastfeeding@dph.ga.gov : 1. Lost or Stolen Multi-User Electric Breast Pump Report 2. Multi-User Electric Breast Pump Loan Agreement 3. Police report 4. Pertinent medical record information that support local recovery efforts.

Authority USDA Breastfeeding Policy and Guidance Georgia WIC Program Policy

Definition/Supporting Information (None)