GEORGIA WIC PROGRAM PROCEDURES MANUAL NS Emory Genetics WIC Participants

Policy No. NS- 210.15 Effective date: October 1, 2020

No. of Pages: 2

Revised October 2020

Page 1 of 2 Policy Local agency will issue prescribed contract brand infant formulas and / or supplemental foods for participants based on medical documentation provided by Emory Genetics. The Emory University Department of Human Genetics and Pediatrics (Emory Genetics) is responsible for the coordination and issuance of the prescribed, exempt infant formulas and/or WIC-eligible nutritionals for all WIC participants under their medical care. The combined issuance of contract formula issued from the WIC clinic and the exempt infant formulas and/or WIC-eligible nutritionals provided through Emory Genetics shall not exceed the maximum monthly allowance for the participant’s age and feeding type. Purpose To reduce participant barriers and improve continuity of care for Emory Genetics WIC participants with limited access to ongoing, highly specialized nutritional management. Procedures

I. Issue Food Package Code 099 (Emory Genetics Food Package) to all active WIC participants who present medical documentation from or are being monitored by the Emory Genetics clinic.

II. Print the Emory Genetics 099 food package for each issuance month based on the participant’s pick-up code. The 099 food package contains four (4) tracking vouchers (no formula or supplemental food vouchers) as follows: A. Voucher code 099 – Participant Copy (1 voucher) B. Voucher code 299 – Emory Genetics’ Copies (2 vouchers) C. Voucher code 399 – Chart Copy (1 voucher)

III. Have the WIC participant sign all voucher receipts and give the participant the 099 “Client Copy” voucher for their records.

IV. Fax both Emory Genetics vouchers (voucher codes 299) for each issuance month to the fax number listed on the voucher. Emory genetics will fill in the “Formula Name” and “Cost” lines on the 299 vouchers.

V. File the 299 vouchers (Emory Genetics Copies) and the 399 (Chart Copy) voucher in the participant’s medical record.

GEORGIA WIC PROGRAM PROCEDURES MANUAL NS Emory Genetics WIC Participants

Policy No. NS- 210.15 Effective date: October 1, 2020

No. of Pages: 2

Revised October 2020

Page 2 of 2 VI. Assign a Second Food Package to issue contract formula and / or supplemental foods authorized by the medical documentation provided by Emory Genetics by entering the appropriate food package code in the “Second Food Package Option” field in the computer system.

VII. Issue contract formula vouchers for the exact amounts requested by Emory Genetics on the Medical Documentation Form (MDF).

VIII. Notify the participant that Emory Genetics will provide the prescribed exempt infant formulas and/or WIC-eligible nutritionals.

IX. Contact the State WIC Office Nutrition Unit at 404-657-2900 or Emory Genetics at 404-778- 8607 for assistance with determining issuance amounts.

X. Enter “000” in the Second Food Package Option field when the participant is not prescribed contract formula or is not approved to receive any supplemental foods.

XI. For additional details on 999 food package requirements, reference Tailoring and 999 Food Package Policy.

Authority 7 CFR 246.10 Definitions/Supporting Documentation Competent Professional Authority (CPA) – An individual on the local agency staff who is authorized to determine nutritional risk and prescribe supplemental foods. The following individuals may be authorized and trained to serve as a CPA: physicians, nutritionists (bachelor’s or master’s degree in Nutritional Sciences, Community Nutrition, Clinical Nutrition, Dietetics, Public Health Nutrition), registered dietitians, licensed dietitians, registered nurses, and physician assistants (certified by the National Committee on certification of Physicians Assistants or certified by the State medical certifying authority), or State or local medically trained health officials.

WIC-Eligible Nutritionals – means certain enteral products that are specifically formulated to provide nutritional support for individuals with a qualifying condition, when the use of conventional foods is precluded, restricted, or inadequate. Such WIC-eligible nutritionals must serve the purpose of a food, meal or diet (may be nutritionally complete or incomplete) and provide a source of calories and one or more nutrients; be designed for enteral digestion via an oral or tube feeding; and may not be a conventional food, drug, flavoring, or enzyme. WIC-eligible nutritionals include many, but not all, products that meet the definition of medical food in Section 5(b)(3) of the Orphan Drug Act (21 U.S.C. 360ee(b)(3)).

Exempt infant formula - means an infant formula that meets the requirements for an exempt infant formula under section 412(h) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 350a(h)) and the regulations at 21 CFR parts 106 and 107.