GEORGIA WIC PROGRAM PROCEDURES MANUAL NS Tailoring and 999 Food Packages

Policy No. NS- 210.16 Effective date: October 1, 2016

No. of Pages: 2

Revised February 2019

Page 1 of 3

Policy The local agency shall tailor the participant’s food package to best meet their nutritional and/or medical needs, food preferences, cultural or religious beliefs, food intolerances, and household conditions. The maximum monthly allowance of all supplemental foods must be made available to the participant unless nutritionally or medically warranted (See Maximum Monthly Allowance Policy NS- 210.01).

Purpose To ensure each participant receives the food package that best meets their medical/nutritional needs and preferences. Procedures I. The CPA will assess the participant’s nutritional needs and dietary preferences prior to assigning a food package.

II. Using the Food Package Handbook the CPA will assign the most appropriate state created food package based on their assessment.

III. The CPA shall assign a combination of milk, cheese, yogurt, soy beverage, and tofu based on the participant’s need and preference.

IV. The CPA must document the reason for assigning a soy or tofu package to children ages one to five years, in the medical record.

V. If there is no state created food package that meets the needs of the participant, the local agency will either develop or assign a district created food package using food package code 999 and the active state created voucher codes. A. Regarding creating and managing district created food packages, the local agency will: 1. Designate a person to create and approve all district created food packages 2. Maintain a master list of the district created food packages (999 food packages) for state agency review. 3. Include the following details for each food package on the master list: a. General description of the food package (intended use/rationale, i.e. “No eggs”)

b. WIC type, age group, and feeding type (as applicable)

c. Food package code and/or sub number

GEORGIA WIC PROGRAM PROCEDURES MANUAL NS Tailoring and 999 Food Packages

Policy No. NS- 210.16 Effective date: October 1, 2016

No. of Pages: 2

Revised February 2019

Page 2 of 3

d. All voucher codes with current voucher message

4. Update their district created food package list as needed and as the state food package database is updated.

5. Follow the substitution rate and the maximum monthly allotment of supplement foods for each food package category (See Food Package Handbook for maximum monthly allowances and substitution rates).

a. The CPA can substitute beans (1 pound dried or 4 cans) for one jar of peanut butter.

b. The CPA can substitute one jar of peanut butter for 1 pound dried beans or 4 cans of beans.

VI. Tailor food packages for participants receiving a Food Package III, for exempt infant formula or medical nutritionals, according to what has been indicated per medical documentation (See Medical Documentation Policy NS- 210.12).

A. Issue only the quantity of formula prescribed to children and women on Food Package III, up to the maximum allowed.

B. Issue children with a qualifying medical condition on food package III 144 ounces of infant fruits and/or vegetables in lieu of the cash value voucher.

C. Issue women with a qualifying medical condition on food package III infant fruits and/or vegetables in lieu of the cash value voucher.

1. $11 cash value voucher equals 176 ounces

2. $16.50 cash value voucher equals 264 ounces

D. Issue women and children receiving a food package III 32 ounces of infant cereal in lieu of the 36 ounces of breakfast cereal.

E. Issue whole milk to women and children over two receiving a food package III.

F. Reference State Ordered Special Formula Policy for how to order formulas for which no state created vouchers are available.

GEORGIA WIC PROGRAM PROCEDURES MANUAL NS Tailoring and 999 Food Packages

Policy No. NS- 210.16 Effective date: October 1, 2016

No. of Pages: 2

Revised February 2019

Page 3 of 3

Authority 7 CFR 246.10 Georgia WIC Program Policy

Definitions/Supporting Information 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.

Nutrition Tailoring – a process of modifying food packages to better meet the supplemental nutrition needs of individual participants. The term “nutrition tailoring” is reserved solely for making food package accommodations, as authorized by WIC regulations in 7 CFR 246.10©, to accommodate the needs of an individual participant based on the CPA’s assessment of the participant’s nutritional risk condition, breastfeeding assessment, dietary needs, and personal food preferences. Nutrition tailoring entails making changes or substitutions to food types (e.g., dry beans vs. peanut butter) and physical food forms (e.g., dry milk vs. fluid milk). Nutrition tailoring may also involve eliminating foods due to allergy, medical or nutritional condition, or in situations where a participant cannot use or refuses the item.