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Section 5.9: Clinic Environment 2/2024 References: 7 CFR 246.8 and 246.11 (c)(7)(i); Nutrition Service Standards, Standard 2 Policy: The clinic environment should support nutrition and breastfeeding services and protect participant privacy. Purpose: The physical environment of WIC clinics is very important to the effectiveness of nutrition services. The clinic space should be welcoming, user-friendly, and provide privacy for WIC applicants and participants. Procedures All WIC clinics must: ▪ Follow Civil Rights requirements regarding accessibility and display proper nondiscrimination and interpreter/accommodation signage. See Section 1.10: Civil Rights for Civil Rights requirements. ▪ Consider whether clinic site locations support health equity and whether services are easily accessible in areas of need where participants may be potentially underserved. ▪ Evaluate any change in clinic sites using Exhibit 1-R: Civil Rights Impact Analysis Survey and submit it to your State Consultant. See Section 1.10: Civil Rights for guidance. ▪ Inform your State Consultant as soon as you learn about a possible change (opening, closing, or relocation) at any clinic site so they can assist you in the planning process and completing the Civil Rights Impact Analysis Survey. ▪ Provide visual and auditory privacy for WIC applicants/participants. See Section 1.7: Data Privacy for data privacy requirements. ▪ Provide a comfortable attractive space that is: ▪ Well-lit and clean. ▪ Maintained at an appropriate temperature. ▪ Child-friendly and safe with age-appropriate toys and books to keep children busy and engaged. Consider kid-friendly/toddler sized furniture in waiting areas. ▪ Family-friendly with adequate space to accommodate multiple family members, strollers, or a wheelchair. Consider a variety of seating options (multiple seats, wide seats, etc.) Provide clear and visible signage directing participants to the clinic.

S E C T I O N 5 . 9 : C L I N I C E N V I R O N M E N T 2 ▪ Provide a supportive breastfeeding environment. ▪ Display positive and diverse images to encourage and support breastfeeding. ▪ Welcome breastfeeding anywhere, and if feasible, provide a quiet, private space for women to breastfeed. Display clear signage so that the space is easily located. ▪ Keep formula, and related materials and equipment, out of sight. ▪ Use Participant Centered procedures and skills (PCS) to provide appropriate Customer Service: ▪ Provide up-to-date messaging on WIC phones indicating when participants can expect a return call. ▪ Emphasize greeting and welcoming all participants upon entering the clinic. ▪ Be courteous and treat all participants and co-workers with dignity and respect. ▪ Be culturally sensitive. ▪ Be timely to minimize wait time for participants. ▪ Provide quality and timely customer service for phone and electronic communications, as well as for appointments. Guidance ▪ Ensure WIC clinics are: ▪ Located in a safe, well-lit area, with consideration for participant travel, such as available parking, public transportation, and pedestrian safety. ▪ Clearly identified and easy to find, with a well-marked and accessible entrance. Make sure there is adequate signage for the WIC clinic outside and inside the building. ▪ Laid out in a way that promotes efficient and high-quality service. ▪ Requirements and considerations also apply to satellite clinics, pop-up clinic sites, and mobile units. That staff should work closely with the Consultant when designing a new clinic space. ▪ Provide adequate and accessible seating, such as chairs with and without arms. ▪ Use signage that is easy to understand, at eye level (either when sitting or standing), and in the primary languages spoken in the clinic. ▪ Use positive signage over negative wording when possible. For example: ▪ Enjoy your food and drink outside. ▪ Thank you for silencing your cell phone during your appointment. ▪ If you are late for your appointment, we will do our best to work you in if it’s possible. ▪ Inform participants if their appointment start time is delayed.

S E C T I O N 5 . 9 : C L I N I C E N V I R O N M E N T 3 ▪ Ensure that phone voicemail messaging reflects current WIC clinic status. If staff availability to answer phones varies, messaging should be updated each time availability changes so participants will know when they can expect a return call. ▪ Consider health equity when designing clinic spaces so the clinic environment is welcoming to all community members. ▪ Display artwork, posters and other media that reflect the cultures and ethnic backgrounds served by the clinic. Rotate these periodically so that messages stay fresh and current. ▪ Coordinate appointments with other services delivered at the same site to the extent possible. ▪ Provide clinic rooms that: ▪ As possible, provide adequate space to accommodate a family, their belongings, and an interpreter. ▪ Are arranged to encourage and support conversation. To the extent possible, arrange the area in a way that allows participants and staff to sit face to face without physical barriers between them (e.g., knee-to-knee). ▪ Are not cluttered or loud. ▪ Display engaging nutrition-related materials directly visible to participants. ▪ Support safety and security for staff and participants. Consider working with local facilities management on these measures. ▪ Provide activities that keep children occupied in order to enhance communication between caregivers and WIC staff. ▪ Allow access to restrooms that are clean and sanitary, accessible to people with disabilities, and have a diaper changing station. Consider family and unisex restrooms to offer flexibility. ▪ Clearly label biohazard containers. Make sure those and medical supplies are out of the reach of children. ▪ Assess the clinic environment periodically to ensure all spaces meet the clinic environment requirements. Exhibit 5-AA: WIC Clinic Assessment is available to use for this assessment. ▪ Notify your State WIC Consultant when a new site is being considered and complete a Civil Rights Impact Analysis Survey (Exhibit 1-R). Reference – Complete Listing of Hyperlinks Nutrition Service Standards (https://wicworks.fns.usda.gov/sites/default/files/media/document/wic-nutrition-services- standards_0.pdf)

S E C T I O N 5 . 9 : C L I N I C E N V I R O N M E N T 4 Section 1.10 Civil Rights (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/chsctns/ch1/sct n1_10.pdf) Section 1.7 Data Privacy (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/chsctns/ch1/sct n1_7.pdf) Exhibit 5-AA WIC Clinic Assessment (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/exhbts/ex5/5aa .pdf) Exhibit 1-R: Civil Rights Impact Analysis Survey (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/exhbts/ex1/1r. docx) Minnesota Department of Health - WIC Program 625 Robert St N, PO BOX 64975, ST PAUL MN 55164-0975; 1-800-657-3942, health.wic@state.mn.us, www.health.state.mn.us. To obtain this information in a different format, call: 1-800-657-3942 This institution is an equal opportunity provider.