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PENNSYLVANIA DEPARTMENT OF HEALTH Policy Number: 5.04 WIC State Agency USDA Approval Date: February 20, 2024 State Effective Date: April 20, 2024
POLICY MANUAL
5. NUTRITION AND BREASTFEEDING SERVICES
5.04 Breastfeeding Peer Counselor Program.
Page 1 of 5
A. POLICY OVERVIEW
The PA WIC Breastfeeding Peer Counselor (BFPC) Program shall operate in accordance with this policy to provide counseling, support, and other services which encourage breastfeeding for WIC participants. The requirements in this policy pertain to local agencies (LAs) that receive specific Peer Counselor Program funding. LAs that choose to operate a BFPC Program using Nutrition Services Administration (NSA) funds shall operate the program according to this policy to the best of their ability.
B. POLICY
1. BFPC Program Purpose and Management
a. The BFPC Program supports normal breastfeeding by providing basic breastfeeding information and encouragement to pregnant and breastfeeding WIC participants. BFPC services support a successful breastfeeding journey through mother-to-mother relationships and frequent communication and referrals to appropriate WIC or external professionals for complex breastfeeding challenges per State agency (SA) guidance. b. The BFPC Program shall be operated by a BFPC and managed by a BFPC Supervisor. A Senior BFPC is an optional position to allow LAs to offer a career ladder for BFPC staff. Refer to Policy 3.02, Local Agency Staffing, for staffing recommendations and required qualifications, experience, duties, and skills for all BFPC Program positions. c. A BFPC Supervisor: (1) Shall monitor BFPCs to ensure BFPC program requirements are met, consistency of services and to confirm that the support offered is professional, confidential, and accurate as well as to provide encouragement and positive feedback. (2) Shall develop partnerships with stakeholders in the area to help establish a referral system as well as promote the BFPC program within the community. These partnerships may include but are not limited to; local breastfeeding coalitions, La Leche League or other local breastfeeding support groups, hospital lactation consultants, Early Head Start, Healthy Beginnings Plus, and Cooperative Extension. These partners will be given the opportunity to support the program by: a) Taking referrals from BFPCs. b) Providing an in-service for BFPCs. c) Promoting the program with health care providers. d) Referring clients to the program. e) Providing a breastfeeding support group.
PENNSYLVANIA DEPARTMENT OF HEALTH Policy Number: 5.04 WIC State Agency USDA Approval Date: February 20, 2024 State Effective Date: April 20, 2024
POLICY MANUAL
5. NUTRITION AND BREASTFEEDING SERVICES
5.04 Breastfeeding Peer Counselor Program.
Page 2 of 5
d. LAs must train BFPC Program staff upon hire according to Policy 3.03, Training of WIC Staff. In addition to the completion of required trainings, BFPC Program staff shall also receive continuing education and support through: (1) LA staff in-services. a) As part of the WIC team, BFPCs are required to attend any in-services scheduled by the LA. (2) Relevant trainings provided by the SA. (3) Weekly phone and email updates with supervisor. (4) BFPC meetings and in-services. (5) Additional trainings as determined by the LA.
e. BFPCs may obtain specific job-related certifications such as Certified Lactation Counselor (CLC); however, BFPCs may not hold a higher credential such as, but not limited to, International Board-Certified Lactation Consultant (IBCLC), which exceeds the qualifications and job responsibilities of a BFPC. (1) BFPCs holding a CLC credential must remain within the BFPC scope of practice as per Section 2 of this policy, Provision of BFPC Program Services. (2) LAs may provide career ladder options for BFPCs who wish to further their education.
f. BFPCs cannot provide peer counselor services to mothers who are not certified on WIC but may educate non-WIC mothers about the WIC Program and encourage them to apply for WIC benefits. (1) If a non-WIC mother needs immediate breastfeeding support, WIC BFPCs shall provide referrals to external breastfeeding resources in the community.
g. BFPC Program Staff shall record hours worked on weekly time sheet. (1) If BFPCs also function as a Program Assistant or clerical staff, the time sheets must document BFPC hours separately for invoicing purposes. Where possible, BFPCs also functioning as a Program Assistant or clerical staff should not perform other WIC duties related to certification and program eligibility determination as this would compromise the unique peer-to-peer relationship. (2) Staff who hold the BFPC or Senior BFPC position shall not also function as a CPA or CPPA regardless of funding source or schedule.
h. BFPC funds may only be used for expenses authorized under the USDA BFPC Program. All receipts for BFPC expenses and staffing time sheets must be maintained for fiscal audit purposes. SA will distribute the Allowable Costs for Breastfeeding Peer Counselor Fund Chart document as provided by USDA.
PENNSYLVANIA DEPARTMENT OF HEALTH Policy Number: 5.04 WIC State Agency USDA Approval Date: February 20, 2024 State Effective Date: April 20, 2024
POLICY MANUAL
5. NUTRITION AND BREASTFEEDING SERVICES
5.04 Breastfeeding Peer Counselor Program.
Page 3 of 5
i. Expenses which are allowed under BFPC funds may also be funded through NSA funding if it is a WIC allowable purchase in accordance with Policy 2.02, Cost Allowability for Travel, Incentive Items, Tuition Reimbursement, and Renovations, and SA Guidance.
2. Provision of BFPC Program Services a. LAs must adhere to the scope of practice for all BFPC Program positions as defined by SA guidance.
b. BFPCs shall: (1) provide breastfeeding contacts using interactive counseling techniques at specific, required time frames before and after delivery based on SA guidance. (2) discuss topics related to stages of pregnancy or postpartum based on anticipatory guidance, assessment and participant needs. (3) document all contacts in the MIS based on SA guidance.
c. BFPCs counsel WIC mothers at the WIC clinic, by phone, by virtual platform, or during hospital or home visits as determined by the LA. Method of communication shall be documented in the MIS in addition to other required documentation set forth by the SA.
d. Each LA must develop a tracking system that BFPCs can use to contact participants within the required time frames. Suggested methods for tracking include but are not limited to: (1) Schedule participants in MIS scheduler under a BFPC column based on Next Contact Date. (2) Virtual work calendar where the participants’ Family ID Numbers (FIDs) and/or Participant ID Numbers (PIDs) names are added on the date and time they should be contacted. Names shall not be displayed on a virtual work calendar to protect the privacy of the participant(s). Names, phone numbers, and birthdate shall not be displayed on a virtual work calendar to protect the privacy of the participant(s). See Policy 1.04, Confidentiality of Participant Records. (3) Microsoft Access or similar database utilization. (4) Cardex system where participant names are filed according to the date they must be contacted.
e. BFPCs must have email and texting capability to contact participants who require or prefer this method of communication.
f. BFPCs must maintain strict confidentiality of participant records where permission is granted in the MIS for phone, voicemail, and/or text message contact. Refer to Policy 1.04, Confidentiality of Participant Records, and SA guidance.
PENNSYLVANIA DEPARTMENT OF HEALTH Policy Number: 5.04 WIC State Agency USDA Approval Date: February 20, 2024 State Effective Date: April 20, 2024
POLICY MANUAL
5. NUTRITION AND BREASTFEEDING SERVICES
5.04 Breastfeeding Peer Counselor Program.
Page 4 of 5
g. BFPCs shall provide accurate, up-to-date breastfeeding information based on the PA WIC Breastfeeding Manual and standardized trainings.
h. BFPCs will refer participants with breastfeeding challenges to the BFPC Supervisor, Designated Breastfeeding Expert (DBE), and/or the LA Breastfeeding Coordinator for immediate follow-up. (1) If none are available, the BFPC will contact other lactation experts in their area from the Breastfeeding Referral Guide that is provided by the SA. The BFPC Supervisor shall update this list as requested.
i. BFPCs shall respond to any calls from participants on the same working day. (1) If there is no BFPC available, the call will be forwarded to the BFPC Supervisor or LA Breastfeeding Coordinator. (2) BFPCs shall also provide participants with a number they can call after hours in case of emergencies. This may be a cell phone provided by the LA, a number connected to voicemail which will be routinely checked by the BFPCs, or use of the WIC Breastfeeding Helpline. (3) BFPCs can determine what times are suitable for participants to call or to check voicemails. Although providing 24-hour emergency coverage would be ideal, BFPCs should, at a minimum, be available until 9:00 PM on weekdays and Saturdays and Sundays until 1:00 PM, except for holidays.
j. BFPCs shall respond to any referrals from outside sources within 24 hours or the next business day. (1) If there is no BFPC available, the referral will be forwarded to the BFPC Supervisor or LA Breastfeeding Coordinator. (2) If a referred patient is not a WIC participant, the BFPC shall forward the patient’s information to a WIC LA staff member for WIC eligibility determination and certification.
k. To generate more referrals to WIC from healthcare providers, a letter or informational packet shall be provided announcing the availability of breastfeeding services for their patients.
l. To further increase program awareness, the BFPC will follow-up using a BFPC consult notes form to keep providers informed of breastfeeding services provided to their patients. Before providing any information to the physician, participants must sign a release form in accordance with Policy 1.04, Confidentiality of Participant Records.
PENNSYLVANIA DEPARTMENT OF HEALTH Policy Number: 5.04 WIC State Agency USDA Approval Date: February 20, 2024 State Effective Date: April 20, 2024
POLICY MANUAL
5. NUTRITION AND BREASTFEEDING SERVICES
5.04 Breastfeeding Peer Counselor Program.
Page 5 of 5
__________________ References: 1. USDA BFPC Management Guide (July 2016) 2. WIC Breastfeeding Model Components for Peer Counseling 3. USDA Breastfeeding Policy and Guidance (July 2016) 4. Nutrition Service Standards: Standard 9 Breastfeeding Peer Counseling (August 2013) 5. Allowable Costs for Breastfeeding Peer Counselor Fund Chart (as provided annually)
_________________________ Policy Status: 1. This Policy supersedes Section B.4. of Policy Number 5.02 dated February 13, 2017.