West Virginia WIC Policy & Procedure 5.05 5.05 Nutrition Education Contacts and Documentation Effective Date: 6/10/22

POLICY:

Nutrition education contacts, including breastfeeding promotion and support, will be considered a benefit of the WIC Program, and will be made available at no cost to the participant. Nutrition education will be designed to be easily understood by participants and bear a practical relationship to participant nutritional needs, household situations, and cultural preferences including information on how to select food for themselves and their families.

Nutrition and breastfeeding education will be provided by the Local Agency and/or by web-based nutrition education through the WICSmart website or mobile application. The Local Agency will stress the positive, long-term benefits of nutrition education and encourage the participant to attend and participate in nutrition education activities. However, individual participants will not be denied supplemental foods (WIC benefits) for failure to attend Durior participate in nutrition education activities.

As an integral part of nutrition education, the Local Agency will provide drug and other harmful substance abuse information to all pregnant women and to parents or caretakers of infants and children participating in the WIC Program.

PROCEDURE:

A. Nutrition Education Contacts

1. During each twelve-month (12) certification period, at least four (4) nutrition education contacts must be made available to all breastfeeding women participants and the parents, guardians and/or caretakers of infant and child participants. When possible, nutrition education should be made available to the child participants themselves.

a. The four (4) nutrition education contacts must take place on four (4) separate dates.

b. All Women completing the program will be offered an exit nutrition counseling session as outlined in Policy 5.07 Exit Counseling Session for WIC Participants. c. Nutrition education contacts will be scheduled at a quarterly rate.

2. During each six-month (6) certification period, at least two (2) nutrition education contacts must be made available to all non-breastfeeding women participants.

a. The two (2) nutrition education contacts must take place on two (2) separate dates.

b. All Women completing the program will be offered an exit nutrition counseling session as outlined in Policy 5.07 Exit Counseling Session for WIC Participants.

c. Nutrition education contacts will be scheduled at a quarterly rate.

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West Virginia WIC Policy & Procedure 5.05 5.05 Nutrition Education Contacts and Documentation Effective Date: 6/10/22

3. During each certification period for pregnant women participants, at least two (2) nutrition education contacts must be made available.

a. The two (2) nutrition education contacts must take place on two (2) separate dates.

b. All prenatal participants will be offered a breastfeeding education class as outlined in Policy 5.20 West Virginia Breastfeeding Program.

4. Nutrition and breastfeeding education will be made available as follows:

a. Contacts will cover topics which are appropriate to the individual participant’s nutritional needs and will be made available by:

i. In-person one-on-one nutrition or breastfeeding education ii. Phone-based one-on-one nutrition or breastfeeding education iii. In-person interactive group nutrition or breastfeeding education iv. Virtual (i.e. Zoom) one-on-one nutrition or breastfeeding education v. Virtual (i.e. Zoom) interactive group nutrition or breastfeeding education vi. WIC Smart, web-based nutrition, and breastfeeding education modules

Note: See Policy 5.14 Telehealth for Nutrition Education and Lactation

b. Nutrition and breastfeeding education contacts may be provided by Nutritionists/Nutrition Associates (CPAs), Nutrition Assistants, Breastfeeding staff, or any other cooperating agency staff who the Local Agency Director has deemed appropriate (i.e. WVU Extension Agency).

c. If the participant was determined to meet high-risk criteria at certification, a high-risk follow-up will be scheduled with a Nutritionist (CPA). The certification appointment and the high-risk follow-up appointment fulfills the requirement of at least two (2) nutrition education contacts (see Policy 5.06 Guidelines for Serving High Risk Participants).

d. Program participants will not be denied supplemental foods for failure to attend or participate in nutrition education activities.

B. Nutrition Education Contacts – Scheduling

1. All Nutrition Education Contacts appointments must be scheduled in the Crossroads Scheduler.

a. When feasible, walk-in appointments will be completed the same day.

b. When feasible, over-the-phone nutrition education contacts, food package changes, and breastfeeding support and education contacts will be 2 of 5

West Virginia WIC Policy & Procedure 5.05 5.05 Nutrition Education Contacts and Documentation Effective Date: 6/10/22

completed the same day as the original phone call (see Policy 5.14 Telehealth for Nutrition Education and Lactation).

C. Documentation of Nutrition Education Contacts

1. The nutrition and breastfeeding education contact that takes place during a certification or high-risk follow-up visit will be documented in the Crossroads Nutrition Care Plan Section. Documentation will include:

a. The nutrition and/or breastfeeding education topic(s) discussed, and delivery method used will be documented on the Crossroads Nutrition Education Screen.

b. The Nutritionist/Nutrition Associate (CPA) will document the initial or subsequent certification visit or high-risk follow-up in an individual Nutrition Care Plan in the Nutrition Assessment section of the Crossroads Nutrition Care Plan (see Policy 5.04 The Nutrition Care Plan).

2. Secondary nutrition and breastfeeding education contacts, which includes in-person one-on-one nutrition education, phone-based one-on-one nutrition education, in-person interactive group nutrition education, virtual one-on-one nutrition or breastfeeding education, virtual interactive group nutrition or breastfeeding education, or WIC Smart, web-based nutrition and breastfeeding education modules.

a. In-person, phone-based or virtual one-on-one nutrition and breastfeeding education

i. A WIC participant, parent/guardian and/or caretaker can complete in-person, one-on-one nutrition, or Breastfeeding education with a Nutritionist/Nutrition Associate (CPA) or breastfeeding staff.

ii. A WIC participant, parent/guardian and/or caretaker can complete one-on-one nutrition or breastfeeding education over the phone with the Nutritionist/Nutrition Associate (CPA) or Breastfeeding staff (see Policy 5.14 Telehealth for Nutrition Education and Lactation).

iii. A Nutrition Care Plan is not required for one-on-one nutrition education.

iv. The nutrition and/or breastfeeding education topic(s) discussed, and delivery method used will be documented on the Crossroads Nutrition Education Screen.

v. WIC staff will confirm the participant’s food package and issue eWIC benefits.

b. In-person or virtual interactive group nutrition or breastfeeding education

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West Virginia WIC Policy & Procedure 5.05 5.05 Nutrition Education Contacts and Documentation Effective Date: 6/10/22

i. The nutrition and/or breastfeeding education topic(s) discussed, and delivery method used will be documented on the Crossroads Nutrition Education Screen.

ii. WIC staff will confirm the participant’s food package and issue eWIC benefits.

iii. A Nutrition Care Plan is not required for group nutrition education.

c. WIC Smart, web-based nutrition, and breastfeeding education modules

i. The WIC participant, parent/guardian and/or caretaker will complete a minimum of one (1) nutrition or breastfeeding education module on WIC Smart.

ii. After completing one (1) nutrition or breastfeeding education module, the participant’s WIC family ID number will be automatically added to the WICSmart Lesson Completion Module History report.

iii. A Nutrition Care Plan is not required for online nutrition education.

iv. WIC staff will credit the WIC participant(s) with the completion of the module by documenting the nutrition and breastfeeding education module(s), and delivery method used (online) on the Crossroads Nutrition Education Screen.

v. WIC staff will call the participant and/or parent/guardian to confirm the completion of nutrition education, discuss concerns or questions, confirm the participant’s food package and issue eWIC benefits.

3. Participants will not be denied WIC benefits for failure to attend or participate in nutrition education activities.

a. The Nutritionist (CPA) will document the refusal on the Crossroads Nutrition Education Screen.

i. Documenting refusal on the Crossroads Nutrition Education Screen can mean that the participant, parent, guardian, or caretaker refused nutrition education, verbally or by written notice.

ii. Documenting refusal on the Crossroads Nutrition Education Screen can mean that WIC staff were unable contact the participant, parent, guardian, or caretaker.

b. WIC staff must call the participant and/or parent, guardian, caretaker to confirm the participant’s food package and issue eWIC benefits.

i. WIC benefits cannot be denied if WIC staff were unable to contact the participant, parent, guardian, or caretaker.

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West Virginia WIC Policy & Procedure 5.05 5.05 Nutrition Education Contacts and Documentation Effective Date: 6/10/22

c. A Nutrition Care Plan is not required for refusal to participate in nutrition education activities.

D. Web-Based Nutrition Education Modules – WIC Smart

1. Web-based nutrition and breastfeeding education provides an alternative for WIC participants and their parents/guardians and/or caretakers, allowing the option of completing their nutrition education requirement on their own time, anywhere they have Internet access.

2. Web-based nutrition education can be used as a method of nutrition and breastfeeding education for:

a. When a participant's schedule conflicts with the in-person interactive group class schedule or WIC clinic hours.

b. Situations when the participant is sick and are unable to attend the in-person interactive group class or in-person one-on-one individual nutrition education.

3. Web-based nutrition education cannot be used for:

a. Replacement of individual counseling at the certification visit.

ATTACHMENT:

1. Nutrition Education Topics for Crossroads

REFERENCES:

1. WIC Regulations 7 CFR 246.11 Nutrition Education 2. WIC Policy Memorandum 94-9 WIC Exit Counseling Brochure 3. USDA Nutrition Services Standards, Standard 7 – Nutrition Education and Counseling 4. USDA Nutrition Service Standards, Standard 8 – Breastfeeding Education, Promotion and Support

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