West Virginia WIC Policy & Procedure 5.14 Effective Date: 6/23/20 5.14 Telehealth for Nutrition Education and Lactation

POLICY: Telehealth can be utilized to provide continuity of care for WIC participants by providing access to nutrition education and lactation services while maintaining confidentiality of WIC participant information. PROCEDURE: A. Telehealth Definitions

1. Telehealth is defined by the Health Resources and Services Administration (HRSA) as the use of electronic information and telecommunication technology to support long distance clinical health care, patient and professional health-related education, public health and health administration.

2. Telehealth is defined by the Academy of Nutrition and Dietetics (AND) as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Telehealth will include both the use of interactive, specialized equipment, for such purposes as health promotion, disease prevention, diagnosis, consultation, therapy, and/or nutrition intervention (or passive) communications, over the internet, video-conferencing, email or fax lines, and other methods of distance communications, for communication of broad-based nutrition information.

B. Utilization of Telehealth

1. Telehealth is utilized to provide continuity of care to:

a. Increase access to nutrition and lactation services throughout West Virginia’s 55 counties. Services include:

i. Complete lactation counseling ii. Complete nutrition counseling iii. Complete clinic to clinic certifications, sub-certifications and follow-ups Note: Physical presence is required in one clinic. iv. Prescribe food packages v. Provide remote access services during a disaster/emergency.

b. Provide 24/7 lactation services through a smartphone app which connects the WIC participant to an International Board-Certified Lactation Consultant (IBCLC) for questions and other breastfeeding issues.

i. WIC staff, specifically Breastfeeding Peer Counselors, Nutrition Assistants, Nutrition Associates and Competent Professional Authorities (CPAs) can use the smartphone app to assist with

West Virginia WIC Policy & Procedure 5.14 Effective Date: 6/23/20 5.14 Telehealth for Nutrition Education and Lactation

counseling when it is outside their scope of practice and/or additional assistance is needed. ii. Pregnant and breastfeeding WIC participants can directly access IBCLC’s as needed.

c. Provide nutrition education modules through a smartphone app and/or website for WIC participants to fulfill nutrition education requirements.

C. Examples of Telecommunication Technologies

1. Use of internet to access Crossroads for participant information, to staff a remote clinic by phone to access lactation services or a CPA, if needed.

2. Use of internet to access Crossroads for participant information and to contact a remote clinic by Skype (or other video-conferencing platform) to view staff and/or participant at a remote clinic to provide WIC services.

3. Use of phone for completion of Nutrition Education and/or Breastfeeding contacts.

4. Use 24/7 smartphone app for lactation services to have video-chat with IBCLC. REFERENCES: 1. HealthIT.gov, Official Website of the Office of the National Coordinator for Health Information Technology (content last reviewed October 17, 2019) 2. WIC Regulations, 7CFR 246.11 Nutrition Education (a)(2) 3. Academy of Nutrition and Dietetics, Definition of Terms List (reviewed September, 2019) 4. Academy of Nutrition and Dietetics, Telehealth is Transforming Health Care: What You Need to Know to Practice Telenutrition ATTACHMENTS: 1. West Virginia WIC Remote Certification Policy During COVID-19