Benefit Issuance. If an applicant is found eligible for WIC services, benefit issuance will occur. Benefits are preferably issued for each household for 3 (three) months at a time. • WIC Clinics • Each local agency will create a clinic environment that maintains the highest levels of friendliness, respect, and helpfulness. Each local agency clinic will display a positive reflection of the Indiana WIC program. In addition, each local agency clinic environment will promote breastfeeding as the normal method of infant feeding. Local Agency WIC programs should adhere to the WIC Clinic Environment policy to ensure a quality client experience. • • WIC services are routinely provided at a WIC clinic located in a major town or city within each county in which the local agency has been approved to provide services. Some local agencies also provide services at other locations (i.e., homeless shelters, hospitals) within the approved service area. It must be cost effective to maintain locations outside of the WIC clinic, and all sites must be approved by the State agency prior to implementation. • An important element of the WIC Program is the building where clients are seen. Some WIC clinics are in an independent building and others occupy a section of a building in conjunction with other services provided by the local agency. The size and room configuration of the WIC clinic depends on: • • The number of people being served. • The number of staff positions. • The flow of clients through the clinic. • The need for confidentiality during income screening, obtaining measurements, and health and nutrition assessment. • The need for confidentiality during income screening, obtaining measurements, health, and nutrition assessment, and providing breastfeeding support. • • The building must be smoke and drug free. Housekeeping must be adequate to maintain sanitation. The building should be kept free of pests and infestations. The local agency is responsible for keeping the clinic well organized and free of extraneous equipment and material. • Physical accessibility of the clinic site location is very important. Clinic site locations must meet the standards of the Americans with Disabilities Act (ADA). This requires reasonable accommodation to individuals with physical impairments and disabilities. Public buildings must have entrances, rooms, restrooms, and hallways that are accessible to persons in wheelchairs. Clinic accessibility is affected by adequate parking space close to the clinic. Parking must be available so children will not be endangered by street traffic while going to or leaving the clinic. • If the clinic site is not accessible to all individuals, including persons with disabilities, a plan must be in place for serving these individuals. A sign must be posted in a public location that is accessible and should include clinic contact information. • The local agency will maintain a clinic environment that supports the racial and ethnic diversity of the community they serve. Clinic staff will use compassion and empathy when serving clients, providing nutrition education, breastfeeding education, and breastfeeding support to the client’s expressed need regardless of racial or ethnic background. Each local agency will display a positive reflection of the Indiana WIC Program through compliance with the WIC Racial Equity and WIC Customer Service policies. • • Safety and security of the clinic must be maintained for the welfare of staff, clients, and visitors to the clinic. There is always a safety concern for young children in the clinic. Electrical outlets should be covered with safety covers and access to stairwells, electrical boxes, and electrical rooms must be restricted. Large glass fixtures or windows may also cause concern. • The general areas needed by the WIC Program include a receptionist area, waiting room, space to screen income, a room to obtain measurements and hemoglobin, a health / nutrition /breastfeeding assessment / counseling area, and a nutrition education class area. There are additional areas needed in the clinic including restroom facilities for staff, clients, and other visitors. A supply room to store program and nutrition education materials, a copy machine, and other supplies are also needed. Breast pumps should be stored securely in a locked cabinet. It is not recommended to provide classes in the waiting room because of constant interruptions. An additional room for nutrition or breastfeeding education classes or staff in-services and meetings is preferred. A separate space for breastfeeding privacy and counseling is also strongly recommended. WIC local agencies may also have a break room for staff. • • Computer equipment will be placed in areas where staff schedule appointments, obtain intake information (including income screening), assess health and nutrition status, and issue benefits. The receptionist area should be large enough to hold desks, chairs, and file cabinets for files, records, and other forms required by the Indiana WIC Program. • • The equipment for obtaining measurements and hemoglobin screens should be in or close to the room used to screen health and nutrition information. Measurements must be performed in an area providing privacy and confidentiality. For good infection control, it is important that a sink with hot and cold running water be close to where the hemoglobin measurements are obtained so hands can be appropriately washed. • • Clinic Flow • • Another major determinant of space needed is clinic flow. Clinic flow may vary from clinic to clinic. Applicant screening must be conducted in a space or area that provides privacy and limits interruption and interference from other individuals checking in or waiting to be seen for services. • • The nutrition risk assessment must be completed by a CPA in the CPA’s office. An explanation of how to use the benefits may occur either in the receptionist area or in the CPA’s office. The next appointment can be scheduled by the Clinic Assistant or CPA. • • Hours of Operation • • State WIC policy addresses hours of operation. Clinic hours should be posted in a location that is visible from the exterior of the building. If posting on the outside of the building is not possible there must be another way to inform applicants of the clinic hours (e.g., website, mobile app, text message). • • Clinic hours of operation are determined by the local agency’s assigned caseload and number of staff hours. Clinic hours of operation must allow for access to services by working applicants and clients, individuals living in rural areas, and other applicant needs specific to the area such as serving migrant populations. As a service to clients needing WIC services, single clinic agencies or the largest clinic in a multi-clinic agency, must not be closed for more than two consecutive days including weekends. • • Clinic hours of operation should include evening hours for one or more days each week in a single clinic agency or in the largest clinic in a multi-clinic agency to accommodate working applicants and clients. Clinic hours must be as consistent as possible to avoid confusion for applicants and clients. For example, if a clinic is open on Monday, then each Monday should have the same clinic hours; if a clinic is open only four days a month, then it should be the same four days each month (i.e., 1st, 2nd, 3rd, and 4th Thursday). • • Scheduled clinic days cannot be closed without prior approval by the Indiana WIC Program. There must be a plan for how clinic services will be met during the proposed closed period. All changes made to the clinic hours and staffing pattern must be submitted in writing to the State of Indiana WIC Program office for approval prior to implementing the changes. The local agency coordinator is responsible for setting clinic hours that accommodate caseload and client need while maintaining the budgeted number of staff hours. Single clinic agencies or the largest clinic in a multi-clinic agency must not be closed for more than two consecutive days, including weekends. • Appointment Scheduling • • In general, clients should be seen for certifications within 20 (twenty) minutes after the clinic is opened and no more than 1 (one) hour before the clinic closes. Benefit issuance can occur up to the time the clinic closes. • • Appointments should be evenly distributed over the hours of clinic operation. All special nutrition risk applicants (pregnant individuals, infants, and workers) must be given a certification appointment within 10 (ten) calendar days of their request for WIC services. Appointment slots must be designated for these individuals within the clinic calendar. All applicants who are not designated as at special nutrition risk must be given a certification appointment within (20) twenty calendar days of their requests. • • Equipment • • The WIC clinic staff needs standard office equipment to appropriately function within the WIC clinic. The local agency is responsible for providing the following, which can be purchased through WIC funding: • • Adequate number of chairs for the waiting room. • Desks and chairs for staff. • Filing cabinets and storage cabinets with locks. • Equipment for obtaining measurements and hemoglobin data. • Telephone. • Document printer. • Copier. • Fax machine. • • Computers, printers, and other specified equipment are required to appropriately provide WIC clinic services. This equipment, software, and maintenance is provided through an IDOH contract and include the following: • • Laptop computers. May also provide desktop computers w/ mouse and keypad if necessary. • ePad. • Card Swipe • Document Scanner. • • Measurement Equipment • • Technical requirements used when purchasing measurement equipment and procedures for weighing measuring clients and testing hemoglobin levels are found in the Indiana WIC Program Policy and Procedure Manual. The required measurement equipment includes: • • Pediatric and adult scales to obtain a weight measurement for applicants and clients. • Recumbent board for obtaining length measurements for infants/young children. • Non-stretchable measuring tape and Handi-Stat, or a wall measuring board/foot piece, for older children/adults. • • All adult and pediatric scales must be inspected annually by state, city, or county inspectors. A list of Weights and Measures Inspectors is listed on the Indiana State Department of Health Web site at ▇▇▇▇://▇▇▇.▇▇.▇▇▇/isdh/25082.htm. This procedure assists with accurate weight measurements. Documentation of the inspection must be available. This may consist of a sticker placed on each scale indicating the month and year of inspection or a written report. If the inspector indicates repairs are needed, then repairs should be made, and a copy of the repair receipt filed. • • Hemoglobin value is the most used test to screen for iron deficiency anemia. In Indiana, a Hemocue analyzer and accompanying Microcuvettes or a Pronto analyzer with accompanying adult and pediatric sensors and cable, are used to measure the hemoglobin level. The Hemocue measurement is obtained by utilizing the following supplies: • • Alcohol. • Sterile gauze squares. • Self-retracting lancets. • Adhesive bandages. • Paper towels. • Disposable non-sterile medical gloves. • Heavyweight trash bags. • Disinfectant products. • Sharps container. • Protective and imperviously backed surface covering material. • • The local agency is responsible for providing training to employees for correct procedures to obtain a hemoglobin value and for using the Hemocue and Pronto analyzers. • • CLIA Waiver • • To perform client hemoglobin testing using the Hemocue machine, the WIC clinic must obtain a Clinical Laboratory Improvement Amendment (CLIA) Waiver, be in compliance with laboratory testing according to CLIA standards and must submit to CLIA review upon request. To ensure optimal operation of testing equipment, and accurate and reliable test results, temperature and cleaning/disinfectant logs must be maintained in each testing area. Procedures for maintaining temperature and cleaning/disinfectant logs can be found in the Management Chapter of the Indiana WIC Program Policy and Procedure Manual. • Infection Prevention/Universal Precautions • • The amount of blood required by the Hemocue machine to measure the hemoglobin level is small, but it is still an invasive procedure. It is the responsibility of all health care workers to protect themselves and others from exposure to blood and other potentially infectious materials that could result in the transmission of blood-borne pathogens that could lead to disease or death. All WIC staff responsible for obtaining the hemoglobin measurement must follow infection control procedures and universal precautions. The local agency must be able to prove that WIC staff performing hemoglobin screenings are covered under current liability insurance. • • The Infection Prevention and Universal Precaution Policy in the Management Chapter, and the Hematological Assessment Policy in the Certification Chapter of the Indiana WIC Program Policy and Procedure Manual outlines specific procedures for infection control, universal precautions, and disposal of supplies. • • The Hepatitis B vaccine and vaccination series must be made available by the local agency to all employees who have occupational exposure to blood and other potentially infectious materials. Employees must sign a waiver form if they choose not to be vaccinated. The local agency employees may later choose to receive the vaccine at no cost to them. • • The sponsoring agencies are responsible for annually providing State WIC or local agency universal precautions training to all employees who have duties that require direct contact with blood or other potentially infectious materials. The Employee Training and Inservice Education Plan policy in the Management Chapter of the Indiana WIC Program Policy and Procedure Manual outlines required new and annual staff training. Documentation of the employee’s in- service attendance must be maintained in either the agency’s annual training records or through the State WIC IN-Train or SharePoint site. • • Local agencies must develop a written personnel policy that requires all employees that have direct contact with blood or body fluids to use universal precautions. The policy must outline sanctions, including discipline and dismissal, for failure to use universal precautions. Any sanctions imposed must be documented in the employees’ personnel files. • • Records and Files • • Record retention and disposal is addressed in the Management Chapter and the Finance Chapter of the Indiana WIC Program Policy and Procedure Manual. There must be an adequate area to store the forms at the local agency clinic. • • Client Records • • All client information is entered into the MIS. As of October 1, 2016, all clinic sites can capture and retain most WIC forms in the MIS. The Indiana WIC Policy and Procedure Manual lists records to be retained in the MIS. Some client records, however, must continue to be retained in the clinic for purposes of complying with Indiana Code and/or for physical audit. There are eight paper files that will most commonly be maintained in each local agency: •
Appears in 1 contract
Sources: Grant Agreement
Benefit Issuance. If an applicant is found eligible for WIC services, benefit issuance will occur. Benefits are preferably issued for each household for 3 (three) months at a time. • Benefits are loaded onto the eWIC card by the appropriate WIC Clinics • staff member, and clients are provided education on how and where to redeem those benefits. Each local agency will create a clinic environment that maintains the highest levels of friendliness, equity, respect, and helpfulness. Each local agency clinic will display a positive reflection of the Indiana WIC program. In addition, each local agency clinic environment will promote breastfeeding as the normal standard method of infant feeding. Local Agency WIC programs should adhere to the WIC Clinic Environment policy policies to ensure a quality client experience. • • WIC services are routinely provided at a WIC clinic located in a major town or city within each county in which the local agency has been approved to provide services. Some local agencies also provide services at other locations (i.e., homeless shelters, hospitals) within the approved service area. It must be cost effective to maintain locations outside of the WIC clinic, and all sites must be approved by the State agency prior to implementation. • An important element of the WIC Program is the building where clients are seen. Some WIC clinics are in an independent building and others occupy a section of a building in conjunction with other services provided by the local agency. The size and room configuration of the WIC clinic depends on: • • The number of people being served. • The number of staff positions. • The flow of clients through the clinic. • The need for confidentiality during income screening, obtaining measurements, and health and nutrition assessment. • The need for confidentiality during income screening, obtaining measurements, health, and nutrition assessment, and providing breastfeeding support. • • The building must be smoke and drug free. Housekeeping must be adequate to maintain sanitation. The building should be kept free of pests and infestations. The local agency is responsible for keeping the clinic well organized and free of extraneous equipment and material. • Physical accessibility of the clinic site location is very important. Clinic site locations must meet the standards of the Americans with Disabilities Act (ADA). This requires reasonable accommodation to individuals with physical impairments and disabilities. Public buildings must have entrances, rooms, restrooms, and hallways that are accessible to persons in wheelchairs. Clinic accessibility is affected by adequate parking space close to the clinic. Parking must be available so children will not be endangered by street traffic while going to or leaving the clinic. • If the clinic site is not accessible to all individuals, including persons with disabilities, a plan must be in place for serving these individuals. A sign must be posted in a public location that is accessible and should include clinic contact information. • The local agency will maintain a clinic environment that supports the racial and ethnic diversity of the community they serve. Clinic staff will use compassion and empathy when serving clients, providing nutrition education, breastfeeding education, and breastfeeding support to the client’s expressed need regardless of racial or ethnic background. Each local agency will display a positive reflection of the Indiana WIC Program through compliance with the WIC Racial Equity and WIC Customer Service policies. • • Safety and security of the clinic must be maintained for the welfare of staff, clients, and visitors to the clinic. There is always a safety concern for young children in the clinic. Electrical outlets should be covered with safety covers and access to stairwells, electrical boxes, and electrical rooms must be restricted. Large glass fixtures or windows may also cause concern. • The general areas needed by the WIC Program include a receptionist area, waiting room, space to screen income, a room to obtain measurements and hemoglobin, a health / nutrition /breastfeeding assessment / counseling area, and a nutrition education class area. There are additional areas needed in the clinic including restroom facilities for staff, clients, and other visitors. A supply room to store program and nutrition education materials, a copy machine, and other supplies are also needed. Breast pumps should be stored securely in a locked cabinet. It is not recommended to provide classes in the waiting room because of constant interruptions. An additional room for nutrition or breastfeeding education classes or staff in-services and meetings is preferred. A separate space for breastfeeding privacy and counseling is also strongly recommended. WIC local agencies may also have a break room for staff. • • Computer equipment will be placed in areas where staff schedule appointments, obtain intake information (including income screening), assess health and nutrition status, and issue benefits. The receptionist area should be large enough to hold desks, chairs, and file cabinets for files, records, and other forms required by the Indiana WIC Program. • • The equipment for obtaining measurements and hemoglobin screens should be in or close to the room used to screen health and nutrition information. Measurements must be performed in an area providing privacy and confidentiality. For good infection control, it is important that a sink with hot and cold running water be close to where the hemoglobin measurements are obtained so hands can be appropriately washed. • • Clinic Flow • • Another major determinant of space needed is clinic flow. Clinic flow may vary from clinic to clinic. Applicant screening must be conducted in a space or area that provides privacy and limits interruption and interference from other individuals checking in or waiting to be seen for services. • • The nutrition risk assessment must be completed by a CPA in the CPA’s office. An explanation of how to use the benefits may occur either in the receptionist area or in the CPA’s office. The next appointment can be scheduled by the Clinic Assistant or CPA. • • Hours of Operation • • State WIC policy addresses hours of operation. Clinic hours should be posted in a location that is visible from the exterior of the building. If posting on the outside of the building is not possible there must be another way to inform applicants of the clinic hours (e.g., website, mobile app, text message). • • Clinic hours of operation are determined by the local agency’s assigned caseload and number of staff hours. Clinic hours of operation must allow for access to services by working applicants and clients, individuals living in rural areas, and other applicant needs specific to the area such as serving migrant populations. As a service to clients needing WIC services, single clinic agencies or the largest clinic in a multi-clinic agency, must not be closed for more than two consecutive days including weekends. • • Clinic hours of operation should include evening hours for one or more days each week in a single clinic agency or in the largest clinic in a multi-clinic agency to accommodate working applicants and clients. Clinic hours must be as consistent as possible to avoid confusion for applicants and clients. For example, if a clinic is open on Monday, then each Monday should have the same clinic hours; if a clinic is open only four days a month, then it should be the same four days each month (i.e., 1st, 2nd, 3rd, and 4th Thursday). • • Scheduled clinic days cannot be closed without prior approval by the Indiana WIC Program. There must be a plan for how clinic services will be met during the proposed closed period. All changes made to the clinic hours and staffing pattern must be submitted in writing to the State of Indiana WIC Program office for approval prior to implementing the changes. The local agency coordinator is responsible for setting clinic hours that accommodate caseload and client need while maintaining the budgeted number of staff hours. Single clinic agencies or the largest clinic in a multi-clinic agency must not be closed for more than two consecutive days, including weekends. • Appointment Scheduling • • In general, clients should be seen for certifications within 20 (twenty) minutes after the clinic is opened and no more than 1 (one) hour before the clinic closes. Benefit issuance can occur up to the time the clinic closes. • • Appointments should be evenly distributed over the hours of clinic operation. All special nutrition risk applicants (pregnant individuals, infants, and workers) must be given a certification appointment within 10 (ten) calendar days of their request for WIC services. Appointment slots must be designated for these individuals within the clinic calendar. All applicants who are not designated as at special nutrition risk must be given a certification appointment within (20) twenty calendar days of their requests. • • Equipment • • The WIC clinic staff needs standard office equipment to appropriately function within the WIC clinic. The local agency is responsible for providing the following, which can be purchased through WIC funding: • • Adequate number of chairs for the waiting room. • Desks and chairs for staff. • Filing cabinets and storage cabinets with locks. • Equipment for obtaining measurements and hemoglobin data. • Telephone. • Document printer. • Copier. • Fax machine. • • Computers, printers, and other specified equipment are required to appropriately provide WIC clinic services. This equipment, software, and maintenance is provided through an IDOH contract and include the following: • • Laptop computers. May also provide desktop computers w/ mouse and keypad if necessary. • ePad. • Card Swipe • Document Scanner. • • Measurement Equipment • • Technical requirements used when purchasing measurement equipment and procedures for weighing measuring clients and testing hemoglobin levels are found in the Indiana WIC Program Policy and Procedure Manual. The required measurement equipment includes: • • Pediatric and adult scales to obtain a weight measurement for applicants and clients. • Recumbent board for obtaining length measurements for infants/young children. • Non-stretchable measuring tape and Handi-Stat, or a wall measuring board/foot piece, for older children/adults. • • All adult and pediatric scales must be inspected annually by state, city, or county inspectors. A list of Weights and Measures Inspectors is listed on the Indiana State Department of Health Web site at ▇▇▇▇://▇▇▇.▇▇.▇▇▇/isdh/25082.htm. This procedure assists with accurate weight measurements. Documentation of the inspection must be available. This may consist of a sticker placed on each scale indicating the month and year of inspection or a written report. If the inspector indicates repairs are needed, then repairs should be made, and a copy of the repair receipt filed. • • Hemoglobin value is the most used test to screen for iron deficiency anemia. In Indiana, a Hemocue analyzer and accompanying Microcuvettes or a Pronto analyzer with accompanying adult and pediatric sensors and cable, are used to measure the hemoglobin level. The Hemocue measurement is obtained by utilizing the following supplies: • • Alcohol. • Sterile gauze squares. • Self-retracting lancets. • Adhesive bandages. • Paper towels. • Disposable non-sterile medical gloves. • Heavyweight trash bags. • Disinfectant products. • Sharps container. • Protective and imperviously backed surface covering material. • • The local agency is responsible for providing training to employees for correct procedures to obtain a hemoglobin value and for using the Hemocue and Pronto analyzers. • • CLIA Waiver • • To perform client hemoglobin testing using the Hemocue machine, the WIC clinic must obtain a Clinical Laboratory Improvement Amendment (CLIA) Waiver, be in compliance with laboratory testing according to CLIA standards and must submit to CLIA review upon request. To ensure optimal operation of testing equipment, and accurate and reliable test results, temperature and cleaning/disinfectant logs must be maintained in each testing area. Procedures for maintaining temperature and cleaning/disinfectant logs can be found in the Management Chapter of the Indiana WIC Program Policy and Procedure Manual. • Infection Prevention/Universal Precautions • • The amount of blood required by the Hemocue machine to measure the hemoglobin level is small, but it is still an invasive procedure. It is the responsibility of all health care workers to protect themselves and others from exposure to blood and other potentially infectious materials that could result in the transmission of blood-borne pathogens that could lead to disease or death. All WIC staff responsible for obtaining the hemoglobin measurement must follow infection control procedures and universal precautions. The local agency must be able to prove that WIC staff performing hemoglobin screenings are covered under current liability insurance. • • The Infection Prevention and Universal Precaution Policy in the Management Chapter, and the Hematological Assessment Policy in the Certification Chapter of the Indiana WIC Program Policy and Procedure Manual outlines specific procedures for infection control, universal precautions, and disposal of supplies. • • The Hepatitis B vaccine and vaccination series must be made available by the local agency to all employees who have occupational exposure to blood and other potentially infectious materials. Employees must sign a waiver form if they choose not to be vaccinated. The local agency employees may later choose to receive the vaccine at no cost to them. • • The sponsoring agencies are responsible for annually providing State WIC or local agency universal precautions training to all employees who have duties that require direct contact with blood or other potentially infectious materials. The Employee Training and Inservice Education Plan policy in the Management Chapter of the Indiana WIC Program Policy and Procedure Manual outlines required new and annual staff training. Documentation of the employee’s in- service attendance must be maintained in either the agency’s annual training records or through the State WIC IN-Train or SharePoint site. • • Local agencies must develop a written personnel policy that requires all employees that have direct contact with blood or body fluids to use universal precautions. The policy must outline sanctions, including discipline and dismissal, for failure to use universal precautions. Any sanctions imposed must be documented in the employees’ personnel files. • • Records and Files • • Record retention and disposal is addressed in the Management Chapter and the Finance Chapter of the Indiana WIC Program Policy and Procedure Manual. There must be an adequate area to store the forms at the local agency clinic. • • Client Records • • All client information is entered into the MIS. As of October 1, 2016, all clinic sites can capture and retain most WIC forms in the MIS. The Indiana WIC Policy and Procedure Manual lists records to be retained in the MIS. Some client records, however, must continue to be retained in the clinic for purposes of complying with Indiana Code and/or for physical audit. There are eight paper files that will most commonly be maintained in each local agency: •
Appears in 1 contract
Sources: Grant Agreement