Policy Overview Goal To inform staff of the new food package changes Policies 7.01, 7.02, 7.04, and 7.05 MI-WIC implementation process Staff education

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1 Overview of the New Food Package Policies Presenters Denise Gearhart, MS, RD Contractor, MI WIC Program Regina Poole, MS, RD Nutrition Consultant, MI WIC Program Outline Policy Overview Why New Food Packages 7.01 Food Package Determination 7.02 Authorized WIC Foods Break 7.04 Maximum Food Packages 7.05 Customized Food Packages Break MI-WIC Implementation Process Staff Educational Resources Questions 1

2 Policy Overview Goal To inform staff of the new food package changes Policies 7.01, 7.02, 7.04, and 7.05 MI-WIC implementation process Staff educational resources Policy Overview Objectives Describe why the food packages are changing. Understand the policies related to the new food packages Understand the MI-WIC implementation processes. Identify ways to communicate the new food package changes to clients and providers. 2

3 WIC Changes Since Expanded food supply WIC population more culturally diverse Obesity - major public health problem New Food Packages Greater amounts of nearly all of the nutrients of concern. Less saturated fat, cholesterol, total fat, and sodium. More consistent with Dietary Guidance. Wider appeal to diverse populations more choices. 3

4 Food Package Changes Fresh fruits and vegetables. Whole grains, such as whole grain bread and soft corn and whole wheat tortillas. Canned beans as an additional legume option for dry beans or peanut butter. Infant fruits and vegetables for all babies; infant meats for exclusively breastfed babies. Less juice, milk, cheese, and eggs for women and children; no juice for babies. New Food Packages Reinforce Nutrition Messages Eat more fruits and vegetables Lower saturated fat and cholesterol intake Increase whole grains and fiber Drink less juice and sweetened beverages Babies are meant to breastfeed 4

5 Changes in Food Packages and Terminology Old Food Packages ages New Food Packages ages Standard Food Package..Maximum Food Package Tailored Food Package Customized Food Package Special Formula Package...Food Package for Qualifying Conditions Revised Food Package Policies Food Package Determination 7.02 Authorized WIC Foods 7.03 Food Package for Qualifying Conditions 7.04 Maximum Food Package 7.05 Customized Food Package 5

6 7.01 Food Package Determination The CPA shall assign a food package for each client, taking into consideration the client's age and nutritional needs. Assign a maximum food package to a client unless it is not appropriate. If not appropriate, assign a customized food package. Assigned food package shall only be for the client s personal use Authorized WIC Foods Infant Foods cereal, fruits, vegetables, meats Breakfast Cereal Juice Cheese Eggs Milk Tuna Fresh Fruits and Vegetables Mature Legumes mature dry beans and peas, mature canned beans and peas, peanut butter Whole Wheat/Whole Grain Breads and Tortillas 6

7 Infant Cereal Infant Foods Beech-Nut, Gerber, or Nature s Goodness: Rice, oatmeal, barley mixed grain, multigrain and whole wheat. 8 oz. or 16 oz. box or carton only. No organic or DHA cereal allowed. Infant Foods Infant Fruits Single ingredients only. 4 oz. glass jars. Multipacks are allowed. No organic or DHA allowed. Beechnut Stage 2 Applesauce, Chiquita Bananas, Peaches, Pears Gerber 2nd Foods Applesauce, Bananas, Pears Nature s Goodness Stage 2 Applesauce, Bananas, Peaches, Pears. 7

8 Infant Foods Infant Vegetables Single ingredients only. 4 oz. glass jars. Multipacks are allowed. No organic or DHA allowed. Beechnut Stage 2 Butternut Squash, Tender Golden Sweet Potatoes, Tender Sweet Carrots, Tender Young Green Beans. Gerber 2nd Foods Carrots, Green Beans, Peas, Squash, Sweet Potatoes. t Nature s Goodness Stage 2 Carrots, Green Beans, Squash, Sweet Peas, Sweet Potatoes. Infant Foods Infant Meats-Single ingredient with added broth or gravy. 2.5 oz. glass jars. Multipacks are allowed. No organic or DHA allowed. Beechnut Stage 1 Beef & Beef Broth, Chicken & Chicken Gravy, Turkey & Turkey Broth Gerber 2nd Foods Beef & Beef Gravy, Chicken & Chicken Gravy, Ham & Ham Gravy, Lamb & Lamb Gravy, Turkey & Turkey Gravy, Veal & Veal Gravy. Nature s Goodness Stage 2 Beef & Beef Gravy, Chicken & Chicken Gravy, Turkey & Turkey Gravy. 8

9 Breakfast Cereals Over half of the breakfast cereals authorized must be whole grain. Cheerios plain and multigrain Wheat Chex Frosted Mini- Wheats Big Bite, Bite Size, Unfrosted Malt-O-Meal Meal Mini-Spooners frosted and strawberry cream Banana Nut Crunch Bran Flakes Honey Bunches of Oats Vanilla Bunches Life Oatmeal Squares Cinnamon, Hint of Brown Sugar Cream of Wheat with Whole Grain Instant Oatmeal Regular flavor Quaker and store brands Breakfast Cereal No longer authorized due to availability and/or meeting the whole grain requirement. Homestat Farm Vermont Style Oatmeal Malt-O-Meal Meal only Mini-Spooners Maple and Brown Sugar and Vanilla Cream. Name Change Honey Bunches of Oats-Cinnamon Bunches and Vanilla Bunches. Limiting Flavors Quaker Instant Grits -Original, Butter flavors 9

10 Juice Women are only allowed the oz. frozen or non-frozen concentrate or 46 oz single strength containers. Children are only allowed juices in 64 oz. single strength containers. Legumes Legumes includes: Peanut butter Dry Beans or Peas Canned Beans or Peas 10

11 Legumes Mature Canned Beans or Peas Any type of mature beans, peas, or lentils in a canned form including, but not limited to: black beans ( turtle beans ), blackeye peas (cowpeas of the blackeye variety, cowpeas ), garbanzo beans (chickpeas), great northern beans, kidney beans, lima beans ( butter beans ), navy beans, pinto beans, soybeans, split peas, and lentils. Legumes Mature Canned Beans or Peas Allowed: Mixtures t of beans and peas. Can sizes -15 to 16 oz. Bush s and store brands listed on the food card. Low sodium. 11

12 Legumes Mature Canned Beans or Peas Not Allowed organic i canned beans or peas. baked beans, chili beans, refried beans, pork and beans, or soups. beans with added fats, oils or meat. green beans, green/sweet peas, snap beans, wax beans. Milk Children months of age are only allowed whole milk. Women and children 2-4 years are only allowed reduced, low fat, and skim milk. Exception: women and children 2-4 years of age may receive whole milk with a Class II or Class III formula package and medical documentation for a qualifying condition. 12

13 Fresh Fruits and Vegetables Any variety of fresh whole or cut fruit, without added sweeteners. Any variety of fresh whole or cut vegetables, without added sweeteners, fats, or oils. Fresh Fruits and Vegetables No potatoes except sweet potatoes and yams. No mature legumes (dry beans and peas) and juices. No herbs or spices, edible blossoms and flowers, e.g. squash blossoms. Broccoli, cauliflower and artichokes are allowed. No nuts or fruit-nut mixtures. 13

14 Fresh Fruits and Vegetables No fruits and vegetables for purchase on salad bars. No ornamental and decorative fruits and vegetables such as chili peppers on a string, garlic on a string, gourds, or painted pumpkins. No fruit baskets and party fruit or vegetable trays with dip, dressing or added food items. Whole Wheat/Whole Grain Breads and Tortillas Whole wheat or whole grain must be the first ingredient. Whole grain bread must meet labeling requirements for making a health claim as a whole grain food with moderate fat content. Per 50 g serving Fiber 2.8 g Saturated fat 1g Cholesterol 20 mg Trans fat 0.5 g Total fat 6.5 g 14

15 Whole Grain/Whole Wheat Breads and Tortillas Soft corn and whole wheat tortillas must have whole grain as the first ingredient. Package size allowed is 1 lb (16 oz). No organic allowed. May not contain saccharin, aspartame, sucralose or DHA. Breads and tortillas are brand specific and identified on the food card. Whole Wheat/Whole Grain Breads Aunt Millies - Cinnamon Raisin Swirl Cranberry Apple Swirl Whole Grain White Healthy Life - 100% Whole Wheat Whole Grain Bunny 100% Whole Wheat Koepplinger s - Lite 100% Whole Wheat Pepperidge Farm - 100% Whole Wheat Very Thin Sliced Bread 100% Whole Wheat Jewish Rye Whole Grain Rye Seeded d Whole Grain Swirl Cinnamon with Raisins Sara Lee - Classic 100% Whole Wheat Wonder - Soft 100% Wheat 15

16 Soft Corn and Whole Wheat Tortillas Don Marcos 18 Corn Don Pancho Whole Wheat 10 ct Don Pancho 18 count White Corn La Burrita 12 count Corn Chi-Chi s Chi s Whole Wheat Fajita Style 8 ct Mejier Soft Taco Size White Corn Meijer Whole Wheat Fajita Style 8 ct 15 Minute Break Will Return Shortly 16

17 7.04 Maximum Food Package The maximum monthly allowances of all supplemental foods in all food packages must be made available to clients. The CPA shall assign a maximum food package to a client unless it is not appropriate. Maximum Food Package Assigning Less than the Maximum: Policy 7.05 Customized Food Package Medically or nutritionally warranted (e.g., to eliminate a food due to a food allergy) A client refuses or cannot use the maximum monthly allowances 17

18 Maximum Food Package Exclusive breastfeeding woman food package: Pregnant women of multiple fetuses Women partially breastfeeding two or more infants Women exclusively breastfeeding two or more infants receives of 1.5 times the maximum exclusively l breastfeeding woman package. Maximum Food Package Foods Juice, single strength Milk, fluid Breakfast cereal Cheese Eggs Fresh fruits and vegetables Whole wheat bread/tortillas Fish (canned) Legumes, And Peanut butter Exclusively Breastfeeding Women (BE) 144 fl oz 144 fl oz 18 qt 19 qt 36 oz 36 oz 3 lb (max. allowed w/o medical doc.) 2 dozen 1 dozen Pregnant Women (PG) and Partially Breastfeeding Women (BP) 1 lb (max. allowed w/o medical documentation) $10.00 cash value $8.00 cash value 1 lb 1 lb 30 oz -- 1 lb (16 oz) dry or 64 oz canned And 18 oz 1 lb (16 oz) dry or 64 oz canned And 18 oz 18

19 Maximum Food Package Non-Lactating Post-Partum Partum Women For breastfeeding women of infants receiving more than the maximum amount of formula for partially breastfed infants. Reduced juice, milk, cheese, and eggs from previous NPP package. Fresh fruits and vegetables have been added. Do not receive whole wheat bread/tortillas. Maximum Food Package Foods Juice, single strength Milk, fluid Cheese Breakfast cereal Eggs Fresh fruits and vegetables Legumes Or Peanut butter Postpartum Women (NPP) Up to 6 months. 96 fl oz 13 qt 1 lb (maximum allowed w/o medical documentation) 36 oz 1 dozen $8.00 cash value 1 lb (16 oz) dry or 64 oz canned Or 18 oz 19

20 Maximum Food Package Partially Breastfed Infants (IBP) and Fully Formula Fed Infants (IFF) Maximum package based on infant s age range. The powdered formula based on the manufacturers reconstituted volume. For IBP no routine issuance of formula CPA must assess IBP to determine if any formula and the amount needed. Maximum Food Package Foods WIC Formula Exclusively Breastfed Infants (IBE) 0-5 months 0 Receive mother s milk priceless! Infant cereal 0 24 oz Exclusively Breastfed Infants (IBE) 6-11 months 0 Receive mother s milk, priceless! Baby food fruits and vegetables Baby food meats oz (64-44 oz jars) oz ( oz jars) 20

21 Foods WIC Formula Maximum Food Package Partially Breastfed Infants (IBP) A: During the first month B: 1-3 months C: 4-5 months Partially Breastfed Infants 6-11 months A: Up to 104 fl oz reconstituted 312 fl oz reconstituted powder liquid concentrate B: 364 fl oz reconstituted liquid or concentrate or 384 fl oz RTF or 320 fl oz RTF 435 fl oz reconstituted powder or C: 442 fl oz reconstituted liquid 384 fl oz reconstituted concentrate or 448 fl oz RTF or powder 522 fl oz reconstituted powder Infant cereal 0 24 oz Baby food fruits and vegetables oz (32-4 oz jars) Foods Maximum Food Package Fully Formula Fed Infants (IFF) A: 0-3 months B: 4-5 months Fully Formula Fed Infants (IFF) 6-11 months WIC Formula A: 806 fl oz reconstituted t 624 fl oz liquid concentrate or 832 fl oz RTF or 870 fl oz reconstituted powder. B: 884 fl oz reconstituted liquid concentrate or 896 fl oz RTF or 960 fl oz reconstituted powder. reconstituted liquid concentrate or 640 fl oz RTF or 696 fl oz reconstituted powder. Infant cereal 0 24 oz Baby food fruits and vegetables oz (32-4 oz jars) 21

22 Maximum Food Package for Children (C1-C4) C4) Children receive less juice, milk, cheese and eggs. Children receive fresh fruits and vegetables, and whole wheat bread or tortillas. Children 1 year of age receive only whole milk. Children 2 4 years of age receive reduced fat, low fat or skim milk unless they have a qualifying condition and require a WIC formula. Maximum Food Package Foods Children (C1-C4) C4) Juice, single strength Milk Cheese Breakfast cereal Eggs Fresh fruits and vegetables Whole wheat bread/tortillas Legumes Or Peanut butter 128 fl oz 13 qt 1 lb (maximum allowed w/o medical documentation.) 36 oz 1 dozen $6.00 cash value 2 lb 1 lb (16 oz.) dry or 64 oz canned Or 18 oz 22

23 7.05 Customized Food Package The CPA shall work with the client to customize the food package for the following situations: Food preference. Medical and nutritional needs or risks (e.g., eliminate a food due to a food allergy). Household conditions (e.g., lack of refrigeration; homelessness). Breastfeeding support by adjusting the food package for the partially breastfeeding infant. Customized Food Package A specific food may also be lessened or excluded from an individual's food package if: It has been determined the food is contraindicated for the client due to a special medical or nutritional problem OR Client refuses or cannot use the maximum monthly allowance 23

24 Customized Food Package Substitutions - Infant cereal and breakfast cereal For children and women, 32 oz of infant cereal may be substituted for 36 oz of breakfast cereal. Customized Food Package Substitutions - Evaporated milk 20 cans evaporated milk = 16 quarts fluid milk + 1 quart fluid milk 28 cans evaporated milk = 22 quarts fluid milk + 1 quart fluid milk. 32 cans evaporated milk = 24 quarts fluid milk 24

25 Customized Food Package Substitutions - Powdered dry milk 64 oz box powdered dry milk = 20 quarts fluid milk 32 oz box powdered dry milk = 10 quarts fluid milk 25.6 oz box powdered dry milk = 8 quarts fluid milk Customized Food Package Substitutions - Cheese 1 pound of cheese per 3 quarts fluid milk. For children, pregnant and partially breastfeeding women and non-lactating postpartum women, no more than 1 lb of cheese may be substituted for 3 quarts of milk without medical documentation. 25

26 Customized Food Package Substitutions - Cheese Exclusively breastfeeding women 1 pound of cheese per 3 quarts of milk. No more than 2 lb of cheese for 6 quarts milk without medical documentation. Children and women May substitute additional cheese for lactose intolerance or other qualifying conditions up to the maximum allowance for milk with medical documentation. Customized Food Package Substitutions - Peanut Butter, Dry Beans/Peas, and Canned Beans/Peas 64 oz canned beans/peas (4 cans) = 1 lb of dry beans/peas = 18 oz. of peanut butter 26

27 Customized Food Package Substitutions - Peanut Butter, Dry Beans/Peas, and Canned Beans/Peas For pregnant (PG), partially breastfeeding (BP) women and exclusively breastfeeding (BE) women Options: 1 lb of dry beans/peas + 64 oz canned beans/peas 2 lb of dry beans/peas 128 oz canned beans/peas 36 oz peanut butter 1 lb of dry beans/peas + 18 oz peanut butter 64 oz canned beans/peas + 18 oz peanut butter MI-WIC Implementation New age ranges for infants IBP 0 through less than 1 month 1 through 3 months IFF 0 through 3 months IBP/IFF 4 through 5 months 6 through 11 months 27

28 BE Food Packages MI-WIC Implementation Will display for PG expecting more than one infant Will display for BP breastfeeding more than one infant Will alert with option to display BE exclusively breastfeeding two or more with 1.5 times the amount Monthly amount of foods will vary depending on the food item. Cheese Maximum MI-WIC Implementation Will provide alert if food package is customized to provide additional cheese The alert will remind staff to scan Medical Documentation form for additional cheese substitute Will require an Expiration Date for additional cheese substitute not to exceed Cert End Date 28

29 Expiration Date Required MI-WIC Implementation For all Class II and Class I formulas for a child Alert For infant 6-11 months old receiving Class II or Class III formula and not receiving infant foods. Option to assign the maximum formula allowed for a 4-5 month old Validate To assign a food package with whole milk to a woman or child 2 years or older, a Class II or Class III formula must be included in the package MI-WIC Implementation Will calculate formula maximums in each food package according to the infant s age range and category and based on the manufacturers reconstituted amount for powder formula Refer to handout MI WIC Contract Formulas Implementation Rule: Current standard food packages will automatically convert to maximum food packages. Underweight risk assignment alert for a maximum food package will be removed. 29

30 BP Woman MI-WIC Implementation When IBP infant (1-5 months) receives more formula than the IBP maximum, NPP packages will display for BP woman. When IBP infant (6-11 months) receives more formula than the IBP maximum, BP woman will not receive food benefits, but will be counted as a client. Educational Resources Staff Spotlight: The New Food Packages Promote Healthier Choices Clients Video Vignettes Shopping list WIC Food Card 30

31 Communicating Changes to Clients What can they expect at their next appointment. The foods that they can expect to receive. What medical documentation they might need. Information specific to their situation. New Food Package Transition Implementation August 1, WIC Notice # No WIC services should be provided August 1, If clients have already been scheduled, please contact to reschedule appointments. Clients will be issued new food packages beginning August 3,

32 WIC provides healthier food packages for healthier WIC families 32