Questions & Answers Overview of the New Food Packages

Transcription

1 Questions & Answers Overview of the New Food Packages Authorized Foods 1) Will baby foods in glass jars be readily available? A staff member has observed that it seems that mainly plastic jars are available in the stores. A: The baby food companies have informed us that these foods will be available for purchase in stores by August 1, ) Are organic fruits and vegetables allowed? Please review the state guidelines on the purchase of organic fruits and vegetables one more time. A: Organic fresh fruits and vegetables may be purchased using the cash value benefit. For example, if a client has $8 on their EBT card they can purchase $8 of organic fresh fruits and vegetables. 3) If the juice is intended for the child to be drinking, I am wondering if it is wise to only allow 64 oz size containers, considering the shelf life. How much juice a child should drink before it begins to spoil? Shouldn t we be encouraging less juice per day? They would have to share it with the family to consume it within a few days or drink a lot of juice over a few days. A: In order to meet the maximum monthly allowance of 128 fl oz of juice for the child package, 64 oz containers of juice were authorized. Michigan WIC has based the maximum allowance on 4 ounces/day. The American Academy of Pediatrics recommends limiting the intake of fruit juice to 4-6 fl oz per day for children1-6 years of age. USDA indicates that opened juice stored in the refrigerator is safe for 7-10 days (Sources are: USDA Food Safety and Inspection Service and The Food Keeper by the Food Marketing Institute). For a cold storage chart go to 4) White potatoes contain significant nutrients and are well accepted by most people, not to mention they are much less expensive than sweet potatoes and yams. Compared to grapes or celery, or even apples, the nutrient density of white potatoes is superior in many ways. What are they lacking? A: The Institute of Medicine (IOM) indicated that white potatoes were not included as they are readily available to clients. They wanted clients to have fruits and vegetables with other nutrients. The IOM committee based this restriction on the amounts suggested in the USDA Food Guide for consumption of starchy vegetables. Food intake data indicated that consumption of starchy vegetables meets or exceeds these suggested amounts, and that white potatoes are the most widely used type of vegetable. Fried potatoes are the most common vegetable consumed by toddlers 15 months and older. 1

2 5) Can you provide the WIC website to evaluate whole grain foods? A: Yes, the website to the whole grain calculator is 6) Are any of the bread selections Kosher? What about baby meat, are any Kosher? A: We are compiling a listing to indicate which Michigan WIC Authorized Foods are Kosher. None of the infant food meats are Kosher. So far we have received the following information from bread companies: Aunt Millies Healthy Goodness Whole Grain White Bread made with Kosher ingredients Aunt Millies Swirl Whole Grain Raisin Bread with Cinnamon Kosher Pareve Aunt Millies Swirl Whole Grain Cranberry Apple Bread Kosher Pareve Koepplinger Lite 100% Whole Wheat Bread Kosher Pareve 7) Are there going to be new juices added to the food card because currently the only ones offered are in the 46 oz container (or concentrate)? A: No new juices will be added at this time. The food card contains Juicy Juice, Welch s Grape Juice, Indian Summer, and Campbell s Tomato Juice which come in 64 oz containers as well. 8) Do C1 and C2 now receive the option of peanut butter? Why the change in policy? Is this a USDA requirement? Can we customize the C2 package to include peanut butter? A: USDA regulations designate peanut butter as part of the maximum food package as an option for all children. The Academy of Pediatric does not recommend consumption of peanut butter for children under 3 years of age due to choking hazards. Michigan still recommends that parents/caregivers are informed of the choking hazard for children under 3 and allow the choice to be made by the parent/caregiver at the store with the peanut butter, dry beans, canned beans option on the shopping list. 9) Will evaporated and/or powdered milk still be included as a food package within MI-WIC or will CPA s need to figure out equivalents? A: Evaporated milk and powdered milk will still be a food package. In order to provide the maximum allowance of milk an additional quart of fluid milk will also be included in the package. 10) Beans sometimes come in cans or glass jars of 64 oz. Can these be purchased or do they have to buy the 16 oz cans? 2

3 A: Clients must purchase the 16 oz cans. The Michigan Food Card allows purchase of 15 to 16 oz canned beans. 11) In the new food package, why do children receive 2 lbs of whole grain per month and non-lactating post-partum women don t receive any? A: The IOM report, which is the basis for the food package revision, notes that the nutritional needs of pregnant and breastfeeding women ordinarily are higher than those for non-lactating postpartum women. The report also notes that nutrient intake for some key vitamins and minerals are lower for pregnant and breastfeeding women than postpartum women (i.e. vitamin B6, folate, niacin, thiamin, and zinc). Both these factors influenced the decision not to include whole grain bread and other whole grain options in the food package for non-lactating post-partum women. For children age one through four years old, priority nutrients identified as lacking in the diet were fiber, vitamin E and potassium. In addition, whole grain consumption tended to be lower for children 2-4 years. The IOM report recommended providing children with repeated exposure to new foods to optimize acceptance and encourage development of healthy eating habits that promote selection of a varied diet. The report also cited increasing intakes of priority foods such as whole grains as a way to help limit intakes of saturated fat, trans fat, cholesterol and added sugars. 12) What s the word on soy milk and tofu? Will we have it on the new Michigan food card? Our agency has many requests for soy and/or lactose reduced milk. Will these be offered on the new Michigan Food Card? A: Soy milk and tofu will be considered for Phase 2 of the food package implementation, but it is not on the food card. Lactose Free Milk has been and continues to be a WIC approved food item. 13) When does Phase 2 begin? When will Phase 2 be implemented? A: This has not yet been determined, but most likely it will begin after November of We need to provide adequate time to evaluate the implementation of Phase I of the new WIC foods. 3

4 Shopping List 14) In what container size will milk be listed on the shopping list now that the amount of milk, with one pound of cheese cannot be converted to an even gallon amount? A: In most cases, milk will be in gallons or half gallons. The one pound of cheese is equivalent to 3 quarts of milk. This will leave 1 quart of milk called the dangling quart. USDA requires that the client receives this remaining quart of milk, which will be provided in a half gallon container every other month. 15) When a parent has children with different ages will the shopping list separate the whole from the low fat milk? A: Yes, the shopping list will separate the whole milk from the low fat milk. As an example, you will see on the shopping list Gallon Whole Milk and Gallon Milk. The gallon milk will allow the client to purchase 2%, 1%, ½%, and skim milk. Policy 16) Can you switch from cheese back to milk if desired? A: Yes, you may substitute the cheese back to milk. The maximum food packages for children and women contain the maximum monthly allowance of cheese substituted without medical justification. If a client wishes to receive no cheese, milk may be substituted back for the cheese. 17) Can a C1 package be customized to provide 2% milk instead of whole milk for an overweight child? A: No, the regulations do not allow a C1 to receive low fat milk. A C1 package can only receive whole milk in various varieties or forms. 18) If a BP (partially breastfeeding woman) chooses the ghost package after 6 months can she be on the CSFP? A: The woman is still considered as a WIC client, including counting them in the participation numbers and cannot be on CSFP. 19) If a woman is pregnant with two or more infants, do we take this information verbally or do we need documentation from the doctor? 4

5 A: At this time our policy does not require physician documentation to validate a pregnancy with multiple fetuses. 20) When can local agencies expect the new food package policies? A: The policies are on the WIC website. 21) Are clients who are active on WIC as breastfeeding women, with babies (over 6 months old) receiving more than the maximum allowed WIC formula, eligible for WIC Farmers Market Nutrition Program (FMNP)? A: Yes, they can still receive WIC FMNP coupons. This is one of the nonfood package benefits breastfeeding women receive, as WIC clients, as long as they are on the WIC Program. Medical Documentation 22) Do you need medical documentation to receive lactose free milk? Not to substitute more milk for cheese, but just to provide lactose free milk? A: No, you do not need medical documentation to receive lactose free milk. 23) Please clarify an underweight child over the age of two. If the physician writes them a Rx for whole milk do they need to be on a formula too? Can we give milk with Class II or III formulas? What else would be in their food package? A: Yes, a child over the age of two would need to be on a Class II or III formula to receive whole milk. The physician must complete a medical documentation form for a child (DCH-1326). The physician would indicate the other foods which are allowed up to the maximum monthly allowance of all foods. Whole milk may be substituted for low fat or skim milk with a qualifying condition. 24) When will we receive the revised Medical Justification Form? A: The new Medical Documentation Forms, DCH-1326 and 1327 are available on the WIC web site and notices have been sent to physicians through their listservs. 25) Should we start using the new Medical Justification Form now? Is it approved? A: The Medical Documentation Forms, DCH-1326 and 1327 have been approved by USDA and should be used beginning August 3 rd at the clinics. 5

6 26) Will the State be sending out information to doctors offices or will local agencies need to do this? A: The family practitioners, pediatrician, and primary care association members have been sent a memo through their listservs, referring them to the WIC website for the Medical Documentation forms and other pertinent information. MI-WIC System 27) Can we do a category change to a mom that was BP for the first 5 months and getting formula to her baby, to a BE after 6 months? A: Yes, a mom would then get a BE package and the infant would not receive formula but would also receive infants foods, including meats. 28) Can a IBP (partially breastfed infant) package be customized to provide more formula than listed on the Michigan WIC Contract Formulas form? A: An IBP can be assigned the maximum amount of formula an IFF receives if the BP mom receives a NPP package. 29) If you have clients scheduled for August 1 st, they need to be rescheduled. We do not want them to have a clinic that day is that correct? A: Any clients scheduled for clinic on August 1 st or 2 nd need to be rescheduled for August 3 rd or later. 30) Will all packages be changed on August 3 rd? What about the clients with benefits already issued until September? A: All clients issued benefits on August 3, 2009 and afterwards, will receive the new food package. Benefits already issued will remain as is, unless the local agency void benefits and reissue. 31) For clients that have benefits for August and September, can we void their benefits and issue the new package? A: Yes, this will be allowed in the system, but it will be extra work for staff to make the change. It is not a requirement by USDA, though. To do this, the client must come in to the clinic for education on the new package, so local agencies would need to have CPAs available. 6

7 32) Can you change the number of infants expected at the subsequent visit? A: Yes. A change can be made on the Income Screen or on the Food Prescription screen with a new box labeled Expected Infants. The number of Expected Infants can be increased but not decreased. 33) MI-WIC gives a warning when we give a maximum package. Will the warning be changed? A: The max package warning in MI-WIC has been removed. Education/Training 34) When are the video vignettes going to be available, we would like to start ASAP having clients watch them? A: The first video went to local agencies on The video contains English, Spanish, Arabic and closed captioning. The fruit/vegetable and whole grain video will be out before the middle of August. 35) When can we expect the new food cards? A: The new English food cards were sent to agencies by July 30 th. The Michigan WIC Food Card in all 3 languages is available on the WIC website at then go to the link New WIC Foods. 36) When will our stores in the UP be trained? There are a lot of changes and it would be best to begin training now. A: Vendors were sent an information letter in May. In June they were sent the new minimum stock requirements with a list of the new food items. The State WIC office is conducting over one hundred group trainings statewide and the UP is scheduled for early September. 7