|DATE:||June 6, 1994|
|MEMO CODE:||WIC Policy Memorandum: #94-9|
|SUBJECT:||WIC Exit Counseling Brochure|
Supplemental Food Programs
This policy memorandum is intended to facilitate the implementation of a Congressional mandate, set forth in the House Appropriations Committee's Report accompanying the Fiscal Year 1994 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act (PL 103- 111), enacted Oct. 21, 1993.
Members of the Committee were concerned that the benefits of nutrition education and counseling sessions provided to women while they are participating in the WIC program be reinforced when a woman "graduates" from WIC. Therefore, the Committee recommended in its accompanying Report that participating women be given one last counseling session along with a written exit brochure to reinforce the important health messages she has been receiving through the WIC program.
FNS is making every effort to ensure compliance with this new requirement while refraining from adding any further or duplicative burdens to the existing administrative responsibilities of state and local WIC agencies. To that end, in regard to the final counseling session stipulated by Congress for women graduating from the WIC program, the local WIC agency or clinic may use a participant's second or final nutrition education contact of each certification period as the counseling session recommended by Congress. This means that this provision is not a mandate for a third contact, nor does it supersede the current regulatory provision that nutrition education contacts must be offered to every participant, but may not be required as a condition of program participation.
To assist states in complying with this requirement, the Food and Nutrition Service (FNS) is now in the process of developing a prototype exit counseling brochure that can be provided to each woman whose eligibility or participation in the WIC program is about to end. This prototype brochure will be distributed by FNS in a camera-ready format to all WIC state agencies, for publication and distribution to WIC local agencies and clinics within their jurisdiction. State agencies may choose either to develop their own exit counseling materials that include the previously mentioned areas, or to publish and distribute the FNS-developed prototype. In Fiscal Year 1995, FNS will provide camera-ready copies of the brochure in Spanish; state agencies that serve large populations of other non-English-speaking WIC participants may want to begin exploring their options for providing the brochure in appropriate languages.
Nutrition education has from the outset of the WIC program been one of the principal benefits provided to participants. Effective nutrition education helps to establish a solid foundation upon which good nutritional health can be based long after a women's eligibility to receive WIC food instruments has expired. The WIC program was established not only to provide food assistance, but also to empower program participants to make wise food choices even after they are no longer on the program.
The Department has long supported the concept that nutrition education contacts involve much more than lessons on nutritious foods and low-cost recipes that maximize the specific components of the WIC food package. Women are also counseled on issues related to their particular nutritional risk condition, including the importance of folic acid intake, continued breastfeeding, up to date immunizations (both for themselves and for their children), the health risks of using alcohol, tobacco and other drugs, and the need for a well-balanced diet. Congress has, through this mandate, taken steps to ensure that women who are about to "graduate" from the WIC program receive reinforcement of these critical messages. state and local agencies should keep in mind; however, that these reinforcement messages are not intended to replace nutrition education when more risk-specific counseling is needed.
Until the prototype brochure is available, state and local agencies should continue to take advantage of the publications that are already available, from FNS as well as other sources, to support the messages on the importance of folic acid intake (in reducing neural tube defects), continued breastfeeding (as the preferred method of infant feeding), the importance of children's immunizations, the health risks of using alcohol, tobacco, and other drugs, and the need for a well-balanced diet that must be communicated to all graduating women participants.:. A list of the FNS publications which are currently available and pertain to these topics for distribution is attached to this memorandum. We will also be exploring the feasibility of purchasing anti-smoking publications produced by public or private health foundations for distribution to WIC state agencies.
FNS hopes to have camera-ready copies of the prototype exit counseling brochure ready for distribution in the fall of 1994. Once the brochure has been made available, State agencies will be responsible for monitoring their local agencies, through their oversight process, to confirm that appropriate counseling sessions are being offered and that the exit brochure is being provided to all women as their WIC eligibility comes to an end. FNS Regional offices in tum will monitor state agency compliance through the state plan approval and management evaluation/STAR processes.
STANLEY C. GARNETT
Supplemental Food Programs Division