Table 3: Possible Roles for WIC and Managed Care in Promoting Health Objectives for Enrollees
Health Role of WIC Role of Managed Care Role of Health Care Provider Objective Organization
Enhance Refer uninsured participants to Medicaid and/or Provide free pregnancy tests and referrals Refer to WIC if not already enrolled. prenatal care CHIP. to prenatal care. and decrease Refer to WIC for nutritional counseling. likelihood of Refer participants to managed care enrollment Conduct orientation sessions at WIC sites. brokers or MCOs as appropriate. Communicate with WIC about nutritional low Analyze delays in processing Medicaid needs of high risk patients. birthweight Refer participants to perinatal programs for applications. high-risk pregnancies, as appropriate. Provide case management and home Refer participants to community-based visiting. services. Share patient information with WIC. Improve Conduct nutritional risk assessment and make Promote patient information sharing Conduct case conferences with WIC staff. maternal referrals when needed. between providers and WIC through nutrition special forms and provider education. Schedule frequent prenatal visits. Schedule participants for nutritional counseling as needed. Support WIC-based interventions with Prescribe nutritional counseling and/or pregnant women at risk. nutrition therapy and refer to WIC. Provide nutritional counseling and communicate with prenatal care providers. Reimburse medical nutrition therapy for high risk conditions. Reduce smoking Screen for smoking and substance abuse. Support WIC-based interventions to Screen patients and refer to perinatal case and substance reduce smoking. management programs. abuse Train staff and offer classes such as smoking cessation to WIC participants and family Inform providers about WIC educational Encourage patients to attend smoking members if program funding available. activities in newsletters and memos. cessation classes at WIC when available. Schedule visits to high risk women on monthly basis. Refer women for counseling and treatment for substance abuse when appropriate and contact MCO and providers as needed. Promote Offer pregnant women group and individual Issue policy on breastfeeding and educate Educate patients about breastfeeding and breastfeeding breastfeeding education. providers. refer to WIC for additional education and support. Sponsor breastfeeding hotlines. Participate in community breastfeeding coalitions. Refer patients to lactation consultants when Offer lactation consultation and referrals. needed. Make breast pumps and lactation Provide breast pumps purchased with WIC food consultants available. Prescribe breast pumps for lactating mothers. funds (new USDA policy). Participate in and sponsor breastfeeding Provide prompt case management coalitions. support, including home visits, to breastfeeding mothers with problems.
Health Role of WIC Role of Managed Care Role of Health Care Provider Objective Organization
Improve infant Reinforce breastfeeding routinely. Inform providers about infant formula Contact WIC regarding prescription of infant feeding policies of WIC. formulas when special formulas are practices Provide anticipatory guidance on infant needed. feeding. Reimburse medical nutrition therapy either at WIC site or another location. Refer infants to WIC for nutrition Refer high risk infants and toddlers to primary management when high risk conditions care providers and contact providers directly require individual care plan. if appropriate. Refer infants with very high risk conditions for medical nutrition therapy by registered dietician. Increase Screen for immunizations at each certification Reimburse WIC for immunizing children on Screen for immunizations and provide immunization visit. site. immunizations. rates Refer newly enrolled infants and children to Facilitate WIC linkage to immunization Reduce missed opportunities for health care provider for needed registry. immunizations. immunizations. Contribute to training of WIC staff in Document immunizations and update Provide immunizations on site, with immunization screening and referral patient’s history at each visit, including reimbursement, in coordination with primary procedures. registry information. care providers. Provide immunization records to patients and WIC staff as appropriate. Improve early Complete dietary histories for toddlers. Inform providers about the WIC role in Refer high risk children to WIC for individual childhood child nutrition. care plans. nutrition Monitor height for weight at each visit. Reimburse WIC for medical nutrition Prescribe medical nutrition therapy for Develop individual care plans for high risk therapy when needed. children with very high risk conditions. individuals. Notify primary care providers about high risk children. Reduce risk of Ask whether participant was screened for lead Promote universal lead screening and/or Conduct lead testing on all children referred lead toxicity and make referral if needed. verification by provider. by WIC. Provide information about lead poisoning Notify enrolled patients about need for Verify blood lead screens conducted prevention to participants. lead testing and availability of service. elsewhere. Develop individual nutrition care plans for Establish program to reimburse WIC for Notify state and local lead programs about children with high blood lead levels. drawing blood for lead testing if feasible children with high blood lead levels and and needed. refer them to WIC or dieticians for Draw blood for lead testing, with development of an individual care plan. reimbursement, in coordination with programs established by public health Share results of blood lead (and iron) test departments and MCOs. with WIC to expedite certification. If services offered in setting that conducts blood lead testing, WIC can reimburse the testing program for the cost of drawing blood for WIC iron screening to determine anemia