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SPIRIT Food Packages

SPIRIT Food Packages.

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SPIRIT Food Packages

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  1. SPIRIT Food Packages

  2. This module, SPIRIT Food Packages, is part of the WIC SPIRIT Readiness training series. The series is designed to be an overview of major changes in the Arkansas WIC Program and to prepare WIC staff for further training in regards to SPIRIT, the new Management Information System. • The series includes VENA, the Value Enhanced Nutrition Assessment initiative; the WIC food packages, and nutrition risk factors. Let’s get started! You can track your progress with this handy guide.

  3. Objectives • Upon completion of this module, the CPA should be able to: • Identify the names of the new food packages • List the major changes to each food package • Define food package tailoring • Apply the basic concepts of tailoring in the WIC management information system SPIRIT

  4. Food Packages • Supplemental foods received will remain the same: • Milk • Cheese • Juice • Cereal • Eggs • Beans • Peanut Butter (special issue; children > 2 or women) • Tuna (exclusively BF only) • Carrots (exclusively BF only)

  5. Total of 11 food packages will be available through SPIRIT: • Infant 1 • Infant 2 • Infant 3 • Infant 4 • Child 1 • Child 2 • Child 3 • Child/Woman with Special Needs • Pregnant/Partially BF Woman • Exclusively BF Woman • Non-breastfeeding Postpartum Woman

  6. Default Food Packages • These 11 food packages will be termed Default Food Packages in SPIRIT. These default food packages are what we used to term as standard food packages.

  7. Food Package vs Food Prescription • Food Packages: the basic food packages authorized by WIC Program Regulations for providing supplemental foods according to participant category. • Food Prescription:  the specific combination and quantities of allowable foods issued to WIC participants to address their nutritional, cultural and dietary related health needs.

  8. Infant 1 (0 - 1 month) • Infant formula

  9. Infant 2 (2 - 3 months) • Infant formula

  10. Infant 3 (4 - 5 months) • Infant formula

  11. Infant 4 (6 – 11 months) • Infant formula • 24 ounces infant cereal • 2 containers juice

  12. Major Changes to Infant Packages Before SPIRIT After SPIRIT • Infant packages were not divided by age • Infants received infant cereal at 4 months of age • Infants were issued 8 ounces infant cereal with the option of adding 16 ounces for a total of 24 ounces • Infant food packages divided by age • Infants will receive infant cereal at 6 months of age • Infants will be issued 24 ounces of infant cereal with the option of tailoring down issued amount

  13. Child 1 (1 year of age) • 3 gallons of whole milk • 2 pounds of cheese • 4 containers of juice • 28 ounces cereal • 2 dozen large white eggs • 1 pounds beans

  14. Child 2 (2 years) • 4 gallons 2%, 1% or skim milk • 2 pounds cheese • 4 containers juice • 28 ounces cereal • 2 dozen large white eggs • 1 pound beans

  15. Child 3 (3 – 5 years) • 4 ½ gallons 2%, 1% or skim milk • 2 pounds cheese • 6 containers juice • 36 ounces cereal • 2 dozen large white eggs • 1 pound beans

  16. Child/Woman with Special Needs • Formula • 36 ounces cereal • 3 containers juice

  17. Major Changes to Child Food Package Before SPIRIT After SPIRIT • Default packages contained a standard amount and amounts could be tailored up to a maximum amount • No default food package for child/woman with special needs in WANG • Default packages contain maximum amounts allowed and amounts can be tailored down • Default food package for child/woman with special needs

  18. Pregnant/Partially BF Woman • 5 ½ gallons 2%, 1% or skim milk • 2 pounds cheese • 6 containers juice • 36 ounces cereal • 2 dozen large white eggs • 1 pound beans

  19. Exclusively BF Woman • 5 ½ gallons 2%, 1% or skim milk • 3 pounds cheese • 7 containers juice • 36 ounces cereal • 2 dozen large white eggs • 2 pounds beans • 2 pounds carrots • 26 ounces tuna

  20. Non-BF Postpartum Woman • 4 ½ gallons 2%, 1% or skim milk • 2 pounds cheese • 4 containers juice • 36 ounces cereal • 2 dozen large white eggs

  21. Major Changes to Women’s Food Package Before SPIRIT After SPIRIT • Term postpartum was used • Default packages contained a standard amount and amounts could be tailored up to a maximum amount • No default food package for child/woman with special needs in WANG • Term postpartum replaced with non-breastfeeding postpartum woman • Default packages contain maximum amounts allowed and amounts can be tailored down • Default food package for child/woman with special needs

  22. Overall Changes Before SPIRIT After SPIRIT • Whole milk could be issued to children > 2 years of age or to women if they met certain risk factor • Whole milk will only be given to children < 2 years of age. The default food packages for children > 2 years of age and women will not allow whole milk to be substituted for any risk factor

  23. Overall Changes Before SPIRIT After SPIRIT • Buttermilk could be issued as a regular milk alternative • Buttermilk will no longer be an allowed food on the Arkansas WIC Program

  24. Overall Changes Before SPIRIT After SPIRIT • Peanut butter could be issued to any child with a qualifying risk factor • Peanut butter can only be issued to children > 2 years of age due to possible allergies and choking hazards Doing great! Keep up the pace!

  25. Overall Changes Before SPIRIT After SPIRIT • Juice was designated on the checks as 12 ounce frozen concentrate, 11.5 ounce non-frozen pourable concentrate, or 46 ounce single strength • Juice will be listed on the checks as number of containers. Ex. 3 containers of juice. Participants must select the same type of juice for each food instrument, but can vary the flavor

  26. Overall Changes Before SPIRIT After SPIRIT • Could split certain items on a food package • Ex. ½ package regular juice, ½ package calcium fortified orange juice • Can no longer split food packages, but can alternate food items received monthly • Ex. Whole package of regular juice for the month of May, and a whole package of calcium fortified orange juice for the month of June

  27. Food Package Tailoring

  28. Food Package Tailoring vs Food Package Changes Tailoring Changing • A change in the amount of a food; an addition or elimination of a food; a change that could affect the nutritional value of the food package • Ex. Adding peanut butter to an underweight pregnant mom’s food package • Ex. Family is eligible to receive 20 gallons of milk per month, yet normally only use 12 gallons, so the CPA tailors down the amount of milk the family receives • A change in the form of an existing food type that does not affect the nutritional value of the food package • Ex. Changing from regular fluid milk to powdered milk

  29. Food Package Tailoring vs Food Package Changes • All formula changes are considered food package tailoring • All special issue food items are considered food package tailoring • Special issue food items include: • Infant juice • Concentrate or ready to use formula • Calcium fortified orange juice • Reduced lactose or lactose free milk • Peanut butter • All food package tailoring and changes are to be completed by the CPA

  30. Tailoring • Food packages can still be tailored based upon: • Participant’s identified risks • Participant’s request of decreased amounts or elimination of a food • As determined nutritionally sound and beneficial by the nutritionist

  31. What can be tailored • Default food packages can be tailored in SPIRIT • Foods tailored due to nutrition risk factors: • Peanut Butter (> 2 years of age) • Reduced lactose or lactose free milk

  32. Peanut Butter • Child • 103 Underweight • 134 Failure to thrive • 135 Inadequate weight gain • 801 Homeless • 802 Migrant • Pregnant • 101 Underweight • 131 Low maternal weight gain • 132 Maternal weight loss during pregnancy • 331 Pregnancy at a young age • 338 Pregnant woman currently breastfeeding • 801 Homeless • 802 Migrant • Partially Breastfeeding Woman • 101 Underweight • 331 Pregnancy at a young age • 335 Multifetal gestation • 801 Homeless • 802 Migrant • Exclusively Breastfeeding Woman • 101 Underweight • 331 Pregnancy at a young age • 335 Multifetal gestation • 801 Homeless • 802 Migrant

  33. Reduced or Lactose Free Milk • 355 Lactose Intolerance (child or any woman)

  34. Tailoring Rules • Substitutions • Child 2 and Child 3 food packages or pregnant/partially BF women may receive one 18 ounce jar of peanut butter (with appropriate nutrition risk factors) in lieu of 1 lb dry beans. • Exclusively BF Women may receive one 18 ounce jar of peanut butter (with appropriate nutrition risk factors) in lieu of 1 lb dry beans. They will still receive an additional one pound of dry beans which cannot be substituted with peanut butter.

  35. Tailoring Rules • Alternating • With SPIRIT, food items from the same category can be alternated on the food checks • Ex. Participant qualifies for peanut butter, however, they also enjoy receiving the beans. The food packages can be tailored so that one month the participant receives peanut butter and the next month they receive dry beans. It would alternate each month until the end of the certification.

  36. Scenario 1—Tailoring or Not Mary B., a pregnant woman, complains of stomach discomfort, cramps, and diarrhea whenever she drinks milk. She tells the clerk she no longer wants to receive milk because it “doesn’t settle well” with her. What should happen next? • The clerk removes the milk from the food package • The clerk refers Mary to the CPA • The clerk makes Mary an appointment to come back to see the CPA • The clerk suggests getting another form of milk, helps Mary decide, and changes the food package

  37. Answer B is correct! This is food package tailoring. The clerk should refer Mary to the CPA. Since Mary is considering having a food item eliminated from her food package, the CPA needs to determine if there is an alternative way to continue to supplement Mary’s diet with the nutrients she needs while providing her with an acceptable alternative.

  38. Scenario 2—Tailoring or Not • Henry W. is a 3 year old child who has lost weight since his last certification. He now plots at the 8th percentile for BMI for age. Due to his risk factors, he qualifies for peanut butter. • What should happen next? • The CPA should let it go, issue the dry beans, and see how his weight looks at his next certification • The CPA should issue peanut butter • The CPA should ask Henry W.’s parent if they would like to receive peanut butter • The CPA should suggest getting a prescription for PediaSure

  39. Answer C is correct! This is food package tailoring and should be done by the CPA. The CPA should ask the parent or guardian if peanut butter is an acceptable substitute and if they would like to have it. If the parent says yes, then peanut butter would be issued. *Peanut butter is not commonly consumed in all cultures, thus we should always take cultural differences into consideration when tailoring a food package.

  40. Scenario 3—Food Tailoring or Not • Alli, an exclusively breastfeeding mom, comes in to pick up her checks. After receiving her first months WIC benefits, she is now requesting to receive half of her milk as dry milk and half of her milk as fluid milk. • What should happen next? • The clerk should tell her she will have to wait till her next certification appointment to make any food package changes. • The clerk tells Alli that food package items can no longer be split, she will either have to do all fluid milk or all powdered milk. • The clerk makes an appointment for Alli to return to the clinic to see the CPA. • The CPA changes the food package so that Alli will receive one month of fluid milk and then one month of powdered milk.

  41. The correct answer is D! This is NOT food package tailoring. The nutritional value of the package is not changing. The CPA should instruct Alli on how the milk can be divided, offer her that solution, and if agreed to, change the food package so that Alli will receive fluid milk and powdered milk alternating months.

  42. Food package information has been condensed to help the CPA to determine the correct food package to issue participants. • It will be available in policy. • It is contained on the next 2 slides.

  43. You’re halfway there!

  44. Food Packages in SPIRIT

  45. Now that we have reviewed the default food packages available in SPIRIT, it is time to see what they will look like and how to edit if needed.

  46. Once your participant has been selected and you have started the certification process you will go through several steps to determine and prescribe the right food package for the participant.

  47. Using the Certification Guided Script, the CPA will be able to determine when it is appropriate to implement the food prescription.

  48. When it is time to prescribe the food package, select Food Prescription.

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